Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California 90095-7076, USA.
Sleep. 2012 Apr 1;35(4):537-43. doi: 10.5665/sleep.1742.
Disturbances of sleep are hypothesized to contribute to pain. However, experimental data are limited to healthy pain-free individuals. This study evaluated the effect of sleep loss during part of the night on daytime mood symptoms and pain perceptions in patients with rheumatoid arthritis in comparison with control subjects.
A between-groups laboratory study with assessment of mood symptoms and pain perception before and after partial night sleep deprivation (PSD; awake 23:00 hr to 03:00 hr).
General clinical research center.
Patients with rheumatoid arthritis (n = 27) and volunteer comparison control subjects (n = 27).
Subjective reports of sleep, mood symptoms and pain, polysomnographic assessment of sleep continuity, and subjective and objective assessment of rheumatoid arthritis-specific joint pain.
PSD induced differential increases in self-reported fatigue (P < 0.09), depression (P < 0.04), anxiety (P < 0.04), and pain (P < 0.01) in patients with rheumatoid arthritis compared with responses in control subjects, in whom differential increases of self-reported pain were independent of changes in mood symptoms, subjective sleep quality, and objective measures of sleep fragmentation. In the patients with rheumatoid arthritis, PSD also induced increases in disease-specific activity as indexed by self-reported pain severity (P < 0.01) and number of painful joints (P < 0.02) as well as clinician-rated joint counts (P < 0.03).
This study provides the first evidence of an exaggerated increase in symptoms of mood and pain in patients with rheumatoid arthritis after sleep loss, along with an activation of rheumatoid arthritis-related joint pain. Given the reciprocal relationship between sleep disturbances and pain, clinical management of pain in patients with rheumatoid arthritis should include an increased focus on the prevention and treatment of sleep disturbance in this clinical population.
睡眠障碍被认为会导致疼痛。然而，实验数据仅限于健康无痛的个体。本研究评估了夜间部分时间睡眠剥夺（PSD；23:00 至 03:00 保持清醒）对类风湿关节炎患者日间情绪症状和疼痛感知的影响，并与对照受试者进行了比较。
一项分组实验室研究，在部分夜间睡眠剥夺前后评估情绪症状和疼痛感知（PSD；23:00 至 03:00 保持清醒）。
一般临床研究中心。
类风湿关节炎患者（n = 27）和志愿者对照受试者（n = 27）。
睡眠、情绪症状和疼痛的主观报告，睡眠连续性的多导睡眠图评估，以及类风湿关节炎特异性关节疼痛的主观和客观评估。
与对照受试者相比，PSD 导致类风湿关节炎患者自我报告的疲劳（P < 0.09）、抑郁（P < 0.04）、焦虑（P < 0.04）和疼痛（P < 0.01）显著增加，而对照受试者的情绪症状、主观睡眠质量和客观睡眠碎片化测量无差异。在类风湿关节炎患者中，PSD 还导致自我报告的疼痛严重程度（P < 0.01）和疼痛关节数（P < 0.02）以及临床医生评估的关节计数（P < 0.03）增加，从而导致疾病特异性活动增加。
本研究首次提供了睡眠不足后类风湿关节炎患者情绪和疼痛症状明显增加的证据，并激活了与类风湿关节炎相关的关节疼痛。鉴于睡眠障碍与疼痛之间的相互关系，类风湿关节炎患者的疼痛临床管理应更加关注该临床人群中睡眠障碍的预防和治疗。
