Poor sleep in adults with pediatric-onset spinal cord injury: associations with pain, health, and activity

Abstract

Objective: To investigate medical complications that increase risk for poor sleep in adults with pediatric-onset spinal cord injury (SCI) and explore the relation of poor sleep to psychosocial outcomes.

Method: This was a cross-sectional study of individuals with pediatric-onset SCI interviewed between 2011–2015. Participants were recruited from a pediatric specialty hospital and answered questions about demographics, injury characteristics, pain, and medical complications and completed standardized outcome measures, including: Pittsburgh Sleep Quality Index, SF12v2 Health Survey, Craig Handicap Assessment and Recording Technique (CHART), and Subjective Happiness Scale.

Results: The study included 180 participants between the ages of 19 and 51 (M=34.20 y; SD=7.28) who sustained their SCI before the age of 19 (M=13.48y; SD=4.59). Participants were predominantly male (62%) and Caucasian (84%). A majority had tetraplegia (56%) and complete injuries (74%). Poor sleep occurred with greater frequency in those with tetraplegia and who were unemployed. Neck (OR=2.80, P = 0.001), shoulder (OR=2.15, P = 0.011), arm (OR=3.06, P = 0.004), and lower extremity pain (OR=2.72, P = 0.004) were associated with increased risk of poor sleep. In a logistic regression analysis, chronic medical conditions and continuous pain were most likely to be associated with poor sleep. Individuals with poor sleep reported lower levels of mobility, perceived health, and subjective happiness.

Conclusion: Pain and secondary complications significantly increase the odds of poor sleep. Furthermore, poor sleep is associated with decreased mobility and measures of well-being. Preventive measures to reduce risk factors and improve sleep quality after pediatric-onset SCI should be considered.

Keywords:

• Sleep
• Spinal Cord Injury
• Activity
• Health
• Pain
• Happiness

Acknowledgements

This study was funded by Shriners Hospitals for Children®-Chicago.

Alicia M. January is an Assistant Investigator at Shriners Hospitals for Children, Chicago and an Assistant Professor at Purdue University Northwest and receives a salary, including grant funding from Shriners Hospitals for Children (grant # 84202).

Kathy Zebracki is Director of Psychology at Shriners Hospitals for Children, Chicago and receives a salary, including grant funding from Shriners Hospitals for Children and Craig H. Neilsen Foundation (grant # 324671).

Kathleen M. Chlan is a Research Specialist at Shriners Hospitals for Children, Chicago and receives a salary, including grant funding from Shriners Hospitals for Children (grant # 324671).

Lawrence Vogel is Chief of Pediatrics at Shriners Hospitals for Children, Chicago and receives a salary.

Disclaimer statements

Contributors None.

Funding None.

Conflict of interest None.

Ethics approval None.