Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Drug Seeking Patients

There is a central problem for all patients in pain,regardless of the cause of the pain. The treating clinician must be certain that the patient’s problems with sleep are among the first things addressed.

But be aware that most often problems with sleep are among the last things addressed.

Rapid eye movement (REM – the part of sleep in which we dream) sleep deprivation may cause increased sensitivity to acute pain.

Even healthy persons without acute pain demonstrated more sensitivity to acute pain following a four-hour general sleep restriction that included a 2/3 decrease in REM sleep.

The relationship between disturbed sleep and pain is two-way – not only does pain disrupt sleep, but disrupted sleep may enhance pain.

This is important: Analgesic (pain) medications have an acute REM-suppressing effect, so they may not work as well during the night due to this side effect (patients being more sensitive to pain).

In an acute pain situation, patients may experience increased pain due to sleep disturbances, and this preliminary association between REM loss and hyperalgesia (increased pain) suggests that improving patient sleep may be an important aspect of pain management.

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