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Polysomnographic characteristics in nonmalignant chronic pain populations : A review of controlled studies

Bjurstrom, Martin F LU and Irwin, Michael R (2016) In Sleep Medicine Reviews 26. p.74-86
Abstract

Sleep and pain are critical homeostatic systems that interact in a bidirectional manner. Complaints of sleep disturbance are ubiquitous among patients with chronic pain disorders, and conversely, patients with persistent insomnia symptoms commonly report suffering from chronic pain. Sleep deprivation paradigms demonstrate that partial or complete sleep loss induce hyperalgesia, possibly due to shared mechanistic pathways including neuroanatomic and molecular substrates. Further, chronic pain conditions and sleep disturbances are intertwined through comorbidities, which together cause detrimental psychological and physical consequences. This critical review examines 29 polysomnography studies to evaluate whether nonmalignant chronic pain... (More)

Sleep and pain are critical homeostatic systems that interact in a bidirectional manner. Complaints of sleep disturbance are ubiquitous among patients with chronic pain disorders, and conversely, patients with persistent insomnia symptoms commonly report suffering from chronic pain. Sleep deprivation paradigms demonstrate that partial or complete sleep loss induce hyperalgesia, possibly due to shared mechanistic pathways including neuroanatomic and molecular substrates. Further, chronic pain conditions and sleep disturbances are intertwined through comorbidities, which together cause detrimental psychological and physical consequences. This critical review examines 29 polysomnography studies to evaluate whether nonmalignant chronic pain patients, as compared to controls, show differences in objective measures of sleep continuity and sleep architecture. Whereas these controlled studies did not reveal a consistent pattern of objective sleep disturbances, alterations of sleep continuity were commonly reported. Alterations of sleep architecture such as increases in light sleep or decreases in slow-wave sleep were less commonly reported and findings were mixed and also inconsistent. Methodological flaws were identified, which complicated interpretation and limited conclusions; hence, recommendations for future research are suggested. Knowledge of abnormalities in the sleep process has implications for understanding the pathophysiology of chronic pain conditions, which might also direct the development of novel intervention strategies.

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subject
keywords
Chronic Pain, Comorbidity, Humans, Polysomnography, Randomized Controlled Trials as Topic, Sleep Deprivation, Sleep Initiation and Maintenance Disorders, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review
in
Sleep Medicine Reviews
volume
26
pages
13 pages
publisher
Elsevier
external identifiers
  • pmid:26140866
  • scopus:84946471082
ISSN
1087-0792
DOI
10.1016/j.smrv.2015.03.004
language
English
LU publication?
no
id
75320236-84c0-484b-8361-30cb8526a1c1
date added to LUP
2018-04-26 11:09:51
date last changed
2024-06-25 16:24:08
@article{75320236-84c0-484b-8361-30cb8526a1c1,
  abstract     = {{<p>Sleep and pain are critical homeostatic systems that interact in a bidirectional manner. Complaints of sleep disturbance are ubiquitous among patients with chronic pain disorders, and conversely, patients with persistent insomnia symptoms commonly report suffering from chronic pain. Sleep deprivation paradigms demonstrate that partial or complete sleep loss induce hyperalgesia, possibly due to shared mechanistic pathways including neuroanatomic and molecular substrates. Further, chronic pain conditions and sleep disturbances are intertwined through comorbidities, which together cause detrimental psychological and physical consequences. This critical review examines 29 polysomnography studies to evaluate whether nonmalignant chronic pain patients, as compared to controls, show differences in objective measures of sleep continuity and sleep architecture. Whereas these controlled studies did not reveal a consistent pattern of objective sleep disturbances, alterations of sleep continuity were commonly reported. Alterations of sleep architecture such as increases in light sleep or decreases in slow-wave sleep were less commonly reported and findings were mixed and also inconsistent. Methodological flaws were identified, which complicated interpretation and limited conclusions; hence, recommendations for future research are suggested. Knowledge of abnormalities in the sleep process has implications for understanding the pathophysiology of chronic pain conditions, which might also direct the development of novel intervention strategies. </p>}},
  author       = {{Bjurstrom, Martin F and Irwin, Michael R}},
  issn         = {{1087-0792}},
  keywords     = {{Chronic Pain; Comorbidity; Humans; Polysomnography; Randomized Controlled Trials as Topic; Sleep Deprivation; Sleep Initiation and Maintenance Disorders; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review}},
  language     = {{eng}},
  pages        = {{74--86}},
  publisher    = {{Elsevier}},
  series       = {{Sleep Medicine Reviews}},
  title        = {{Polysomnographic characteristics in nonmalignant chronic pain populations : A review of controlled studies}},
  url          = {{http://dx.doi.org/10.1016/j.smrv.2015.03.004}},
  doi          = {{10.1016/j.smrv.2015.03.004}},
  volume       = {{26}},
  year         = {{2016}},
}