How Pain and Analgesics Disturb Sleep

Abstract

If many factors, including pain, disease process per se, as well as medication, could disturb sleep, sleep disturbances may also adversely affect the natural course of the painful disease. Improving sleep quantity and quality in patients with painful disorders may break this vicious circle and as consequence enhance the patients' overall health and quality of life.

Postoperative Sleep Disturbances after Zolpidem Treatment in Fast-Track Hip and Knee Replacement

“…Furthermore, an especially important aspect in elderly patients is the detrimental effect on cognition by sleep deprivation. 5,6,9,11,[21][22][23] We also aimed to evaluate the patients' well-being and level of fatigue to illustrate their energy levels, since active participation in physical rehabilitation and training is a cornerstone in the fast-track setup with length of stay less than 3 days. Though we cannot explain the significantly better scores on fatigue and sleep quality in the zolpidem group by any of our objective findings from the PSG data on sleep duration, it does correlate well with the fact that the zolpidem group also experienced significantly fewer arousals on the postoperative night.…”

“…However, we did not find a difference in either pain or use of opioids for the first 24 hours after surgery to explain the differences in arousals and fatigue, despite the fact that pain, inflammation, and opioids may all affect sleep in a negative way. [6][7][8]10,22 Although we used a multimodal opioid-sparing analgesic regimen, the patients received morphine (< 20 mg/24h), which may have influenced sleep. 8 Total sleep time and distribution of sleep stages were not modified by zolpidem after surgery.…”

“…3,4 Sleep in the postoperative period is affected by many factors, and postoperative pain has a major negative impact. 5,6 In addition an intricate relationship exists between sleep, opioids, and pain, where reduced sleep can lead to hyperalgesia and increased opioid demand, and opioid per se has a negative impact on sleep architectur e. [7][8][9][10] Finally, postoperative sleep disturbances may contribute to delirium and cognitive dysfuncti on. 11,12 Since previous studies have shown that sleep, especially REM sleep, is severely disturbed immediately after major surge ry, 1-4 we hypothesized that a short-acting hypnotic might play a role in preserving sleep architecture immediately after sur gery, [13][14][15] and possibly affect pain and overall well-being following major joint replacement surgery in an elderly population.…”

Effects of Acute Sleep Deprivation Resulting from Night Shift Work on Young Doctors

“…8 Deficient sleep also may be associated to greater emotional lability with increased anxiety and depression. 9 Dinges, 10 among others, have shown that sleep deprivation is associated with an increased incidence of traffic accidents, 11 comparable to driving under the influence of alcohol.…”

Nocturnal Enuresis in Children and Adolescent with Sickle cell Anemia

“…Vitamin D deficiency in children and an adolescent with SCA was associated with painful crisis [146]. Pain literature had shown than nocturnal pain disturbed sleep [147]. A subjective sleepiness can accompany the relative elevation of the levels of inflammatory mediators as part of immune dysregulation that is proposed to occur with low 25(OH) D [148].…”