Pain and Sleep

  

  

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Have you ever wondered if pain and sleep are related? Have you ever experienced trouble falling or staying asleep due to another source of pain? Or, have you ever felt increased levels of pain or irritability due to a lack of good sleep?

Russell Rosenberg, Ph. D, D.ABSM, the Atlanta Sleep Clinic’s founder and an early pioneer in sleep medicine, recently posed these question to a group of sleep professionals at the 2009 Southern Sleep Society meeting.

Dr. Rosenberg began by looking at the history of research about the relationship between pain and sleep. The first notable study was performed in 1963 by Dr. Kleitman when he tested sensitivity to pain among groups that had received different levels of sleep. Dr. Kleitman found that after 8 hours of sleep loss, there was a reduction in the pain-threshold.

More recent studies show the following five relationships between pain and sleep.

1. Pain can cause individuals to awaken which can hinder falling and staying asleep
2. Pain and the body’s regulation of sleeping and waking share common neurobiological systems
3. Sleep actively protects against pain, therefore poor sleep can interfere with pain tolerance and processing
4. In fibromyagia patients, the subjective quality of sleep is inversely related to pain sensitivity
5. Disturbed sleep increases acute pain. For example, burn patients have increased pain sensitivity after poor sleep.

(Foo and Mason, 2003)(Asikainen et al, 1997)(Argargun et al, 1999)(Raymond et al, 2001)

One of the best studies of Pain and Sleep to date is Tim Roehrs’ study in 2006 that exposed subjects to a radiant heat stimulus after undergoingpartial sleep loss or REM loss conditions. He measured patients’ ability to withstand different levels of heat after various levels of sleep deprivation.He found that more sleep loss led to less pain tolerance.

A survey of 15,000 subjects in 2003 found that chronic pain has a unique relationship with sleep loss. Those surveyed who reported chronic pain also reported double the likelihood of nighttime awakenings, double the likelihood of waking up over five times a nights, and greater difficulty falling asleep than subjects without chronic pain. (Ohayon and Roth, 2003)

In conclusion, Dr. Rosenberg’s talk exposed the importance of studying the relationship between sleep and pain. The field is still in its infancy and there are still many questions left unanswered. Solutions to some of these questions could greatly enhance the well-being of many who suffer from pain and sleep problems.