The differential effects of sleep deprivation on pain perception in individuals with or without chronic pain: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of experimental sleep deprivation trials
PubMed 36334461 · doi:10.1016/j.smrv.2022.101695
What was done
A systematic review and meta-analysis of experimental sleep deprivation (SD) paradigms searched five databases up to June 2022. Separate random-effects models estimated pooled effect sizes (ES) of different SD paradigms (total, partial, fragmentation) on subjective pain intensity, thresholds, tolerance, and sensitization in healthy participants and those with chronic pain.
What was found
Across 31 studies (699 healthy participants, 47 with chronic pain): - In healthy individuals, total SD reduced pain threshold and tolerance (ES 0.74 to 0.95), partial SD increased spontaneous pain intensity (ES 0.30), and sleep fragmentation increased peripheral and central sensitization (ES 0.42 to 0.79). - In individuals with chronic pain, very limited evidence indicated that total or partial SD worsened spontaneous pain intensity (no specific numerical effect size reported in the abstract).
Why it matters
This review clarifies how specific types of sleep loss alter distinct pain processing mechanisms in healthy humans, while emphasizing that experimental evidence in clinical chronic pain populations is severely lacking.
Limits
The clinical chronic pain cohort was extremely small (n = 47 total), preventing reliable conclusions for patient populations. Evidence grades for specific outcomes ranged from very limited to moderate, and the abstract omitted exact confidence intervals, specific pain testing modalities, and statistical heterogeneity metrics.
Cited by
- supports Under sleep deprivation, individuals experience heightened sensitivity to pain.