The overall goal of this project is to address the critical issue of sleep problems and poor sleep behavior among adolescents and young adults, which significantly impacts their overall well-being and daily functioning.

Sleep disorders are often intertwined with chronic pain, creating a cycle that can lead to severe functional impairments. The first part of this project will use device-measured sleep data to investigate how sleep behaviors and disorders, alone, and together with pain contribute to school dropouts and use of healthcare services. We will also examine how family dynamics and school environment influence these associations. Building on this understanding, the second part of the project will introduce an innovative video-based psychoeducational tool designed to improve sleep quality and promote better sleep hygiene among young adults with chronic pain. This tool will be evaluated for its effectiveness in improving sleep quality and, consequently, enhancing participation in education and work. Our interdisciplinary team, including experts from five faculties at NTNU, St. Olav’s University Hospital, the Norwegian Labor and Welfare Administration (NAV), and Trondheim municipality, will ensure a comprehensive approach to this pressing issue.  

Project I

Sleep, Musculoskeletal Pain and School Participation: Understanding Adolescent Health, School participation and Healthcare utilization

PhD Candidate: Elisa Maharjan

Sleep is an important construct for physical, emotional, and cognitive regulation, in addition to overall functioning in adolescents.  Adolescents naturally undergo changes in sleep homeostasis and circadian rhythms leading to later bedtimes and waketimes. With the development in our societies, sleep habits have changed significantly due to behavioral factors such as increased screen time, consumption of caffeinated drinks, and social activities. Consequently, sleep habits, -patterns, and -quality are induced to be irregular, insufficient, and poor. Many do not meet the daily requirement of 8 hours of sleep, increasing the vulnerability of insomnia symptoms such as difficulties initiating or maintaining sleep, and early morning awakenings leading to daytime functional interference.  

Additionally, a considerable number of adolescents report having musculoskeletal pain that interferes with their daily functioning and impacts overall health. This could also negatively impact school performance, and in worst case dropping out of school. Musculoskeletal pain during adolescence may also be carried over into adulthood, causing the chances of long-term pain.  

This project explores sleep characterstics in adolescents in relation to musculoskeletal pain in their daily functioning and examines how sleep and musculoskeletal pain interacts to influence academic performance, school participation, and healthcare utilization. By understanding these connections, the study seeks to provide knowledge that can support improved sleep and pain, improved educational outcomes, and reduced risk of school dropouts. 

Project II 

Sleep, pain and work participation 

PhD Candidate: Charlotte Borgan Hessevik

The main goal of this project is to examine how insomnia severity influences pain patients and functional outcomes in patients with chronic pain, and to evaluate the effectiveness of digital sleep treatment in improving these outcomes. We have established a strong interdisciplinary team, including experts from five faculties at NTNU, St. Olav’s University Hospital, and the Norwegian Labor and Welfare Administration (NAV). We will ensure a comprehensive approach to this pressing issue. 

In the first study, we will use registry data from NOKSmerte (Norwegian registry for patients with long-term pain) and NAV to examine the association between insomnia severity and work participation in patients referring to multidisciplinary pain clinics.  

In the second study, the aim is to explore needs, expectations, and challenges related to digital sleep treatment for patients with long-term and complex pain conditions in specialist healthcare. Insomnia is highly prevalent in this group, affecting more than half of the patients, and is closely linked to poorer pain outcomes. To address this, we will first examine the perspectives of patients and key stakeholders, including healthcare professionals, employers, and NAV staff, on the development and implementation of digital sleep interventions. These perspectives will be followed by co-design processes to develop user-centered and context-adapted solutions. We will collaborate closely with NTNU's Department for Design throughout this process.

In the final study, we will develop and conduct a pilot test of a tailored digital sleep treatment. We will evaluate the tool using qualitative interviews and validated user experience measures. In addition, we will assess its usability and acceptability among patients.