Daily Pain and Sleep in Children with Sickle Cell Disease: An Analysis of Daily Diaries Utilizing Multilevel Models

This study investigated the temporal relationship between pain and sleep in children with sickle cell disease (SCD) and examined the influence of additional stressors and pain medication practices on this relationship. To accomplish the goals of the study, 20 children with SCD aged 8 to 12 years of age completed daily diaries for approximately 5 weeks. These diaries were analyzed using multilevel models. Results were consistent with the hypothesis that there is a cyclic relationship between high SCD pain and poor sleep. Specifically, high levels of daily SCD pain were significantly related to poor sleep quality that night. Also, poor sleep quality during the night was significantly related to high SCD pain that day. Poor sleep quality appeared to be the stronger predictor in the pain-sleep cycle. Additional stressors and pain medication use did not evidence a substantial impact on the relationship between SCD pain and sleep, but instead evidenced more direct influences on SCD pain and sleep aspects. Clinical and policy implications include the possible benefits of raising awareness among clinicians, policymakers, patients, and their parents about the interaction between the child's symptoms and sleep patterns. Additional research should study how other disease symptoms may influence sleep and how sleep may influence other disease symptoms. In addition, this research should examine the role of disease management strategies implemented by the child and his/her family on these relationships

A Systematic Review of Sleep in Pediatric Pain Populations

The primary aim of this systematic review was to examine the evidence for a pain-sleep relationship in children with persistent pain by reviewing studies using single and mixed pediatric persistent pain samples

Perceived Racial Discrimination and Self-Esteem in African American Youth: Racial Socialization as a Protective Factor

Racial socialization was examined as a protective factor that might buffer African American youth from the negative effects of perceived racial discrimination. Two types of racial socialization were examined: messages about race pride and preparation for bias. One hundred twenty-eight eighth-grade African American students participated in the study. As anticipated, both types of socialization moderated the relationship between discrimination and self-esteem. The negative relationship between perceived discrimination and self-esteem was mitigated for youth who reported more messages about race pride and a moderate amount of preparation for bias from their parents. In contrast, low race pride socialization and both high and low preparation for bias were associated with a negative relationship between perceived discrimination and self-esteem. (Contains 3 tables.