Halpin Stephen J, Casson Alexander J, Tang Nicole K Y, Jones Anthony K P, O'Connor Rory J, Sivan Manoj
Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.
Human Pain Research Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom.
Front Pain Res (Lausanne). 2023 Feb 23;4:1096084. doi: 10.3389/fpain.2023.1096084. eCollection 2023.
Chronic pain and sleep disturbance are bi-directionally related. Cortical electrical activity in the alpha frequency band can be enhanced with sensory stimulation the phenomenon of entrainment, and may reduce pain perception. A smartphone based programme which delivers 10 Hz stimulation through flickering light or binaural beats was developed for use at night, pre-sleep, with the aim of improving night time pain and sleep and thereby subsequent pain and related daytime symptoms. The aim of this study was to assess the feasibility and give an indication of effect of this programme for individuals with chronic pain and sleep disturbance.
In a non-controlled feasibility study participants used audio or visual alpha entrainment for 30 min pre-sleep each night for 4 weeks, following a 1 week baseline period. The study was pre-registered at ClinicalTrials.gov with the ID NCT04176861.
28 participants (79% female, mean age 45 years) completed the study with high levels of data completeness (86%) and intervention adherence (92%). Daily sleep diaries showed an increase compared to baseline in total sleep time of 29 min ( = 0.0033), reduction in sleep onset latency of 13 min ( = 0.0043), and increase in sleep efficiency of 4.7% ( = 0.0009). Daily 0-10 numerical rating scale of average pain at night improved by 0.5 points compared to baseline ( = 0.027). Standardised questionnaires showed significant within-participant improvements in sleep quality (change in median Global PSQI from 16 to 12.5), pain interference (change in median BPI Pain Interference from 7.5 to 6.8), fatigue (change in median MFI total score from 82.5 to 77), and depression and anxiety (change in median HADS depression score from 12 to 10.5 and anxiety from 13.5 to 11).
Pre-sleep use of a smartphone programme for alpha entrainment by audio or visual stimulation was feasible for individuals with chronic pain and sleep disturbance. The effect on symptoms requires further exploration in controlled studies.
慢性疼痛与睡眠障碍存在双向关联。通过感觉刺激（即夹带现象）可增强α频段的皮质电活动，这可能会降低疼痛感知。开发了一种基于智能手机的程序，该程序通过闪烁光或双耳节拍提供10赫兹的刺激，用于夜间睡前使用，目的是改善夜间疼痛和睡眠，从而缓解后续疼痛及相关的日间症状。本研究的目的是评估该程序对慢性疼痛和睡眠障碍患者的可行性，并初步显示其效果。
在一项非对照可行性研究中，参与者在1周的基线期后，每晚睡前使用音频或视觉α夹带30分钟，共持续4周。该研究已在ClinicalTrials.gov上进行预注册，注册号为NCT04176861。
28名参与者（79%为女性，平均年龄45岁）完成了研究，数据完整性（86%）和干预依从性（92%）较高。每日睡眠日记显示，与基线相比，总睡眠时间增加了29分钟（P = 0.0033），入睡潜伏期缩短了13分钟（P = 0.0043），睡眠效率提高了4.7%（P = 0.0009）。夜间平均疼痛的每日0至10数字评分量表与基线相比改善了0.5分（P = 0.027）。标准化问卷显示，参与者在睡眠质量（全球PSQI中位数从16变为12.5）、疼痛干扰（BPI疼痛干扰中位数从7.5变为6.8）、疲劳（MFI总分中位数从82.5变为77）以及抑郁和焦虑（HADS抑郁评分中位数从12变为10.5，焦虑评分从13.5变为11）方面有显著的自身改善。
对于慢性疼痛和睡眠障碍患者，睡前使用智能手机程序通过音频或视觉刺激进行α夹带是可行的。对症状的影响需要在对照研究中进一步探索。
