The Chronic Pain Connection: Analgesics Won't Pay for Sleep Debt

Degree of Alertness Connected to Pain Sensitivity from Sleep Loss

New research on mouse models may provide a greater understanding of the connection between pain intensity and sleep loss, a topic that has been explored in the past by various members of the PAINWeek faculty. Sleep psychologist Chloe Alexandre, PhD, and pain psychologist Alban Latremoliere, PhD, led a study concluding that decreased alertness due to chronic sleep loss is associated with an increase in pain sensitivity. In the study, sleep loss was induced through the introduction of additional mental stimuli, to mimic the causal factors for sleep reduction in humans. Pain sensitivity, as measured by the application of heat, cold, pressure, or capsaicin, was found to be significantly aggravated in this mouse population after one week of sleep loss. The findings were published online earlier this month in the journal Nature Medicine.

The team found that sleep loss, but not sleep fragmentation, increased the sensitivity of otherwise healthy mice to noxious stimuli, and that repeated sleep loss led to an accumulated sleep debt that tended to exaggerate this sensitivity. The study found that the wake-promoting agents caffeine and modafinil normalized pain sensitivity in the sleep deprived mice, revealing an unsuspected role for alertness in determining pain sensitivity. The authors write that “Clinically, insufficient or poor-quality sleep may worsen pain and this enhanced pain may be reduced not by analgesics, whose effectiveness is reduced, but by increasing alertness or providing better sleep.” Concurring with the finding, sleep disorder specialist Kiran Maski, MD, commented, "Many patients with chronic pain suffer from poor sleep and daytime fatigue, and some pain medications themselves can contribute to these co-morbidities."

Read more about the findings.

The journal abstract may be read here.

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