Causes of Sleep Deprivation – One of the TEDMED Great Challenges in Health Care
Finding the 20 most important great challenges in healthcare was one of the tasks at TEDMED 2012 in Washington DC last week, where I had the great pleasure of being one of the delegates. These challenges should be selected from a list of 51 challenges, a difficult task, since ALL the challenges are of importance. The 20 selected were of course those who got the most votes.
In this and some of the forthcoming blogs I will discuss some of these challenges, starting today with “Causes of Sleep Deprivation”, which was one of the challenges with many votes.
Sleeping too few hours can have serious health consequences, the optimal sleep interval have been found to be between 6 and 8 hours pr. night, and both lower and higher sleep time is associated with significantly higher mortality. Use of sleep pills are a single major risk predictor, so this is not the answer, and studies have found that not necessarily the lack of sleep itself that provides health risk, but often it is the reason for the sleep problem causing the trouble.
The TEDMED challenge looking at the causes of sleep deprivation is therefore very important. The causes of the disturbed sleep are many, but we have a substantial knowledge from studies, that (chronic) pain is one of the most frequent causes of sleep problems at all. Research has found that at least 50% of patients with persistent pain problems report significant sleep disturbance, some studies even find that number to be 70-80%. Since the prevalence of persistent pain in the western world have been shown to be around 20% it can be estimated that more than approximately 50 million persons in EU and more than 28 million persons in USA are affected by the combined problems with pain and sleep. Co-existence of persistent pain and insomnia has shown to have a negative impact on both the course and the management of pain conditions and to be a major risk factor for disability and absence from work, and “sleep” is by pain patients rated as one of the most important factors of their Quality of Life. Yes, pain is one of the leading causes of sleep deprivation. We actually know from research, that just one night where sleep is interrupted several times leads to experience of higher pain intensity for a given stimulus, than experienced for the same stimulus after a good nights sleep. Just one night!
When I came back from TEDMED I received an acceptance for presenting data from a sleep study I have made at “The World Congress of Pain 2012” held by IASP this fall. This study documents that “sleep” is only included as a parameter in clinical and epidemiologic pain research in close to half of the published papers in major pain journals. This is the studies and papers on which we build and decide the best pain management. The reason for not including sleep problems in research is “tradition”, as the most frequent used assessment tools do not include “sleep”. We need to change that tradition, we need to create awareness in both research AND clinic work of pain and other causes of sleep deprivation, to catch up on one of the great challenges in todays health care.
I will of course present the study in details here on the Picture of Pain blog at a later stage.
Kim Kristiansen, M.D (2012). Causes of Sleep Deprivation – One of the TEDMED Great Challenges in Health Care Picture of Pain