Older S A, Battafarano D F, Danning C L, Ward J A, Grady E P, Derman S, Russell I J
Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6272, USA.
J Rheumatol. 1998 Jun;25(6):1180-6.
To assess the effects of delta wave sleep interruption (DWSI) on pain thresholds and fibromyalgia-like symptoms. To examine the potential correlations between DWSI and serum insulin-like growth factor 1 (IGF-1).
Thirteen healthy volunteers were subjected to 3 consecutive nights of DWSI (Group 1). Pain thresholds were measured by dolorimetry and symptoms by visual analog scale. Six subjects not undergoing DWSI served as dolorimetry and symptom controls (Group 2). Serum IGF-1 was measured by competitive binding radioimmunoassay before and after DWSI.
No significant differences in pain thresholds as a function of condition (baseline, DWSI, recovery) or overnight change were detected between or within groups (p>0.05). Morning mean dolorimeter scores were lower than evening scores in both groups during all 3 conditions, and were lower in Group 1 than in Group 2 during DWSI. Group 1 subjects had higher composite symptom scores during DWSI (p< or =0.005), attributed largely to increases in fatigue. Serum levels of IGF-1 from Group 1 subjects showed no significant change after DWSI (p>0.05).
In our study subjects, 3 nights of DWSI caused no significant lowering of pain thresholds compared with a control group. Subjects appeared to have lower pain thresholds in the mornings, and DWSI appeared to augment this effect. Symptoms were more apparent during DWSI, but were primarily related to fatigue. IGF-1 was not altered by 3 nights of DWSI. The low levels of IGF-1 seen in patients with fibromyalgia syndrome may result from chronic rather than acute DWSI, or may be dependent on factors other than disturbances of delta wave sleep.
评估δ波睡眠中断(DWSI)对疼痛阈值和纤维肌痛样症状的影响。研究DWSI与血清胰岛素样生长因子1(IGF-1)之间的潜在相关性。
13名健康志愿者连续3晚接受DWSI(第1组)。通过痛觉测量法测量疼痛阈值,通过视觉模拟量表评估症状。6名未接受DWSI的受试者作为痛觉测量和症状对照(第2组)。在DWSI前后通过竞争性结合放射免疫分析法测量血清IGF-1。
在组间或组内,未检测到疼痛阈值随条件(基线、DWSI、恢复)或夜间变化的显著差异(p>0.05)。在所有3种条件下,两组的早晨平均痛觉计评分均低于晚上评分,且在DWSI期间第1组低于第2组。第1组受试者在DWSI期间的综合症状评分更高(p≤0.005),主要归因于疲劳增加。第1组受试者的血清IGF-1水平在DWSI后无显著变化(p>0.05)。
在我们的研究对象中,与对照组相比,3晚的DWSI并未导致疼痛阈值显著降低。受试者在早晨似乎疼痛阈值较低,而DWSI似乎增强了这种效应。症状在DWSI期间更明显,但主要与疲劳有关。3晚的DWSI未改变IGF-1。纤维肌痛综合征患者中所见的低水平IGF-1可能是由慢性而非急性DWSI导致的,或者可能取决于δ波睡眠障碍以外的因素。