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Pain. 2015 Aug;156(8):1433-9. doi: 10.1097/j.pain.0000000000000131.

Sleep and pain sensitivity in adults.

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aDivision of Mental Health, Norwegian Institute of Public Health, Bergen and Oslo, Norway bRegional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway cDepartment of Psychiatry, Helse Fonna HF, Haugesund, Norway dFinnish Institute of Occupational Health, Helsinki, Finland eDepartment of Public Health, University of Helsinki, Helsinki, Finland fDepartment of Psychological Medicine, University of Auckland, Auckland, New Zealand gDepartment of Health Statistics, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway hDepartment of Pain Management and Research, Oslo University Hospital, Oslo, Norway iInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.


Sleep problems and pain are major public health concerns, but the nature of the association between the 2 conditions is inadequately studied. The aim of this study was to determine whether a range of sleep measures is associated with experimental increased pain sensitivity. A cross-sectional large population-based study from 2007 to 2008, the Tromsø 6 study, provided data from 10,412 participants (age: mean [SD], 58 [13] years; 54% women). Self-reported sleep measures provided information on sleep duration, sleep onset latency (SOL), and sleep efficiency, as well as frequency and severity of insomnia. The main outcome measure was pain sensitivity tests, including assessment of cold-pressor pain tolerance. We found that all sleep parameters, except sleep duration, were significantly associated with reduced pain tolerance. Both the frequency and severity of insomnia, in addition to SOL and sleep efficiency, were associated with pain sensitivity in a dose-response manner. Adjusting for demographics and psychological distress reduced the strengths of the hazard ratios, but most associations remained significant in the fully adjusted models. There was also a synergistic interaction effect on pain tolerance when combining insomnia and chronic pain. We conclude that sleep problems significantly increase the risk for reduced pain tolerance. Because comorbid sleep problems and pain have been linked to elevated disability, the need to improve sleep among patients with chronic pain, and vice versa, should be an important agenda for future research.

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