(175) Mechanisms between Sleep and Pain – What Do We Know from Studies of Mediation?

Whibley, Daniel; AlKandari, Nourah; Kristensen, Kaja; Barnish, Max; Rzewuska, Magdalena; Druce, Katie L; Tang, Nicole K. Y.

doi:10.1016/j.jpain.2019.01.095

Cited by 7 publications

(6 citation statements)

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“…Pain can result in depression and sleep disturbances, which have been reported to interact with each other. [40][41][42] Furthermore, in contrast to the findings in patients with depression or pain alone, patients with pain and depression have been reported to experience a greater decrease in physical, mental, and social functioning. [43] In our study, compared with NTM-PD patients without pain, those with pain were significantly more likely to be prescribed anxiolytics/sedatives/ hypnotics, or at least 1 pain or pain-related medication.…”

Section: Discussionmentioning

confidence: 91%

Effects of pain on depression, sleep, exercise tolerance, and quality of life in patients with nontuberculous mycobacterial pulmonary disease

et al. 2021

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The experience and causes of pain in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) have not been clarified. This study aimed to determine the prevalence and severity of bodily pain (BP) in patients with NTM-PD. We also investigated the clinical indicators that contribute to pain. We used a retrospective cross-sectional study design. The participants were 114 NTM-PD patients (109 women) with a mean age of 65 years. The prevalence and severity of pain were measured using 2 items from the 36-Item Short Form Survey version 2 (SF-36), and the BP score was calculated. Functional limitation due to dyspnea was quantified using the Modified Medical Research Council Dyspnea Scale (mMRC), depression was assessed using the Center for Epidemiological Studies Depression Scale (CES-D), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); health-related quality of life was assessed using the Leicester Cough Questionnaire (LCQ), and exercise tolerance was measured using the Incremental Shuttle Walk Test (ISWT). Pain was reported by 70.2% of the patients (n = 80), and of these, 35.7% (n = 25) reported moderate to very severe pain. NTM-PD patients with high levels of pain had significantly higher scores on the mMRC, CES-D, and PSQI scores, and significantly lower performance on the ISWT and LCQ. Multiple regression analysis identified ISWT, CES-D, and PSQI as independent factors that affected BP scores. Our findings suggest that pain significantly impacts daily life associated with reduced exercise tolerance, the presence of depressive symptoms, and poor sleep quality in patients with NTM-PD.

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Section: Discussionmentioning

confidence: 91%

Effects of pain on depression, sleep, exercise tolerance, and quality of life in patients with nontuberculous mycobacterial pulmonary disease

et al. 2021

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“…Whibley et al, did a systematic review of these mediation studies and concluded that they, while suggestive, could not be considered conclusive because of limitations in the methods (eg, most studies have been cross-sectional. 53 More recently, Krause et al, examined 25 healthy adults with a balanced, repeated measures experimental design using functional MRI (fMRI). In this study, the participants were subject to 1 night of sleep deprivation and had pain thresholds (using a standard thermal test) determined while in the fMRI scanner.…”

Section: Discussionmentioning

confidence: 99%

Lengthening sleep reduces pain in childhood arthritis: a crossover randomised controlled trial

Clairman,

Dover,

Tomlinson

et al. 2023

RMD Open

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ObjectivesJuvenile idiopathic arthritis (JIA) is a common chronic childhood disease and chronic pain is a debilitating feature. A strong link has been shown between poor sleep and pain in JIA. However, the causal direction is unknown. This study’s aim was to determine if, in adolescents with JIA, a recommended healthful sleep duration leads to reductions in pain when compared with the restricted sleep (RS) duration that is commonly seen.MethodsPatients with JIA (12–18 years old; pain score of ≥1 on a visual analogue scale) participated in a randomised, crossover sleep manipulation protocol. The 3-week protocol comprised a baseline week (BL), a week with healthy sleep duration (HSD; 9.5 hours in bed/night) and a RS week (RS; 6.5 hours in bed/night). After BL, participants were randomly assigned to either HSD or RS, and then crossed over to the other condition. Pain was self-assessed using the iCanCope with Pain app. We used Bayesian hierarchical models to estimate the effect of sleep duration on pain.ResultsParticipants (n=31; mean age=15.0±1.8 years) averaged 1.4 (95% credible interval (CrI) 1.2–1.6) more hours of sleep per night during HSD relative to RS. Compared with RS, HSD resulted in a favourable effect on pain scores (OR 0.61, 95% CrI 0.39–0.95).ConclusionIt is possible to have adolescents with childhood arthritis get a healthier sleep duration, and this longer sleep results in reduced pain. These findings complement prior correlational studies and confirm a causal relationship between reduced sleep duration and increased pain.Trial registration numberNCT04133662.

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“…Postoperative fatigue is a common clinical symptom, which often leads to delay in early recovery and affects patients' initiative rehabilitation. [20,21,32] In their meta-analysis of the relationship among pain, sleep, and fatigue, Whibley et al [32] pointed out that these 3 factors influence each other and interact. Only when each factor is positively controlled, this virtuous circle can be established to promote early recovery of patients, shorten the average length of stay in the hospital, and improve patients' satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Application of dexamethasone combined with tranexamic acid in perioperative period of total hip arthroplasty

Huang

Liu

et al. 2022

Medicine

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Objective: To evaluate the efficacy and safety of dexamethasone (DEXA) combined with tranexamic acid (TXA) in the perioperative period of total hip arthroplasty. Materials and Methods: A total of 100 cases were randomly divided into 2 groups (50 cases per group). All patients were given 15 mg/kg TXA before skin incision and 3 hours later. Patients in the intervention group (TXA + DEXA group) were given 20 mg dexamethasone intravenously after the onset of anesthesia, and the same dose of DEXA was administered again 24 hours later. Patients in the placebo group (TXA group) were only given the same dose of normal saline. Postoperative c-reactive protein and interleukin-6, postoperative nausea and vomiting, fatigue visual analogue scale score, postoperative length of stay, range of motion, and consumption of analgesic and antiemetics were statistically analyzed in the 2 groups. Results: The levels of c-reactive protein and interleukin-6 in the TXA + DEXA group were lower than those in the TXA group at 24, 48, 72 hours post-operatively ( P < .001). Walking pain scores in the TXA + DEXA group were also significantly lower than those in the TXA group at 24 and 48 hours ( P < .001); rest pain scores were lower at 24 hours ( P < .001). Compared with the TXA group, the incidence of nausea VAS, postoperative nausea and vomiting, fatigue, analgesia and antiemetics consumption, postoperative length of stay, and range of motion were lower in the TXA + DEXA group (all P < .05), while there were no significant differences in postoperative hematocrit, total blood loss, and complications ( P > .05). Conclusion: The combination of TXA (15 mg/kg; before skin incision and 3 hours later) and DEX (20 mg dexamethasone intravenously after the onset of anesthesia, and again 24 hours later) is an effective and safe strategy for patients undergoing total hip arthroplasty.

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(175) Mechanisms between Sleep and Pain – What Do We Know from Studies of Mediation?

Cited by 7 publications

References 0 publications

Effects of pain on depression, sleep, exercise tolerance, and quality of life in patients with nontuberculous mycobacterial pulmonary disease

Effects of pain on depression, sleep, exercise tolerance, and quality of life in patients with nontuberculous mycobacterial pulmonary disease

Lengthening sleep reduces pain in childhood arthritis: a crossover randomised controlled trial

Application of dexamethasone combined with tranexamic acid in perioperative period of total hip arthroplasty

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