Painkillers might not work if you are sleep deprived

*Common brands linked to increased risk of heart attack, study finds

New research uncovers unexpected links between sleep deprivation and pain sensitivity. The findings may have significant implications for pain management therapies.

A recent study from the United States National Institutes of Health (NIH) estimates that more than 25 million adults in the United States live with chronic pain, and almost 40 million adults have experienced severe pain in the past three months.

Any pain that lasts for longer than 12 weeks is considered to be chronic. Chronic pain can be a consequence of injury, an underlying illness, or it may have no known cause.

Many people resort to complementary medical practices such as yoga or meditation to ease the pain. New research, however, examines the link between sleep deprivation, pain sensitivity, and common painkillers, and finds surprising connections. In the future, these findings could help patients with chronic pain to better manage their discomfort.

The study was carried out by researchers at Boston Children’s Hospital and Beth Israel Deaconess Medical Center (BIDMC), both in Boston, MA, United States (US) and their findings were published in the journal Nature Medicine.Studying the link between sleep deprivation and pain in mice

The team – co-led by brain physiologist Alban Latremoliere, Ph.D., and sleep physiologist Chloe Alexandre, Ph.D. – investigated the impact of acute and chronic sleep deprivation, as well as the resulting sleepiness, on sensitivity to painful and non-painful stimuli.

They also examined the effect of common painkillers such as ibuprofen and morphine, alongside the effect of wakefulness-promoting drugs such as caffeine and modafinil, on pain sensitivity.

At the beginning of the study, the team monitored the sleep cycles and sensory sensitivity of between six and 12 mice using small headsets that took electroencephalography and electromyography measurements. This provided the researchers with baseline data.

The researchers then found a way to deprive the mice of sleep in a manner that was not stressful: by entertaining them. To replicate what happens when humans stay up too late, they distracted the mice with toys and fun activities when they were supposed to be asleep.

They were careful to prevent the mice from sleeping without overstimulating them. The mice were kept awake for either 12 hours straight, or for six hours during five successive days. Throughout these periods of wakefulness, the researchers monitored sleepiness, stress levels, and tested for pain sensitivity.

Also, taking even over-the-counter doses of common painkillers known as NSAIDs — nonsteroidal anti-inflammatory drugs — has been linked to an increased risk of heart attack in a new study.

The likelihood of experiencing a heart attack was calculated to increase by an average of 20 per cent to 50 per cent, compared with someone not taking the drugs, regardless of the dosage and amount of time the medications are taken.

The findings are observational and based on an association, however, with the drugs not proved to be a direct cause of heart attack.This group of drugs includes ibuprofen, diclofenac, celecoxib and naproxen, which are available over the counter or by prescription for higher doses, to relieve pain or fever resulting from a range of causes, including flu, headaches, back pain and menstrual cramps. Their range of uses also means they are often taken as needed, for short periods of time.

“We found that all common NSAIDs shared a heightened risk of heart attack,” said Dr. Michèle Bally, an epidemiologist at the University of Montreal Hospital Research Center, who led the research. “There is a perception that naproxen has the lowest cardiovascular risk (among the NSAIDs), but that’s not true.”

Based on the paper, published Tuesday in the BMJ, Bally’s team suggests that doctors and patients weigh the potential harms and benefits before relying on the drugs as a treatment option.