0775 Sleep Timing in Children and Adolescents with Functional Abdominal Pain Disorders

Abstract Introduction Functional abdominal pain disorders (FAPD) are among the most common chronic pain conditions in childhood, affecting 25% of children worldwide and accounting for about 50% of pediatric gastroenterology visits. Self-reported sleep disturbances with impaired functioning have been reported in FAPD patients, however, objective sleep measures, specifically circadian rhythm disruptions, are scarce. Hence, we aimed to objectively characterize the sleep quality, duration, and timing of children with FAPD compared to healthy controls. Methods Patients who met the criteria for FAPD through the Rome 4 diagnostic questionnaire were recruited throughout the year from the Disorders of Gut Brain Interaction (DGBI) Clinic at CCHMC. Healthy controls aged 11-18 years, matched in demographic variables (BMI, race, gender) with cases, were recruited in a 1:1 ratio. Demographic information, medications (including timing), dietary patterns, school schedule, validated questionnaires (ASWS: Adolescents Sleep-Wake Scale, PISI: Pediatric Insomnia Severity Index) and other medical comorbidities were collected in cases and controls. Subjects were sent home with an actiwatch (Philips Respironics) to complete actigraphy assessments for 7 days. Results Youth with FAPD (n= 26) subjectively reported significantly poorer sleep quality and insomnia severity than controls (n=28) on questionnaires (p<.0001). However, we did not observe statistically significant differences in sleep duration or sleep efficiency on actigraphy (p>.05). Compared to controls, youth with FAPD had notably delayed sleep timing on actigraphy, measured by the sleep midpoint (198.44+/-50.1 vs 237.00+/- 75.0, d=.61, p=.039). When using sleep midpoint to group into morning, intermediate, or evening chronotype, youth with FAPD disproportionately showed an evening (night owl) chronotype (φ=.40; d=.87; p=.033) Conclusion Objective actigraphy suggests that youth with FAPD experience delayed sleep timing, disrupted circadian rest–activity rhythms compared to pain-free peers. As youth with late circadian phase can have their sleep truncated by environmental demands (e.g., early school start), and since there are effective phase-shifting interventions, these findings may open new doors for intervention. Support (if any)