Re: The Impact of Disturbed Sleep on Pain

[Guest guest]

One way to help counter the problem with sleep deprivation is doing

meditation. What the body needs is to achieve the Theda brain wave pattern

which is exactly what we are attempting to achieve through meditation.

Dorey

www.LivingWithRheumatoidArthritis.com

----- Original Message -----

From: " Nina " <ncampbell@...>

" Rheumatoid Arthritis " <Rheumatoid Arthritis >

Sent: Tuesday, June 21, 2005 8:32 PM

Subject: The Impact of Disturbed Sleep on Pain

>I saw this on another list today and thought you might be interested.

>

> Nina

>

>

> Ask the Experts about Insomnia

> From Medscape Primary Care

>

> The Impact of Disturbed Sleep on Pain

> Question

> What is the impact of disturbed sleep on pain?

>

> Response from Roth, PhD

> Professor, Department of Psychiatry, Wayne State University College of

> Medicine, Detroit; Director, Sleep Disorders Center, Henry Ford Hospital,

> Detroit.

>

>

>

>

> A variety of sleep disturbances, including difficulty falling asleep and

> frequent nocturnal awakenings, are commonly reported by patients

> experiencing pain. Even among pain patients not reporting frequent

> awakening, reports of nonrefreshing sleep are common. Sleep

> laboratory-based

> studies in patients with acute pain (eg, postoperative patients), as well

> as

> in patients with chronic pain (eg, neuropathic pain and rheumatologic

> conditions), show frequent arousals, difficulty falling back to sleep

> after

> nocturnal awakenings, and a reduced time spent in REM sleep.[1]

> Clearly, pain causes sleep disturbances. However, it is becoming

> increasingly clear that these sleep disturbances result in an increased

> sensitivity to pain, thereby setting up a cycle of pain leading to

> disturbed

> sleep which, in turn, leads to more pain.[2] Both the loss of REM sleep,

> even for 1 night, and partial sleep deprivation can lead to increased pain

> sensitivity.[3-5] A loss of sleep as small as 4 hours over 1 night results

> in a significant decrease in pain threshold.[6] Although 4 hours of sleep

> loss for a night may seem extreme, it is important to remember that the

> consequences of sleep loss accumulate across nights. Thus, 1-2 hours of

> sleep loss across 2-4 nights would have the same effect. Furthermore, it

> may

> not simply be disturbed sleep that exacerbates pain. The administration of

> opiates to alleviate pain may turn out to be counterproductive, as these

> medications are REM suppressants, and loss of REM sleep increases pain

> sensitivity, as noted earlier. Thus, t!

> he preservation of sleep time and sleep architecture are important parts

> of

> pain management. Interventions such as maximizing the sleep environment in

> postoperative and other hospital patients as well as the use of behavioral

> and pharmacologic treatment to manage insomnia in chronic pain patients

> are

> important aids in the management of pain. Finally, insomnia clinical

> trials

> in comorbid pain conditions should measure treatment efficacy, not only in

> terms of sleep, but also in terms of pain control and the need for

> analgesics.

>

>

> References

> Menefee LA, Cohen M, WR, Doghramji K, ED, Lee H. Sleep

> disturbance and nonmalignant pain: a comprehensive review of the

> literature.

> Pain Med. 2000;1:156-172. Abstract

> Affleck G, Urrows S, Tennen H, Higgins P, Abeles M. Sequential daily

> relations of sleep, pain intensity, and attention to pain among women with

> fibromyalgia. Pain. 1996;68:363-368. Abstract

> Moldofsky H, Scarisbrick P. Induction of neurasthenic musculoskeletal pain

> syndrome by selective sleep stage deprivation. Psychosom Med.

> 1976;38:35-44.

> Abstract

> Moldofsky H, Scarisbrick P, England R, Smythe H. Musculoskeletal symptoms

> and non-REM sleep disturbance in patients with " fibrositis syndrome " and

> healthy subjects. Psychosom Med. 1975;37:341-351. Abstract

> Lentz MJ, Landis CA, Rothermel J, Shaver JL. Effects of selective slow

> wave

> sleep disruption on musculoskeletal pain and fatigue in middle aged women.

> J

> Rheumatol. 1999;26:1586-1592. Abstract

> Roehrs TA, Blaisdell B, Greenwald MK, Roth T. Pain threshold and sleep

> loss.

> Sleep. 2003;26(suppl):A196.

>

> Funding Information

>

> Supported through an educational grant from Sanofi-Synthelabo Inc., a

> member

> of the sanofi-aventis Group.

>

> Disclosure: Roth, PhD, has disclosed that he has received grants

> from

> Aventis, Cephalon, GlaxoKline, Neurocrine, Pfizer, Sanofi, Sepracor,

> Somaxon, Syrex, and Takeda. Dr. Roth has also disclosed that he has served

> as a consultant for AstraZeneca, Aventis, Cephalon, Cypress, Eli Lilly,

> GlaxoKline, Hypnion, King, Lundbeck, McNeil, Merck, Neurocrine,

> Organon, Orginer, Pfizer, Roche, Sanofi, Sepracor, Somaxon, Syrex, Takeda,

> Transoral, Vivometrics, and Wyeth, and as a speaker for Sanofi.

>

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