A sleep-friendly hospital environment will help ease our patient’s pain and promote healing. A recent study with significant implications for nursing care found that even minor sleep deprivation can increase pain sensitivity and cause a drop in the neurotransmitters that relieve pain.

The effect of pain on sleep disruption has been well documented, but scientists at the Neuroscience Institute at US Berkeley set out to determine how poor sleep affects pain.

Controlled sleep vs pain study

The study involved applying uncomfortable levels of heat to the legs of the 24 young adult participants while at the same time doing brain scans. The researchers first determined each participant’s baseline pain sensitivity after a full night’s sleep and then the procedure was repeated after a sleepless night.

After sleep deprivation, most of the participants reported feeling pain at a lower temperature than during the baseline measurements. Brain imaging showed disruptions at various levels in the brain’s physiological responses to the painful stimuli. As expected there was higher activity in the somatosensory cortex – where pain is felt.

The researchers were however surprised that there was less activity in the nucleus accumbens which, among other functions, increases the release of dopamine that acts as a natural analgesic. Activity in the insula – a region of the brain that evaluates pain signals and directs the body’s response to pain – was also reduced. This meant that less sleep not only intensified the feeling of pain but also blocked the centers responsible for activating the body’s natural pain relief mechanisms.

Sleep vs pain survey

The researchers then went further to test their findings in a normal living environment. They surveyed over 230 adults using Amazon’s Mechanical Turk online marketplace. Respondents were asked to simply report, for a number of days, how many hours they had slept during the night and how much pain they experienced during the day.

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The results clearly showed that even small changes in sleeping patterns had an impact on the levels of pain reported by the respondents.

Hospital environments should promote sleep

The findings clearly demonstrate that sleep is a significant natural analgesic and should be considered in the contexts of chronic pain and the opioid epidemic. Most importantly, we should create a more sleep-friendly environment in the hospital unit – the one place where people are in the most pain. Interventions could include reducing noise and non-essential procedures, particularly at night.

“If poor sleep intensifies our sensitivity to pain, as this study demonstrates, then sleep must be placed much closer to the center of patient care, especially in hospital wards,” emphasized Matthew Walker, study senior author, and professor of neuroscience and psychology at UC Berkeley.

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Frieda Paton is a registered nurse with a Master’s degree in nursing education. Her passion for nursing education, nursing issues and advocacy for the profession were ignited while she worked as an education officer, and later editor, at a national nurses’ association. This passion, together with interest in health and wellness education since her student days, stayed with her throughout her further career as a nurse educator and occupational health nurse. Having reached retirement age, she continues to contribute to the profession as a full-time freelance writer. In the news and feature articles she writes for Nurseslabs, she hopes to inspire nursing students and nurses on the job to reflect on the trends and issues that affect their profession and communities - and play their part in advocacy wherever they find themselves.

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