Sleep and Pain

AS A SLEEP RESEARCHER, THE IMPORTANCE OF SLEEP FOR A VARIETY OF HEALTH-RELATED FIELDS IS READILY APPARENT. THE SAME CAN BE SAID OF pain. Thus, it is surprising that the relationship between these two complex phenomena has not received greater study. Sleep and Pain is an edited, multiauthor volume that provides a broad view of what is presently known about the interaction between sleep and pain. It is divided into two main parts, with the first part focused on basic science issues and the second on clinical issues that link sleep and pain. Each chapter is written by recognized experts and provides coherent and well-presented information on a variety of topics linking sleep and pain. Part one of the book begins with two chapters designed to orient the reader to current thinking regarding the mechanisms and function of sleep, definitions, basic neural mechanisms, and theories of pain. This is followed by a chapter on the modulation during sleep and wakefulness of sensory information in the primary pain pathways (spinothalamic and trigemino-thalamic tracts) prior to thalamic integration and a chapter that discusses the role of the thalamus and cerebral cortex in the perception of pain across arousal states. These chapters provide the fundamental concepts to support seven succeeding basic science chapters that cover a range of topics integrating sleep and pain. Topics covered include potential mechanisms underlying the disruptive effects of opioids on rapid eye movement sleep, pain perception in sleep, sleep deprivation and the perception of pain, functional neuroimaging studies of sleep and pain, pain-related cortical activity in sleep and attention, electroencephalographic correlates of sleep and pain, and lastly the occurrence of sleep fragmentation and arousal in pain patients. For the neuroscientist, the discussions highlighting neural regions and systems involved in the interaction between sleep and pain should be of particular interest. Part two of the book consists of ten chapters written by clinician-scientists and is devoted to clinical issues involving interactions between sleep disorders and pain. The first two chapters discuss methodological issues involved in research and epidemiology of the relationship between sleep and pain. Other chapters cover how sleep disorders and pain can interact, special issues in pediatric and geriatric life stages, pain in dreams and nightmares, pain medications and sleep, and sleep medications and pain. The last two chapters cover the clinical consequences of pain and sleep disorders and cognitive-behavioral treatment for insomnia and pain. These chapters cover a number of obvious (medications and sleep and pain) and some possibly not so obvious (e.g., the importance of considering age) topics. The editors state that they hope this book “inspires more collaborative research that will clarify the interactions between sleep and pain, and that it encourages the emergence of more interdisciplinary management approaches for the treatment of disorders involving both pain and sleep problems.” It is doubtful that scientists in either field will be able to read it and not be moved to think about new integrative research possibilities, or that clinicians will not gain useful insight into the interaction between these two complex phenomena. Thus, the book could well be the stimulus needed to generate the research the interaction between sleep and pain needs and deserves. In summary, this book provides timely coverage of an important, understudied topic. The chapters are generally well written and provide information that will be useful to basic and clinical researchers interested in mechanisms underlying the interaction between sleep and pain and to clinicians treating patients with sleep disturbances associated with pain. As this is an edited volume that covers a range of topics linking sleep and pain, it is virtually impossible to provide a description that does justice to the content and to the effort the authors put into their respective chapters. Even so, the book is not all-encompassing. However, it is an excellent reference book and would have been immensely valuable to this reviewer when writing a recent paper touching on the relationship between sleep and pain.