Université de Montréal, Québec, Canada.
Curr Rheumatol Rep. 2011 Dec;13(6):535-42. doi: 10.1007/s11926-011-0209-3.
Most patients with chronic musculoskeletal pain report poor-quality sleep. The impact of chronic pain on sleep can be described as a vicious circle with mutual deleterious influences between pain and sleep-associated symptoms. It is difficult, however, to extract quantitative or consistent and specific sleep variables (eg, total sleep time, slow-wave sleep, sleep stage duration) that characterize the pain-related disruption of sleep. Comorbidity (eg, fatigue; depression; anxiety, sleep, movement, or breathing disorders) often confounds the reading and interpretation of sleep traces. Furthermore, many other methodologic issues complicate our ability to generalize findings (low external validity) to first-line medicine. Because sleep alterations in common musculoskeletal pain are neither specific nor pathognomonic, the aim is to provide a critical overview of the current understanding of pain and sleep interaction, discussing evidence-based and empiric knowledge that should be considered in further research and clinical applications.
大多数慢性肌肉骨骼疼痛患者报告睡眠质量差。慢性疼痛对睡眠的影响可以描述为一个恶性循环，疼痛和与睡眠相关的症状之间存在相互有害的影响。然而，很难提取出定量的或一致的、特定的睡眠变量（例如，总睡眠时间、慢波睡眠、睡眠阶段持续时间）来描述与疼痛相关的睡眠中断。合并症（例如疲劳；抑郁；焦虑、睡眠、运动或呼吸障碍）常常使睡眠轨迹的解读变得复杂。此外，许多其他方法学问题使我们难以将研究结果推广到一线医学（外部有效性低）。由于常见肌肉骨骼疼痛中的睡眠改变既不具有特异性也无特征性，因此本文旨在批判性地概述目前对疼痛和睡眠相互作用的理解，讨论应在进一步研究和临床应用中考虑的基于证据和经验的知识。
