Health
A new study suggests that extending nightly sleep in mildly sleepy, healthy adults increases daytime alertness and reduces pain sensitivity.
“Our results suggest the importance of adequate sleep in various chronic pain conditions or in preparation for elective surgical procedures,” said Timothy Roehrs, PhD, the study’s principal investigator and lead author. “We were surprised by the magnitude of the reduction in pain sensitivity, when compared to the reduction produced by taking codeine.”
The study, appearing in the December issue of the journal SLEEP, involved 18 healthy, pain-free, sleepy volunteers.
They were randomly assigned to four nights of either maintaining their habitual sleep time or extending their sleep time by spending 10 hours in bed per night.
Objective daytime sleepiness was measured using the multiple sleep latency test (MSLT), and pain sensitivity was assessed using a radiant heat stimulus.
Results show that the extended sleep group slept 1.8 hours more per night than the habitual sleep group.
This nightly increase in sleep time during the four experimental nights was correlated with increased daytime alertness, which was associated with less pain sensitivity.
In the extended sleep group, the length of time before participants removed their finger from a radiant heat source increased by 25 percent, reflecting a reduction in pain sensitivity.
The authors report that the magnitude of this increase in finger withdrawal latency is greater than the effect found in a previous study of 60 mg of codeine.
According to the authors, this is the first study to show that extended sleep in mildly, chronically sleep deprived volunteers reduces their pain sensitivity.
The results, combined with data from previous research, suggest that increased pain sensitivity in sleepy individuals is the result of their underlying sleepiness.
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Postmenopausal women suffered significant bone density loss in their hip after they were treated with an epidural steroid injection for back pain relief, according to a Henry Ford Hospital study.
Bone density loss after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal woman who doesn’t receive steroid injection, researchers said.
Shlomo Mandel, M.D., a Henry Ford orthopedic physician and the study’s lead author, said physicians should exercise caution prescribing an epidural steroid for select patients, suggesting that multiple injections may compromise bone strength.
“The findings of our study suggest that epidural steroid injections for back pain relief should be approached cautiously in patients at risk for bone fragility,” Dr. Mandel said. “Physicians who do prescribe them should consider measures that optimize bone health such as calcium and vitamin D supplements and exercise as part of their patient’s treatment plan.
The study will be published in the Dec. 1 edition of Spine, http://journals.lww.com/spinejournal/pages/default.aspx .
Back pain is one of the most common medical conditions in the United States, affecting eight out of 10 people at some point during their lives.
As people age, their spine ages with them, causing degenerative changes in the spine.
Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.
In the observational study, Henry Ford sought to evaluate whether steroid injections used for treating lumbar stenosis, increased the risk of bone loss in postmenopausal women. Lumbar stenosis is an abnormal narrowing of the spine canal.
Twenty-eight patients, aged 65 and older and treated between 2007 and 2010, were evaluated for bone loss using bone density testing and serum biochemical markers prior to receiving an injection, then at three- and six-month intervals.
The bone loss data was compared to bone loss data for postmenopausal women who hadn’t been treated with an epidural injection.
“Patients receiving multiple steroid injections with a history of steroid exposure may be especially susceptible to compromised bone strength,” Dr. Mandel said.
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