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Abstract
Objectives: The interaction between sleep and pain is important in patients suffering from rheumatic illness. Not only can pain disturb sleep, but alterations in the deeper sleep stages induced by the disease process may have the potential to decrease the pain threshold. Previous studies however, have shown diverging results. In the current experiment we studied the effects of deep sleep deprivation using a standardized, computer-assisted system on subjective symptoms and pain elicited by different experimental modalities.
Methods: Ten healthy males, mean age 22.7 years, were subjected to deprivation of the deeper sleep stages for three nights. Following a baseline recording, sleep was analyzed in 2 s segments with on-line frequency analysis. If any 30 s epoch contained more than seven 2 s segments dominated by low frequency content corresponding to deep sleep, the sleep was disturbed by an acoustic stimulus. The amount of delta power was computed in sleep stages non-rapid-eye-movement [NREM] 2–4. Subjects rated different questions regarding their feeling of pain, discomfort and psychological complaints twice a day during the experiment. Experimental pain was assessed with thermal [heat and cold pressor] and electrical stimuli as well as pressure pain thresholds in different areas of the body.
Results: The first night of deep sleep deprivation resulted in a reduction in delta power to 39.3 and 10.5% of the baseline in stages NREM3 and 4, respectively [P = 0.005, P = 0.015]. In five subjects the delta power deprivation in stages NREM3 + 4 was 62.2% of baseline in the second deprivation night [P = 0.043]. No consistent changes however, were found for the subjective ratings or the experimental pain assessments following the first deprivation night. For the five subjects who were sufficiently deprived for deep sleep in two nights, the same findings as above were seen following both nights.
Conclusion: Controlled delta power deprivation during sleep did not result in pain in healthy, young males. Although sleep disturbances may interact with pain and other daytime symptoms, we believe that other factors such as premorbid genetic constitution, age, sex, and several external factors are necessary before sleep disturbances per se are able to induce musculoskeletal symptoms.
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