(190) Effects of sleep continuity disruption on cold pain tolerance and accompanying pain catastrophizing in healthy, good sleepers

Abstract

Chronic sleep problems, such as those associated with insomnia, have been shown to increase vulnerability for chronic pain at the population level. However, there is limited understanding of the mechanisms linking sleep and pain. Cold pain tolerance (CPT) is a predictor of clinical pain severity in chronic pain patients. Pain catastrophizing, a maladaptive cognitive coping strategy, is associated with lower pain tolerance and higher clinical pain. In the present study, we investigated the effects of sleep continuity disruption -- an experimental model of sleep deprivation with ecological validity for comorbid chronic pain and insomnia -- on CPT and accompanying catastrophizing cognitions. Healthy good sleepers underwent one night of uninterrupted sleep (US) and one night of forced awakenings (FA) in a randomized, within-person, counter-balanced design. On the day following each sleep condition, participants placed their dominant hand palm-down in a 4°C circulating water bath for a maximum of 300 seconds and were instructed to remove their hand when the pain became intolerable. CPT was measured as the time to withdrawal. Participants completed a self-report pain catastrophizing scale immediately following CPT. A total of 33 subjects provided usable data on these measures. Results indicated that CPT was significantly lower following FA compared to US (p<0.05). Pain catastrophizing was not significantly different between sleep conditions. Together these findings indicate that a single night of sleep continuity disruption is associated with a reduction in CPT that does not appear to be driven by catastrophizing. The present data suggest that the association of sleep continuity disruption and pain tolerance may be one avenue through which chronic sleep disorders, such as insomnia, increase vulnerability to chronic pain.