disease interaction(s) of sleep disorder with chronic pain
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Introduction
Interactions:
- sleep disturbance is a stronger predictor of worsening pain than pain is of worsening sleep[1][2]
- baseline sleep disturbance increases risk of developing chronic musculoskeletal pain ~1.6-1.8-fold[1][3]
- sleep loss, especially loss of slow-wave N3 sleep, triggers cellular inflammation & lowers pain thresholds ~ 35% of this effect is mediated via upregulation of inflammatory cytokines[4]
- insomnia is thus a high-yield treatment target for chronic pain
- cognitive behavioral therapy for insomnia has shown durable improvements in both sleep & pain outcomes in patients with chronic pain[5]
More general terms
References
- ↑ 1.0 1.1 1.2 Runge N, Ahmed I, Saueressig T, et al The bidirectional relationship between sleep problems and chronic musculoskeletal pain: a systematic review with meta-analysis. Pain. 2024 Nov 1;165(11):2455-2467. PMID: https://pubmed.ncbi.nlm.nih.gov/38809241
Runge N, Goossens Z, De Baets L, Understanding the complex relationship between sleep and pain symptoms in people with chronic musculoskeletal pain - A pre-registered network analysis. J Pain. 2025 Nov;36:105555. PMID: https://pubmed.ncbi.nlm.nih.gov/40945639 - ↑ 2.0 2.1 Goossens Z, Van Stallen A, Vermuyten J, et al Day-to-day associations between pain intensity and sleep outcomes in an adult chronic musculoskeletal pain population: A systematic review. Sleep Med Rev. 2025 Feb;79:102013. PMID: https://pubmed.ncbi.nlm.nih.gov/39467486
- ↑ 3.0 3.1 Santos M, Gabani FL, de Andrade SM, et al The bidirectional association between chronic musculoskeletal pain and sleep-related problems: a systematic review and meta-analysis. Rheumatology (Oxford). 2023 Sep 1;62(9):2951-2962. PMID: https://pubmed.ncbi.nlm.nih.gov/37104741
- ↑ 4.0 4.1 Irwin MR, Olmstead R, Bjurstrom MF, Finan PH, Smith MT. Sleep disruption and activation of cellular inflammation mediate heightened pain sensitivity: a randomized clinical trial. Pain. 2023 May 1;164(5):1128-1137. PMID: https://pubmed.ncbi.nlm.nih.gov/36314570 Free PMC article. Clinical Trial. https://pmc.ncbi.nlm.nih.gov/articles/PMC10106531/
- ↑ 5.0 5.1 Husak AJ, Bair MJ. Chronic Pain and Sleep Disturbances: A Pragmatic Review of Their Relationships, Comorbidities, and Treatments. Pain Med. 2020 Jun 1;21(6):1142-1152. PMID: https://pubmed.ncbi.nlm.nih.gov/31909797 Review.