{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:01:01Z","timestamp":1791979261795,"version":"4.4.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":168,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Opioids are effective for acute pain management following surgery among adolescents, yet are associated with significant negative consequences, including respiratory depression and opioid misuse. Sleep deficiency is common following surgery and extant research indicates strong cross-sectional associations between sleep deficiency and increased problematic opioid use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study examined longitudinal associations between postsurgical sleep deficiency and opioid use among adolescents undergoing outpatient surgery. We also examined daily pain and mood as mechanisms linking previous night\u2019s sleep deficiency and next day prescription opioid use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective, observational study enrolled 106 adolescents (11\u201319 years) who underwent orthopedic outpatient surgery and collected pre-surgery and longitudinal measurements. Participants were 52% female, African-American (7%), American Indian\/Alaska Native (7%), Hispanic (9%), Native Hawaiian or Other Pacific Islander (4%), or white, non-Hispanic (66%). Using ecological momentary assessment methods, participants reported sleep, pain, and mood in real time over the first 14 days following surgery. Postsurgical opioid use was measured using an electronic medication cap monitoring device, eCAPTM. Associations between variables were measured using multilevel structural equation modeling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Using multi-level mediation models, pain, but not mood-mediated associations between postsurgical sleep deficiency (sleep quality, total sleep time, sleep onset latency, and wake after sleep onset) and opioid use, at both the within-person and between-person levels. Results highlight that greater previous night\u2019s sleep deficiency (both generally and greater than a person\u2019s mean level) was associated with higher next day pain (both generally and greater than a person\u2019s mean level), which, in turn, was associated with higher opioid use. Furthermore, between-person total effect models provide support for sleep deficiency predicting higher opioid use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings should be considered preliminary yet underscore the need for a comprehensive and personalized approach to postsurgical pain management and opioid use, potentially implementing interventions targeting sleep quality and quantity to reduce pain and opioid use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/sleepadvances\/zpae039","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T10:08:57Z","timestamp":1718618937000},"source":"Crossref","is-referenced-by-count":12,"title":["Ecological momentary assessment of sleep, pain, and opioid use among adolescents following surgery"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0755-8659","authenticated-orcid":false,"given":"Andrew H","family":"Rogers","sequence":"first","affiliation":[{"name":"Center for Child Health, Behavior & Development, Seattle Children\u2019s Research Institute , Seattle, WA , USA"},{"name":"Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A","family":"Rabbitts","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine , Stanford, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G","family":"Saper","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, University of Washington School of Medicine , Seattle, WA , USA"},{"name":"Department of Orthopedic Surgery and Sports Medicine, Seattle Children\u2019s Hospital , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A","family":"Schmale","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, University of Washington School of Medicine , Seattle, WA , USA"},{"name":"Department of Orthopedic Surgery and Sports Medicine, Seattle Children\u2019s Hospital , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6036-6715","authenticated-orcid":false,"given":"Tonya M","family":"Palermo","sequence":"additional","affiliation":[{"name":"Center for Child Health, Behavior & Development, Seattle Children\u2019s Research Institute , Seattle, WA , USA"},{"name":"Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7601-0270","authenticated-orcid":false,"given":"Cornelius B","family":"Groenewald","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine , Stanford, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"key":"2024071912265334300_CIT0001","doi-asserted-by":"crossref","first-page":"3071","DOI":"10.2147\/JPR.S239320","article-title":"A conceptual model of biopsychosocial mechanisms of transition from acute to chronic postsurgical pain in children and adolescents","volume":"13","author":"Rabbitts","year":"2020","journal-title":"J Pain Res"},{"issue":"1","key":"2024071912265334300_CIT0002","doi-asserted-by":"crossref","first-page":"e20172439","DOI":"10.1542\/peds.2017-2439","article-title":"Persistent opioid use among pediatric patients after surgery","volume":"141","author":"Harbaugh","year":"2018","journal-title":"Pediatrics."},{"issue":"1","key":"2024071912265334300_CIT0003","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11606-016-3810-3","article-title":"Association between initial opioid prescribing patterns and subsequent long-term use among opioid-na\u00efve patients: a Statewide Retrospective Cohort Study","volume":"32","author":"Deyo","year":"2017","journal-title":"J Gen Intern Med."},{"issue":"1","key":"2024071912265334300_CIT0004","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/ACO.0000000000000538","article-title":"Improve postoperative sleep: what can we do","volume":"31","author":"Su","year":"2018","journal-title":"Curr Opin Anaesthesiol."},{"key":"2024071912265334300_CIT0005","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.sleep.2017.01.012","article-title":"Increasing presurgery sleep reduces postsurgery pain and analgesic use following joint replacement: a feasibility study","volume":"33","author":"Roehrs","year":"2017","journal-title":"Sleep Med."},{"issue":"5","key":"2024071912265334300_CIT0006","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1097\/ALN.0000000000001325","article-title":"Low-dose dexmedetomidine improves sleep quality pattern in elderly patients after noncardiac surgery in the intensive care unit: a Pilot randomized controlled trial","volume":"125","author":"Wu","year":"2016","journal-title":"Anesthesiology."},{"issue":"2","key":"2024071912265334300_CIT0007","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1055\/s-0030-1248088","article-title":"Zolpidem reduces postoperative pain, fatigue, and narcotic consumption following knee arthroscopy: a prospective randomized placebo-controlled double-blinded study","volume":"19","author":"Tashjian","year":"2006","journal-title":"J Knee Surg."},{"issue":"2","key":"2024071912265334300_CIT0008","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1460-9592.2005.01706.x","article-title":"Psychological predictors of postoperative sleep in children undergoing outpatient surgery","volume":"16","author":"Caldwell-Andrews","year":"2006","journal-title":"Paediatr Anaesth."},{"issue":"5","key":"2024071912265334300_CIT0009","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1097\/00000542-200211000-00010","article-title":"Sleeping characteristics of children undergoing outpatient elective surgery","volume":"97","author":"Kain","year":"2002","journal-title":"Anesthesiology."},{"issue":"3","key":"2024071912265334300_CIT0010","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsaa201","article-title":"Associations between adolescent sleep deficiency and prescription opioid misuse in adulthood","volume":"44","author":"Groenewald","year":"2021","journal-title":"Sleep."},{"issue":"11","key":"2024071912265334300_CIT0011","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.5664\/jcsm.9418","article-title":"Associations between insufficient sleep and prescription opioid misuse among high school students in the United States","volume":"17","author":"Groenewald","year":"2021","journal-title":"J Clin Sleep Med"},{"issue":"6","key":"2024071912265334300_CIT0012","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1093\/abm\/kaaa099","article-title":"A preliminary investigation of the underlying mechanism associating daily sleep continuity disturbance and prescription opioid use among individuals with sickle cell disease","volume":"55","author":"Mun","year":"2021","journal-title":"Ann Behav Med"},{"issue":"6","key":"2024071912265334300_CIT0013","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.sleep.2004.07.007","article-title":"Sleep disturbances, pain and analgesia in adults hospitalized for burn injuries","volume":"5","author":"Raymond","year":"2004","journal-title":"Sleep Med."},{"issue":"12","key":"2024071912265334300_CIT0014","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1016\/j.jpain.2013.08.007","article-title":"The association of sleep and pain: an update and a path forward","volume":"14","author":"Finan","year":"2013","journal-title":"J Pain."},{"issue":"14","key":"2024071912265334300_CIT0015","doi-asserted-by":"crossref","first-page":"2737","DOI":"10.1111\/bph.13812","article-title":"Opioid system and human emotions","volume":"175","author":"Nummenmaa","year":"2018","journal-title":"Br J Pharmacol."},{"key":"2024071912265334300_CIT0016","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.cophys.2019.04.012","article-title":"The interrelationship between sleep and chronic pain in adolescents","volume":"11","author":"Badawy","year":"2019","journal-title":"Curr Opin Physiol"},{"issue":"2","key":"2024071912265334300_CIT0017","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/jcpp.12125","article-title":"Sleep restriction worsens mood and emotion regulation in adolescents","volume":"55","author":"Baum","year":"2014","journal-title":"J Child Psychol Psychiatry."},{"issue":"6","key":"2024071912265334300_CIT0018","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1037\/amp0000678","article-title":"Emotion regulation as a transdiagnostic factor underlying co-occurring chronic pain and problematic opioid use","volume":"75","author":"Aaron","year":"2020","journal-title":"Am Psychol."},{"issue":"5","key":"2024071912265334300_CIT0019","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1177\/2167702618773323","article-title":"A model of the intersection of pain and opioid misuse in children and adolescents","volume":"6","author":"Dash","year":"2018","journal-title":"Clin Psychol Sci"},{"issue":"1","key":"2024071912265334300_CIT0020","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jpain.2018.07.007","article-title":"Associations between adolescent chronic pain and prescription opioid misuse in adulthood","volume":"20","author":"Groenewald","year":"2019","journal-title":"J Pain."},{"issue":"6","key":"2024071912265334300_CIT0021","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1037\/amp0000655","article-title":"Comorbid chronic pain and opioid misuse in youth: knowns, unknowns, and implications for behavioral treatment","volume":"75","author":"Pielech","year":"2020","journal-title":"Am Psychol."},{"key":"2024071912265334300_CIT0022","author":"Muth\u00e9n","year":"2017"},{"issue":"2","key":"2024071912265334300_CIT0023","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1037\/1082-989X.12.2.121","article-title":"Centering predictor variables in cross-sectional multilevel models: a new look at an old issue","volume":"12","author":"Enders","year":"2007","journal-title":"Psychol Methods."},{"key":"2024071912265334300_CIT0024","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.brat.2016.11.001","article-title":"Regression-based statistical mediation and moderation analysis in clinical research: observations, recommendations, and implementation","volume":"98","author":"Hayes","year":"2017","journal-title":"Behav Res Ther."},{"issue":"4","key":"2024071912265334300_CIT0025","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1124\/mol.119.119107","article-title":"Bidirectional relationship between opioids and disrupted sleep: Putative mechanisms","volume":"98","author":"Eacret","year":"2020","journal-title":"Mol Pharmacol."},{"issue":"2","key":"2024071912265334300_CIT0026","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ccm.2022.05.001","article-title":"Sleep deficiency and opioid use disorder: trajectory, mechanisms, and interventions","volume":"43","author":"Langstengel","year":"2022","journal-title":"Clin Chest Med."},{"key":"2024071912265334300_CIT0027","doi-asserted-by":"crossref","first-page":"e97","DOI":"10.1017\/S2045796020000037","article-title":"Prescription opioid misuse motive latent classes: outcomes from a nationally representative US sample","volume":"29","author":"Schepis","year":"2020","journal-title":"Epidemiol Psychiatr Sci"},{"issue":"1","key":"2024071912265334300_CIT0028","first-page":"33","article-title":"The effect of opioids on sleep architecture","volume":"3","author":"Dimsdale","year":"2007","journal-title":"J Clin Sleep Med."},{"key":"2024071912265334300_CIT0029","doi-asserted-by":"crossref","first-page":"640416","DOI":"10.3389\/fmed.2021.640416","article-title":"Perioperative sleep disorder: a review","volume":"8","author":"Lin","year":"2021","journal-title":"Front Med"},{"issue":"1","key":"2024071912265334300_CIT0030","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.chc.2020.08.006","article-title":"Behavioral treatment of insomnia and sleep disturbances in school-aged children and adolescents","volume":"30","author":"Lunsford-Avery","year":"2021","journal-title":"Child Adolesc Psychiatr Clin N Am."},{"key":"2024071912265334300_CIT0031","doi-asserted-by":"crossref","first-page":"102048","DOI":"10.1016\/j.eclinm.2023.102048","article-title":"Use of melatonin in children and adolescents with idiopathic chronic insomnia: a systematic review, meta-analysis, and clinical recommendation","volume":"61","author":"Edemann-Callesen","year":"2023","journal-title":"eClinicalMedicine"},{"issue":"3","key":"2024071912265334300_CIT0032","doi-asserted-by":"crossref","first-page":"401","DOI":"10.5664\/jcsm.6490","article-title":"A single arm pilot trial of brief cognitive behavioral therapy for insomnia in adolescents with physical and psychiatric comorbidities","volume":"13","author":"Palermo","year":"2017","journal-title":"J Clin Sleep Med"}],"container-title":["Sleep Advances"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/sleepadvances\/advance-article-pdf\/doi\/10.1093\/sleepadvances\/zpae039\/58250086\/zpae039.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleepadvances\/article-pdf\/5\/1\/zpae039\/58596159\/zpae039.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleepadvances\/article-pdf\/5\/1\/zpae039\/58596159\/zpae039.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T12:27:38Z","timestamp":1721392058000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sleepadvances\/article\/doi\/10.1093\/sleepadvances\/zpae039\/7694264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,1]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/sleepadvances\/zpae039","relation":{},"ISSN":["2632-5012"],"issn-type":[{"value":"2632-5012","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024]]},"published":{"date-parts":[[2024,1,1]]},"article-number":"zpae039"}}