Total Sleep Deprivation and Pain Perception during Cold Noxious Stimuli in Humans.
Total Sleep Deprivation and Pain Perception during Cold Noxious Stimuli in Humans.
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DOI：
10.1016/j.sjpain.2016.05.037
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发表时间：
2016-10
影响因子：
1.6
通讯作者：
Carter, Jason R
中科院分区：
文献类型：
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作者：
Larson, Robert A;Carter, Jason R
相当一部分人口遭受慢性疼痛，导致巨大的医疗费用和生产力损失。据广泛报道，患有各种急性或慢性疼痛的患者会失去睡眠时间和睡眠质量。相反，睡眠不足会提高痛觉，因此在睡眠不足和疼痛之间存在潜在的双向关系。到目前为止，研究实验引起的疼痛和失眠之间的关系的大多数研究都集中在痛阈值的测量上。此外，尽管有证据表明感觉到的疼痛程度存在性别差异，但之前研究失眠后疼痛的研究并没有探索性别差异。我们在2分钟的冷加压试验(CPT)中检测了24小时完全睡眠剥夺(TSD)对痛觉的影响。我们假设TSD会增加感知到的疼痛，与男性相比，女性会表现出更高的疼痛反应。对14名男性和13名女性进行了测试。所有受试者都是非吸烟者，没有心血管疾病、自主神经功能障碍、哮喘或糖尿病的病史。所有女性受试者都没有使用口服避孕药，并在月经周期的早期卵泡阶段进行了测试。试验顺序是随机的，测试阶段(正常睡眠(NS)和TSD)间隔大约一个月。受试者将他们的左手浸泡在冰水浴(~1°C)中，直到手腕，每15秒记录一次感觉到的疼痛，采用改良的Borg量表(6-20个任意单位A.U..)。持续正压治疗期间感觉到的疼痛反应在TSD后增加(Δ1.2A.U..；时间×条件，p<；0.05)。当感觉到的疼痛表现为平均(NSΔ7.0±0.5vs.TsDΔ8.2±0.5A.U.p<；0.0 5)或峰值(NSΔ8.9±0.6vs.TsdΔ10.2±0.5A.U.p<；0.0 5)时，TSD后的疼痛反应增强。男性和女性TSD对知觉疼痛的影响相似(条件×时间×性别，p>；0.05)。我们的结论是，TSD显著增加了CPT期间感知的疼痛，但这种反应不依赖于性别。这些发现支持了新出现的证据，即充足的睡眠是一种相关的、具有成本效益的预防/治疗策略，可以减少男性和女性的自我感觉到的疼痛。
A substantial portion of the population suffers from chronic pain leading to significant health care costs and lost productivity. Loss of sleep duration and quality are widely reported in patients suffering from a variety of acute or chronic pain conditions. Conversely, sleep loss has been known to elevate pain perception; thus a potential bi-directional relationship exists between sleep deprivation and pain. To date, the majority of studies examining the relationship between experimentally induced pain and sleep loss have focused on the measurement of pain threshold. Additionally, despite evidence of sex differences in ratings of perceived pain, previous studies examining pain following sleep loss have not probed for sex differences. We examined the effects of 24-hour total sleep deprivation (TSD) on perceived pain during a 2-minute cold pressor test (CPT). We hypothesized that TSD would augment perceived pain and that women would demonstrate an elevated pain response compared to men. Testing was carried out in 14 men and 13 women. All subjects reported to be nonsmokers with no history of cardiovascular disease, autonomic dysfunction, asthma, or diabetes. All female subjects were free of oral contraceptive use, and were tested during the early follicular phase of the menstrual cycle. Trial order was randomized and testing sessions (Normal sleep (NS) and TSD) were separated by approximately one month. Subjects immersed their left hand, up to the wrist, in an ice water bath (~1°C), and perceived pain was recorded every 15 seconds from a modified Borg scale (6-20 arbitrary units a.u.). Perceived pain responses during CPT were augmented following TSD (Δ1.2 a.u.; time × condition, p<0.05). The augmented pain response following TSD was noted when perceived pain was expressed as mean (NS Δ7.0±0.5 vs. TSD Δ8.2±0.5 a.u.; p<0.05) or peak (NS Δ8.9±0.6 vs. TSD Δ10.2±0.5 a.u.; p<0.05) perceived pain. The effects of TSD on perceived pain were similar in both men and women (condition × time × sex, p>0.05). We conclude that TSD significantly augments perceived pain during CPT, but this response was not sex dependent. These findings support emerging evidence that adequate sleep represents a relevant, and cost effective, preventative/therapeutic strategy to reduce self-perceived pain in both men and women.