Efficacy of psychological interventions on sleep in children and adolescents with chronic pain: a systematic review with meta-analysis of randomized controlled trials.

STUDY

OBJECTIVES

Chronic pain and comorbid sleep difficulties impact many children and adolescents. This study aimed to evaluate the efficacy of psychological interventions on sleep in children and adolescents with chronic pain.

METHODS

Five databases (PubMed, CINAHL, APA PsychInfo, Embase, CENTRAL) were searched from inception to April 17, 2023, for randomized controlled trials examining the effects of psychological interventions on sleep in participants aged ≤ 19 years with pain persisting for ≥ 12 weeks. Six studies (participants, n = 686; 78.43% female) were included. Cochrane Risk-of-Bias 2 and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) criteria were employed.

RESULTS

Pairwise random-effects restricted maximum likelihood meta-analysis demonstrated no effect of psychological interventions on sleep (g [95% confidence interval]: -0.04 [-0.19, 0.11], P = .613, GRADE: high), pain intensity (0.05 [-0.17, 0.27], P = .563, GRADE: high), depressive symptomatology (0.17 [-0.27, 0.62], P = .304, GRADE: moderate), or anxious symptomatology (g: 0.13 [-0.32, 0.57], P = .351, GRADE: moderate). Subjective outcomes may limit clinical utility, and risk of bias (some concern for all studies) decreased confidence in effect estimates.

CONCLUSIONS

Development and evaluation of psychological interventions specifically tailored to address comorbidities of sleep difficulties in child and adolescent chronic pain populations is warranted.

SYSTEMATIC REVIEW REGISTRATION: Registry: PROSPERO; Name: Efficacy of Psychological Interventions for Sleep in Children and Adolescents with Chronic Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials; URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023454620; Identifier: CRD42023454620.

CITATION: Thwaite TL, Craige EA, Mundell N, et al. Efficacy of psychological interventions on sleep in children and adolescents with chronic pain: a systematic review with meta-analysis of randomized controlled trials. J Clin Sleep Med. 2025;21(8):1445-1461.