693 Sleep Health in the Young Adult Clinic: A retrospective observational cohort study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A271-A271
Author(s):  
Mohamed Eissa ◽  
Shikha Bansal ◽  
Rachael Bosma ◽  
Sarah Sheffe ◽  
Yen Shuang Law ◽  
...  

Abstract Introduction The Toronto Academic Pain Medicine Institute (TAPMI) Young Adult Clinic (YAC) was developed to offer transition services for clients aged 17–25 with persistent pain. It was noticed that YAC patients had significant problems with their sleep and the program was expanded in January 2019 by including a sleep medicine specialist for systematic evaluation of sleep health. Long-term sleep disruption has been associated with increase sensitivity to pain, prolonged pain duration, and predicts chronic pain. The degree of pain relief can directly impact the quality and disruption of sleep. Methods After approval from institutional review board, we reviewed YAC medical charts from March 2018 to April 2019 and extracted information pertaining to demographics, chronic pain and sleep. We present here the preliminary data of our multidisciplinary clinic Results 55 medical charts were reviewed which included 40 females, 13 males, 2 nonbinary individuals, with a mean age of 20.3±2.4 years. 53% of the patients had chronic widespread pain. Symptoms of or disorder of sleep were reported in 72.7% of the patients. The various nighttime disorders of sleep were trouble falling asleep, insomnia, problems with sleep initiation, difficulty in maintaining sleep, poor sleep continuity, frequent night awakenings due to pain, restless leg syndrome (RLS), obstructive sleep apnea, parasomnic behavior, circadian rhythm disorder such as delayed sleep phase disorder. As assessed by Epworth Sleepiness scale, 7% of the patients had mild, 7% had moderate and 2% had severe daytime sleepiness. 42% of the youths demonstrated a low self-efficacy score as per Pain Self Efficacy Questionnaire (PSEQ). Patient Health Questionnaire (PHQ-9) was used to measure the severity of depression which showed that 5.5%, 27%, 18%, 14.5%, 22% of the YAC patients suffered from minimal, mild, moderate, moderately-severe and severe depression respectively. The information collected on Pain Catastrophizing scale (PCS) suggested that 24%, 29% and 31% were at low, moderate, and high risk respectively in having catastrophizing thoughts and feelings related to pain. There was no statistical difference in the means PSEQ, PHQ-9 and PCS scores of young adults. Conclusion Sleep disturbances may be an important modifiable risk factor for alleviating distress in young adults with chronic pain. Support (if any):

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A211-A211
Author(s):  
Nyree Riley ◽  
Dana Alhasan ◽  
W Braxton Jackson ◽  
Chandra Jackson

Abstract Introduction Food insecurity may influence sleep through poor mental health (e.g., depression) and immune system suppression. Although prior studies have found food insecurity to be associated with poor sleep, few studies have investigated the food security-sleep association among racially/ethnically diverse participants and with multiple sleep dimensions. Methods Using National Health Interview Survey data, we examined overall, age-, sex/gender-, and racial/ethnic-specific associations between food insecurity and sleep health. Food security was categorized as very low, low, marginal, and high. Sleep duration was categorized as very short (<6 hours), short (<7 hours), recommended (7–9 hours), and long (≥9 hours). Sleep disturbances included trouble falling and staying asleep, insomnia symptoms, waking up feeling unrested, and using sleep medication (all ≥3 days/times in the previous week). Adjusting for sociodemographic characteristics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (95% CI) for sleep dimensions by very low, low, and marginal vs. high food security. Results The 177,435 participants’ mean age was 47.2±0.1 years, 52.0% were women, 68.4% were Non-Hispanic (NH)-White. Among individuals reporting very low food security, 75.4% had an annual income of <$35,000 and 60.3% were ≥50 years old. After adjustment, very low vs. high food security was associated with a higher prevalence of very short (PR=2.61 [95%CI: 2.44–2.80]) and short (PR=1.66 [95% CI: 1.60–1.72]) sleep duration. Very low vs. high food security was associated with both trouble falling asleep (PR=2.21 [95% CI: 2.12–2.30]) and trouble staying asleep (PR=1.98 [95% CI: 1.91–2.06]). Very low vs. high food security was associated with higher prevalence of very short sleep duration among Asians (PR=3.64 [95% CI: 2.67–4.97]), Whites (PR=2.73 [95% CI: 2.50–2.99]), Blacks (PR=2.03 [95% CI: 1.80–2.31]), and Hispanic/Latinxs (PR=2.65 [95% CI: 2.30–3.07]). Conclusion Food insecurity was associated with poor sleep in a diverse sample of the US population. Support (if any):


2021 ◽  
Author(s):  
Antonio Varela

Abstract Background Chronic pain in all its forms and the accompanying level of disability is a healthcare crisis that reaches epidemic proportions and is considered a world level crisis. Chronic non-specific low back pain contributes a significant proportion of chronic pain. Specific psychosocial factors and their influence on reported disability in a chronic non-specific low back pain (CNLBP) population was researched. Methods Psychosocial factors examined include fear, catastrophizing, depression, and pain self-efficacy. This cross-sectional correlational study examined the mediating role between pain self-efficacy and the specific psychosocial factors with reported disability. The study included 90 participants with CNLBP between 20 and 60 years of age. Participants completed the Fear Avoidance Belief Questionnaire, The Pain Catastrophizing Scale, The Patient Health Questionnaire-9, The Pain Self-Efficacy Questionnaire, and The Lumbar Oswestry Disability Index to measure fear of physical activity, pain catastrophizing, depression, pain self-efficacy, and reported disability, respectively. The study used multivariate regression and mediation analyses. Results The principal finding of the study was a strong inverse relationship between pain self-efficacy and reported disability. Further, pain self-efficacy was considered a statistic mediator for all psychosocial factors investigated within this data set. Pain self-efficacy was strongly considered to have a mediating role between reported fear of physical activity and disability, reported pain catastrophizing and disability, and reported depression and disability. Additionally, adjusting for age and reported pain levels proved to be statistically significant, and it did not alter the role of pain self-efficacy. Conclusion The results identified that pain self-efficacy had a mediating role in the relationship between the specific psychosocial factors of fear, catastrophizing, and depression and reported disability. Pain self-efficacy plays a more significant role in the relationships between specific psychosocial factors and reported disability with CNLBP than previously considered.


Author(s):  
Susan Redline ◽  
Brian Redline ◽  
Peter James

This chapter is a primer on sleep epidemiology—the methods of assessment on how sleep is measured (e.g., self-report [such as the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale] vs. with use of objective tools such as actigraphy); validity of sleep measurements; the different dimensions of sleep health and disorders that are of interest (e.g., sleep duration, sleep quality, sleep fragmentation, insomnia, obstructive sleep apnea, social jetlag, snoring, narcolepsy, etc.); general sleep biology and physiology; and why sleep matters (i.e., the epidemiologic consequences of poor sleep health, e.g., connection to other health behaviors and health outcomes such as drug use; sexual risk behaviors; depression; dietary behaviors such as sugar-sweetened beverage consumption; cardiometabolic diseases like obesity, diabetes, and hypertension; and cancer outcomes such as breast cancer).


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A76-A76
Author(s):  
K Fergason ◽  
W Rowatt ◽  
M K Scullin

Abstract Introduction The psychology of religion literature indicates that religious engagement is beneficial to physical and mental health. Such effects might be mediated by sleep health, which causally affects mood, cognitive, and immune functioning. However, few studies have investigated whether religiosity is associated with better sleep, and no studies have considered the reverse causal direction: better sleep may impact religious behaviors or perceptions. Methods We conducted a secondary data analysis of 1,501 participants in Wave 5 of the Baylor Religion Survey (BRS-5). Completed in Spring 2017, the BRS-5 used Address Based Sample methodology to derive a population-based sample. The survey included questions on religious affiliation, behaviors, and perceptions (e.g., certainty of Heaven). Additionally, participants rated their difficulty falling asleep and their average total sleep time. We investigated whether participants were meeting AASM/SRS consensus guidelines of 7–9 hours/night. Results Religious affiliation was associated with sleep duration, but not in the predicted direction. Atheists/Agnostics (73%) were significantly more likely to report meeting consensus sleep duration guidelines than religiously-affiliated individuals (65%), p<.05. For example, Atheists/Agnostics reported better sleep duration than Catholics (63%, p<.01) and Baptists (55%, p<.001). Atheists/Agnostics also reported less difficulty falling asleep at night than Catholics (p=.02) and Baptists (p<.001). The effects persisted when controlling for age and were particularly evident in members of African American congregations. Perceptions of getting into Heaven were significantly higher in participants who obtained better sleep duration, p<.05, but interestingly, such beliefs/perceptions were unrelated to difficulty falling asleep at night, suggesting that better sleep may lead to these perceptions rather than vice versa. Conclusion In contrast to predictions, religious affiliation was associated with significantly poorer sleep health. Poor sleep health has implications for physical and mental health, and seemingly also religious perceptions/beliefs. Future experimental work is required to disentangle the causal direction of sleep-religiosity associations. Support The Baylor Religion Survey was supported by the John Templeton Foundation.


2019 ◽  
Vol 19 (2) ◽  
pp. 365-373 ◽  
Author(s):  
Lars-Petter Granan ◽  
Silje Endresen Reme ◽  
Henrik Børsting Jacobsen ◽  
Audun Stubhaug ◽  
Tone Marte Ljoså

Abstract Background and aims Chronic pain is a leading cause to years lived with disability worldwide. However, few of the interventions used in pain medicine have proven efficacy, and evidence from the existing studies may not be valid for the general pain population. Therefore, it is of utmost need that we describe chronic pain conditions in their most relevant aspects, their various guises, as well as the real world outcomes of our clinical interventions. The most obvious and crude way to make these assessments are through large registries where patient characteristics, treatment characteristics (including but not limited to what, when, how often and by whom), treatment outcomes and patient outcomes are scrutinized and recorded. Methods and results This article describes in detail the design and baseline data of the comprehensive Oslo University Hospital Pain Registry (OPR). OPR is the local registry of the largest university and interdisciplinary outpatient pain clinic in Norway. Data registration started in October 2015, and approximately 1,000 patients are assessed and treated at the clinic each year. During the first 2 years of running the OPR (through September 2017), a total of 1,712 patient baseline reports were recorded from 2,001 patients. Clinicians enter data about relevant treatments and interventions, while patients provide self-reported data on aspects related to pain and pain management. The patients complete an electronic registration immediately before their first consultation at the outpatient pain clinic. The baseline questions of the OPR cover: Basic demographics; The Modified Oswestry Disability Index to assess general function; A pain drawing to assess pain location; Questions regarding the temporal aspects of pain; Six 0–10 Numeric Rating Scales to assess pain intensity and bothersomeness; The EQ-5D-5L to measure health-related quality of life; The Hopkins Symptom Check List-25 to assess psychological distress; A single question about self-rated health; The general self-efficacy scale to assess the patient’s perceived self-efficacy; The Bodily Distress Syndrome checklist to assess functional disorders; The Injustice Experience Questionnaire to assess whether the patients experience injustice; Chalder Fatigue Questionnaire to assess fatigue; The Insomnia Severity Index to assesses the levels of insomnia symptoms; The Pain Catastrophizing Scale to measure pain catastrophizing and exaggerated negative orientation toward pain stimuli and pain experience; And the SF36v2 to assess patients’ self-report of generic health and wellbeing. The baseline data show that chronic pain patients have a high degree of negative impact in all aspects of their lives. Conclusions and implications The OPR is the most comprehensive pain registry for multidisciplinary and interdisciplinary outpatient pain clinics in Norway. Detailed design of the registry and key baseline data are presented. Registries are of great value in that they enable real world effectiveness outcomes for patients with chronic pain conditions. The OPR can thus serve as a model for similar initiatives elsewhere. The OPR cohort may also serve as a historical control in future studies, both with experimental and observational design.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Janna D. Stephens ◽  
Andrew Althouse ◽  
Alai Tan ◽  
Bernadette Mazurek Melnyk

Overweight and obesity are a massive public health problem and young adults are at high risk for gaining weight once they enter a college. This study sought to examine gender and race as they relate to nutrition habits and self-efficacy in a population of diverse young adults from the Young Adult Weight Loss Study. Participants(N=62)were 29% males, 38.7% white, 33.8% Asian, and 12.9% African American. Males had lower self-efficacy for healthy eating (mean score = 92.5, SD = 17.1) compared to females (mean = 102.3, SD = 13.7,p=0.02). Males had higher consumption of sodium compared to females (4308 versus 3239 milligrams/day,p=0.01). There were no significant differences across racial subgroups in self-efficacy for healthy eating (p=0.67) or self-efficacy for exercise (p=0.61). Higher self-efficacy scores for healthy eating were significantly associated with less total sodium (r=-0.37,p=0.007), greater fruit consumption, and less saturated fat. Our results indicate that weight loss interventions should be individualized and that there may be specific areas to target that are different for men and women. Additional larger studies should be conducted to confirm if racial differences exist across nutrition habits and self-efficacy and to confirm gender differences noted in this study.


2021 ◽  
Author(s):  
Bethany Shorey-Fennell ◽  
Renee Magnan ◽  
Benjamin Ladd ◽  
Jessica Fales

Many young adults experience chronic pain and given its wide availability and potential pain reducing properties, young adults may use cannabis to self-medicate for pain. However, little is known about young adult users’ perceptions of potential health risks and benefits of cannabis, and whether these perceptions differ by chronic pain status. As a part of a larger study, young adult recreational cannabis users (N=176, ages 18-29) who reported using at least once a week completed assessments of use frequency and perceived cannabis-related risks and benefits. The sample had a high proportion of participants who met criteria for chronic pain (51.1%). The majority of the sample reported using daily or multiple times daily (80.7%) with an average of 2.68 (SD=1.42) sessions per day across administration modes (e.g. smoking, edibles, tinctures). Participants answered questions about their lifetime chances of experiencing five cannabis-related risks (personal harm, negative health outcome, negative mental health outcome, harming someone else, increased pain) and benefits (personal benefit, positive health outcome, positive mental health outcome, benefitting someone else, decreased pain; 1=Very low to 7=Very high). Overall, young adult users perceived their risk to be very low (M=1.62, SD=.73) and 40.3% of the sample had an average risk score (combined across the five risk items) of 1.00, while only one participant reported an average risk above 4.00. In particular, participants reported a low lifetime chance of experiencing personal harm (M=1.51, SD=.90), harming someone else (M=1.20, SD=.58), or experiencing increased pain (M=1.24, SD=.74) due to their cannabis use. In contrast, young adult users perceived somewhat high chances of experiencing benefits related to their cannabis use (M=4.78, SD=1.46). In particular, participants perceived a high chance of experiencing reduced pain (M=5.88, SD=1.55), personal benefit (M=4.84, SD=1.86), and positive mental health outcomes (M=4.82, SD=1.77). There was no difference based on pain status on frequency of use, average daily sessions, or perceived risks, and only one difference in perceived benefits. Participants without chronic pain anticipated more personal benefit from cannabis use (M=5.15, SD=1.74) than those with chronic pain (M=4.53, SD=1.94, t(171)=2.21, p=.03). Overall, results suggest young adult recreational users perceive very low risks of their cannabis consumption and moderately high benefits, regardless of pain status. Looking at individual areas of potential risk and benefits may yield targets for future health education campaigns. For example, perceptions of low risk/high benefits regarding mental health outcomes may not be accurate for this heavy using sample.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
María Dolores López-Bravo ◽  
Javier Lorenzo-Prol ◽  
Eva Pascual-Vaquerizo

Objetivo: El objetivo principal de este estudio es hacer una comparativa por sexos y analizar la asociación entre las variables: sensibilidad y autopercepción de sensibilidad, resistencia y disposición a informar del dolor, catastrofismo y autoeficacia en una muestra de sujetos jóvenes sanos.  El objetivo secundario es analizar la imagen social sobre la sensibilidad, resistencia y disposición a informar del dolor en ambos sexos. Diseño: Estudio descriptivo transversal. Marco: Lugar de realización Centro Superior de Estudios Universitarios La Salle (Madrid). Participantes: Individuos sanos de edades comprendidas entre los 18 y 35 años, sin conocimientos fisiológicos del dolor. Se dividieron en dos grupos: hombres (n=35) y mujeres (n=44). Variables: Las variables psicológicas fueron la autopercepción de sensibilidad, la resistencia y la expresión del dolor (Gender Role Expectation of Pain), catastrofismo (Pain Catastrophizing Scale), autoeficacia (Chronic Pain Self-Efficacy Scale). La Variable física fue la medición del umbral de sensibilidad a la presión con el algómetro. Resultados: Los resultados mostraron un menor umbral de sensibilidad a la presión en mujeres que además se correlacionaba con menores puntuaciones en autoeficacia. No se observaron diferencias en autopercepción de sensibilidad, resistencia y disposición a informar del dolor ni en los niveles de catastrofismo entre ambos sexos.  Conclusión: Debido a la cantidad de variables que pueden influir en la percepción de dolor entre hombres y mujeres, se necesitan futuros estudios que sigan con esta línea de investigación.


Pain Medicine ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 501-510
Author(s):  
Caitlan A Tighe ◽  
Ada Youk ◽  
Said A Ibrahim ◽  
Debra K Weiner ◽  
Ernest R Vina ◽  
...  

Abstract Objective Sleep and pain-related experiences are consistently associated, but the pathways linking these experiences are not well understood. We evaluated whether pain catastrophizing and arthritis self-efficacy mediate the association between sleep disturbance and osteoarthritis (OA) symptom severity in patients with knee OA. Methods We analyzed cross-sectional baseline data collected from Veterans Affairs (VA) patients enrolled in a clinical trial examining the effectiveness of a positive psychology intervention in managing pain from knee OA. Participants indicated how often in the past two weeks they were bothered by trouble falling asleep, staying asleep, or sleeping too much. We used validated scales to assess the primary outcome (OA symptom severity) and potential mediators (arthritis self-efficacy and pain catastrophizing). To test the proposed mediation model, we used parallel multiple mediation analyses with bootstrapping, controlling for sociodemographic and clinical characteristics with bivariate associations with OA symptom severity. Results The sample included 517 patients (Mage = 64 years, 72.9% male, 52.2% African American). On average, participants reported experiencing sleep disturbance at least several days in the past two weeks (M = 1.41, SD = 1.18) and reported moderate OA symptom severity (M = 48.22, SD = 16.36). More frequent sleep disturbance was associated with higher OA symptom severity directly (b = 3.08, P <0.001) and indirectly, through higher pain catastrophizing (b = 0.60, 95% confidence interval [CI] = 0.20 to 1.11) and lower arthritis self-efficacy (b = 0.84, 95% CI = 0.42 to 1.42). Conclusions Pain catastrophizing and arthritis self-efficacy partially mediated the association between sleep disturbance and OA symptom severity. Behavioral interventions that address pain catastrophizing and/or self-efficacy may buffer the association between sleep disturbance and OA symptom severity.


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