Assessing relationships between cognition, sleep, and mental health in pediatric patients with chronic pain

Abstract

Chronic pain in adolescents commonly disrupts cognitive functioning, sleep, and mental health. Research suggests underdeveloped cognitive skills in adolescents may lead to poor self-management thus reinforcing pain-related disability. This study aims to examine changes across cognition, sleep, and mental health in youth with chronic pain undergoing rehabilitation in addition to identifying associations between improvements across domains of interest. A 4-week observational study was conducted in 42 adolescents (M_age=15.1 years, 76% female) diagnosed with non-cancer chronic pain syndromes and engaged in intensive interdisciplinary pain treatment (IIPT). Questionnaires assessing pain, sleep, and mental health were administered at baseline and discharge. Standardized performance-based assessments (CANTAB®) were employed to measure cognitive domains. Cognitive domains of memory, attention, and executive functioning improved over time (all ps<0.01). Significant reductions in self-reported measures related to pain, sleep disruptions, and mental health symptoms (all ps<0.01) were observed across rehabilitation. Positive associations were identified between improvements in pain, sleep, and mental health measures (all ps<0.05). No significant correlations were identified between improvements in cognition and improvements in other domains. Findings highlight the prospective gains for cognitive outcomes in adolescents with chronic pain undergoing IIPT. Further research is essential to explore mechanisms by which IIPT may directly improve cognitive functioning over the course of treatment.

Keywords: Cognition; Mental health; Pediatric; Sleep.