Importance of sleep in the management of pediatric pain

This article outlines several aspects of sleep regulation relevant to pedia tric pain management. A broad range of connections between sleep and pain a re described: (1) pain can interfere with the quality and quantity of child ren's sleep; (2) insufficient sleep (quality or quantity) can cause daytime sequelae (behavioral and emotional changes) that interfere with the coping skills necessary for effective pain management; (3) fear and anxiety often have a negative impact on both pain and sleep; (4) feelings of safety and control frequently have a positive effect on both sleep and pain symptoms; (5) adequate sleep seems to promote both physiological (tissue repair) and psychological (transient cessation of the perception of pain signals) proce sses relevant to recovery from pain, injury, and illness; and (6) treatment approaches to pediatric sleep and pain problems show considerable overlap with respect to many pharmacological as well as cognitive-behavioral interv entions. Given these multiple links, a better understanding of sleep-and it s importance in physical and mental health-is likely to be of value to clin icians and researchers working in areas of pediatric pain management. One s pecific hypothesis to be addressed is the possible contribution of sleep di sruption as a step in the progression to some chronic pain syndromes.