The Differential Association Between Affect and Sleep in Adolescents With and Without FGIDs

Abstract

Background: Children and adolescents with chronic abdominal pain experience more disruptions to their daily living than their healthy same-aged peers. Adolescents experiencing chronic pain associated with Functional Gastrointestinal Disorders (FGIDs) suffer negative impacts on their health behaviors (i.e., sleep) and are also at risk for a range of problems related to negative affect such as subclinical symptoms of depression and symptoms of anxiety, which may serve to exacerbate one another in a reciprocal fashion. The aim of the study was to determine if the strength of the relationship between affect and sleep differs across healthy adolescents and a chronic abdominal pain group. Methods: Twenty-five adolescents with FGIDs were compared to 25 of their same-aged peers to examine the differential association between affect and total sleep time (TST). This study utilized ecological momentary assessment surveys and objective assessments of sleep to capture intensive longitudinal data for both groups. Data analysis included both between- and within-person variables examined using multilevel models. Results: Results from the group comparison analysis revealed that adolescents in the FGID group reported significantly lower quality of life than their same-aged peers. The results of the multilevel models revealed that TST was associated with group status (β = 31.35, p < .05), indicating that community adolescents exhibited longer sleep duration than the adolescents with an FGID. Models predicting TST revealed a significant 3-way interaction between weekday, group status, and negative affect (β = 26.27, p < .05). Simple slopes analysis indicated that when negative affect is one standard deviation below the child’s own average on weekends, participants in the FGID group obtained significantly more sleep than those in the comparison group (β = 47.67, p < .05). Conclusions: The adolescents with FGIDs in the present study reported significantly lower quality of life on both the psychosocial and school subscales, indicating quality of life may be reduced when there is emotional distress regarding school issues. The findings of the present study show that when adolescents with FGIDs have lower emotional distress, or negative affect, on the weekend when demands are reduced, they are able to obtain longer sleep durations. These findings confirm that unique relationships exist between negative affect and sleep duration for youth with FGIDs, and the interaction of these variables on weekend days may hold value in understanding and addressing these potential targets in treatment.