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Bumgarner JR, McCray EW, Nelson RJ. The disruptive relationship among circadian rhythms, pain, and opioids. Front Neurosci 2023; 17:1109480. [PMID: 36875657 PMCID: PMC9975345 DOI: 10.3389/fnins.2023.1109480] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/26/2023] [Indexed: 02/17/2023] Open
Abstract
Pain behavior and the systems that mediate opioid analgesia and opioid reward processing display circadian rhythms. Moreover, the pain system and opioid processing systems, including the mesolimbic reward circuitry, reciprocally interact with the circadian system. Recent work has demonstrated the disruptive relationship among these three systems. Disruption of circadian rhythms can exacerbate pain behavior and modulate opioid processing, and pain and opioids can influence circadian rhythms. This review highlights evidence demonstrating the relationship among the circadian, pain, and opioid systems. Evidence of how disruption of one of these systems can lead to reciprocal disruptions of the other is then reviewed. Finally, we discuss the interconnected nature of these systems to emphasize the importance of their interactions in therapeutic contexts.
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Affiliation(s)
- Jacob R Bumgarner
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Evan W McCray
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Randy J Nelson
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
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4
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Salwen-Deremer JK, Smith MT, Haskell HG, Schreyer C, Siegel CA. Poor Sleep in Inflammatory Bowel Disease Is Reflective of Distinct Sleep Disorders. Dig Dis Sci 2022; 67:3096-3107. [PMID: 34331174 DOI: 10.1007/s10620-021-07176-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Poor sleep is common in inflammatory bowel disease (IBD), predicting increased risk of flares, surgery, and/or hospitalization and reducing quality of life. AIMS To profile specific sleep disorder symptoms in IBD, informing intervention efforts. METHODS 312 adults with Crohn's disease or ulcerative colitis were recruited from an academic medical center in New Hampshire, USA. Participants completed online surveys about sleep including well-validated measures of sleep quality, insomnia, restless leg syndrome, sleep apnea, and circadian rhythms. Participants also answered questions about IBD-related problems that could interfere with sleep. RESULTS 69.4% of participants reported experiencing poor sleep and 50% reported clinically significant insomnia. Participants with active IBD symptoms were more likely to have poor sleep and insomnia. Of those with poor sleep, 67.8% met the clinical threshold for insomnia disorder and 31.3% met criteria for two or more sleep disorders. IBD-related sleep disruptions (e.g., nighttime awakenings due to bowel movements) were not significantly related to poor sleep quality, but significantly related to insomnia severity for participants with active Crohn's disease. CONCLUSIONS While poor sleep in IBD is reflective of a number of different sleep problems, it is most frequently related to insomnia. IBD symptom severity contributes to insomnia, but insomnia is also distinct from IBD-related sleep disruptions. Future research on the treatment of insomnia disorder in particular in individuals with IBD is warranted.
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Affiliation(s)
- Jessica K Salwen-Deremer
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03784, USA. .,Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Hannah G Haskell
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03784, USA
| | - Colleen Schreyer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Corey A Siegel
- Department of Medicine, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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Van Looveren E, Bilterys T, Munneke W, Cagnie B, Ickmans K, Mairesse O, Malfliet A, De Baets L, Nijs J, Goubert D, Danneels L, Moens M, Meeus M. The Association between Sleep and Chronic Spinal Pain: A Systematic Review from the Last Decade. J Clin Med 2021; 10:3836. [PMID: 34501283 PMCID: PMC8432009 DOI: 10.3390/jcm10173836] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Chronic spinal pain, including both neck and low back pain, is a common disabling disorder in which sleep problems are frequently reported as a comorbidity. The complex processes of both sleep and chronic pain seem to have overlapping mechanisms, which may explain their often established bidirectional relationship. This systematic review aims to investigate the assumed association between sleep and chronic spinal pain by providing an overview of the literature from the last decade. Eligible studies were obtained by searching four databases (PubMed, Embase, Web of Science, and PsycARTICLES). Articles were found relevant if they included a human adult population and investigated the possible association between sleep parameters and chronic spinal pain. Only studies published after January 2009 were included, as this review aimed to provide an update of a previous literature overview on this topic. The quality of the studies was assessed by risk of bias and level of evidence. A total of twenty-seven studies (6 cohort, 5 case-control, and 16 cross-sectional studies) were included in this systematic review. The methodological quality of these studies was low to moderate. The majority of studies reported weak to moderate evidence for an association between sleep parameters and chronic spinal pain, with more severe pain accompanied by more disturbed sleep. Addressing frequently reported sleep problems in chronic spinal pain patients therefore appears to be a necessary complement to pain management to achieve optimal treatment outcomes.
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Affiliation(s)
- Eveline Van Looveren
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (T.B.); (B.C.); (L.D.); (M.M.)
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (W.M.); (K.I.); (A.M.); (L.D.B.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Thomas Bilterys
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (T.B.); (B.C.); (L.D.); (M.M.)
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (W.M.); (K.I.); (A.M.); (L.D.B.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Wouter Munneke
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (W.M.); (K.I.); (A.M.); (L.D.B.); (J.N.)
| | - Barbara Cagnie
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (T.B.); (B.C.); (L.D.); (M.M.)
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (W.M.); (K.I.); (A.M.); (L.D.B.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Research Foundation—Flanders (FWO), 1000 Brussels, Belgium
| | - Olivier Mairesse
- Sleep Laboratory and Unit for Chronobiology U78, Brugmann University Hospital, Université Libre de Bruxelles—Vrije Universiteit Brussel, 1020 Brussels, Belgium;
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (W.M.); (K.I.); (A.M.); (L.D.B.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Research Foundation—Flanders (FWO), 1000 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (W.M.); (K.I.); (A.M.); (L.D.B.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (W.M.); (K.I.); (A.M.); (L.D.B.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- University of Gothenburg Center for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Dorien Goubert
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Lieven Danneels
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (T.B.); (B.C.); (L.D.); (M.M.)
| | - Maarten Moens
- Department of Neurosurgery and Radiology, University Hospital, 1090 Brussels, Belgium;
- Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Mira Meeus
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (T.B.); (B.C.); (L.D.); (M.M.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium
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Stroemel-Scheder C, Kundermann B, Lautenbacher S. The effects of recovery sleep on pain perception: A systematic review. Neurosci Biobehav Rev 2020; 113:408-425. [PMID: 32275917 DOI: 10.1016/j.neubiorev.2020.03.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 03/13/2020] [Accepted: 03/29/2020] [Indexed: 01/04/2023]
Abstract
Experimental studies highlight profound effects of sleep disruptions on pain, showing that sleep deprivation (SD) leads to hyperalgesic pain changes. On the other hand, given that sleep helps normalizing bodily functions, a crucial role of restorative sleep in the overnight restoration of the pain system seems likely. Thus, a systematic review of experimental studies on effects of recovery sleep (RS; subsequently to SD) on pain was performed with the aim to check whether RS resets hyperalgesic pain changes occurring due to SD. Empirical animal and human studies including SD-paradigms, RS and pain assessments were searched in three databases (PubMed, Web of Science, PsycINFO) using a predefined algorithm. 29 studies were included in this review. Most results indicated a reset of enhanced pain sensitivity and vulnerability following RS, especially when total SD was implemented and pressure pain or painful symptoms (human studies) were assessed. Further research should focus on whether and how recovery is altered in chronic pain patients, as this yields implications for pain treatment by enhancing or stabilizing RS.
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Affiliation(s)
| | - Bernd Kundermann
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Giessen, Germany; Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
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Feneberg AC, Kappert MB, Maidhof RM, Doering BK, Olbrich D, Nater UM. Efficacy, Treatment Characteristics, and Biopsychological Mechanisms of Music-Listening Interventions in Reducing Pain (MINTREP): Study Protocol of a Three-Armed Pilot Randomized Controlled Trial. Front Psychiatry 2020; 11:518316. [PMID: 33329075 PMCID: PMC7672017 DOI: 10.3389/fpsyt.2020.518316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 09/22/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Pain can severely compromise a person's overall health and well-being. Music-listening interventions have been shown to alleviate perceived pain and to modulate the body's stress-sensitive systems. Despite the growing evidence of pain- and stress-reducing effects of music-listening interventions from experimental and clinical research, current findings on music-induced analgesia are inconclusive regarding the role of specific treatment characteristics and the biopsychological mechanisms underlying these effects. Objective: The overall aim of this pilot randomized controlled trial is to test and compare the differential effects of frequency-modulated and unmodulated music (both researcher-selected) on experimentally induced perception of acute pain and to test the efficacy of the interventions in reducing biological and subjective stress levels. Moreover, these two interventions will be compared to a third condition, in which participants listen to self-selected unmodulated music. Methods and Analysis: A total of 90 healthy participants will be randomly allocated to one of the three music-listening intervention groups. Each intervention encompasses 10 sessions of music listening in our laboratory. Frequency-modulation will involve stepwise filtering of frequencies in the audible range of 50-4,000 Hz. Acute pain will be induced via the cold pressor test. Primary (i.e., pain tolerance, perceived pain intensity) and secondary (i.e., heart rate variability, electrodermal activity, hair cortisol, subjective stress) outcomes will be measured at baseline, post, and follow-up. In addition, intermittent measurements as well as a follow-up assessment and a range of tertiary measures (e.g., music-induced emotions) are included. Discussion: This is the first study to systematically test and compare the effects of music frequencies along with the control over music selection, both of which qualify as central treatment characteristics of music-listening interventions. Results will be highly informative for the design of subsequent large-scale clinical trials and provide valuable conclusions for the implementation of music-listening interventions for the reduction of perceived pain. Clinical Trial Registration: Clinical Trials Database of the U.S. National Library of Medicine: Identifier NCT02991014.
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Affiliation(s)
- Anja C Feneberg
- Clinical Psychology of Adulthood, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Mattes B Kappert
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
| | - Rosa M Maidhof
- Clinical Psychology of Adulthood, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Bettina K Doering
- Division of Clinical and Biological Psychology, Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Dieter Olbrich
- Center for Psychosomatic Rehabilitation, Klinik Lipperland, Bad Salzuflen, Germany
| | - Urs M Nater
- Clinical Psychology of Adulthood, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
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