Division of Experimental Medicine, McGill University, Montreal, Québec, Canada; Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal), Québec, Canada; Faculty of Dental Medicine, Université de Montréal, Québec, Canada.
Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal), Québec, Canada.
Sleep Med Rev. 2021 Oct;59:101459. doi: 10.1016/j.smrv.2021.101459. Epub 2021 Jan 28.
The multimorbidity formed by sleep disturbances and pain conditions is highly prevalent and has a significant impact in global health and in the socioeconomic system. Although different approaches have been directed toward its management, evidence regarding an optimal treatment is lacking, and pharmacological options are often preferred. Health professionals (e.g., pain and sleep clinicians) tend to focus on their respective expertise, targeting a single symptom with a single drug. This may increase polypharmacy and the risk of drug interactions, adverse events, and mortality. Hence, the use of medications that can directly or indirectly improve sleep, pain, and other possible accompanying conditions without exacerbating them becomes especially relevant. The objectives of this comprehensive review are to: a) describe the beneficial or deleterious effects that some commonly used medications to manage pain have on sleep and sleep disorders; and b) describe the beneficial or deleterious effects that frequently prescribed medications for sleep may have on pain. Moreover, medications targeting some specific sleep-pain interactions will be suggested and future directions for improving sleep and alleviating pain of these patients will be provided with clinical and research perspectives.
由睡眠障碍和疼痛状况构成的多种疾病发病率极高，对全球健康和社会经济系统都有重大影响。尽管已经针对其管理采取了不同的方法，但缺乏关于最佳治疗方法的证据，而且往往更倾向于选择药物治疗。医疗保健专业人员（例如，疼痛和睡眠临床医生）往往专注于各自的专业知识，针对单一症状使用单一药物。这可能会增加多药并用的风险，以及药物相互作用、不良事件和死亡率的风险。因此，使用既能直接又能间接改善睡眠、疼痛和其他可能伴随的疾病，又不会加重这些疾病的药物就显得尤为重要。本综述的目的是：a）描述一些常用的疼痛管理药物对睡眠和睡眠障碍的有益或有害影响；b）描述常用于治疗睡眠的药物对疼痛的有益或有害影响。此外，还将针对一些特定的睡眠-疼痛相互作用的药物进行建议，并从临床和研究角度为这些患者改善睡眠和缓解疼痛提供未来的方向。
