Skip to main content

Advertisement

SpringerLink
Log in

Do Sleep Disorders Contribute to Pain Sensitivity?

  • Rheumatic Manifestations of Other Diseases (Roland Staud, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Sleep disturbance is one of the most common comorbid problems for chronic pain patients. The association between the two phenomena has long been recognized, but the nature of the relationship is not well-understood. Many agree that the relationship is likely bidirectional. In this review, we focus on one side of the relationship: whether and how disordered sleep adversely impacts pain. We discuss the available evidence from the epidemiologic, clinical, and human, as well as infrahuman laboratory studies. Generally, the literature supports the positive relationship between poor sleep and increased pain. Sleep deprivation also seems to attenuate analgesic effects of medications. Research delineating the causal or associative relationship between sleep and pain is still preliminary at this time. Continuing efforts in both experimental and clinical research are needed to develop a translationally meaningful understanding of how poor sleep impacts pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Johnson EO, Roth T, Schultz L, Breslau N. Epidemiology of DSM-IV insomnia in adolescence: lifetime prevalence, chronicity, and an emergent gender difference. Pediatrics. 2006;117(2):e247–56.

    Article  PubMed  Google Scholar 

  2. National Sleep Foundation: Summary of Findings: Sleep in America Poll. Washington, DC; 2005.

  3. Orzel-Gryglewska J. Consequences of sleep deprivation. Int J Occup Med Environ Health. 2010;23(1):95–114.

    Article  PubMed  Google Scholar 

  4. Sivertsen B, Krokstad S, Overland S, Mykletun A. The epidemiology of insomnia: associations with physical and mental health. The HUNT-2 study. J Psychosom Res. 2009;67(2):109–16.

    Article  PubMed  Google Scholar 

  5. Tang NK, Wright KJ, Salkovskis PM. Prevalence and correlates of clinical insomnia co-occurring with chronic back pain. J Sleep Res. 2007;16(1):85–95.

    Article  PubMed  Google Scholar 

  6. McCracken LM, Iverson GL. Disrupted sleep patterns and daily functioning in patients with chronic pain. Pain Res Manag. 2002;7(2):75–9.

    PubMed  Google Scholar 

  7. Smith MT, Wickwire EM, Grace EG, et al. Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder. Sleep. 2009;32(6):779–90.

    PubMed  Google Scholar 

  8. Theadom A, Cropley M, Humphrey KL. Exploring the role of sleep and coping in quality of life in fibromyalgia. J Psychosom Res. 2007;62(2):145–51.

    Article  PubMed  Google Scholar 

  9. Okifuji A, Turk DC. Stress and psychophysiological dysregulation in patients with fibromyalgia syndrome. Appl Psychophysiol Biofeedback. 2002;27(2):129–41.

    Article  PubMed  Google Scholar 

  10. Lautenbacher S, Kundermann B, Krieg JC. Sleep deprivation and pain perception. Sleep Med Rev. 2006;10(5):357–69.

    Article  PubMed  Google Scholar 

  11. Delgado-Guay M, Yennurajalingam S, Parsons H, Palmer JL, Bruera E: Association between self-reported sleep disturbance and other symptoms in patients with advanced cancer. J Pain Symptom Manage. 2011.

  12. Raymond I, Nielsen TA, Lavigne G, Manzini C, Choiniere M. Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patients. Pain. 2001;92(3):381–8.

    Article  PubMed  CAS  Google Scholar 

  13. Luyster FS, Chasens ER, Wasko MC, Dunbar-Jacob J. Sleep quality and functional disability in patients with rheumatoid arthritis. J Clin Sleep Med. 2011;7(1):49–55.

    PubMed  Google Scholar 

  14. Lovati C, D’Amico D, Bertora P, et al. Correlation between presence of allodynia and sleep quality in migraineurs. Neurol Sci. 2010;31 Suppl 1:S155–8.

    Article  PubMed  Google Scholar 

  15. O’Brien EM, Waxenberg LB, Atchison JW, et al. Negative mood mediates the effect of poor sleep on pain among chronic pain patients. Clin J Pain. 2010;26(4):310–9.

    Article  PubMed  Google Scholar 

  16. Vendrame M, Kaleyias J, Valencia I, Legido A, Kothare SV. Polysomnographic findings in children with headaches. Pediatr Neurol. 2008;39(1):6–11.

    Article  PubMed  Google Scholar 

  17. Okifuji A, Hare BD. Nightly analyses of subjective and objective (actigraphy) measures of sleep in fibromyalgia syndrome: what accounts for the discrepancy? Clin J Pain. 2011;27(4):289–96.

    Article  PubMed  Google Scholar 

  18. Carette S, Oakson G, Guimont C, Steriade M. Sleep electroencephalography and the clinical response to amitriptyline in patients with fibromyalgia. Arthritis Rheum. 1995;38(9):1211–7.

    Article  PubMed  CAS  Google Scholar 

  19. Chervin RD, Teodorescu M, Kushwaha R, et al. Objective measures of disordered sleep in fibromyalgia. J Rheumatol. 2009;36(9):2009–16.

    Article  PubMed  Google Scholar 

  20. Burns JW, Crofford LJ, Chervin RD. Sleep stage dynamics in fibromyalgia patients and controls. Sleep Med. 2008;9(6):689–96.

    Article  PubMed  Google Scholar 

  21. Haack M, Mullington JM. Sustained sleep restriction reduces emotional and physical well-being. Pain. 2005;119(1–3):56–64.

    Article  PubMed  Google Scholar 

  22. Edwards RR, Almeida DM, Klick B, Haythornthwaite JA, Smith MT. Duration of sleep contributes to next-day pain report in the general population. Pain. 2008;137(1):202–7.

    Article  PubMed  Google Scholar 

  23. Affleck G, Urrows S, Tennen H, Higgins P, Abeles M. Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia. Pain. 1996;68(2–3):363–8.

    Article  PubMed  CAS  Google Scholar 

  24. Lewandowski AS, Palermo TM, De la Motte S, Fu R. Temporal daily associations between pain and sleep in adolescents with chronic pain versus healthy adolescents. Pain. 2010;151(1):220–5.

    Article  PubMed  Google Scholar 

  25. O’Brien EM, Waxenberg LB, Atchison JW, et al. Intraindividual variability in daily sleep and pain ratings among chronic pain patients: bidirectional association and the role of negative mood. Clin J Pain. 2011.

  26. Lee YC, Chibnik LB, Lu B, et al. The relationship between disease activity, sleep, psychiatric distress and pain sensitivity in rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther. 2009;11(5):R160.

    Article  PubMed  Google Scholar 

  27. • Campbell CM, Bounds SC, Simango MB, et al. Self-reported sleep duration associated with distraction analgesia, hyperemia, and secondary hyperalgesia in the heat-capsaicin nociceptive model. Eur J Pain 2010. Although sleep deprivation was not experimentally controlled, the study shows hyperalgesia as well as secondary hyperalgesia in response to the heat-capsaicin testing in healthy people following chronic sleep restriction. The results also suggest that sleep restriction may interfere with distraction analgesia.

  28. Tracey I, Ploghaus A, Gati JS, et al. Imaging attentional modulation of pain in the periaqueductal gray in humans. J Neurosci. 2002;22(7):2748–52.

    PubMed  CAS  Google Scholar 

  29. Kundermann B, Krieg JC, Schreiber W, Lautenbacher S. The effect of sleep deprivation on pain. Pain Res Manag. 2004;9(1):25–32.

    PubMed  Google Scholar 

  30. Nascimento DC, Andersen ML, Hipolide DC, Nobrega JN, Tufik S. Pain hypersensitivity induced by paradoxical sleep deprivation is not due to altered binding to brain mu-opioid receptors. Behav Brain Res. 2007;178(2):216–20.

    Article  PubMed  CAS  Google Scholar 

  31. •• Damasceno F, Skinner GO, Gomes A, Araujo PC, de Almeida OM. Systemic amitriptyline administration does not prevent the increased thermal response induced by paradoxical sleep deprivation. Pharmacol Biochem Behav. 2009; 94(1): 51–5. This was a well-designed animal study demonstrating the attenuating effects of sleep deprivation on analgesia by amitriptyline.

    Article  PubMed  CAS  Google Scholar 

  32. Moldofsky H, Scarisbrick P, England R, Smythe H. Musculosketal symptoms and non-REM sleep disturbance in patients with “fibrositis syndrome” and healthy subjects. Psychosom Med. 1975;37(4):341–51.

    PubMed  CAS  Google Scholar 

  33. Moldofsky H, Scarisbrick P. Induction of neurasthenic musculoskeletal pain syndrome by selective sleep stage deprivation. Psychosom Med. 1976;38(1):35–44.

    PubMed  CAS  Google Scholar 

  34. Lentz MJ, Landis CA, Rothermel J, Shaver JL. Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women. J Rheumatol. 1999;26(7):1586–92.

    PubMed  CAS  Google Scholar 

  35. Onen SH, Alloui A, Gross A, Eschallier A, Dubray C. The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects. J Sleep Res. 2001;10(1):35–42.

    Article  PubMed  CAS  Google Scholar 

  36. Kundermann B, Spernal J, Huber MT, Krieg JC, Lautenbacher S. Sleep deprivation affects thermal pain thresholds but not somatosensory thresholds in healthy volunteers. Psychosom Med. 2004;66(6):932–7.

    Article  PubMed  Google Scholar 

  37. •• Tiede W, Magerl W, Baumgartner U, Durrer B, Ehlert U, Treede RD. Sleep restriction attenuates amplitudes and attentional modulation of pain-related evoked potentials, but augments pain ratings in healthy volunteers. Pain 2010; 148(1): 36–42. This was an elegantly done study evaluating the increased hyperalgesia and decreased evoked potential response following sleep deprivation. The results may have a significant implication for the mechanisms underlying the effects of sleep deprivation on pain sensitivity.

    Article  PubMed  Google Scholar 

  38. Davies KA, Macfarlane GJ, Nicholl BI, et al. Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology (Oxford). 2008;47(12):1809–13.

    Article  CAS  Google Scholar 

  39. Onen SH, Onen F, Albrand G, Decullier E, Chapuis F, Dubray C. Pain tolerance and obstructive sleep apnea in the elderly. J Am Med Dir Assoc. 2010;11(9):612–6.

    Article  PubMed  Google Scholar 

  40. Okifuji A, Ashburn M. Fibromyalgia syndrome: Toward an integration of the literature. Crit Rev Phys Rehabil Med. 2001;13(1):27–54.

    Google Scholar 

  41. Edinger JD, Wohlgemuth WK, Krystal AD, Rice JR. Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial. Arch Intern Med. 2005;165(21):2527–35.

    Article  PubMed  Google Scholar 

  42. Miro E, Lupianez J, Martinez MP, et al. Cognitive-behavioral therapy for insomnia improves attentional function in fibromyalgia syndrome: a pilot, randomized controlled trial. J Health Psychol 2011.

  43. Russell IJ, Holman AJ, Swick TJ, Alvarez-Horine S, Wang YG, Guinta D. Sodium oxybate reduces pain, fatigue, and sleep disturbance and improves functionality in fibromyalgia: results from a 14-week, randomized, double-blind, placebo-controlled study. Pain. 2011;152(5):1007–17.

    Article  PubMed  CAS  Google Scholar 

  44. Scharf MB, Baumann M, Berkowitz DV. The effects of sodium oxybate on clinical symptoms and sleep patterns in patients with fibromyalgia. J Rheumatol. 2003;30(5):1070–4.

    PubMed  CAS  Google Scholar 

  45. Mullington JM, Simpson NS, Meier-Ewert HK, Haack M. Sleep loss and inflammation. Best Pract Res Clin Endocrinol Metab. 2010;24(5):775–84.

    Article  PubMed  CAS  Google Scholar 

  46. Wei H, Ma A, Wang YX, Pertovaara A. Role of spinal 5-HT receptors in cutaneous hypersensitivity induced by REM sleep deprivation. Pharmacol Res. 2008;57(6):469–75.

    Article  PubMed  CAS  Google Scholar 

  47. Turk DC, Okifuji A. Psychological factors in chronic pain: evolution and revolution. J Consult Clin Psychol. 2002;70(3):678–90.

    Article  PubMed  Google Scholar 

  48. Okifuji A, Donaldson GW. Use of ecological momentary assessment to monitor fibromyalgia. Pain Manage 2011 (in press).

Download references

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

  1. Pain Research and Management Center, Department of Anesthesiology, University of Utah, 615 Arapeen Drive, Suite 200, Salt Lake City, UT, 84108, USA

    Akiko Okifuji

  2. Department of Anesthesiology, University of Utah, 30 N 1900 E, Room 3C444, Salt Lake City, UT, 84132, USA

    Bradford D. Hare

Authors
  1. Akiko Okifuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bradford D. Hare
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akiko Okifuji.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Okifuji, A., Hare, B.D. Do Sleep Disorders Contribute to Pain Sensitivity?. Curr Rheumatol Rep 13, 528–534 (2011). https://doi.org/10.1007/s11926-011-0204-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11926-011-0204-8

Keywords

Search

Navigation