Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms
Table 4
Unstandardized coefficients and indirect effect sizes.
Model
b
SE
t
p
CIBCa (LL)
CIBCa (UL)
Pain intensity
Sleep quality → anxiety symptoms (a)
−5.60
1.16
−4.84
<0.001
−7.89
−3.32
Anxiety symptoms → pain intensity (b)
0.04
0.02
2.48
0.014
0.01
0.08
Sleep quality → pain intensity (c′)
−0.30
0.26
−1.15
0.254
−0.82
0.22
Sleep quality → anxiety symptoms → pain intensity (a ∗ b)
−0.25
0.11
—
—
−0.52
−0.07
Pain interference
Sleep quality → anxiety symptoms (a)
−5.73
1.16
−4.94
<0.001
−8.02
−3.44
Anxiety symptoms → pain interference (b)
0.28
0.06
4.28
<0.001
0.15
0.40
Sleep quality → pain interference (c′)
−3.20
0.95
−3.37
0.001
−5.09
−1.33
Sleep quality → anxiety symptoms → pain interference (a ∗ b)
−1.58
0.49
—
—
−2.75
−0.77
Pain intensity
Sleep quality → depressive symptoms (a)
−5.37
1.04
−5.15
<0.001
−7.44
−3.31
Depressive symptoms → pain intensity (b)
0.04
0.02
2.08
0.040
0.002
0.08
Sleep quality → pain intensity (c′)
−0.32
0.26
−1.21
0.228
−0.84
0.20
Sleep quality → depressive symptoms → pain intensity (a ∗ b)
−0.22
0.11
—
—
−0.46
−0.02
Pain interference
Sleep quality → depressive symptoms (a)
−5.40
1.05
−5.13
<0.001
−7.48
−3.32
Depressive symptoms → Pain interference (b)
0.25
0.07
3.50
0.001
0.11
0.39
Sleep quality → pain interference (c′)
−3.49
0.96
−3.63
0.0004
−5.39
−1.59
Sleep quality → depressive symptoms → pain interference (a ∗ b)
−1.33
0.46
—
—
−2.40
−0.57
Note. N for analyses is 144 cases for pain intensity-anxiety symptoms, 142 cases for pain interference-anxiety symptoms, 147 cases for pain intensity-depressive symptoms, and 145 cases for pain interference-depressive symptoms models. Sleep quality (rASWS, total score) is the independent variable (IV) in all models. Anxiety or depressive symptoms (PROMIS Anxiety and Depression subscales, T-scores; M); pain intensity (NRS; DV1); and pain interference (PROMIS Pain Interference subscale, T-score; DV2) are the outcome variables. CIBCa (LL) = lower limit of a 95% confidence interval; CIBCa (UL) = upper limit. Analyses are controlling for youth’s age and sex.
