InquiryOrofacial pain and disturbed sleep
Section snippets
Background
Pain can disrupt sleep, whether the pain is acute or chronic in nature. A complex relationship exists between pain and sleep, with acute pain having a more linear and rapidly reversible effect but chronic pain leading to a vicious cycle between the two (Fig 1). Challenges in managing patients who have both sleep disturbances and pain are related to the complexity of these relationships. Advances have been made in our knowledge of the processes that underlie pain experiences, the nature of
Orofacial Pain Processes
Pain, whether acute or chronic, is a common experience in the area of the face, mouth, and jaws. Its diagnosis and treatment are complicated by (1) the complexity of chronic pain with respect to its sensory-discriminative, cognitive, affective, and motivational aspects; (2) the differing types of chronic orofacial pain; (3) lack of understanding regarding the etiology and pathogenesis of orofacial pain; and (4) comorbid conditions such as psychosocial problems and sleep disturbances. Chronic
Sleep Mechanisms
Sleep is essential for the body’s recovery from fatigue and for tissue repair, memory consolidation, and brain function at both cellular and CNS levels. Sleep deprivation leads to a susceptibility to infection, organic dysfunction, reduced functionality, and altered mood, cognition, immune system responses, and somatic pain−related experiences. Usually sleep commences within 20 to 30 minutes after going to bed and lasts 6 to 9 hours, with considerable variation between individuals. Insomnia
Pain-Sleep Interactions
During normal sleep, there is a higher threshold or a lower response rate to noxious stimuli, allowing the preservation of sleep to continue. Sensory transmission in general is attenuated during sleep, so that low-intensity stimuli are seldom perceived in a healthy individual with good sleep quality. In contrast, patients with chronic pain tend to experience short or long periods of sleep. Their stability of sleep is altered. In addition, nonrestorative sleep is a powerful predictor of
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Lavigne GJ, Sessle BJ: The neurobiology of orofacial pain and sleep and their interactions. J Dent Res 95:1109-1116, 2016
Reprints available from GJ Lavigne, Faculty of Dental Medicine, Université de Montréal, Case postale 6128, succursale Centre-ville, Montréal, Québec H3C 3J7, Canada; e-mail: [email protected]