Fragmentation du sommeil chez le patient éprouvant de la douleur

Translated title of the contribution: Sleep fragmentation in patients with pain

L. Parrino, M. Zucconi, M. Giovanni Terzano

Research output: Contribution to journalArticlepeer-review

Abstract

Pain is reported as a leading cause of insomnia in medical illness and more than 70% of patients with painful syndromes complain of sleep problems. Polysomnographic investigation has demostrated that patients with chronic pain have a marked alteration of sleep structure and continuity. The most common findings are: frequent stage shifts, increase of nocturnal awakenings, decreased amounts of slow wave sleep and REM sleep, increase of superficial sleep and body movements, intrusion of alpha-delta sleep, increased arousals and CAP rate. CAP (cyclic alternating pattern) is the EEG marker of unstable sleep and is enhanced by any factor or event that interferes with sleep consolidation. The maintenance of sleep relies on cerebral mechanisms that evaluate sensorial inputs, prevent awakening for non-meaningful information and protect vital integrity allowing relevant inputs to trigger arousals or other behavioural responses. These safeguarding processes require a gate for sensory inputs. Gating is exerted at the thalamic level, leading the cortex to be awakened, aroused or maintain sleep continuity in relation to the intensity and risk of the stimulus and to the ongoing condition of sleep depth and stability. During sleep, the neurovegetative system remains active to external stimuli and proceeds in synchrony with the CAP process. In healthy subjects, a significant cardiac acceleration provoked by nociceptive thermal stimulation occurs during all sleep stages with a decreasing gradient from stage 2, slow wave sleep and REM sleep. Autonomic responses may vary in fibromyalgic patients without the normal decrease in sympathetic activity during sleep and in chronic pain patients already affected by sleep fragmentation or insomnia. The specific alterations of sleep in single painful syndromes and in parasomnias associated with pain during sleep (such as bruxism, nocturnal leg cramps and gastrogsophageal reflux) are described.

Translated title of the contributionSleep fragmentation in patients with pain
Original languageFrench
Pages (from-to)71-78
Number of pages8
JournalDouleur et Analgesie
Volume16
Issue number2
Publication statusPublished - 2003

Keywords

  • Arousals
  • Cyclic alternating pattern
  • Pain
  • Polysomnography
  • Sleep
  • Sleep fragmentation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint

Dive into the research topics of 'Sleep fragmentation in patients with pain'. Together they form a unique fingerprint.

Cite this