Sleep disturbances have been known to cause or modulate acute and chronic pain.
Some studies have shown a relationship between sleep disruption and pain hypersensitivity.
Pain hypersensitivity from paradoxical sleep
deprivation could be due to a reduction of participation of the opioid and serotoninergic mechanisms of action in neurotransmission
in the brain. Apparently, sleep deprivation can interfere with
analgesic treatments involving opioid and serotoninergic mechanisms of action.
Substance
P (SP) and neurokinins have been implicated in modulating pain and mood and have
also been found to produce disturbances in sleep to action on different receptors.
Whether the pain hypersensitivity effects are due to
the deprivation of specific sleep stages or whether they result from a generalized
disruption of sleep continuity are still not known.
However, in a study on normal participants,
loss of 4 hours of sleep and specific rapid eye movement (REM) sleep
loss cause the pain-free participants to be hyperalgesic the following day. These findings imply that pharmacologic treatments
and clinical conditions that reduce sleep and REM sleep
time may increase pain.
Sleep quality is also found to be significantly predictive
of pain, fatigue, and social functioning in patients with fibromyalgia interfering
with health-related quality of life. Interventions designed to improve sleep quality
may help to improve health-related quality of life for patients with fibromyalgia.
Since depression is a significant contribution to sleep
problems, treatment of associated depression will need to be also addressed for those who suffer from pain related sleep disturbances.
