Measuring Pain Relief through Actigraphy in People with Intellectual Disability

Information about reliable pain detection in people with intellectual disabilities is scarce. Pain (acute as well as chronic) has a great influence on daily activities and is often under-recognized. Chronic and acute pain also severely influences the quality and duration of sleep. Lack of sleep negatively influences chronic pain. There is no research about the influence of pain on sleep in people with Intellectual Disability. Yet we think there is a link between sleep and pain (we had no reason to assume there is no link between the two). We measured sleep in people with Intellectual Disability at an institution in the Netherlands. All the participants had pain or chronic pain or were suspected of having chronic pain. We measured sleep using actigraphy and we assessed the pain of participants with suspected pain using the Rotterdam Elderly Pain Observation Scale (REPOS) or the Checklist Pain Behavior (CPG) for children. A sleep problem was found in all the measurements and this was confirmed using the REPOS or CPG for the group with suspected chronic pain. There were 25 participants included in this research. After treatment (with analgesics for 68%) most participants experienced improved sleep. There was a significant improvement in the entire group in sleep efficiency, sleep latency, hours of sleep and/or WASO (waking after sleep onset). Although the group is small, our outcomes suggest that there is a strong relationship between chronic and acute pain and sleep in people with Intellectual Disability. Actigraphy can be used with the REPOS and the CPG to confirm suspected pain and to measure the effect of the intervention. Suspected pain can also be confirmed by actigraphy.