Abstract:
Various lines of evidence suggest that a bidirectional relationship exists between poor sleep quality and chronic pain, with each condition tending to promote and exacerbate the other. This has led to the hypothesis that the two conditions may be linked by common underlying mechanisms. It has thus been suggested that inadequate sleep and chronic pain may share neurophysiological and molecular pathways that are similar or overlapping. Some studies based on self-report measures have tended to support the inference that chronic neck pain may promote sleep disturbance, but this association has not, until now, been investigated with quantitative measures. The present study is the first to evaluate the sleep quality of patients with chronic neck pain through the use of polysomnography. The study sought to identify the sleep characteristics of patients with chronic neck pain and then to determine whether these characteristics were associated with the severity of their neck pain. Laboratory testing with polysomnography was carried out on 32 males who had complaints of chronic neck pain and on 12 healthy participants who served as controls. Compared to the control subjects, patients with chronic neck pain were found to have significantly shorter times spent in sleep (p = 0.015), longer latencies to sleep onset (p = 0.015) and rapid eye movement (REM) sleep (p < 0.05), longer durations spent in Stage 1 (p < 0.05), and shorter durations spent in both Stage 2 (p = 0.001) and REM sleep (p = 0.00). The severity of discomfort was related negatively to the amount of time spent in REM sleep. The present study\'s quantitative measures corroborate the view that patients with chronic neck pain have poor sleep quality. These findings confirm long-held clinical observations that the sleep quality of patients with chronic neck pain is compromised, and that, in this clinical group, poor sleep is at least a correlate of and may be an amplifier of perceived pain.
摘要:
各种证据表明,睡眠质量差和慢性疼痛之间存在双向关系。每种情况都倾向于促进和加剧另一种情况。这导致了一种假设,即这两个条件可能是由共同的潜在机制联系在一起的。因此,有人提出,睡眠不足和慢性疼痛可能具有相似或重叠的神经生理学和分子途径。一些基于自我报告测量的研究倾向于支持慢性颈部疼痛可能促进睡眠障碍的推断,但是这个协会没有,直到现在,用定量措施进行了调查。本研究首次通过多导睡眠图评估慢性颈痛患者的睡眠质量。该研究试图确定慢性颈部疼痛患者的睡眠特征,然后确定这些特征是否与颈部疼痛的严重程度有关。对32名患有慢性颈部疼痛的男性和12名作为对照的健康参与者进行了多导睡眠图的实验室测试。与对照组相比,慢性颈痛患者的睡眠时间明显缩短(p=0.015),睡眠发作延迟更长(p=0.015)和快速眼动(REM)睡眠(p<0.05),在第1阶段花费的持续时间更长(p<0.05),并且在阶段2(p=0.001)和REM睡眠(p=0.00)中花费的持续时间更短。不适的严重程度与REM睡眠时间呈负相关。本研究的定量措施证实了慢性颈痛患者睡眠质量差的观点。这些发现证实了长期以来的临床观察,即慢性颈痛患者的睡眠质量受到损害,而且,在这个临床组中,睡眠不足至少与感觉到的疼痛有关,并且可能是感觉到的疼痛的放大器。