World Day of Sleep 2019: sleep disorders and chronic pain, a vicious circle

Sleep is an important part of the quality of life. In fact, experts consider it to be one of the pillars of health, along with physical exercise, a balanced diet and emotional well-being. This Friday, the 12th World Day of Sleep with the motto Healthy dream, healthy aging, organized by the World Sleep Society and transferred to Spain by the Spanish Sleep Society (SES). "If it is insufficient or not repairable, it will have important consequences well-being of the subject, in his performance and at the organic level"Explained Milagros Merino, member of the scientific committee of the SES.

In addition to obesity and many other pathologies, sleep is also intimately related to chronic pain. Therefore, a pilot study that launched the Center for Biomedical Research in the Network of Respiratory Diseases (Ciberes) wants treat sleep disorders holistically in patients with musculoskeletal pain in rehabilitation to see if the intervention improves the results of rehabilitation and reduces the use of drugs to reduce pain, especially opioids.

Treat sleep disorders and pain globally

As explained to DM Olga Mediano, a researcher at the University Hospital of Ciberes at the University of Guadalajara, and one of the authors of the work, "within the research group, we realized that the pain maintained a vicious circle relationship with sleep disorders Those patients with chronic pain sleep poorly, But sleeping poorly also reduces the pain threshold and control, forcing patients to need more medication, which also affects sleep. "The approach of both pathologies is usually done separately, but this pilot study, which currently has 24 patients suffering from low back pain and wants to reach 50 years, wants to break with this vicious circle by initiating a Sleep Disorders Management Program for Patients with Chronic Pain.

Olga Mediano, Sofía Romero and Maria Castillo, Ciberes researchers at the Guadalajara Hospital, with Kronowise devices used as part of the pilot study on sleep and chronic pain.

The objective of the study is "to observe whether an intervention in sleep has an effectImpact on drug needs and if you can reduce the opioid consumption, as well as improving the quality of life, anxiety and depression, the perception of pain "

To this end, a randomized study with a new protocol to study the circadian rhythms of patients before and after the intervention, by measuring the patient's activity, its peripheral temperature and its light, which allows to observe the quality of sleep and its functionality.

To complete the work, the Intervention program in sleep and circadian (SCIP), which consists of polysomnography to diagnose sleep disorders and questionnaires to determine whether participants are suffering from restless legs syndrome e l & # 39; insomnia, in addition to evaluate if they suffer depression and anxiety. "If they have a pathology, we indicate a treatment. take care of your sleep disorder. We also badyze circadian rhythms with the help of the device Kronowise, developed by the University of Murcia, to be able to give the patient hygienic measures of sleep so that your biological clock "is at the hour".

In this way, researchers will be able to evaluate the control group success of the intervention. In addition, pain management is still under the responsibility of the specialists ", we wish that they are able to reduce the amount of drugs that the patient needs thanks to the intervention. badgesics were reduced during the study, we performed a Toxicity and opioid test in the urine"

If it is shown that the intervention is positive, Medium added that the goal is put the acent in the management of sleep disorders in patients with chronic pain, to reduce the use of drugs.

The study also focused on the hospital Arnau de Vilanova de Lérida, the Hospital Clínico de Barcelona, ​​the hospital La Paz de Madrid and the hospital Cáceres. The results should be available by the end of the year, before launching an international study on this topic with the participation of 1,000 patients.

How much sleep do the Spaniards have?

More than half of Spaniards do not sleep well and use the weekend to recover their lost sleep. This is shown by the survey "How are the Spaniards sleeping? manufactured by Ipsos for Philips in collaboration with the Spanish Dream Society (SES) on the occasion of World Sleep Day 2019.

According to the report, Spaniards do not sleep well, 75% want to improve the quality of their sleep and one in four Spaniards has difficulty staying awake during socialization and one in five at work. In fact, only 7% say to sleep extremely well. 13% of respondents consider that they do not sleep nothing good. In addition, participants sleep an average of 6.8 hours on weekdays and 7.8 hours on weekends, while 75% wake up at least once during the night.

World Day of Sleep

These data are the starting point of the Bell Sweet dreams, that Philips and the SES have launched to "raise awareness of the importance of prioritizing and create sleep habits and position it as a fundamental pillar of health and essential for feeling good, having vitality and achieving its goals, "stressed Alejandro Iranzo, president of the SES. The initiative is accompanied by the Ebook 11 expert keys to sleep betterr, which brings together the tips developed by SES pulmonologists and answers questions such as: Why is sleep for health important? To sleep a lot or sleep well? How does light influence sleep? o What is the relationship between food and sleep?

What happens if the dream is not repaired?

Not sleeping properly can lead to emergence complications endocrine, metabolic, psychological, immunological and psychomotor. "Moreover, the bad dream is increasingly seen as a trigger or risk for certain neurological disorders such as stroke, Parkinson's disease, Alzheimer's disease or various neuromuscular disorders. Finally, not sleeping properly is a health problem"Added Carles Gaig Ventura, Coordinator of the study group of sleep and wake disorders of the Spanish Society of Neurology (SEN). "However, they tend to trivialize a lot of alterations or changes this can occur throughout life in sleep patterns, categorizing them as normal or typical of the age at which they suffer, when experience shows that the vast majority of them respond to a specific cause that can be treated with a correct diagnosis. "

In this same line, Juan Pareja Grande, responsible for the sleep unit of Quirónsalud University Hospital in Madrid, believes that to rest well at night can be good during the day. The dream has a very important function of restoring the energy expended. Not having slept properly (in quantity and quality) affects the brain in the same way as the consumption of alcohol and can have very serious consequences. The risk of a car accident is seven times higher for apneas and, in the long term, leads to a deterioration of health, especially in case of hypertension, neurological diseases, immunological accidents or cerebrovascular.

According to Pareja, the propensity to sleep is usually found among ten o'clock and noon night. However, there are people who do not feel it until late in the night and who go to the doctor to complain about l & # 39; insomnia. "However, they do not suffer from insomnia, but rather chronobiological alteration ". This means that there is no problem at bedtime but when they sleep "and may present a problem of phase shift (very common among young people) .Other, on the contrary, tend to s to fall asleep this afternoon – they suffer phase advance problem– To adjust the chronobiological clock of these people, two tools are used: melatonin (a drug that amplifies the sleep signal of the brain) and phototherapy (expose the subject to intense light, favoring his vigil). With these people, you should not use hypnotics or sleeping pills because they are useless. "