Internalizing symptoms mediate the relationship between sleep disordered breathing and pain symptoms in a pediatric hematology/oncology sample

• Published in: Children's health care Vol. 46; no. 1; pp. 34 - 48
• Main Authors: Baker, Anna M., Raiker, Joseph S., Elkin, T. David, Palermo, Tonya M., Karlson, Cynthia W.
• Format: Journal Article
• Language: English
• Published: Philadelphia Taylor & Francis 02.01.2017; Routledge, Taylor & Francis Group
• Subjects: African Americans; Anxiety-Depression; Cancer; Caregivers; Confidence intervals; Hematology; Internalization; Mediation; Mothers; Oncology; Pain; Pediatrics; Questionnaires; Respiration; Sick children; Sickle cell disease; Sleep; Sleep disorders; Symptoms
• ISSN: 0273-9615; 1532-6888
• DOI: 10.1080/02739615.2015.1124326

Objective: To examine caregiver ratings of children's internalizing symptoms as a potential mediator between sleep disordered breathing and pain symptoms. Caregiver depression/anxiety symptoms were further examined as a potential moderator of the mediation model. Methods: Participants were 96 caregivers (82% mothers) of children with cancer, sickle cell disease, or other hematological conditions (M age = 10.45 years; 46.9% female, 78.1% African American). Caregivers completed questionnaires on child patient symptoms during regular clinic visits. Results: As hypothesized, the effect of sleep on pain (β = 0.31) was reduced (β = 0.15) after accounting for child internalizing symptoms (β = 0.17, 95% confidence interval = 0.03 to 0.42). The indirect effect accounted for 54.8% of the total effect. However, caregiver depression/anxiety symptoms were not a significant moderator of this mediation model. Conclusions: Sleep may play an important role in the experience of pain in children with hematology/oncology conditions. A child's mood may mediate this relationship.