Schlaf und Schmerz: Ein wechselseitiger Zusammenhang?

Zusammenfassung

Anliegen Diese Arbeit gibt einen Überblick über die Auswirkungen von Schlafdeprivation (SD) auf das Schmerzempfinden und thematisiert den wechselseitigen Zusammenhang von Schlaf und Schmerz. Methode Anhand einer medline-Recherche wurden 7 Studien gefunden, die die gestellten Einschlusskriterien erfüllten. Ergebnisse SD führt bei 5 von 6 Studien zu einer Zunahme von körperlichen Beschwerden anhand von Selbstbeurteilungstests. In 3 von 5 Studien nimmt die Schmerzlatenz und in einer Studie die endogene Schmerzhemmung nach SD ab. Schlussfolgerung Schmerzen können nicht nur den Schlaf stören, SD kann auch die Schmerzschwelle senken.

Abstract

Objective This review gives an overview about the consequences of sleep deprivation (SD) on pain perception and discusses the bi-directional relation between sleep and pain. Methods A medline research (16.7.2010) for the terms „sleep” AND „pain” AND („sleep deprivation” OR „sleep loss” OR „sleep restriction” OR „sleep interruption”) showed 177 hits. Only studies with control group or cross-over design that investigated sleep deprivation (total or partial form) as independent and pain as dependent variable were included. Results 7 studies fulfilled the inclusion criteria. SD leads in 5 of 6 studies to an increase of bodily complaints measured by self rating tests and a decrease of pain inhibition. 3 of 5 studies show a decrease of mechanical or thermal pain threshold after SD. Conclusions Not only can pain lead to sleep disruption, but SD can also reduce pain threshold. Sleep and pain might be mutually related, by shared neurotransmitter pathways. A further explanation is an influence of SD on opioid protein synthesis and / or opioid receptors. So when chronic pain and sleep disorder coexist, both conditions should be treated.

Schlüsselwörter

Schlaf - Schlafdeprivation - Schlafrestriktion - Schmerz - Übersichtsarbeit

Keywords

sleep deprivation - sleep restriction - pain perception - pain threshold - review

Literatur

• 1 Nickel R, Raspe H H. Chronischer Schmerz: Epidemiologie und Inanspruchnahme.  Nervenarzt. 2001;  72 897-906
• 2 Onen S H, Alloui A, Gross A et al. The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects.  J Sleep Res. 2001;  10 35-42
• 3 Harman K, Pivik R T, D'Eon J L et al. Sleep in depressed and nondepressed participants with chronic low back pain: electroencephalographic and behaviour findings.  Sleep. 2002;  25 775-783
• 4 Raymond I, Nielsen T A, Lavigne G et al. Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patients.  Pain. 2001;  92 381-388
• 5 Morin C M, Gibson D, Wade J. Self-reported sleep and mood disturbance in chronic pain patients.  Clin J Pain. 1998;  14 311-314
• 6 Ohayon M M. Relationship between chronic painful physical condition and insomnia.  J Psychiatr Res. 2005;  39 151-159
• 7 Roehrs T, Roth T. Sleep and pain: interaction of two vital functions.  Semin Neurol. 2005;  25 106-116
• 8 Roehrs T, Hyde M, Blaisdell B et al. Sleep loss and REM sleep loss are hyperalgesic.  Sleep. 2006;  29 145-151
• 9 Smith M T, Edwards R R, McCann D U et al. The effects of sleep deprivation on pain inhibition and spontaneous pain in women.  Sleep. 2007;  30 494-505
• 10 Moffitt P F, Kalucy E C, Kalucy R S et al. Sleep difficulties, pain and other correlates.  J Intern Med. 1991;  230 245-249
• 11 Onen S H, Onen F, Courpron P et al. How pain and analgesics disturb sleep.  Clin J Pain. 2005;  21 422-431
• 12 Pilowsky I, Crettenden I, Townley M. Sleep disturbance in pain clinic patients.  Pain. 1985;  23 27-33
• 13 Gislason T, Almqvist M. Somatic diseases and sleep complaints. An epidemiological study of 3,201 Swedish men.  Acta Med Scand. 1987;  221 475-481
• 14 Smith M T, Perlis M L, Smith M S et al. Sleep quality and presleep arousal in chronic pain.  J Behav Med. 2000;  23 1-13
• 15 Moldofsky H, Scarisbrick P, England R et al. Musculosketal symptoms and non-REM sleep disturbance in patients with „fibrositis syndrome” and healthy subjects.  Psychosom Med. 1975;  37 341-351
• 16 Affleck G, Urrows S, Tennen H et al. Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia.  Pain. 1996;  68 363-368
• 17 Kundermann B, Krieg J C, Schreiber W et al. The effect of sleep deprivation on pain.  Pain Res Manag. 2004;  9 25-32
• 18 Kundermann B, Spernal J, Huber M T et al. Sleep deprivation affects thermal pain thresholds but not somatosensory thresholds in healthy volunteers.  Psychosom Med. 2004;  66 932-937
• 19 Smith M T, Edwards R R, Stonerock G L et al. Individual variation in rapid eye movement sleep is associated with pain perception in healthy women: preliminary data.  Sleep. 2005;  28 809-812
• 20 Farooqui S M, Brock J W, Zhou J. Changes in monoamines and their metabolite concentrations in REM sleep-deprived rat forebrain nuclei.  Pharmacol Biochem Behav. 1996;  54 385-391
• 21 Orzeł-Gryglewska J. Consequences of sleep deprivation.  Int J Occup Med Environ Health. 2010;  23 95-114
• 22 Patel M, Gomez S, Berg S et al. Effects of 24-h and 36-h sleep deprivation on human postural control and adaptation.  Exp Brain Res. 2008;  185 165-173
• 23 Hui L, Hua F, Diandong H et al. Effects of sleep and sleep deprivation on immunoglobulins and complement in humans (Erratum in: Brain Behav Immun 2010; 24: 672–677).  Brain Behav Immun. 2007;  21 308-310
• 24 Everson C A. Functional consequences of sustained sleep deprivation in the rat.  Behav Brain Res. 1995;  69 43-54
• 25 Chaput J P, Després J P, Bouchard C et al. The association between sleep duration and weight gain in adults: a 6-year prospective study from the Quebec Family Study.  Sleep. 2008;  31 517-523
• 26 Gangwisch J E, Malaspina D, Babiss L A et al. Short sleep duration as a risk factor for hypercholesterolemia: analyses of the National Longitudinal Study of Adolescent Health.  Sleep. 2010;  33 956-961
• 27 Foo H, Mason P. Brainstem modulation of pain during sleep and waking.  Sleep Med Rev. 2003;  7 145-154
• 28 Lautenbacher S, Kundermann B, Krieg J C. Sleep deprivation and pain perception.  Sleep Med Rev. 2006;  10 357-369
• 29 Older S A, Battafarano D F, Danning C L et al. The effects of delta wave sleep interruption on pain thresholds and fibromyalgialike symptoms in healthy subjects; correlations with insulin-like growth factor I.  J Rheumatol. 1998;  25 1180-1186
• 30 Haack M, Sanchez E, Mullington J M. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers.  Sleep. 2007;  30 1145-1152
• 31 Kundermann B, Hemmeter-Spernal J, Huber M T et al. Effects of total sleep deprivation in major depression: overnight improvement of mood is accompanied by increased pain sensitivity and augmented pain complaints.  Psychosom Med. 2008;  70 92-101
• 32 Haack M, Lee E, Cohen D A et al. Activation of the prostaglandin system in response to sleep loss in healthy humans: potential mediator of increased spontaneous pain.  Pain. 2009;  145 136-141
• 33 Wright C E, Bovbjerg D H, Montgomery G H et al. Disrupted sleep the night before breast surgery is associated with increased postoperative pain.  J Pain Symptom Manage. 2009;  37 352-362
• 34 Roth T, Price J M, Amato D A et al. The effect of eszopiclone in patients with insomnia and coexisting rheumatoid arthritis: a pilot study.  Prim Care Companion J Clin Psychiatry. 2009;  11 292-301
• 35 Fadda P, Tortorella A, Fratta W. Sleep deprivation decreases mu and delta opioid receptor binding in the rat limbic system.  Neurosci Lett. 1991;  129 315-317
• 36 Shapiro C, Girdwood P. Protein synthesis in rat brain during sleep.  Neuropharmacology. 1981;  20 457-460
• 37 Bjorvatn B, Grønli J, Hamre F et al. Effects of sleep deprivation on extracellular serotonin in hippocampus and frontal cortex of the rat.  Neuroscience. 2002;  113 323-330
• 38 Arnold L M, Keck Jr P E, Welge J A. Antidepressant treatment of fibromyalgia. A meta-analysis and review.  Psychosomatics. 2000;  41 104-113