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Sleep Disturbance Increases Spontaneous Pain in Women

Sleep continuity disturbance impairs endogenous pain-inhibitory function and increases spontaneous pain in women. This supports a possible pathophysiologic role of sleep disturbance in chronic pain, according to a study in the April 1 issue of the journal Sleep.

The study, conducted by Michael T. Smith, PhD, and colleagues at John's Hopkins University, Baltimore, focused on 32 healthy females, who were studied with polysomnography for seven nights. On the first two nights, the subjects slept undisturbed for eight hours. Then, the women were assigned to one of three groups: control, forced awakening (FA), and restricted sleep opportunity (RSO).

From nights three to five, the control group continued to sleep undisturbed, while the FA group underwent eight forced awakenings, one per hour, and the RSO group received partial sleep deprivation by delayed bedtime. On night six, both the FA and RSO groups underwent 36 hours of total sleep deprivation, followed by 11-hour recovery sleep.

In an assessment of the subjects' completion of twice-daily psychophysical assessments of mechanical pain thresholds and pain inhibition, the FA group demonstrated an increase in spontaneous pain. Neither the control nor the RSO group showed changes in pain inhibition or spontaneous pain during partial sleep deprivation.

"This study finds that fragmented sleep profiles, akin to individuals suffering from middle-of-the-night insomnia, health care workers on call, and parents caring for infants, alter natural systems that regulate and control pain, and can lead to spontaneous painful symptoms," Dr. Smith said. "Our research shows that disrupted sleep, marked by multiple prolonged awakenings, impairs natural pain control mechanisms that are thought to play a key role in the development, maintenance, and exacerbation of chronic pain."


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