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Chest. 2018 Nov;154(5):1249-1259. doi: 10.1016/j.chest.2018.07.019. Epub 2018 Jul 27.

Sleep Disturbance and Pain: A Tale of Two Common Problems.

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Departamento de Psicobiologia, Universidade Federal de São Paulo, Brazil. Electronic address:
Departamento de Psicobiologia, Universidade Federal de São Paulo, Brazil.


Chronic pain has been associated with sleep disturbances in a bidirectional manner, with pain disrupting sleep, and sleep deprivation or disturbance increasing pain. This conventional view began to be reassessed with data from longitudinal and microlongitudinal studies investigating the causal relationship. In this review, we examine the current thinking on the temporal associations between sleep and pain, focusing on studies that considered whether sleep disturbances could predispose individuals to pain conditions. The evidence suggests that insomnia predisposes individuals to chronic pain or to the worsening of painful conditions. A limited number of studies are available that explore this outcome in relation to some of the most prevalent sleep disturbances, such as short sleep duration, sleep apnea, narcolepsy, and sleep bruxism conditions. Despite consistent data showing that sleep and pain are related, there are still few longitudinal studies investigating sleep disturbances as a possible pathogenic condition of chronic pain. Because of the effect of pain and sleep problems on quality of life, investigating how sleep and pain are associated is key to improving health outcomes through better treatments and prevention strategies.


chronic pain; sleep; sleep apnea; sleep disturbance; temporal association

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