Chang Jeremy R, Fu Siu-Ngor, Li Xun, Li Shirley X, Wang Xiaoyue, Zhou Zhixing, Pinto Sabina M, Samartzis Dino, Karppinen Jaro, Wong Arnold Yl
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong, China.
Sleep Med Rev. 2022 Dec;66:101695. doi: 10.1016/j.smrv.2022.101695. Epub 2022 Sep 27.
Many experimental sleep deprivation (SD) studies were conducted to clarify the causal relationship between sleep and pain. This systematic review and meta-analysis aimed to update the evidence regarding the effects of different experimental SD paradigms on various pain outcomes. Five databases were searched from their inception to June 2022. Separate random-effects models were used to estimate the pooled effect sizes (ES) of different experimental SD paradigms on various pain outcomes. Thirty-one studies involving 699 healthy individuals and 47 individuals with chronic pain were included. For healthy individuals, limited evidence substantiated that total SD significantly reduced pain threshold and tolerance (ES 0.74-0.95), while moderate evidence supported that partial SD significantly increased spontaneous pain intensity (ES 0.30). Very limited to moderate evidence showed that sleep fragmentation significantly increased peripheral and central sensitization in healthy individuals (ES 0.42-0.79). Further, there was very limited evidence that total or partial SD significantly aggravated spontaneous pain intensity in people with chronic pain. Our results accentuated that different SD paradigms differentially increased subjective pain intensity and worsened peripheral/central pain sensitization in healthy individuals, whereas the corresponding findings in people with chronic pain remain uncertain. Further rigorous studies are warranted to quantify their relationships in clinical populations.
许多实验性睡眠剥夺（SD）研究旨在阐明睡眠与疼痛之间的因果关系。本系统评价和荟萃分析旨在更新有关不同实验性SD范式对各种疼痛结局影响的证据。检索了五个数据库，检索时间从各数据库建库至2022年6月。采用单独的随机效应模型来估计不同实验性SD范式对各种疼痛结局的合并效应量（ES）。纳入了31项研究，涉及699名健康个体和47名慢性疼痛患者。对于健康个体，有限的证据证实完全睡眠剥夺显著降低疼痛阈值和耐受性（ES 0.74 - 0.95），而中等证据支持部分睡眠剥夺显著增加自发疼痛强度（ES 0.30）。非常有限至中等的证据表明，睡眠碎片化显著增加健康个体的外周和中枢敏化（ES 0.42 - 0.79）。此外，非常有限的证据表明完全或部分睡眠剥夺显著加重慢性疼痛患者的自发疼痛强度。我们的结果强调，不同的睡眠剥夺范式在健康个体中不同程度地增加主观疼痛强度并加重外周/中枢疼痛敏化，而在慢性疼痛患者中的相应发现仍不确定。需要进一步进行严格的研究来量化它们在临床人群中的关系。
