Perrig S, Espa-Cervena K, Pépin J L
Laboratoire du sommeil-EEG Service de Neuropsychiatrie, HUG, Genève.
Rev Med Suisse. 2011 Jun 29;7(301):1414-8, 1420.
Chronic pain and sleep disorder can put the patient in a vicious circle (bidirectional relation between those two morbid entities). Clinical management must be global. The physiopathology includes chronic sleep deficit, mainly in deep sleep (the "restoring" sleep) generated principally by the prefrontal regions. These areas are also implicated in the modulation of pain. To break this "loops", we advocate an approach based on three main components: hygiene principles, cognitive and behavioral therapy, medications with analgesic and hypnotic proprieties.
慢性疼痛和睡眠障碍会使患者陷入恶性循环（这两种病态情况之间存在双向关系）。临床管理必须全面。其病理生理学包括慢性睡眠不足，主要是由前额叶区域产生的深度睡眠（“恢复性”睡眠）不足。这些区域也参与疼痛的调节。为了打破这种“循环”，我们提倡一种基于三个主要组成部分的方法：卫生原则、认知行为疗法以及具有镇痛和催眠特性的药物。
