Sex differences in measures of central sensitization and pain sensitivity to experimental sleep disruption: implications for sex differences in chronic pain

Smith, Michael T.; Remeniuk, Bethany; Finan, Patrick H.; Speed, Traci J.; Tompkins, D. Andrew; Robinson, Marc; Gonzalez, Kaylin; Bjurström, Martin F.; Irwin, Michael R.

doi:10.1093/sleep/zsy209

Cited by 73 publications

(70 citation statements)

References 110 publications

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“…Emerging evidence shows that sleep fragmentation and total sleep deprivation may impair descending pain‐inhibitory capacity . We have recently found that 2 consecutive nights of forced awakenings enhances measures of central sensitization in a sex‐dependent manner such that males experience enhanced secondary hyperalgesia while females demonstrate enhanced temporal summation . Also, cross‐sectional studies have shown that decreased sleep efficiency and sleep disturbance are associated with heightened temporal summation .…”

Section: Discussionmentioning

confidence: 96%

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Bjurström

Irwin

2019

Pain Practice

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Background: Sleep macrostructure is commonly disturbed after surgery. Postoperative pain control remains challenging. Given the bidirectional interaction between sleep and pain, understanding the role of modulation of sleep during the perioperative period on postoperative pain is needed. Methods: This was a systematic review. Controlled trials examining the effects of perioperative sleep-promoting pharmacological agents on postoperative pain and analgesic consumption were identified through a systematic search strategy utilizing multiple electronic databases. Results: Fourteen studies (9 melatonin, 5 zolpidem) involving 921 patients (melatonin n = 586, zolpidem n = 335) were included. Compared to placebo, melatonin reduced postoperative pain scores by ≥30% and significantly decreased opioid consumption in 3 studies (postoperative day [POD]

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Section: Discussionmentioning

confidence: 96%

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Bjurström

Irwin

2019

Pain Practice

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“…It is unclear why the association is stronger among women than men, but it has been suggested that there exists an interplay between insomnia and female gender on pain,22 possibly explained by a female predisposition to both pain and insomnia 23 24. Furthermore, it has been shown that sleep disruption amplifies central sensitisation in women and men differently, suggesting that there exists sex-specific differences for the association between poor sleep and development of chronic pain 9. However, we cannot exclude the possibility that these sex-differences may be due to chance.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that insomnia symptoms increase the risk of chronic LBP5 and that poor sleep is associated with subsequent pain intensity6 and persistence of pain7 in people with LBP. Furthermore, experimental studies have revealed a possible pathway between poor sleep and pain by showing that sleep deprivation leads to elevated levels of pro-inflammatory cytokines8 and alterations in central pain processing 9. One observational study has shown that occasional LBP and co-existing sleep problems are associated with higher risk of troublesome LBP 10.…”

Section: Introductionmentioning

confidence: 99%

Influence of sleep problems and co-occurring musculoskeletal pain on long-term prognosis of chronic low back pain: the HUNT Study

Skarpsno¹,

Mork

Nilsen³

et al. 2019

J Epidemiol Community Health

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BackgroundWe investigated the influence of sleeplessness and number of insomnia symptoms on the probability of recovery from chronic low back pain (LBP), and the possible interplay between sleeplessness and co-occurring musculoskeletal pain on this association.MethodsThe study comprised data on 3712 women and 2488 men in the Norwegian HUNT study who reported chronic LBP at baseline in 1995–1997. A modified Poisson regression model was used to calculate adjusted risk ratios (RRs) for the probability of recovery from chronic LBP at follow-up in 2006–2008, associated with sleep problems and co-occurring musculoskeletal pain at baseline.ResultsCompared with persons without sleeplessness, persons who often/always experienced sleeplessness had a lower probability of recovery from chronic LBP (RR 0.65, 95% CI 0.57 to 0.74 in women and RR 0.81, 95% CI 0.69 to 0.95 in men). Although there was no clear evidence of statistical interaction between sleeplessness and co-occurring musculoskeletal pain, women and men who often/always experienced sleeplessness and had ≥5 additional chronic pain sites had RRs of recovery of 0.40 (95% CI 0.33 to 0.48) and 0.59 (95% CI 0.45 to 0.78), respectively, compared with persons without sleeplessness and 1–2 chronic pain sites.ConclusionThese findings suggest that preventing or reducing sleep problems among people with chronic LBP may have the potential of improving the long-term prognosis of this condition, also among those with several additional pain sites.

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“…First, it was a generally young sample, so we were unable to probe differences in reward learning across the developmental spectrum. Second, although we have found sex differences in other effects of sleep disruption, such as pain sensitivity [55], we did not have a large enough sample to examine whether sex moderated the interaction of sleep condition and positive affective response. Third, we only assessed changes in reward learning after a single night of sleep disruption and were, therefore, unable to characterize dose-response effects or the possible reversibility of reward learning changes with recovery sleep.…”

Section: Discussionmentioning

confidence: 91%

Experimental sleep disruption and reward learning: moderating role of positive affect responses

Finan

Whitton

Letzen

et al. 2019

Sleep

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Study Objectives: Sleep disturbances increase vulnerability for depression, but the mechanisms underlying this relationship are not well known. We investigated the effects of experimental sleep disruption on response bias (RB), a measure of reward learning previously linked to depression, and the moderating role of positive affect responses. Methods: Participants (N = 42) were healthy adults enrolled in a within-subject crossover sleep disruption experiment that incorporated one night of uninterrupted sleep (US) and one night of forced awakenings (FA) in random order. On the day following each experimental sleep night, participants completed a probabilistic reward task to assess RB, and the Positive and Negative Affect Schedule-X. Participants were subgrouped according to positive affect responses: Preserved Positive Affect (i.e. positive affect scores maintained or increased; n = 15) or Reduced Positive Affect (i.e. positive affect scores decreased; n = 27) following FA. Results: Contrary to our hypotheses, across participants, RB did not significantly differ between the US and FA sleep conditions (p = .67). However, the effect of sleep condition on RB was moderated by positive affect response (p = .01); those with preserved positive affect showed heightened RB following FA, whereas those with reduced positive affect showed diminished RB following FA. Changes in negative affect between US and FA did not moderate RB. Conclusion: The inability to preserve positive affect through periods of sleep disruption may be a marker of diminished reward learning capability. Understanding how sleep disruption impacts positive affect responses and reward learning identifies a pathway by which sleep disturbances may confer risk for depression.

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Sex differences in measures of central sensitization and pain sensitivity to experimental sleep disruption: implications for sex differences in chronic pain

Cited by 73 publications

References 110 publications

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Perioperative Pharmacological Sleep‐Promotion and Pain Control: A Systematic Review

Influence of sleep problems and co-occurring musculoskeletal pain on long-term prognosis of chronic low back pain: the HUNT Study

Experimental sleep disruption and reward learning: moderating role of positive affect responses

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