Association of pain and sleep in clinical practice

M.G. Poluektov¹, N.A. Shuvakhina², I.A. Lamkova¹

¹Sechenov University, Moscow

²Peoples’ Friendship University of Russia, Moscow

Sleep is a natural analgesic condition, due to both the processes of relative deafferentation and the influence of neurotransmitters and hormones. An important role in the pain reduction during sleep is a conduct impairment at the thalamus level and orexin activity suppression (neuropeptide involved in the regulation processes of excitation, «sleep-wake» cycle), and melatonin secretion increase. Night sleep disorder is accompanied by an increase in the frequency of various pain syndromes occurrence, both due to a reduction in the overall duration and because of the sleep continuity deterioration. Correction of the common sleep disorder — chronic insomnia — is accompanied by both an improvement in sleep itself and a decrease in concomitant pain. This is shown concerning cognitive behavioral therapy (CBT) — the choice  method in chronic insomnia treatment. Some psychological mechanisms commonality of chronic pain syndromes and sleep disorders allows the use of a combined technique that affects both conditions. The pharmacological possibilities of improving sleep in chronic pain syndromes and combining CBT with pharmacotherapy are discussed. Combined techniques application both concerning the intervention direction and pharmacological and non-pharmacological approach combination is promising for improving sleep in pain syndromes and, as a result, for better pain management.

Keywords: sleep, insomnia, chronic pain, cognitive behavioral therapy.

For citation: Poluektov M.G., Shuvakhina N.A., Lamkova I.A. Association of pain and sleep in clinical practice. RMJ. 2019;9:56–60.