Philipps-University of Marburg/ Institute for Internal Medicine, Department of Pulmonology, Marburg, Hessen, Germany.
Philipps-University of Marburg/ Institute for Internal Medicine, Department of Pulmonology, Marburg, Hessen, Germany; Pulmonology Schoen Clinic Berchtesgadener Land, Teaching Hospital of Philipps-University of Marburg, Germany.
Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101434. doi: 10.1016/j.berh.2019.101434. Epub 2019 Sep 11.
This review article discusses various forms of sleep disorders associated with musculoskeletal diseases (MD). It presents the pathophysiology and interaction of sleep-related disorders and MD and summarizes clinical symptoms and therapies from a somnological perspective. BACKGROUND: A large number of patients suffering from MD report fragmented sleep with poor overall sleep quality. Sleep disorders often lead to increased symptoms such as daytime fatigue, depression, or increased pain intensity. In contrast, the perception of pain worsens the quality of sleep. Sleep is a complex regulation of hormonal and neuromodulatory influences to maintain regenerative processes and signal processing. Furthermore, interleukins (e.g., IL-6 and TNFα), messenger substances, or inflammatory markers (e.g., CRP) may have a regulatory influence on sleep. THERAPY: Sleep disorders in MD can often be treated with behavioral therapies or drug approaches. Another and very important influence is physical activity. In combination with training, regular physical activity can lead, for instance, to improved sleep quality, endurance performance, and reduced inflammation values. The change of lifestyle with regard to activity and nutrition is another key concept in the optimal therapy of patients with MD.
这篇综述文章讨论了与肌肉骨骼疾病（MD）相关的各种形式的睡眠障碍。它介绍了与睡眠相关的障碍和 MD 的病理生理学和相互作用，并从睡眠学的角度总结了临床症状和治疗方法。
大量患有 MD 的患者报告说睡眠碎片化，整体睡眠质量差。睡眠障碍常导致日间疲劳、抑郁或疼痛强度增加等症状加重。相反，疼痛的感知会降低睡眠质量。睡眠是一种复杂的激素和神经调质影响的调节，以维持再生过程和信号处理。此外，白细胞介素（如 IL-6 和 TNFα）、信使物质或炎症标志物（如 CRP）可能对睡眠有调节作用。
MD 中的睡眠障碍通常可以通过行为疗法或药物治疗来治疗。另一个非常重要的影响是身体活动。与训练相结合，有规律的身体活动可以改善睡眠质量、耐力表现和降低炎症值。改变活动和营养的生活方式是 MD 患者最佳治疗的另一个关键概念。
