The role of sleep disturbance in endogenous pain modulation through opioidergic, placebo, and positive affective mechanisms

Abstract

Abstract Sleep is a fascinating biological phenomenon that regulates learning effects and many behaviors. Poor sleep quality and sleep disturbance have been identified as risk factors with tangible consequences such as pain, impairments in executive functions, memory loss and/or low mood. In this chapter, we focus on the role of sleep disturbance in the context of chronic pain and pain management with a mechanistic emphasis on sleep as a potential regulator of endogenous pain modulation. Through that lens, we describe interactions between sleep and the opioid system, effects on positive affective analgesia, and the influence of sleep on the occurrence and consolidation of placebo effects and expectations of pain reduction in both healthy participants and chronic pain patients. Future areas of research are identified and discussed.