Although literature indicates bidirectional associations between sleep disturbances and pain, few longitudinal studies have examined the role of sleep disturbances in contributing to chronic pain, according to a review published in Chest.

In this review, the investigators focused on studies that assessed whether sleep disturbances could predispose individuals to pain conditions. Insomnia was found to predispose patients to chronic pain or to contribute to the worsening of pain conditions, prompting the study authors to recommend that clinicians managing patients with chronic pain assess them for insomnia.

In studies examining the association between common sleep disturbances and chronic pain, some evidence was found linking short sleep duration, sleep apnea, narcolepsy, and sleep bruxism to chronic pain. The small number of studies and limitations in study design prevented the researchers from defining the directionality of these associations.

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The review authors formulated 4 recommendations for clinicians managing patients with chronic pain:

  • Chronic pain conditions should be managed as comorbidities of sleep disturbances.
  • Pain symptoms in patients with sleep disturbances should be investigated via experimental and clinical settings using the best available methodological tools.
  • Longitudinal studies should be conducted to assess temporal associations between sleep disturbances and chronic pain.
  • The mechanisms associated with pain development in patients with sleep disturbances should be investigated.

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“The elevated prevalence of sleep disturbances in general society highlights the need to investigate negative health outcomes caused by sleep problems,” the researchers wrote.


Andersen ML, Araujo P, Frange C, Tufik S. Sleep disturbance and pain: a tale of two common problems. [published online July 27, 2018]. Chest. doi:10.1016/j.chest.2018.07.019

This article originally appeared on Clinical Pain Advisor