Ease Pain with Caffeine and Sleep, Study Says

Ease Pain with Caffeine and Sleep, Study Says

By Staff.

A new study in the May2017 issue of Nature Medicine says that getting better sleep or taking caffeine can “ease pain better than analgesics.”

Boston Children’s Hospital announced their study in an announcement stating the following:

Pain physiologist Alban Latremoliere, PhD, of Boston Children’s and sleep physiologist Chloe Alexandre, PhD, of BIDMC precisely measured the effects of acute or chronic sleep loss on sleepiness and sensitivity to both painful and non-painful stimuli. They then tested standard pain medications, like ibuprofen and morphine, as well as wakefulness-promoting agents like caffeine and modafinil. Their findings reveal an unexpected role for alertness in setting pain sensitivity.

Keeping mice awake, through custom entertainment

The team started by measuring normal sleep cycles, using tiny headsets that took electroencephalography (EEG) and electromyography (EMG) readings. “For each mouse, we have exact baseline data on how much they sleep and what their sensory sensitivity is,” says Latremoliere, who works in the lab of Clifford Woolf, PhD, in the F.M. Kirby Neurobiology Center at Boston Children’s.

Next, unlike other sleep studies that force mice to stay awake walking treadmills or falling from platforms, Alexandre, Latremoliere and colleagues deprived mice of sleep in a way that mimics what happens with people: They entertained them.

“We developed a protocol to chronically sleep-deprive mice in a non-stressful manner, by providing them with toys and activities at the time they were supposed to go to sleep, thereby extending the wake period,” says Alexandre, who works in the lab of Thomas Scammell, MD, at BIDMC. “This is similar to what most of us do when we stay awake a little bit too much watching late-night TV each weekday.”

To keep the mice awake, researchers kept vigil, providing the mice with custom-made toys as interest flagged while being careful not to overstimulate them. “Mice love nesting, so when they started to get sleepy (as seen by their EEG/EMG pattern) we would give them nesting materials like a wipe or cotton ball,” says Latremoliere. “Rodents also like chewing, so we introduced a lot of activities based around chewing, for example, having to chew through something to get to a cotton ball.”

In this way, they kept groups of six to 12 mice awake for as long as 12 hours in one session, or six hours for five consecutive days, monitoring sleepiness and stress hormones (to make sure they weren’t stressed) and testing for pain along the way.

Pain sensitivity was measured in a blinded fashion by exposing mice to controlled amounts of heat, cold, pressure or capsaicin (the agent in hot chili peppers) and then measuring how long it took the animal to move away (or lick away the discomfort caused by capsaicin). The researchers also tested responses to non-painful stimuli, such as jumping when startled by a sudden loud sound.

“We found that five consecutive days of moderate sleep deprivation can significantly exacerbate pain sensitivity over time in otherwise healthy mice,” says Alexandre. “The response was specific to pain, and was not due to a state of general hyperexcitability to any stimuli.”

Analgesics vs. wake-promoting agents

Surprisingly, common analgesics like ibuprofen did not block sleep-loss-induced pain hypersensitivity. Even morphine lost most of its efficacy in sleep-deprived mice. These observations suggest that patients using these drugs for pain relief might have to increase their dose to compensate for lost efficacy due to sleep loss, thereby increasing their risk for side effects.

In contrast, both caffeine and modafinil, drugs used to promote wakefulness, successfully blocked the pain hypersensitivity caused by both acute and chronic sleep loss. Interestingly, in non-sleep-deprived mice, these compounds had no analgesic properties.

“This represents a new kind of analgesic that hadn’t been considered before, one that depends on the biological state of the animal,” says Woolf, director of the Kirby Center at Boston Children’s. “Such drugs could help disrupt the chronic pain cycle, in which pain disrupts sleep, which then promotes pain, which further disrupts sleep.”

A new approach to chronic pain?

The researchers conclude that rather than just taking painkillers, patients with chronic pain might benefit from better sleep habits or sleep-promoting medications at night, coupled with daytime alertness-promoting agents to try to break the pain cycle. Some painkillers already include caffeine as an ingredient, although its mechanism of action isn’t yet known. Both caffeine and modafinil boost dopamine circuits in the brain, so that may provide a clue.

“This work was supported by a novel NIH program that required a pain scientist to join a non-pain scientist to tackle a completely new area of research,” notes Scammel, professor of neurology at BIDMC. “This cross-disciplinary collaboration enabled our labs to discover unsuspected links between sleep and pain with actionable clinical implications for improving pain management.”

“Many patients with chronic pain suffer from poor sleep and daytime fatigue, and some pain medications themselves can contribute to these co-morbidities,” notes Kiran Maski, MD, a specialist in sleep disorders at Boston Children’s. “This study suggests a novel approach to pain management that would be relatively easy to implement in clinical care. Clinical research is needed to understand what sleep duration is required and to test the efficacy of wake-promoting medications in chronic pain patients.”

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Authored by: Staff

There are 13 comments for this article
  1. Maureen at 7:53 pm

    Ibin Aiken, love your handle. 👍🏻. Always enjoy your writings. This one is…comedic, poetic, oooo so true, relatable and engaging.
    God bless you for your commitment to your family and continuing to work (construction no less!) while suffering with CP. I admire that, yet have no idea how you continue doing it. I too have had several failed spine surgeries and had to end my long nursing career due to it.
    We are all in this together and until THEY give in and turn their stuffy heads in our direction… WE must keep strong, vigilant and make noise. Hang in there!

  2. Maureen at 7:00 pm

    Right on Jean! Oh when oh when will they come to US and hear it from US for we are the true experts.

  3. Jean Price at 5:51 am

    It’s a little frustrating to see such “common sense” issues always be the ones that are studied! The idea that sleep can increase pain…and things that stimulate us can decrease it…may all be related to distraction and levels of relaxation and levels of sleep where the body can repair itself! So what’s new about any of this!?

    Maybe for the mice, it really WAS a new approach…yet seriously, WHY can’t they study…and REPORT…SIGNIFICANT research about pain? Things we don’t prove daily by LIVING IT OUT in our lives!? Now a study to zero in on how much pain meds DO help sleep and function levels too, would be helpful! This would be good information to have! Oh, wait…I forgot…pain medication isn’t “supposed” to be helpful AT ALL, right?! At least they don’t want it to be, it seems! Ugh! Such crazy science!! (Such weird research!)

  4. Ibin Aiken at 2:08 pm

    If I were a mouse, I would be impressed. Truly, this day and time, as per the CDC “guideline” I can’t sleep or it is interrupted…….nightly. I do everything possible after being reduced 80% daily of a prescribed medication that I was very stable on for 15 years. I actually reduced myself from 160 milligrams of the same medication to 100 milligrams about 4 years ago. Then the mis-guided-line was enforced and I am now at 20 milligrams per day. I employ a heating pad, ice packs, Kratom (non FDA approved), and CBD oil(no thc, illegal) along with attempted sleep. Life is hard. My doctor. tells me that coffee MAY help the pain a bit so, I drink it. (Actually I like coffee). All new therapies for the treatment of sever, continuous pain is worth a try because the CDC has profiled ALL opioid users, prescribed or illicit, chronic pain patients or recreational users.. I have prevailed over 2 failed back surgeries and the relentless accompanying pain for over 20 years. I know there are good people that suffer worse but, when the level of intolerable pain occurs with chronic pain, there is no where to turn. “Sucking up” more pain does not make us more responsible, more attentive, or change the way we live and view the world we live in. Through decades of pain and treatment, I have managed to stay in the work world. Building houses. I don’t “manage” the construction, I am a part of all the construction. Construction is how I came to have to require back surgery. I did not “quit” because of the pain, I dealt with it, legally. No income for my spouse and family was not even an option. Blue collar workers keep the supply and demand chain open throughout America. Everyone can’t be lawyers or physicians. I am not saying that either is an easy work life but, the blue collar worker(s) are the forgotten people that President Trump based part of his platform on and Jeff Sessions represent. However with the “guideline” I will not be able to continue but, who cares? I along with my doctor were doing quite well before the mis-guided-line was enforced. He monitored my health, prescribed sufficient medication in the best “form” and life went on. CDC “guideline” and the opioid medication “conversion chart” may not affect many people but, according to CDC information it will affect about 10 million people with chronic pain. It affects chronic pain patients without taking into consideration of the individual patients weight, metabolism, history of opioid medication use, whether the patient needed income, or a different source of pain relief. Commune-ism. Everyone receives…….the same. Of course seek alternative relief from severe, continuous pain. Chronic pain patients don’t always take the easiest path, we take the only path. We as chronic pain patients KNOW that if ANY of the authors of the guideline and conversion chart face daily/nightly hardships of never ending pain, the guideline would be abolished. I don’t believe that the chronic pain patient would ask to be prescribed sufficient opioid medication if there was an effective alternative. No one wishes to be dependent on elevated blood pressure medicine, insulin, or kidney dialysis but, we do what we have to. Guideline is not in the best interest of people, it is another form of crowd “control”. Education, responsibility, integrity, compassion, work ethics, and even manners are “learned” attributes. To be kept “in line? by our ELECTED officials seems to be “top priority”. Our physicians WERE doing a fantastic job giving the chronic pain patient some quality of life. If they did not, the proper measures were working well. It seems that monitoring opioid prescribing physicians would be a much easier task than making people suffer. After all Jeff says “good people don’t “use” marijuana”.

  5. Heather at 1:36 pm

    Waste of useful money as anyone knows that sleep deprivation can exacerbate pain especially in those who already suffer. Seriously. Could have just done a blind study of REAL PAIN PATIENTS….. WE SEEM TO BECOMING DISTINCT AS NO ONE CARES WHAT WE THINK OR WHAT WE GO THRU ON A DAILY BASIS. JIST KEEP LISTENING TO THE ADDICTS THEY SEEM TO GIVE YOU ACCURATE RATINGS. WHAT BS………THIS MAKES ME MAD. EVERYONE PLEASE SPEAK UP AND LET YOUR VOICES BE HEARD. WE ARE REAL AJD NOT ADDICTS AND DEAL WITH WAY MORE THAN SLEEP DEPRIVATION ID PEOPLE WOULD JIST LISTEN OR ASK US!!!! So sad what America and our medical field has come to.

  6. Steven Pitkin at 8:39 pm

    Slitting my carotid artery induces sleep too; doesn’t mean it works for what ails one 24/7.
    This report pegs my “stupid meter”!

  7. Tim Mason at 6:42 pm

    Debbie I am just like you. I love my coffee. Black and dark roast. French press is good to. My awakes me about 2 to 3 hours after falling asleep. the pain is in the area of my ALIF 360 with hardware. I keep water and a breakthrough pain pill on my night stand but usually have to lean forward for about 30 minutes for the pain to subside. I do keep well hydrated throughout the day. In late 2015 I bought one of those hybrid mattresses with adjustable base this helps some as well as monthly clinical massages. (expensive).
    My pain management guy told me that our discs “gel up” during our sleep. I could use diphenhydramine sleep aid but I do not dream well when I take that stuff.
    It is really hard to improve on older narcotics for good pain control. (I won’t mention the “O” word. It seems to be overused today and always in a negative way.
    Be well,

  8. Sheryl M Donnell at 3:40 pm

    Anyone of us could have told them our pain is worse when our sleep is worse. Yes, stimulants help us feel better during during the day but mess up our sleep at night too! Better pain meds just help without adding uppers and downers to the mix!

  9. Margie at 11:40 am

    Poor sleep exacerbates pain!! You had to do a study for that!# Just ask a chronic pain victim and we could have told you that!! Common sense.

  10. Maureen at 11:19 am

    I appreciate and I get the concept of this but… once again, perhaps the research team ought to bring on a chronic pain person(s) to help! Reading this stirred up the same issue for me… Maybe they should consult us! I truly believe it would be beneficial for them.
    We are NOT the same, our habits and management are not the same and again…we should not be generalized. We are not mice!
    My bedtime pain med usually helps me sleep fine these days (for some odd reason!.,) but for many years pain got me up 2-3 times/night.
    When would they suggest a CP person begin their caffeine ingestion if you’re are up often all night?! Hmmmm….?

  11. Debbie De Anda at 6:50 am

    I drink alot of caffeine and it doesn’t seem to take the pain away. And if I lay to much my back and hips start hurting worse. So, I don’t believe that works for me.

  12. Morgan S. at 6:18 am

    So if your sleep is better, pain is better? Or the chronic pain patient is having experiencing pain that is interfering with a good nights sleep. I am so glad I can drink more caffeine without the side effect of keeping me awake, and allowing my body sleep, and that will improve my chronic pain. Such a wonderful study, and results – by the way how much did the study cost, who funded the study?

  13. Denise Bault at 4:59 am

    Unfortunately, I don’t think this applies to fibromyalgia and chronic fatigue syndrome patients. We NEVER get a good night’s sleep! Sleep medications and good sleep hygiene aren’t enough to get even one night of decent sleep!