Investigation of pain sensitivity following 3 nights of disrupted sleep in healthy individuals

Abstract

Background Poor quality sleep is a common complaint among people with chronic pain. The co‐occurrence of poor sleep quality and chronic pain often comes with increased pain intensity, more disability and a higher cost of healthcare. Poor sleep has been suggested to affect measures of peripheral and central pain mechanisms. To date, sleep provocations are the only models proven to affect measures of central pain mechanisms in healthy subjects. However, there are limited studies investigating the effect of several nights of sleep disruption on measures of central pain mechanisms. Methods The current study implemented three nights of sleep disruption with three planned awakenings per night in 30 healthy subjects sleeping at home. Pain testing was conducted at the same time of day at baseline and follow‐up for each subject. Pressure pain thresholds were assessed bilaterally on the infraspinatus and gastrocnemius muscles. Using handheld pressure algometry, suprathreshold pressure pain sensitivity and area were also investigated on the dominant infraspinatus muscle. Cuff‐pressure pain detection and tolerance thresholds, temporal summation of pain and conditioned pain modulation were investigated using cuff‐pressure algometry. Results Temporal summation of pain was significantly facilitated (p = 0.022), suprathreshold pain areas (p = 0.005) and intensities (p < 0.05) were significantly increased, and all pressure pain thresholds were decreased (p < 0.005) after sleep disruption compared to baseline. Conclusions The current study found that three consecutive nights of sleep disruption at home induced pressure hyperalgesia and increased measures of pain facilitation in healthy subjects, which is consistent with previous findings. Significance Poor quality of sleep is often experienced by patients with chronic pain, with the most common complaint being nightly awakenings. This exploratory study is the first to investigate changes in measures of central and peripheral pain sensitivity in healthy subjects after sleep disruptions for three consecutive nights without any restrictions on total sleep time. The findings suggest that disruptions to sleep continuity in healthy individuals can induce increased sensitivity to measures of central and peripheral pain sensitization.

Personalized assessment and management of non‐specific low back pain

“…Another example of the close interaction between psychosocial and biological factors is the Hypothalamic-Pituitary-Adrenal Stress (HPA) axis: there is evidence that increased reactivity of the HPA axis, caused, for example, by childhood adversities (Tidmarsh et al, 2022), can predispose to chronic pain (McBeth et al, 2005(McBeth et al, , 2007. In addition, the HPA-axis might be the link between sleep deprivation and hyperalgesia (de Oliveira et al, 2017;Hertel et al, 2023;van Dalfsen & Markus, 2018).…”