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Short-Term Sleep Disturbance–Induced Stress Does not Affect Basal Pain Perception, but Does Delay Postsurgical Pain Recovery

  • Po-Kai Wang
    Affiliations
    Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey

    Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Institute of Medical Sciences, School of Medicine, Tzu Chi University, Hualien, Taiwan
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  • Jing Cao
    Affiliations
    Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey

    Department of Anatomy, College of Basic Medicine, Zhengzhou University, Zhengzhou, Henan, China
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  • Hongzhen Wang
    Affiliations
    Department of Orthopedics, The First People's Hospital of Kunshan City, Kunshan, Jiangsu, China
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  • Lingli Liang
    Affiliations
    Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey
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  • Jun Zhang
    Affiliations
    Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey
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  • Brianna Marie Lutz
    Affiliations
    Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey

    Rutgers Graduate School of Biomedical Sciences, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey
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  • Kun-Ruey Shieh
    Affiliations
    Institute of Medical Sciences and Department of Physiology, School of Medicine, Tzu Chi University, Hualien, Taiwan
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  • Alex Bekker
    Affiliations
    Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey
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  • Yuan-Xiang Tao
    Correspondence
    Address reprint requests to Dr. Yuan-Xiang Tao, MD, PhD, Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, 185 S. Orange Ave., MSB, F-548, Newark, NJ 07103.
    Affiliations
    Department of Anesthesiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey

    Department of Cell Biology & Molecular Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey

    Department of Neurology & Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey

    Department of Physiology & Pharmacology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey
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Published:September 02, 2015DOI:https://doi.org/10.1016/j.jpain.2015.07.006

      Highlights

      • Short-term sleep disturbance causes stress, but does not alter basal pain perception.
      • Short-term sleep disturbance prolongs postoperative pain.
      • Opioid receptor reduction in spinal cord and dorsal root ganglion contribute to this prolongation.

      Abstract

      Chronic sleep disturbance–induced stress is known to increase basal pain sensitivity. However, most surgical patients frequently report short-term sleep disturbance/deprivation during the pre- and postoperation periods and have normal pain perception presurgery. Whether this short-term sleep disturbance affects postsurgical pain is elusive. Here, we report that pre- or postexposure to rapid eye movement sleep disturbance (REMSD) for 6 hours daily for 3 consecutive days did not alter basal responses to mechanical, heat, and cold stimuli, but did delay recovery in incision-induced reductions in paw withdrawal threshold to mechanical stimulation and paw withdrawal latencies to heat and cold stimuli on the ipsilateral side of male or female rats. This short-term REMSD led to stress shown by an increase in swim immobility time, a decrease in sucrose consumption, and an increase in the level of corticosterone in serum. Blocking this stress via intrathecal RU38486 or bilateral adrenalectomy abolished REMSD-caused delay in recovery of incision-induced reductions in behavioral responses to mechanical, heat, and cold stimuli. Moreover, this short-term REMSD produced significant reductions in the levels of mu opioid receptor and kappa opioid receptor, but not Kv1.2, in the ipsilateral L4/5 spinal cord and dorsal root ganglia on day 9 after incision (but not after sham surgery).

      Perspective

      Our findings show that short-term sleep disturbance either pre- or postsurgery does not alter basal pain perception, but does exacerbate postsurgical pain hypersensitivity. The latter may be related to the reductions of mu and kappa opioid receptors in the spinal cord and dorsal root ganglia caused by REMSD plus incision. Prevention of short-term sleep disturbance may help recovery from postsurgical pain in patients.

      Key words

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