Contemporary approaches to the relationships between chronic pain and sleep

Kukushkin M.L.; Poluektov M.G.

doi:https://doi.org/10.17116/jnevro20171174219-27

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Abstract:

Chronic pain represents the unique pathophysiological condition characterized by the sustainable chemical, morphological and behavioral patterns. Sleep facilitates many chronic pain syndromes by the blockade of nociceptive ways, release of specific neuromediators and the absence of conscious perception in this time. The restriction of sleep duration or disruption of its structure results in intensification of pain while the improvement of sleep leads to the alleviation of pain in some cases.

Keywords:

sleep

chronic pain

insomnia

Authors:

Kukushkin M.L.

NII obshcheĭ patologii i patofiziologii RAMN, Moskva

ORCID: 0000-0002-9406-5846

Poluektov M.G.

Kurs somnologii pri kafedre nervnykh bolezneĭ fakul'teta poslevuzovskogo professional'nogo obrazovaniia Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova

ORCID: 0000-0001-6215-0918

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References:

Merskey H, Bogduk N, eds. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Prepared by International Association for the Study of Pain, Task Force on Taxonomy. 2^nd ed. Seattle: IASP Press; 1994.
Bol’. Prakticheskoe rukovodstvo dlya vrachei. Pod red. Yakhno NN, Kukushkina ML. M.: Izdatel’stvo RAMN; 2011. (In Russ.).
Yakhno NN, Kukushkin ML. Khronicheskaya bol’: medico-biologicheskie I sotsial’no-ekonomichenskie aspekty. Vestnik RAMN. 2012;9:54-58. (In Russ.).
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain. 2006;10:287-333. https://doi.org/10.1016/j.ejpain.2005.06.009
McMahon SB, Koltzenburg M, eds. Wall and Melzack’s Textbook of Pain. 5^th ed. Elsevier Churchill Livingstone; 2005.
Buskila D. Genetics of chronic pain states. Best Pract Res Clin Rheumatol. 2007;21:535-547. https://doi.org/10.1016/j.berh.2007.02.011
Kukushkin ML, Khitrov NK. Obshchaya patologiya boli. M.: Meditsina; 2004. (In Russ.).
Edwards RR. Genetic predictors of acute and chronic pain. Curr Rheumatol Rep. 2006;8:411-417. https://doi.org/10.1007/s11926-006-0034-2
Diatchenko L, Slade GD, Nackley AG, Bhalang K, Sigurdsson A, Belfer I, Goldman D, Xu K, Shabalina SA, Shagin D, Max MB, Makarov SS. Maixner Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Human Molecular Genetics. 2005;14(1):135-143. https://doi.org/10.1093/hmg/ddi013
Lacroix-Fralish ML, Mogil JS. Progress in genetic studies of pain and analgesia. Annu Rev Pharmacol Toxicol. 2009;49:97-121. https://doi.org/10.1146/annurev-pharmtox-061008-103222
Seifert F, Maihöfner C. Functional and structural imaging of pain-induced neuroplasticity. Curr Opin Anaesthesiol. 2011;24:515-523. https://doi.org/10.1097/ACO.0b013e32834a1079
Jetzer AK, Morel A, Magnin M, Jeanmonod D. Cross-modal plasticity in the human thalamus: evidence from intraoperative macrostimulations. Neuroscience. 2009;164:1867-1875. https://doi.org/10.1016/j.neuroscience.2009.09.064
Pshennikova MG, Smirnova VS, Grafova VN, Shimkovich MV, Malyshev IU, Kukushkin ML. Ustoichivost’ k razvitiu neuropaticheskogo bolevogo sindroma u krys linii avgust i populyacii vistar, obladayuschih raznoi vrozhdennoi ustoichivost’yu k stressovomu vozdeistvyu. Bol’. 2008;2:13-16.
Buskila D, Sarzi-Puttini P, Ablin JN. The genetics of fibromyalgia syndrome. Pharmacogenomic. 2007;8:67-74. https://doi.org/10.2217/14622416.8.1.67
Osipov AV, Kukushkin ML. Vliyanie stressa na razvitie deafferentatsionnogo bolevogo sindroma u krys posle pererezki sedalishchnogo nerva. Byulleten’ eksperimental’noi biologii i meditsiny. 1993;115(5):471-473. (In Russ.).
Kohlschütter E. Messungen der Festigkeit des Schlafes. Z Ration Med. 1863;17:209-253.
Steriade M, McCormick DA, Sejnowski TJ. Thalamocortical oscillations in the sleeping and aroused brain. Science. 1993;262(5134):679-685.
Peever JH. Sessle BJ. Sensory and Motor Processing During Sleep and Wakefulness Chapter. In: Kryger M.H., Roth T., Dement W.C., eds. Principles and Practice of Sleep Medicine. 6^th ed. Philadelphia: Elsevier; 2016.
Sandrini G, Milanov I, Rossi B, Murri L, Alfonsi E, Moglia A, Nappi G. Effects of sleep on spinal nociceptive reflexes in humans. Sleep. 2001;24(1):13-17.
Ødegård SS, Omland PM, Nilsen KB, Stjern M, Gravdahl GB, Sand T. The effect of sleep restriction on laser evoked potentials, thermal sensory and pain thresholds and suprathreshold pain in healthy subjects. Clin Neurophysiol. 2015;126(10):1979-1978. https://doi.org/10.1016/j.clinph.2014.12.011
Roehrs T, Hyde M, Blaisdell B, Greenwald M, Roth T. Sleep loss and REM sleep loss are hyperalgesic. Sleep. 2006;29(2):145-151.
Roehrs TA, Harris E, Randall S, Roth T. Pain sensitivity and recovery from mild chronic sleep loss. Sleep. 2012;35(12):1667-1672. https://doi.org/10.5665/sleep.2240
Finan PH, Goodin BR, Smith MT. The association of sleep and pain: An update and a path forward. Pain. 2013;14(12):1539-1552. https://doi.org/10.1016/j.jpain.2013.08.007
Smith MT, Haythornthwaite JA. How do sleep disturbance and chronic pain inter-relate? Insights from the longitudinal and cognitive-behavioral clinical trials literature. Sleep Med Rev. 2004;8:119-132. https://doi.org/10.1016/S1087-0792(03)00044-3
Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep. 2007;30:213-218.
Smith MT, Perlis M., Smith MS, Giles DE, Carmody TP. Sleep quality and presleep arousal in chronic pain. J Behav Med. 2000;23:1-13.
Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007;27:394-402. https://doi.org/10.1111/j.1468-2982.2007.01303.x
Sahota PK, Dexter JD. Sleep and headache syndromes: A clinical review. Headache. 1990;30:80-84.
Holland PR. Headache and sleep: Shared pathophysiological mechanisms. Cephalalgia. 2014;34(10):725-744. https://doi.org/10.1177/0333102414541687
Arushanyan EB, Beier EV. Gormon mozgovoi zhelezy epifiza melatonin — universal’nyi estestvennyi adaptogen. Uspekhi Fiziol. Nauk. 2012;43(2):82-100. (In Russ.).
Arushanyan EB. Sravnitel’naya otsenka epifizarnogo melatonina i benzodiazepinovykh anksiolitikov. Eksp Klin Farmakol. 2012;75(3):35-40. (In Russ.).
Laurido C, Pelissie T, Soto-Moyano R, Valladares L, Flores F, Hernández A. Effect of melatonin on rat spinal cord nociceptive transmission. Neuroreport. 2002;13(1):89-91.
El-Shenawy SM, Abdel-Salam OM, Baiuomy AR, EL-Batran S, Arbid MS. Studies on the inflammatory and anti-nociceptive effect of melatonin in the rat. Pharmacol Res. 2002;46:3:235-243.
Ambriz-Tututi M, Granados-Soto V. Oral and spinal melatonin reduces tactile allodynia in rats via activation of MT2 and opioid receptors. Pain. 2007;132:3:273-280. https://doi.org/10.1016/j.pain.2007.01.025
Srinivasan V, Lauterbach EC, Ho KY, Acuña-Castroviejo D, Zakaria R, Brzezinski A. Melatonin in antinociception: Its therapeutic applications. Curr Neuropharmacol. 2012;10:167-178. https://doi.org/10.2174/157015912800604489
Wilhelmsen M, Amirian I, Reiter RJ, Rosenberg J, Gögenur I. Analgesic effects of melatonin: a review of current evidence from experimental and clinical studies. J Pineal Res. 2011;51(3):270-277. https://doi.org/10.1111/j.1600-079X.2011.00895.x
Hussain SA, Al-Khalifa H, Jasim NA, Gorial FI. Adjuvant use of melatonin for treatment of fibromyalgia. J Pineal Res. 2011;50:267-271. https://doi.org/10.1111/j.1600-079X.2010.00836.x
Kovalzon VM. Orexin/Hypocretin System of the Brain in the Regulation of Wakefulness and Sleep. Effektivnaya farmakoterapiya. Nevrologiya I psikhiatriya (Spetsvypusk «Son I ego rasstroistva-4»). 2016;19:6-14. (In Russ.).
Yamamoto T, Nozaki-Taguchi N, Chiba T. Analgesic effect of intrathecally administered orexin-A in the rat formalin test and in the rat hot plate test. British journal of pharmacology. 2002;137:170-176. https://doi.org/10.1038/sj.bjp.0704851
Estabrooke IV, McCarthy MT, Ko E, Chou TC, Chemelli RM, Yanagisawa M, Saper CB, Scammell TE. Fos expression in orexin neurons varies with behavioral state. J Neurosci. 2001;21(5):1656-1662.
Mahler SV, Moorman DE, Smith RJ, James MH, Aston-Jones G. Motivational activation: a unifying hypothesis of orexin/hypocretin function. Nature neuroscience. 2014;17:1298-1303. https://doi.org/10.1038/nn.3810
Inutsuka A, Yamashita A, Chowdhur S, Nakai J, Ohkura M, Taguchi T, Yamanaka A. The integrative role of orexin/hypocretin neurons in nociceptiveperception and analgesic regulation. Scientific Reports. 2016;6:29480. https://doi.org/10.1038/srep29480
Somnologiya i meditsina sna. Natsional’noe rukovodstvo pamyati AM. Veina I YaI. Levina. Pod red. Poluektova MG. M.: Medforum; 2016. (In Russ.).
Currie SR, Wilson KG, Curran D. Clinical significance and predictors of treatment response to cognitive-behavior therapy for insomnia secondary to chronic pain. J Behav Med. 2002;25:135-153.
Edinger JD, Wohlgemuth WK, Krystal AD, Rice JR. Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial. Arch Intern Med. 2005;165(21):2527-2535. https://doi.org/10.1001/archinte.165.21.2527
abstract no.0302. Sleep. 2007;30(suppl. A):103-194.
Tang NK. Cognitive-behavioral therapy for sleep abnormalities of chronic pain patients. Curr Rheumatol Rep. 2009;11(6):451-460.
Grönblad M, Nykänen J, Konttinen Y, Järvinen E, Helve T. Effect of zopiclone on sleep quality, morning stiffness, widespread tenderness and pain and general discomfort in primary fibromyalgia patients. A double-blind randomized trial. Clin Rheumatol. 1993;12:186-191.
Moldofsky H, Lue FA, Mously C, Roth-Schechter B, Reynolds WJ. The effect of zolpidem in patients with fibromyalgia: a dose ranging, double blind, placebo controlled, modified crossover study. J Rheumatol. 1996;23:529-533.
Roehrs TA. Does effective management of sleep disorders improve pain symptoms? Drugs. 2009;69:2:5-11. https://doi.org/10.2165/11531260-000000000-00000
Walsh JK, Muehlbach MJ, Lauter SA, Hilliker NA, Schweitzer PK. Effects of triazolam on sleep, daytime sleepiness, and morning stiffness in patients with rheumatoid arthritis. J Rheumatol. 1996;23(2):245-252.
Morillas-Arques P, Rodriguez-Lopez CM, Molina-Barea R, Rico-Villademoros F, Calandre EP. Trazodone for the treatment of fibromyalgia: an open-label, 12-week study. BMC Musculoskelet Disord. 2010;11:204. https://doi.org/10.1186/1471-2474-11-204
Saletu B, Prause W, Anderer P, Mandl M, Aigner M, Mikova O, Saletu-Zyhlarz GM. Insomnia in somatoform pain disorder: sleep laboratory studies on differences to controls and acute effects of trazodone, evaluated by the Somnolyzer 24×7 and the Siesta database. Neuropsychobiology. 2005;51(3):148-63. https://doi.org/10.1159/000085207
Poluektov MG, Levin YaI, Mikhailov VA, Babak SL, Strygin KN. Primenenie Trittiko (trazodona) dlya lecheniya narushenii sna pri depressii: rezul’taty mul’titsentrovogo issledovaniya. Effektivnaya farmakoterapiya. Nevrologiya i psikhiatriya. Spetsvypusk «Son i ego rasstroistva». 2013;12:82-90.