Sleep and Experimental Pain Sensitivity in People with HIV

Abstract

People with HIV (PWH) appear to be at high risk for the experience of recurring pain symptoms throughout their lifetimes. There is also evidence to suggest a high prevalence of insomnia and sleep difficulties in PWH. Insomnia may lead to exaggerated pain states in PWH such as hyperalgesia, which refers to the phenomenon of heightened sensitivity to painful stimuli. The goals of this research are to examine differences in insomnia severity, sleep behaviors, and experimental pain sensitivity between PWH and controls without HIV. Participants included 25 PWH and 25 without HIV, who were all recruited from a local HIV treatment center (PWH) and the surrounding community (without HIV). Participants completed the Insomnia Severity Index and the RU_SATED scale, a measure of subjective sleep health. A quantitative sensory testing (QST) battery was then completed that included an assessment of pressure pain threshold (PPT) followed by temporal summation (TS) of mechanical pain; both administered at the trapezius. Compared to those without HIV, PWH reported greater severity of insomnia symptoms (p<.001) as well as poorer sleep health (p<.001). PWH also demonstrated significantly greater TS of mechanical pain compared to participants without HIV (p=.027). There was no significant difference for PPT (p=.901). In a stratified correlation analysis, the association between poorer sleep health and greater TS of mechanical pain was larger for PWH (r=-.344, p=.092) than it was for participants without HIV (r=-.004, p=.985). This ongoing study provides tentative evidence that PWH may experience worse sleep and enhanced pain facilitation (i.e., TS of mechanical pain) compared to those without HIV. It may also be that poor sleep is promoting enhanced pain facilitation in PWH; however, this possibility should be considered with caution given the small sample size and cross-sectional study design. Grant support from NHLBI - R01HL147603.