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Poor Sleep Associated With Higher Risk Of Chronic Pain

(Reuters Health) – People who sleep poorly may be more likely to develop a chronic pain condition and have worse physical health, a study from the UK suggests.

A general decline in both the quantity and quality of hours slept led to a two- to three-fold increase in pain problems over time, researchers found.

“Sleep and pain problems are two of the biggest health problems in today’s society,” said lead study author Esther Afolalu of the University of Warwick in Coventry.

Pain is known to interfere with sleep, she told Reuters Health by email. But the new study shows “that the impact of sleep on pain is often bigger than (the impact of) pain on sleep,” she said.

Sleep disturbances, she added, contribute to problems in the ability to process and cope with pain.

Afolalu and colleagues reviewed 16 studies involving more than 60,000 adults from 10 countries. The studies looked at how well people were sleeping at the start, and then evaluated the effects of long-term sleep changes on pain, immune function and physical health. Half the participants were tracked for at least four and a half years.

Overall, sleep reductions led to impaired responses to bacteria, viruses and other foreign substances, more inflammation, higher levels of the stress hormone cortisol and other biomarkers related to pain, fatigue and poor health. Newly developed insomnia doubled the risk of a chronic pain disorder and hip fracture problems, the study authors wrote in the journal Sleep Medicine.

Deterioration in sleep was also associated with worse self-reported physical functioning.

At the same time, researchers didn’t find links between increased sleep and less pain or arthritis, although they did find that improvement in sleep was associated with better physical functioning.

One limitation of the analysis is that the studies relied on participants to recall their own sleep patterns. Also, the studies didn’t all use the same tools to measure sleep quality and quantity.

Future studies should look at sleep patterns for different groups of people and how that affects health, Afolalu said. Her team is now analyzing data from the UK Household Longitudinal Survey to understand sleep, insomnia and health for people with arthritis.

Additional studies should also investigate how sleep deficiency leads to chronic pain disorders, said Dr. Monika Haack, who studies sleep, pain and inflammation at Harvard Medical School’s Human Sleep and Inflammatory Systems Lab in Boston.

Haack, who wasn’t involved with the new research, said in an email, “It is also important to identify whether there is a specific sleep pattern that is most dangerous for pain. For example, does sleep disruption (with frequent, intermittent awakening throughout the night) have a higher impact than a short but consolidated sleep?”

Haack and colleagues recently reported in the journal Pain that restricting sleep on weekdays and catching up on the weekends led to more pain. Furthermore, people who caught up on weekends had a tougher time dealing with pain than those who slept eight hours every night.

“In those already suffering from chronic pain, it is of critical importance to incorporate sleep improvement strategies,” Haack said. “And to have sleep specialists as part of the pain management team.”

SEPTEMBER 19, 2017    Carolyn Crist
SOURCE: bit.ly/2xcwb8b Sleep Medicine, online August 18, 2017.    www.reuters.com
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Fun Fact Friday

  • People who speak two languages, may unconsciously change their personality when they switch languages.

  • Cuddling has the same effect on your brain as taking painkillers.

 

  • Your mind spends about 70% of it’s time replaying memories and creating scenarios.

  • When a person becomes more likeable because they are clumsy or make mistakes, it’s called the “Pratfall Effect.”

Happy Friday!
 source:   factualfacts.com   https://twitter.com/Fact   @Fact


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More Sleep Can Lead To Less Chronic Pain: Study

A new animal study, published in the journal Nature Medicine, suggests that sleeping more and drinking coffee rather than taking analgesics can help reduce the intensity of chronic pain.

Chronic pain sufferers could benefit from combining good sleep habits, taking sleep-promoting medications at night and alertness-promoting agents such as coffee during the day, according to a joint study by Boston Children’s Hospital and Beth Israel Deaconess Medical Center (BIDMC).

The researchers first studied the sleep cycles of lab animals (mice), measuring how long they slept and their sensory sensitivity.

To assess the impact of lack of sleep on pain, the research team kept the mice awake for as long as 12 hours in one session, or for 6 hours for five consecutive days. They did this by entertaining them with games without over-stimulating them or stressing them, thus mimicking the way people watch TV late in the evening instead of going to sleep.

Sensitivity to pain was gauged by exposing the mice to heat, cold, pressure or capsaicin (found in hot chili peppers) and “measuring how long it took the animal to move away or lick away the discomfort caused by the capsaicin.”

The researchers also tested responses to non-painful stimuli, such as loud noise which made the mice start.

The study showed that moderate sleep deprivation for five consecutive days can significantly increase pain sensitivity in healthy mice.

Analgesics (such as morphine and ibuprofen) did not reduce heightened pain sensitivity due to sleep loss. The study showed that morphine in particular lost most of its efficacy in mice deprived of sleep.
The study points out that in general, patients tend to increase analgesic dosage to compensate for the loss of efficacy due to sleep deprivation, thus increasing the risk of side-effects.

In contrast, caffeine and modafinil, both of which are known for promoting wakefulness, successfully blocked hyper-sensitivity to pain caused by acute and chronic sleep loss. But the study showed that in non-sleep-deprived mice, these substances did not have any analgesic effect.

The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” It can be acute when associated with trauma or an operation, or chronic if it lasts longer than 3 months and responds poorly to treatment.

According to the World Health Organization, one in five adults suffers from moderate to severe chronic pain and one in three of those are unable to live independently.

Relaxnews      Published Friday, May 12, 2017


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Fun Fact Friday

  • Human bones are 31% water.

  • Deja Vu occurs when your brain tries to apply a memory of a past situation to your current one, fails, and makes you feel like it has happened.

  • Women have twice as many pain receptors on their bodies than men. But, a much higher pain tolerance.

  • Studies show being ‘grateful’ helps you make better decisions and investments.

Happy Friday!
 source:   factualfacts.com   https://twitter.com/Fact   @Fact


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Fun Fact Friday

  • Alexithymia describes a person who has a difficult time expressing their feelings to others.
  • Having a large amount of hair on your body is linked to having higher intelligence.
  • Kissing is good for teeth. The anticipation of a kiss increases the flow of saliva to the mouth, giving the teeth a plaque-dispersing bath.
  • If everyone in the world washed their hands properly, we could save 1 million lives a year.

cuddle

 

  • Depressed people tend to eat more chocolate.
  • The inventor of the television would not let his own children watch TV.
  • Human saliva has a painkiller called opiorphin that’s more powerful than morphine.
  • Cuddling with loved ones releases oxytocin, a hormone which reduces stress and prevents nausea and headaches.
Happy Friday  🙂
 
source:       factualfacts.com       https://twitter.com/Fact       @Fact


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Fun Fact Friday

  • Studies show that the walking through a doorway causes memory lapses, which is why we walk into another room, only to forget why we did.
  • A man named Walter Summerford was struck by lightning 3 times in his life.  After his death, his gravestone was also struck. 
  • Long distance relationships are as satisfying as normal relationships in terms of communication, intimacy, and commitment, studies show. 
overthinking
  • Emotional pain lasts for 10 to 20 minutes, anything longer is actually self inflicted by over thinking, making things worse.
  • Just 20 minutes of exercise three days a week will increase your happiness by around 10 to 20% .
  • A sunflower is actually a cluster of hundreds of flowers.
  • Coffee is the second most traded commodity on Earth after oil.

 

Happy Friday  🙂
source:       factualfacts.com       https://twitter.com/Fact       @Fact


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Should you take Tylenol, Advil, or aspirin for pain? Here’s what the evidence says.

by Julia Belluz     August 18, 2015   @juliaoftoronto    julia.belluz@voxmedia.com

What’s the difference between Tylenol, Advil, and aspirin? Which is the best to take for pain?

I used to take acetaminophen (usually referred to by its brand name, Tylenol) for the occasional headache or sore muscle, mostly because that’s what we used in my house growing up. I didn’t think much about whether it was more or less effective than any other type of over-the-counter pain reliever, and I suspect the same is true for many folks. Acetaminophen, after all, is the most popular over-the-counter painkiller worldwide.

So I was surprised when I found out there’s a huge gap between how pain researchers think about this drug and how the public does. More specifically, every researcher I contacted for this piece said some variation of what Andrew Moore, a pain researcher at Oxford University, told me: Tylenol doesn’t actually work that well for pain. To be more exact, “I can’t imagine why anybody would take acetaminophen,” he said.

Moore has done a number of systematic reviews on over-the-counter pain medications, looking at all the available evidence to figure out which ones work best for various problems. I asked him to describe the overall success rates for the most common three: acetaminophen (like Tylenol), ibuprofen (like Advil), and aspirin.

Like all good evidence-based medicine thinkers, he was able to provide a very practical answer: “If you’re talking about aspirin in doses of 500 to 1,000 mg or two tablets, 30 percent of people get relief from acute pain. For acetaminophen at doses of 500 to 1,000 mg, about 40 percent have a success. For ibuprofen, in its normal formulation at something around 400 mg or two tablets, about 50 percent have success.”

Now, Moore was referring here to acute pain that strikes after a specific event, like a surgery, a cut, or a burn, but his message was simple: Ibuprofen seems to work best, followed by acetaminophen, and then aspirin.

For ongoing (or chronic) pain — a sore lower back, say, or the kind of degenerative arthritis that typically develops with age — ibuprofen still outperforms acetaminophen. In fact, study after study has shown that acetaminophen on its own just doesn’t work that well for most people to treat this kind of pain, either.

“WE FOUND THAT [TYLENOL] IS INEFFECTIVE ON BOTH PAIN AND DISABILITY OUTCOMES FOR LOW BACK PAIN”

A 2015 systematic review of high-quality evidence, published in the BMJ, found that acetaminophen didn’t seem to help most sufferers of chronic low back pain, and that it barely alleviates pain in people with osteoarthritis. As the researchers wrote, “We found that [acetaminophen] is ineffective on both pain and disability outcomes for low back pain in the immediate and short term and is not clinically superior to placebo on both pain and disability outcomes for osteoarthritis.”

They also noted that patients on acetaminophen “are nearly four times more likely to have abnormal results on liver function tests compared with those taking oral placebo.”

Other studies, like this well-designed randomized control trial of people with knee pain, have similar conclusions: Acetaminophen doesn’t perform as well as ibuprofen, and it’s linked to higher rates of liver problems.

acetaminophen

So what about the occasional headache? What works best for that?

It turns out this is another fascinating problem area for pain researchers. Moore has looked at all the evidence for what he calls “infrequent tension headaches” and found “it is surprising how poor [the research] is and how little it tells us.” Either the outcomes in studies are badly defined, the studies have too few participants to say anything concrete, or many people in the studies actually seem to have chronic headaches as opposed to the ordinary ones they’re allegedly studying.

“Most people would say, if you look at the data, take an ibuprofen tablet,” Moore said. “Acetaminophen is just not a very good analgesic [pain reliever], yet it’s the go-to drug because it’s thought to be safe.”

And that’s where things get even more interesting: Acetaminophen isn’t actually that safe.

“We always thought [acetaminophen] was safe, but there are increasing signals of accidental overdose in people who are regularly using it for chronic pain, and some liver toxicity,” explained the University of Leeds’s Philip Conaghan, who has studied adverse events data related to this popular drug.

Between 1998 and 2003, acetaminophen was the leading cause of acute liver failure in the US. There are also hundreds of related deaths every year — though keep in mind that millions of people take drugs with acetaminophen, so these more extreme side effects are rare (especially if you’re only taking them in small doses occasionally). Still, for the drug’s minimal pain-killing benefits, the risks may not be worth it.

“Don’t believe that just because something is over-the-counter, it’s safe,” Conaghan added. (He advised people to see their doctor if they’re taking any of these painkillers for more than a few days — particularly if they’re on other drugs already.)

“[TYLENOL] IS AN OLD DRUG, OBSOLETE, AND SHOULD BE AVOIDED ALTOGETHER”

Kay Brune, a professor of pharmacology and toxicology at Germany’s Friedrich-Alexander University who has also studied the toxicity of painkillers, was even more direct in his thoughts on acetaminophen: “It’s an old drug, obsolete, and should be avoided altogether.”

Aspirin is safer than acetaminophen, he said, though to be used as a pain reliever it requires much higher doses — which can have side effects like stomach upset. Aspirin also interferes with blood coagulation for days after taking it. “If you take one gram of aspirin,” Brune explained, “you’re at risk of bleeding for another four days.” This is why aspirin has its place as a protective agent against strokes and heart attacks for people at a higher risk.

Ibuprofen doesn’t have these two problems — it’s less toxic than the others in the doses that give people pain relief. But it has other side effects. “Ibuprofen puts people at risk of bleeds in the gastrointestinal tract and kidney damage — so it’s not free of risk,” said Brune. Using it in high doses also seems to raise blood pressure, and increase the risk of heart attack and stroke — one reason the Food and Drug Administration recently warned people should only use ibuprofen (and other “Nonsteroidal anti-inflammatory drugs” or “NSAIDS” like naproxen) for short periods of time and in small amounts.

I asked Brune about what he’d suggest for the occasional headache or sore muscle. “Taking 400 mg of ibuprofen won’t cause measurable harm,” he answered. “Of all drugs we have available, for most indications, it’s also the most effective one.”

If the research community seems to have sided with ibuprofen for pain, is acetaminophen good for anything?

Patients with kidney and cardiovascular problems may need to avoid NSAIDS like ibuprofen, so doctors could suggest Tylenol here even though it probably won’t provide as much pain relief. NSAIDS can also cause psychosis and cognitive impairment, so doctors may avoid prescribing them for elderly patients.

Fever is another area where acetaminophen can help, said Moore. According to one systematic review, acetaminophen seems to be safe for treating very young kids with fever, and you can give children as young as 3 months old acetaminophen, whereas you need to wait until kids are at least 6 months old to safely treat them with ibuprofen. (Aspirin is not recommended for anyone under 18 years old since it can cause a potentially fatal condition called Reye syndrome.) This may help to explain the popularity of drugs like Tylenol for kids.

But a final caveat here: If your child is older than 6 months, it’s not all that clear that acetaminophen outperforms ibuprofen for reducing fevers, and the same is true for adults. So keep that in mind when you’re rethinking your medicine cabinet.

source: www.vox.com