Rather than just taking painkillers, persons with chronic pain should try to get more sleep, or increase one’s daily alertness by taking medications to promote wakefulness or drinking a cup of coffee, according to researchers.
The study, from Boston Children’s Hospital and Beth Israel Deaconess Medical Center (BIDMC), suggests that chronic sleep loss increases pain sensitivity and wakefulness helps reduce it.
Chronic pain sufferers can get relief by getting more sleep, or, short of that, taking medications to promote wakefulness such as caffeine. Both approaches performed better than standard analgesics in a rigorous study in mice, states a media release from Boston Children’s Hospital.
Pain physiologist Alban Latremoliere, PhD, of Boston Children’s Hospital and sleep physiologist Chloe Alexandre, PhD, of BIDMC conducted the study, which was published recently in Nature Medicine.
Among a group of mice, the duo measured the effects of acute or chronic sleep loss on sleepiness and sensitivity to both painful and non-painful stimuli. They then tested standard pain medications, like ibuprofen and morphine, as well as wakefulness-promoting agents like caffeine and modafinil.
The team started by measuring normal sleep cycles, using tiny headsets that took electroencephalography (EEG) and electromyography (EMG) readings. “For each mouse, we have exact baseline data on how much they sleep and what their sensory sensitivity is,” says Latremoliere, in the release.
Next, they deprived the mice of sleep by entertaining them.
“We developed a protocol to chronically sleep-deprive mice in a non-stressful manner, by providing them with toys and activities at the time they were supposed to go to sleep, thereby extending the wake period,” Alexandre adds. “This is similar to what most of us do when we stay awake a little bit too much watching late-night TV each weekday.”
In this way, they kept groups of six to 12 mice awake for as long as 12 hours in one session, or 6 hours for 5 consecutive days, monitoring sleepiness and stress hormones (to make sure they weren’t stressed) and testing for pain along the way, per the release.
During this time, they measured the mice’s pain sensitivity and response to non-painful stimuli.
“We found that five consecutive days of moderate sleep deprivation can significantly exacerbate pain sensitivity over time in otherwise healthy mice,” Alexandre says. “The response was specific to pain, and was not due to a state of general hyperexcitability to any stimuli.”
The duo notes that common analgesics like ibuprofen, and even morphine, did not block the sleep-loss pain hypersensitivity. However, caffeine and modafinil—drugs used to promote wakefulness—did block the pain hypersensitivity.
“Many patients with chronic pain suffer from poor sleep and daytime fatigue, and some pain medications themselves can contribute to these co-morbidities,” notes Kiran Maski, MD, a specialist in sleep disorders at Boston Children’s, in the release.
“This study suggests a novel approach to pain management that would be relatively easy to implement in clinical care. Clinical research is needed to understand what sleep duration is required and to test the efficacy of wake-promoting medications in chronic pain patients,” Maski adds.
[Source(s): Boston Children’s Hospital, Science Daily]