In patients with osteoarthritis (OA), more than half experience pain during the night, resulting in sleep disruption, poor sleep quality, sleep fragmentation and frequent shifts between sleep stages. Recent studies have shown that sleep disruption can be a predictor of pain severity. Sleep disruption, therefore, could be associated with increased pain sensitivity and enhanced pain facilitation in addition to reduced pain inhibition in persons with chronic pain.

A team of researchers from Arizona State University, University of Alabama and University of Florida analyzed the relationships of self-reported insomnia severity and maladaptive sleep behaviors with pain sensitivity in persons with knee osteoarthritis (OA). They hypothesized that reports of greater insomnia severity would be associated with lower pain thresholds and inhibition and with greater temporal summation of pain.

For the study, participants with knee pain were recruited from the community with eligibility being age 45 to 85, African American or non-Hispanic white and knee OA based on American College of Rheumatology criteria. Subjects completed sleep questionnaires and experimental pain applications.

Results showed that severity of sleep disruption were associated with altered pain processing, and that sleep interventions for persons with knee OA-related pain might contribute to pain reductions. The authors noted that cognitive-behavioral therapies focused on sleep may have the most significant benefits for improving sleep in patients with insomnia and OA pain.