Rouhi Shima, Topcu Jamie, Egorova-Brumley Natalia, Jordan Amy S
The University of Melbourne, Australia.
The University of Melbourne, Australia.
Sleep Med Rev. 2023 Oct;71:101835. doi: 10.1016/j.smrv.2023.101835. Epub 2023 Aug 7.
Females have increased pain sensitivity and are more vulnerable to chronic pain conditions. Sleep disturbances are comorbid with chronic pain and exacerbate pain symptoms. Different types of sleep disturbance affect pain perception distinctly, but it is not clear if these effects are equal in men and women. This systematic review investigated potential differences in how sleep disturbance affects pain in males and females. We searched EBSCO, MEDLINE, Psych INFO, Science Direct, and Web of Science from January 2001 to November 2022 and found 38 studies with 978 participants. Separate random-effects models were used to estimate the pooled effect sizes based on standardized mean differences (SMDs) of experimental sleep disturbance paradigms on various pain outcomes. Sex moderated the effect of sleep disturbance on pain facilitation (SMD = 0.13; 95%CI: 0.004 to 0.022; p=.009) and pain inhibition (SMD = 0.033; 95%CI: 0.011 to 0.054; p=.005), with increased facilitation and decreased inhibition in females, but the opposite effect in males. Further, age moderated the effects of total sleep deprivation (SMD = -0.194; 95%CI -0.328 to -0.060; p=.008) on pain sensitivity and fragmented sleep (SMD = -0.110; 95%CI: 0.148 to -0.072; p<.001) on pain threshold. While the moderating effect of sex and age on the sleep-pain relationship was small, these factors need to be considered in future sleep-pain research.
女性的疼痛敏感性更高，更容易患上慢性疼痛疾病。睡眠障碍与慢性疼痛共存，并会加剧疼痛症状。不同类型的睡眠障碍对疼痛感知的影响截然不同，但尚不清楚这些影响在男性和女性中是否相同。本系统评价调查了睡眠障碍对男性和女性疼痛影响的潜在差异。我们检索了2001年1月至2022年11月期间的EBSCO、MEDLINE、Psych INFO、Science Direct和Web of Science数据库，共找到38项研究，涉及978名参与者。基于实验性睡眠障碍范式对各种疼痛结果的标准化平均差（SMD），使用单独的随机效应模型来估计合并效应量。性别调节了睡眠障碍对疼痛易化（SMD = 0.13；95%CI：0.004至0.022；p = 0.009）和疼痛抑制（SMD = 0.033；95%CI：0.011至0.054；p = 0.005）的影响，女性的疼痛易化增加而疼痛抑制减少，而男性则相反。此外，年龄调节了总睡眠剥夺（SMD = -0.194；95%CI -0.328至-0.060；p = 0.008）对疼痛敏感性的影响，以及碎片化睡眠（SMD = -0.110；95%CI：0.148至-0.072；p < 0.001）对疼痛阈值的影响。虽然性别和年龄对睡眠-疼痛关系的调节作用较小，但在未来的睡眠-疼痛研究中仍需考虑这些因素。
