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Cited by 18Sleep and related disordersPediatric Pain Management TechniquesSleep and Wakefulness Research

Sleep phase and pre-sleep arousal predicted co-developmental trajectories of pain and insomnia within adolescence

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Arnison, Tor, Schrooten, Martien G. S., Bauducco, Serena, Jansson-Fröjmark, Markus, Persson, Jonas·2022·Scientific Reports
DOI 10.1038/s41598-022-08207-yPMC PMC8927379
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Abstract

The onset of both chronic pain and insomnia is high during adolescence. Although a bidirectional relationship between pain and insomnia has support, how pain and sleep co-develop throughout adolescence remains unknown. Sleep–wake patterns, pre-sleep behavior and pre-sleep arousal may influence the co-development of pain and insomnia. Four waves of longitudinal self-report data were used (N baseline = 2767, Age baseline M = 13.65 years, SD = 0.65). Multidimensional growth mixture modeling was used to identify four subgroups of adolescents with different concurrent trajectories of pain and insomnia. The trajectories followed each other across time in all classes: one class of consistently low pain and insomnia (68.7%), one class with persistent high symptoms (4.9%), as well as one class of increasing (13.9%), and one of decreasing (12.5%), trajectories. Later sleep–wake patterns and more pre-sleep cognitive-emotional arousal predicted both increasing and decreasing trajectories of concurrent pain and insomnia. The current study showed that developmental trajectories of pain and insomnia follow each other within adolescents and across adolescence. Both sleep-phase focused interventions as well as psychological interventions that focus on pre-sleep cognitive-emotional arousal may prove beneficial for adolescents with comorbid pain and insomnia.

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Crossref · 10.1038/s41598-022-08207-y

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  • Outcomes of SHUTi and the CBT-I Coach app are variable and generally smaller than those observed with therapist-delivered CBT-I.

    “Similarly, SHUTi (Sleep Healthy Using the Internet) and the CBT-I Coach app show improvements in sleep onset latency, total sleep time, and daytime functioning; however, outcomes are variable and are generally smaller than those observed with therapist-delivered CBT-I [96,97].”

    From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [97]

    The Discussion (page unavailable) mentions inconsistent results for non-pharmacological treatment of comorbid pain and insomnia, but does not discuss SHUTi, CBT-I Coach, or a comparison with therapist-delivered CBT-I. Searches for the named apps and for internet-delivered CBT-I outcomes found no passage addressing the attributed claim. (LLM, conf=0.77)

    Experimental — accuracy not yet measured

  • Most efficacy data for digital programs derive from broader chronic insomnia populations, and sleep-onset anxiety is typically addressed as one component of an overall insomnia presentation rather than as a primary, isolated outcome.

    “It is important to note that most efficacy data for these digital programs derive from broader chronic insomnia populations, and sleep-onset anxiety is typically addressed as one component of an overall insomnia presentation rather than as a primary, isolated outcome [97].”

    From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [97]

    The Discussion discusses pre-sleep arousal in adolescents with pain and insomnia and proposes future interventions, but does not report efficacy data for digital programs. Searches for digital-program efficacy and sleep-onset anxiety found no passage addressing whether such anxiety is typically treated as a component of insomnia rather than an isolated outcome. The indexed copy provides no page numbers for these passages. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • SHUTi and the CBT-I Coach app improve sleep onset latency, total sleep time, and daytime functioning.

    “Similarly, SHUTi (Sleep Healthy Using the Internet) and the CBT-I Coach app show improvements in sleep onset latency, total sleep time, and daytime functioning; however, outcomes are variable and are generally smaller than those observed with therapist-delivered CBT-I [96,97].”

    From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [97]

    The Methods and Results passages examine adolescents’ sleep measures and trajectories of pain and insomnia, not outcomes of SHUTi or CBT-I Coach. A search for both apps and for improvements in sleep onset latency, total sleep time, daytime functioning, or comparisons with therapist-delivered CBT-I found no passage addressing the claim. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 3

  1. [31]Olsson G von Knorring A-L Depression among Swedish adolescents measured by the self-rating scale Center for Epidemiology Studies-Depression Child (CES-DC) Eur. Child Adolesc. Psychiatry 1997 6 81 87 9257089
  2. [32]Little TD Longitudinal Structural Equation Modeling 2013 ] The Guilford Press
  3. [51]Enders CK Applied Missing Data Analysis 2010 The Guilford Press

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Authors
Arnison, T., Schrooten, M. G. S., Bauducco, S., Jansson-Fröjmark, M., & Persson, J.
Affiliations
  • Örebro University (SE)
  • Region Stockholm (SE)
  • Stockholm University (SE)
Corresponding author
Arnison, Tor
ORCID
Schrooten, Martien G. S.
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2022-03-16
Volume
12
Issue
1
Pages
4480-4480
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-022-08207-y
PMC
PMC8927379
OpenAlex
W4220912666
Cited by
18
References
61
Citations by year
2026: 4 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 1
FWCI
3.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Örebro University (Örebro University) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Örebro University
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
adolescent pain, insomnia, sleep stages, pre-sleep arousal, sleep-wake patterns, developmental trajectories, growth mixture modeling, sleep interventions
MeSH terms
Adolescent, Arousal, Humans, Sleep Initiation and Maintenance Disorders, Sleep, Sleep Stages, Chronic Pain

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