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Lucena L, Lavigne G, Fabbro CD, Andersen ML, Tufik S, Hachul H. Association between night pain and quality of life in women: A general population sleep study. Eur J Pain 2023; 27:401-412. [PMID: 36516369 DOI: 10.1002/ejp.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Women with pain present decreased sleep duration and quality of life, but little is known about the consequences of nighttime pain on overall health. Our goal was to compare levels of anxiety, depression and fatigue in women with pain during the night with those without pain. We hypothesized that pain perception is associated with the worsening of fatigue and mood. METHODS In total, 244 women aged 20-80 years who took part in the Epidemiologic Sleep Study (EPISONO) met the inclusion criteria, 85 in the self-reported pain group and 171 in the control group. Participants were assigned to the pain group if they both responded (i) they generally had pain, according to Pre-Sleep Questionnaire (PSQ) and (ii) their pain generally interfered with their sleep 3 or more times a week, according to Pittsburg Sleep Quality Index (PSQI). Those who answered negatively to both questions were allocated to the control group. All participants underwent a full night laboratory polysomnography, and completed questionnaires related to fatigue, depression, anxiety and quality of life. RESULTS Pain group participants had a significantly lower perception of quality of life, and significantly higher levels of fatigue (5.4 times), anxiety and depression. Pain perception was also correlated to levels of anxiety and depression in the psychological (rs = -0.463, -0.607, respectively) and social (rs = -0.423, -0.438, respectively) quality of life domains. CONCLUSIONS Nighttime pain in women was associated with decreased quality of life, worsening mood and fatigue. Our data shows the importance of investigating pain and its deleterious effects on women's health. SIGNIFICANCE Our study highlights that women experiencing nighttime pain also reported worse mood outcomes and decreased quality of life, regardless of the level and type of pain. Our data, based on association analysis and not investigating causality, suggest it is important to consider nighttime pain in clinical care to improve quality of life and general health.
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Affiliation(s)
- Leandro Lucena
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS Nord lle de Montréal and Stomatology, CHUM, Montréal, Canada
| | - Cibele Dal Fabbro
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS Nord lle de Montréal and Stomatology, CHUM, Montréal, Canada
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Helena Hachul
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
- Departamento de Ginecologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Athnaiel O, Cantillo S, Paredes S, Knezevic NN. The Role of Sex Hormones in Pain-Related Conditions. Int J Mol Sci 2023; 24:ijms24031866. [PMID: 36768188 PMCID: PMC9915903 DOI: 10.3390/ijms24031866] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
Millions of people are affected by pain-related conditions worldwide. Literature has consistently shown that each individual experiences and perceives pain in a unique manner due to biological, environmental, and cultural factors in which they have been raised. It has been established that biological males and females perceive pain differently and that it may be partially explained by their distinct hormonal profiles since birth, which are only further magnified during puberty. For biological males, high levels of testosterone have shown to increase their pain threshold; and for biological females, estrogen fluctuations have shown to increase pain intensity and perception. However, sex hormones have not been studied in the context of pain treatment or their impact on biochemical pathways involved in pain perception. For this purpose, the transgender community serves as a unique population to investigate the impact of hormone replacement therapy on molecular pathways involved in the perception of pain. The purpose of this review is to explore the biochemistry of hormone replacement in transgender patients who also have other pain-related conditions such as headaches, fibromyalgia, temporomandibular myalgia, and visceral pain.
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Affiliation(s)
- Onella Athnaiel
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA
| | - Santiago Cantillo
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA
| | - Stephania Paredes
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
- Correspondence:
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Carvalho B, Tufik S, Hachul H. Apnea and pain: is there an association? Menopause 2022. [PMID: 36256950 DOI: 10.1097/GME.0000000000002091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Duymaz T, Yagci N, Gayef A, Telatar B. Study on the relationship between low back pain and emotional state, sleep and quality of life in postmenopausal women. J Back Musculoskelet Rehabil 2021; 33:989-994. [PMID: 32804115 DOI: 10.3233/bmr-181381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the incidence of low back pain in the postmenopausal period and the relationship between low back pain and emotional state, sleep and quality of life. METHODS This cross-sectional study was conducted with 368 postmenopausal women between 40 and 65 years old. The frequency and severity of low back pain were recorded for all participants, as well as depressive symptoms and anxiety, quality of life and sleep quality. RESULTS 90.2% of the participants reported low back pain. As low back pain severity increased, it was found that depression, anxiety levels, NHP and PSQI total scores increased as well (p= 0.0001). Significant positive correlations were found between pain intensity and outcome measures, except for sleep duration and habitual sleep efficiency (p< 0.01). CONCLUSION A great majority of women experience postmenopausal low back pain, which causes significant problems that negatively affect their quality of life, emotional state and sleep quality.
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Affiliation(s)
- T Duymaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey
| | - N Yagci
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - A Gayef
- Department of Medical Education, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - B Telatar
- Department of Family Medicine, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey
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Abstract
PURPOSE The purpose of this study was to describe the association between type 2 diabetes and musculoskeletal symptoms among midlife women from 4 major racial/ethnic groups in the United States. METHODS This is a secondary data analysis using the data from 164 participants aged 40 to 60 years of 2 larger survey studies (62 with type 2 diabetes and 102 without type 2 diabetes). In the original studies, the participants completed multiple questionnaires on background characteristics, health status, menopausal status, and musculoskeletal symptoms. The Musculoskeletal Symptom Index for Midlife Women was used to determine the number and severity of musculoskeletal symptoms. For data analysis, independent t tests, Mann-Whitney U tests, and multiple regression analyses were used. RESULTS The mean number of musculoskeletal symptoms was significantly higher in women with vs without type 2 diabetes as was the mean severity score. In subgroup analyses, among each menopausal stage and non-Hispanic white women, there were significant differences in the numbers and total severity scores between those with type 2 diabetes and without type 2 diabetes. When background characteristics, health status, and menopausal status were controlled, having diagnosis of type 2 diabetes was positively associated with the numbers and total severity scores of musculoskeletal symptoms. CONCLUSION Study findings supported significant associations of type 2 diabetes with musculoskeletal symptoms among midlife women. Further studies are recommended to confirm relationships in larger populations.
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Affiliation(s)
- You Lee Yang
- School of Nursing, Duke University, Durham, North Carolina
| | - Wonshik Chee
- School of Nursing, Duke University, Durham, North Carolina
| | - Eun-Ok Im
- School of Nursing, Duke University, Durham, North Carolina
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Payrits M, Sághy É, Cseko K, Pohóczky K, Bölcskei K, Ernszt D, Barabás K, Szolcsányi J, Ábrahám IM, Helyes Z, Szoke É. Estradiol Sensitizes the Transient Receptor Potential Vanilloid 1 Receptor in Pain Responses. Endocrinology 2017; 158:3249-3258. [PMID: 28977586 DOI: 10.1210/en.2017-00101] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/29/2017] [Indexed: 11/19/2022]
Abstract
Sex differences exist in chronic pain pathologies, and gonadal estradiol (E2) alters the pain sensation. The nocisensor transient receptor potential vanilloid 1 (TRPV1) receptor plays a critical role in triggering pain. Here we examined the impact of E2 on the function of TRPV1 receptor in mice sensory neurons in vitro and in vivo. Both mechano- and thermonociceptive thresholds of the plantar surface of the paw of female mice were significantly lower in proestrus compared with the estrus phase. These thresholds were higher in ovariectomized (OVX) mice and significantly lower in sham-operated mice in proestrus compared with the sham-operated mice in estrus phase. This difference was absent in TRPV1 receptor-deficient mice. Furthermore, E2 potentiated the TRPV1 receptor activation-induced mechanical hyperalgesia in OVX mice. Long pretreatment (14 hours) with E2 induced a significant increase in TRPV1 receptor messenger RNA expression and abolished the capsaicin-induced TRPV1 receptor desensitization in primary sensory neurons. The short E2 incubation (10 minutes) also prevented the desensitization, which reverted after coadministration of E2 and the tropomyosin-related kinase A (TrkA) receptor inhibitor. Our study provides in vivo and in vitro evidence for E2-induced TRPV1 receptor upregulation and sensitization mediated by TrkAR via E2-induced genomic and nongenomic mechanisms. The sensitization and upregulation of TRPV1 receptor by E2 in sensory neurons may explain the greater pain sensitivity in female mice.
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Affiliation(s)
- Maja Payrits
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
| | - Éva Sághy
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, H-1089, Budapest, Hungary
| | - Kata Cseko
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
| | - Krisztina Pohóczky
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
| | - Kata Bölcskei
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
| | - Dávid Ernszt
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
- Department of Pharmaceutical Biotechnology, University of Pécs, Medical School, H-7624 Pécs, Hungary
| | - Klaudia Barabás
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
- Institute of Physiology, University of Pécs, Medical School, H-7624 Pécs, Hungary
| | - János Szolcsányi
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
| | - István M Ábrahám
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
- Institute of Physiology, University of Pécs, Medical School, H-7624 Pécs, Hungary
- MTA-PTE NAP B Molecular Neuroendocrinology Research Group-Hungary, H-7624 Pécs, Hungary
- Centre for Neuroscience, University of Pécs, H-7624 Pécs, Hungary
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
- Centre for Neuroscience, University of Pécs, H-7624 Pécs, Hungary
- MTA-PTE NAP B Chronic Pain Research Group-Hungary, H-7624 Pécs, Hungary
| | - Éva Szoke
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, H-7624 Pécs, Hungary
- Janos Szentagothai Research Centre, University of Pécs, H-7624 Pécs, Hungary
- MTA-PTE NAP B Chronic Pain Research Group-Hungary, H-7624 Pécs, Hungary
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Abstract
BACKGROUND Sleep disturbances and pain are assumed to be reciprocally linked. Insomnia and pain are central symptoms of the postmenopausal period and are closely related. Insomnia affects quality of life, increases pain sensitivity, the risk of pain-related disability, and other health problems. OBJECTIVE To investigate whether insomnia influences aspects of pain (pain intensity and the effect of pain on daily function) in postmenopausal women, and to evaluate the objective sleep pattern of insomniacs with pain. METHODS Fifty-seven women completed questionnaires about insomnia, climacteric symptoms, and pain. Polysomnography data were collected as well as their medical history. Patients were allocated into three groups: control, subthreshold insomnia, and insomnia. Pain intensity, climacteric symptoms and objective sleep pattern were compared between groups. RESULTS Postmenopausal women with insomnia had statistically significant higher pain interference in their activities (e.g. relationships with other people, enjoyment of life and sleep) than controls, and had more severe climacteric symptoms. There were no statistically significant differences in pain intensity and objective sleep pattern between groups. CONCLUSIONS Insomnia status affected climacteric symptoms and pain interference, but not pain intensity in postmenopausal women. Women with insomnia had higher rates of climacteric symptoms than those without insomnia or those with subthreshold insomnia. No changes in objective sleep pattern were found.
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Affiliation(s)
- C Frange
- a Department of Psychobiology , Universidade Federal de São Paulo , São Paulo , Brazil
| | - M Fernanda Naufel
- b Department of Nutrition , Universidade Federal de São Paulo , São Paulo , Brazil
| | - M Levy Andersen
- a Department of Psychobiology , Universidade Federal de São Paulo , São Paulo , Brazil
| | - E Beraldi Ribeiro
- b Department of Nutrition , Universidade Federal de São Paulo , São Paulo , Brazil
| | - M J B Castelo Girão
- c Department of Gynecology , Universidade Federal de São Paulo , São Paulo , Brazil
| | - S Tufik
- a Department of Psychobiology , Universidade Federal de São Paulo , São Paulo , Brazil
| | - H Hachul
- a Department of Psychobiology , Universidade Federal de São Paulo , São Paulo , Brazil.,c Department of Gynecology , Universidade Federal de São Paulo , São Paulo , Brazil
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