During adolescence major shifts in sleep and circadian systems occur with a notable circadian phase delay. Yet, the circadian influence on pain during early adolescence is largely unknown. Using 2 years of data from the Adolescent Brain Cognitive Development study, we investigated the impact of chronotype on pain incidence, moderate-to-severe pain, and multiregion pain 1 year later in U.S. adolescents. Based on the Munich ChronoType Questionnaire, chronotype was calculated as the midpoint between sleep onset and offset on free days, corrected for sleep debt over the week. Adolescents reported pain presence over the past month, and if present, rated pain intensity (0-10 numerical rating scale; ≥ 4 defined as moderate-to-severe pain) and body site locations (Collaborative Health Outcomes Information Registry Body Map; ≥2 regions defined as multiregion pain). Three-level random intercept logistic regression models were specified for each pain outcome, adjusting for baseline sociodemographic and developmental characteristics. Among 5991 initially pain-free adolescents (mean age 12.0 years, SD 0.7), the mean chronotype was 3:59 am (SD 97 minutes), and the 1-year incidence of pain, moderate-to-severe pain, and multiregion pain was 24.4%, 15.2%, and 13.5%, respectively. Each hour later chronotype at baseline was associated with higher odds of developing any pain (odds ratio [OR] = 1.06, 95% confidence interval [CI] = 1.01, 1.11), moderate-to-severe pain (OR = 1.10, 95% CI = 1.05-1.17), and multiregion pain (OR = 1.08, 95% CI = 1.02-1.14) during 1-year follow-up. In this diverse U.S. adolescent sample, later chronotype predicted higher incidence of new-onset pain.

中文翻译：

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睡眠时间型对青春期早期疼痛发生率的影响。


在青春期，睡眠和昼夜节律系统发生重大变化，并伴有明显的昼夜节律相位延迟。然而，昼夜节律对青春期早期疼痛的影响在很大程度上尚不清楚。我们利用青少年大脑认知发展研究的 2 年数据，研究了时间型对美国青少年一年后疼痛发生率、中度至重度疼痛和多区域疼痛的影响。根据慕尼黑 ChronoType 问卷，睡眠类型计算为空闲日睡眠开始时间和睡眠抵消时间之间的中点，并根据一周内的睡眠债务进行校正。青少年报告过去一个月是否存在疼痛，如果存在，则评定疼痛强度（0-10 数字评级量表；≥ 4 定义为中度至重度疼痛）和身体部位位置（协作健康结果信息登记身体地图；≥2区域定义为多区域疼痛）。针对每种疼痛结果指定三水平随机截距逻辑回归模型，并根据基线社会人口统计学和发育特征进行调整。在 5991 名最初无疼痛的青少年中（平均年龄 12.0 岁，SD 0.7），平均时间型为凌晨 3:59（SD 97 分钟），疼痛、中度至重度疼痛和多区域疼痛的 1 年发生率分别为24.4%、15.2%和13.5%。每小时后，基线时型与发生任何疼痛（比值比 [OR] = 1.06，95% 置信区间 [CI] = 1.01, 1.11）、中度至重度疼痛（OR = 1.10，95%）的几率较高相关。 CI = 1.05-1.17），以及 1 年随访期间的多区域疼痛（OR = 1.08，95% CI = 1.02-1.14）。在这个多样化的美国青少年样本中，较晚的时间型预测新发疼痛的发生率较高。