PDF(Pubmed)
Abstract：
Native Americans (NAs) are more likely to experience chronic pain than non-Hispanic Whites (NHWs); however, the proximate causes predisposing NAs to chronic pain remain elusive. Likely due to centuries of adversity, discrimination, and marginalization, NAs report greater psychological stress than NHWs, which may place them at risk for sleep problems, a well-established risk factor for chronic pain onset.
This study examined the effects of psychological stress and sleep problems on subjective and physiological measures of pain processing in NAs and NHWs.
Structural equation modeling was used to determine whether ethnicity (NA or NHW) was associated with psychological stress or sleep problems and whether these variables were related to conditioned pain modulation of pain perception (CPM-pain) and the nociceptive flexion reflex (CPM-NFR), temporal summation of pain (TS-pain) and NFR (TS-NFR), and pain tolerance in a sample of 302 (153 NAs) pain-free participants.
NAs experienced more psychological stress (Estimate = 0.027, p = .009) and sleep problems (Estimate = 1.375, p = .015) than NHWs. When controlling for age, sex, physical activity, BMI, and general health, NA ethnicity was no longer related to greater sleep problems. Psychological stress was also related to sleep problems (Estimate = 30.173, p = <.001) and psychological stress promoted sleep problems in NAs (indirect effect = 0.802, p = .014). In turn, sleep problems were associated with greater TS-pain (Estimate = 0.714, p = .004), but not other pain measures.
Sleep problems may contribute to chronic pain risk by facilitating pain perception without affecting facilitation of spinal neurons or endogenous inhibition of nociceptive processes. Since psychological stress promoted pain facilitation via enhanced sleep problems, efforts to reduce psychological stress and sleep problems among NAs may improve health outcomes.
This study examined the effects of psychological stress and sleep problems on subjective and physiological measures of pain processing in NAs and NHWs.
Structural equation modeling was used to determine whether ethnicity (NA or NHW) was associated with psychological stress or sleep problems and whether these variables were related to conditioned pain modulation of pain perception (CPM-pain) and the nociceptive flexion reflex (CPM-NFR), temporal summation of pain (TS-pain) and NFR (TS-NFR), and pain tolerance in a sample of 302 (153 NAs) pain-free participants.
NAs experienced more psychological stress (Estimate = 0.027, p = .009) and sleep problems (Estimate = 1.375, p = .015) than NHWs. When controlling for age, sex, physical activity, BMI, and general health, NA ethnicity was no longer related to greater sleep problems. Psychological stress was also related to sleep problems (Estimate = 30.173, p = <.001) and psychological stress promoted sleep problems in NAs (indirect effect = 0.802, p = .014). In turn, sleep problems were associated with greater TS-pain (Estimate = 0.714, p = .004), but not other pain measures.
Sleep problems may contribute to chronic pain risk by facilitating pain perception without affecting facilitation of spinal neurons or endogenous inhibition of nociceptive processes. Since psychological stress promoted pain facilitation via enhanced sleep problems, efforts to reduce psychological stress and sleep problems among NAs may improve health outcomes.
摘要：
美洲原住民（NAs）比非西班牙裔白人（NHW）更有可能经历慢性疼痛；然而，导致慢性疼痛的潜在原因仍然难以捉摸。可能是由于几个世纪的逆境，歧视,边缘化,NAs报告的心理压力比NHWs更大，这可能会使他们面临睡眠问题的风险，一个公认的慢性疼痛发作的危险因素。
这项研究检查了心理压力和睡眠问题对NAs和NHWs疼痛处理的主观和生理指标的影响。
结构方程模型用于确定种族（NA或NHW）是否与心理压力或睡眠问题有关，以及这些变量是否与疼痛感知的条件性疼痛调节（CPM-疼痛）和伤害性屈曲反射（CPM-NFR）有关。疼痛（TS-疼痛）和NFR（TS-NFR）的时间总和，和疼痛耐受性在302（153NAs）无痛参与者的样本中。
与NHW相比，NAs经历了更多的心理压力（估计值=0.027，p=.009）和睡眠问题（估计值=1.375，p=.015）。当控制年龄时，性别,身体活动,BMI,和一般健康，NA种族不再与更大的睡眠问题有关。心理压力也与睡眠问题有关（估计值=30.173，p=<.001），心理压力促进了NAs的睡眠问题（间接效应=0.802，p=.014）。反过来,睡眠问题与更大的TS疼痛相关（估计值=0.714，p=.004），但不是其他疼痛措施。
睡眠问题可能通过促进疼痛感知而不影响脊髓神经元的促进或伤害性过程的内源性抑制而导致慢性疼痛风险。由于心理压力通过增强睡眠问题促进疼痛促进，努力减少NAs中的心理压力和睡眠问题可能会改善健康结果。
这项研究检查了心理压力和睡眠问题对NAs和NHWs疼痛处理的主观和生理指标的影响。
结构方程模型用于确定种族（NA或NHW）是否与心理压力或睡眠问题有关，以及这些变量是否与疼痛感知的条件性疼痛调节（CPM-疼痛）和伤害性屈曲反射（CPM-NFR）有关。疼痛（TS-疼痛）和NFR（TS-NFR）的时间总和，和疼痛耐受性在302（153NAs）无痛参与者的样本中。
与NHW相比，NAs经历了更多的心理压力（估计值=0.027，p=.009）和睡眠问题（估计值=1.375，p=.015）。当控制年龄时，性别,身体活动,BMI,和一般健康，NA种族不再与更大的睡眠问题有关。心理压力也与睡眠问题有关（估计值=30.173，p=<.001），心理压力促进了NAs的睡眠问题（间接效应=0.802，p=.014）。反过来,睡眠问题与更大的TS疼痛相关（估计值=0.714，p=.004），但不是其他疼痛措施。
睡眠问题可能通过促进疼痛感知而不影响脊髓神经元的促进或伤害性过程的内源性抑制而导致慢性疼痛风险。由于心理压力通过增强睡眠问题促进疼痛促进，努力减少NAs中的心理压力和睡眠问题可能会改善健康结果。
