Pain–autonomic interaction after work-induced sleep restriction

Authors

  • P. Schestatsky,

    Corresponding author
    1. Department of Neurology, EMG Unit from Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
    2. Post-Graduation Program of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
    3. Post-Graduation Program of Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
    • Correspondence: Pedro Schestatsky, Department of Neurology, EMG Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350 – CEP 90035-003, Porto Alegre, Brazil

      (tel.: 51 3359 8520; fax: 51 3359 8083; e-mail: pedro.schestatsky@gmail.com).

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  • L. Dall-Agnol,

    1. Post-Graduation Program of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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  • L. Gheller,

    1. Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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  • L. C. Stefani,

    1. Pain and Palliative Care Service, HCPA, Porto Alegre, Brazil
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  • P. R. S. Sanches,

    1. Department of Biomedical Engineering, HCPA, Porto Alegre, Brazil
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  • I. C. de Souza,

    1. Department of Pharmacology, Instituto de Ciências Básicas da Saúde da UFRGS, Porto Alegre, Brazil
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  • I. L. Torres,

    1. Department of Pharmacology, Instituto de Ciências Básicas da Saúde da UFRGS, Porto Alegre, Brazil
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  • W. Caumo

    1. Post-Graduation Program of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
    2. Department of Pharmacology, Instituto de Ciências Básicas da Saúde da UFRGS, Porto Alegre, Brazil
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Abstract

Background and purpose

Poor sleep is commonly associated with alterations in pain perception. However, there is a lack of studies that address work-associated sleep restriction (SR) and changes in non-nociceptive perception and autonomic responses after work-induced SR.

Methods

This study was performed with 19 medical students after a normal-sleep night (NS phase) and after a night shift at the local emergency room (SR phase). We performed clinical assessment, quantitative sensory testing for electrical and temperature sensation, RR interval analysis, and recorded sudomotor skin responses (SSRs).

Results

The total mean duration of sleep was 436 ± 18 min in the NS group and 120 ± 28 min in the SR group (P < 0.001). The anxiety scores were higher following the SR phase compared with those after the NS phase (P < 0.01). After SR, there was a decrease in heat-pain threshold, but neither warm nor electrical thresholds were affected. Following SR, subjects showed higher SSR amplitudes and an increased number of double responses at an interstimulus interval of 2 s. We also observed a moderate inverse correlation between heat-pain thresholds and SSR amplitude (= −0.46; < 0.01). However, there was no correlation between anxiety scores and SSR parameters.

Conclusions

The effects of SR in the context of work stress on pain are specific and appear unrelated to general changes in sensory perception. Hyperalgesia was associated with abnormal autonomic responses, but not with increased anxiety, which suggests an association between the nociceptive and autonomic nervous systems that is independent of the emotional state.

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