Pediatric recurring pain in the community: the role of children's sleep and internalizing symptoms.

Associations between poor sleep and pain may be amplified for children who also have depressive or anxious symptoms. This study examined associations between child sleep at eight years and recurrent pain at nine years along with the moderating role of internalizing symptoms. Families were from a community-based, ongoing longitudinal study (N = 632 children). At eight and nine years, twins (49.2% female, 56.7% non-Latinx European American, 28.8% Latinx) and caregivers participated in assessments focused on child sleep and pain, respectively. Approximately 53% of children had pain in at least one location at least monthly. Internalizing symptoms at age eight were positively associated with number of pain sites at age nine. Lower sleep efficiencies were associated with more pain sites for children with higher levels of internalizing symptoms. Later midpoint times were associated with more pain sites for children with lower levels of internalizing symptoms. Interventions focused on improving children's pain outcomes may consider targeting sleep behaviors and mental health.