![]() Neuropathic pain is also associated with sleep disturbances, and there is a strong bidirectional relationship between sleep disturbances and neuropathic features of pain. 5 Daytime fatigue and non-restorative sleep are common complaints among patients who have fibromyalgia, and these polysomnogram findings are consistent with inadequate sleep quality, even when patients might seem to have slept for an adequate number of hours. 1 Patients with fibromyalgia have reduced short-wave sleep and abnormal α-rhythms, with episodes of wakefulness during non-REM sleep. 4 This observation suggests that the pain itself (rather than the general anesthetic wearing off) is at least a contributing factor to post-operative pain-associated sleep disturbances.įibromyalgia is frequently associated with sleep disturbances. Changes are noted not only after general anesthesia, but also after regional anesthesia. ![]() Research into various pain syndromes and their physiological impact on sleep provide a range of insights into the ways that pain interferes with sleep.įor example, acute post-surgical pain also has quantifiable effects on sleep, including a measurable decrease in the time spent in the rapid eye movement phase (REM) of sleep. Furthermore, the impact of chronic pain on sleep appears to be multidimensional. There is a variability in chronic pain diagnoses, and the distinctive types of pain syndromes affect sleep differently. Pain is an obvious distraction that makes it hard to fall asleep and can lead to waking up at night, especially when pain medication wears off. However, pain also interferes with the physiology of sleep in targeted ways that go beyond the conscious distraction caused by the discomfort. There are several mechanisms by which pain interferes with sleep. 3 It is notable that the 3 most commonly observed sleep disorders added up to greater than 100%, underscoring the fact that chronic pain can be associated with more than 1 type of sleep disturbance at a time ( Table). A large meta-analysis noted a high prevalence of other sleep disruptions as well, with the 3 most common being insomnia at 72%, restless leg syndrome with a prevalence of 32%, and obstructive sleep apnea with a prevalence of 32%. Insomnia is the most commonly noted sleep disorder associated with chronic pain. 2 There is also a potential a dose-response link between the intensity of pain and its impact on sleep. For example, a study revealed 53% of participants with chronic pain met criteria for insomnia, while only 3% of the pain-free controls met the criteria. It is estimated that between 50% to 80% of those living with chronic pain experience sleep disruption. Sleep disturbances caused by chronic pain Treatment of sleep issues caused by chronic pain is individualized and multifaceted and must take the chronic pain condition, the specific sleep disturbance, and the psychiatric sequalae into account. Evaluation of sleep disturbances in the context of chronic pain requires a comprehensive assessment of subjective symptoms and objective tests, such as sleep questionnaires and an overnight polysomnogram. A pain management strategy may also require dedicated attention to sleep quality and sleep quantity. Restorative sleep is a benefit of effective pain management. 1 More recent research attempts to elucidate the contributing factors and address treatment planning. Chronic pain can lead to prolonged sleep deprivation that can have physical, emotional, and behavioral complications. For example, in the rheumatologic literature, it has long been noted that there is an association between chronic musculoskeletal pain, sleep disruption, and depression. The symptoms can begin to manifest as soon as the day after a night of inadequate sleep. Brief bouts of pain-such as pain due to a traumatic injury or a short-lived medical issue-can cause almost immediate adverse effects on daytime functioning and alertness. Pain has a substantial impact on sleep, and an insufficient amount of restful sleep can increase pain susceptibility. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |