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How sleep loss may lead to heightened pain sensitivity

Lack of sleep is a global problem. Researchers estimate two-thirds of all adults occasionally experience insomnia symptoms, and between 50 to 70 million Americans have a recurring sleep disorder, such as sleep apnea or insomnia.

Insufficient sleep has been linked to seven of the 15Trusted Source leading causes of death in the U.S., such as cardiovascular diseaseTrusted Source, accidents, and diabetesTrusted Source.

Additionally, those who do not get enough sleep frequently experience headaches and/or migrainesTrusted Sourcebody achesTrusted Sourcelower back painTrusted Source, and even chronic pain that does not go away.

Why would insufficient sleep cause body pain? Researchers from Massachusetts General Hospital believe it has to do with a specific neurotransmitterTrusted Source that decreases during insufficient sleep.

How sleep loss promotes pain

Although common life experience and scientific research both suggest a tight link between pain and sleep loss, the mechanisms by which sleep loss promotes pain are not clear, said Dr. Shiqian Shen, associate professor of anesthesia at Harvard Medical School, clinical director of Mass General Research Institute’s Tele Pain Program, and co-senior author of this study.

For this study, Dr. Shen and his team used a mouse model to try to find out why there is a correlation between sleep loss and pain.

Researchers found that lack of sleep causes low levels of a neurotransmitter called N-arachidonoyl dopamineTrusted Source (NADA) within an area of the brain called the thalamic reticular nucleusTrusted Source (TRN), resulting in heightened pain sensitivity, medically known as hyperalgesia.

“TRN is an important node to modulate information flowing between the thalamus and the cerebral cortex, both are brain regions of critical importance for the pain experience,” Dr. Shen explained to Medical News Today.

“Lack of sleep leads to decreased NADA levels in the TRN, which induces TRN malfunction. TRN dysfunction, through its projections to the thalamus, can promote pain sensitivity,” he said.

Chronic pain: Cause or consequence of sleep issues?

While pain is something every person experiences throughout their life, it usually goes away over time.

For some people, their pain does not stop. Pain that lasts for more than three to six monthsTrusted Source is considered chronic pain.

Common types of chronic pain include:

Past studies show chronic pain can be both a cause and consequenceTrusted Source of insufficient sleep.

“It is a vicious circle,” Dr. Medhat Mikhael, a pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved in this study, told Medical News Today.

“Lack of sleep will make the pain worse (and) chronic pain can make patients insomniac because of their anxiety, depression, and because they are preoccupied in their mind with their chronic pain. It is a vicious circle of pain, insomnia, insomnia, more pain, pain, insomnia, insomnia, more pain, and so forth.”
— Dr. Medhat Mikhael

Treating pain induced by sleep loss

Dr. Shen and his colleagues believe these findings may be used in the future to help prevent or reduce chronic pain associated with sleep loss.

“It provides a framework to examine the comorbid interactions between chronic pain and sleep loss. Additionally, the identification of [a neurotransmitter called N-arachidonoyl dopamineTrusted Source (NADA)] leads to future opportunities in testing this molecule or other similar ones for their potential in alleviating pain induced by sleep loss,” he continued.

“More importantly, these findings highlight that chronic pain is a multi-faceted condition and that a multidisciplinary approach is warranted to tackle chronic pain.”
— Dr. Shiqian Shen

“In mechanistic studies, we plan to dissect the mechanisms that how different cell types in the TRN coordinate to output a collective impact on pain induced by sleep loss. For translational studies, we plan to examine whether NADA or other molecules can be used to treat pain induced by sleep loss,” Dr. Shen added.

Better pain treatments that aren’t narcotics

After reviewing this study, Dr. Monique May, MHA family medicine and medical advisor for Aeroflow Sleep, told MNT that having alternatives other than habit-forming medicines such as narcotics is highly desirable.

“This study was very interesting because it highlighted the impact of sleep deprivation on pain by using a naturally occurring substance that the body produces (NADA) to decrease pain,” she explained.

“Sleep deprivation led to lower levels of NADA, which seemed to lead to a higher level of pain. This study points to another reason why sleep is so important in helping the body to heal itself and regenerate,” she said.

“As the article mentions, this same brain chemical (NADA) can play a role in chronic diseases such as Parkinson’s diseaseAlzheimer’s diseasemultiple sclerosisepilepsy, and others, so studies in populations with those diseases could lead to better treatment options,” Dr. May added.

Dr. Mikhael said he would like to see pharmaceutical companies take that research and try to work on producing something that can treat the lack of NADA in the central nervous system that can modulate the central nervous system, and avoid the hyperalgesia state in the nighttime in chronic pain patients.

“It can be very helpful to allow those patients to have a good night’s sleep and it will also help to avoid any increase or augmentation in their pain with this hyperalgesia state. So I would like to see this research extended to human beings and pharmaceuticals working on producing such a product because it can be produced,” he added.

Tips for better sleep

Both Drs. May and Mikhael offered tips for improved sleep hygiene.

They offered the following recommendations to get a better night’s sleep:

  • Set and keep a sleep schedule.
  • Use the bed for sleep and sex only.
  • Keep the bedroom cool and noise-free with dim or no light and comfortable with supportive bedding such as pillows, sheets, and blankets.
  • Avoid any excitement or watching anything that has violence before going to sleep.
  • Take a hot shower before bedtime.
  • Drink a hot, calming drink like chamomile or a hot cup of milk.
  • Avoid any stressful events, discussions, or argumentative phone calls before going to bed.
  • Take any prescribed nighttime medication regularly.
  • Avoid caffeinated products if possible.
  • If drinking caffeinated beverages, stop drinking them in the early afternoon.
  • Exercise regularly.
  • Eat a healthy diet.
  • Meditate.
  • Practice relaxation techniques.
  • Speak with your doctor if you have medical issues that affect sleep, such as pain, anxiety, swelling, shortness of breath, or heart failure.

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