During
Sleep, patients with chronic pain could trigger a sleep awaking response over
all sleep stages and not only in light sleep.
Thus, sleep disruption is usually considered to be a consequence of
the pain experience.
The
patients with a sleep problems had significantly higher maximum and medium pain, a significantly higher level of psychosocial disability and a significantly lower
overall subjective well-being. The medium pain and psychosocial disability in leisure
and social activities are significant predictors for sleep disorder.
Even in normal subjects, disrupting slow wave sleep,
without reducing total sleep or sleep efficiency,
for several consecutive nights is associated with decreased pain threshold, increased
discomfort, fatigue, and the inflammatory flare response in skin. These findings are common in patients
with fibromyalgia. These results therefore suggest that disrupted sleep
is probably an important factor in the pathophysiology of symptoms in fibromyalgia.
Sleep deprivation and restriction diminish vigilance, alter neuroendocrine
control, and negatively impact immune function. Decrements in vigilance can negatively impact performance.
However, studies have shown that sleep disturbance
may have a bidirectional relation with other features of chronic pain such as disability,
daily uptime and physical symptoms independent of pain or depression. Therefore,
it needs to be confirmed that repairing disrupted sleep leads
to an improvement in patients' daily activity and a reduction in their suffering.
Clinically, since
sleep disorder may be a factor in the
persistence and aggravation of pain as well as psychosocial disability, sleep
disorders should be integrated in the therapeutic targets.
