Kundermann Bernd, Spernal Julia, Huber Martin Tobias, Krieg Jürgen-Christian, Lautenbacher Stefan
Department of Psychiatry and Psychotherapy, Philipps University Marburg, Rudolf-Bultmann-Str. 8, Marburg D-35033, Germany.
Psychosom Med. 2004 Nov-Dec;66(6):932-7. doi: 10.1097/01.psy.0000145912.24553.c0.
Sleep disturbances have been thought to augment pain. Sleep deprivation has been proven to produce hyperalgesic effects. It is still unclear whether these changes are truly specific to pain and not related to general changes in somatosensory functions. The aim of the present study was to evaluate the effect of total sleep deprivation on thermal pain thresholds (heat, cold) and pain complaints. Thermal detection thresholds (warmth, cold) were included as covariates to determine the contribution of somatosensory functions to changes in pain processing.
Twenty healthy volunteers were randomly assigned either to two nights of total sleep deprivation or to two nights of undisturbed night sleep. Sleep deprivation nights were separated by two days with normal night sleep. Heat and cold pain thresholds as well as warmth and cold detection thresholds were measured by use of a peltier thermode in the evening before and the morning after each deprivation or control night. Pain complaints were examined by use of a questionnaire in parallel.
During treatment nights, sleep deprivation produced a significant overnight decrease in heat pain thresholds. Cold pain thresholds tended to decrease also during sleep deprivation, whereas the warmth and cold detection thresholds remained unaffected. Accordingly, no substantial contributions of the changes in thermal detection thresholds to the changes in thermal pain thresholds were determined by regression analyses. Pain complaints were not induced by sleep deprivation.
The present findings suggest that sleep deprivation produces hyperalgesic changes that cannot be explained by nonspecific alterations in somatosensory functions.
睡眠障碍被认为会加重疼痛。睡眠剥夺已被证明会产生痛觉过敏效应。目前尚不清楚这些变化是否真的特定于疼痛,而与躯体感觉功能的一般变化无关。本研究的目的是评估完全睡眠剥夺对热痛阈值(热、冷)和疼痛主诉的影响。纳入热觉检测阈值(温暖、寒冷)作为协变量,以确定躯体感觉功能对疼痛处理变化的影响。
20名健康志愿者被随机分配到两晚完全睡眠剥夺组或两晚无干扰夜间睡眠组。睡眠剥夺的夜晚之间间隔两天正常夜间睡眠。在每次剥夺或对照夜晚之前的晚上和之后的早晨,使用珀尔帖热电极测量热痛和冷痛阈值以及热觉和冷觉检测阈值。同时使用问卷检查疼痛主诉。
在治疗夜晚,睡眠剥夺导致热痛阈值显著夜间降低。冷痛阈值在睡眠剥夺期间也有降低趋势,而热觉和冷觉检测阈值保持不变。因此,回归分析未确定热觉检测阈值变化对热痛阈值变化有实质性影响。睡眠剥夺未引发疼痛主诉。
目前的研究结果表明,睡眠剥夺会产生痛觉过敏变化,而这种变化无法用躯体感觉功能的非特异性改变来解释。