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Good sleep reduces pain and helps patients recover.



Anyone who has been hospitalized for at least one night knows that being able to sleep in a hurry can be elusive. In addition to being in an unfamiliar place, in someone else’s bed and experiencing discomfort due to some kind of injury or operation, other factors interrupting sleep are added: there are monitors in the work, light and vital functions are turned on.

“What bothered me most was that they came two or three times at night to take the pressure off and look at the monitors. I felt that I was just falling asleep, a nurse came with a cart, they didn’t talk, but they made noise or woke you. Take yourself by the hand, ”Patricia Poblete (50 years old) recalls of her visit to the clinic three months ago for an operation.

For centuries, people have associated rest and sleep as something healing, says Dr. Pablo Brockmann, president of the Chilean Sleep Medicine Society. "Sleep regulates many bodily phenomena, highlighting a number of substances that activate or suppress certain phenomena during the day, such as pain."

It is a dream and pain – a couple, which is aimed at science, adding more and more evidence. This week, a study in California at Berkeley (USA) showed that poor sleep can increase a person's sensitivity to pain the next day by up to 30%.

The explanation is that interrupted sleep not only strengthens the pain-sensitive areas of the brain, but also blocks the centers of natural analgesia. “It was not clear to us which brain mechanisms explained this relationship, but this work provides information about this,” says Dr. Victoria Neri, a neurologist from the German Clinical Sleep Center.

For example, it is emphasized that a key area of ​​the brain that has been found to slow down after a night of poor sleep is the nsula, which assesses signs of pain and prepares the body to respond.

“All this indicates that sleep is a natural analgesic that can help control and reduce pain,” explains Dr. Matthew Walker, author of the study. “However, ironically, the environment in which people experience more pain is the worst place to sleep: hospital wards,” he adds.

According to the researcher, recovery or the patient's condition will improve significantly if “sleep is an integral component of health care management,” he stresses.

An opinion with which local experts agree. “Particular attention is paid to strict patient control, which can change the quality of their sleep, forgetting that it can be a more therapeutic tool,” says Brockman, who admits that although there are initiatives in favor of better sleep, much remains to be done.

Dr. Julia Santin, neuroscientist at the UC Sleep Center at Christus Health Network, says that excessive brightness in rooms or monitoring vital functions every two hours is a practice that gradually changes. "In patients who are not serious, the control can be carried further, sometimes they wake up too early to give them breakfast, which interrupts the last stages of sleep."

The problem is visible in both patients with acute and chronic pain. A 2012 study found that between 50 and 70% of the latter suffer from a sleep disorder. “It may be difficult for them to fall asleep, that they have fragmented sleep, or that it does not restore,” explains Dr. Ana Louise Miranda, head of Pain Crnico at Clnico U. de Chile hospital. “A vicious circle is created: if you have a bad dream, the pain increases the next day, making it difficult to sleep at night,” he adds.

To this is added the abuse of sleep substances by patients who, while interned, cannot use them, enter into periods of deprivation, as doctors do. “The first thing a patient who cannot sleep is prescribed is a sleep inducer, such as benzodiazepine, but there is no evidence that this is a restorative sleep that reduces pain,” warns Brockmann.

Therefore, experts emphasize the need to implement more strategies that promote rest. “The dream should be located much closer to the patient’s center of attention,” says Walker.


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