The effect of sleep deprivation on pain perception in healthy subjects: a meta-analysis.
BACKGROUND
There is strong evidence indicating an interaction between sleep and pain. However, the size of this effect, as well as the clinical relevance, is unclear. Therefore, this meta-analysis was conducted to quantify the effect of sleep deprivation on pain perception.


METHODS
A systematic literature search was conducted using the electronic databases PubMed, Cochrane, Psyndex, Psycinfo, and Scopus. By conducting a random-effect model, the pooled standardized mean differences (SMDs) of sleep deprivation on pain perception was calculated. Studies that investigated any kind of sleep deprivation in conjunction with a pain measurement were included. In cases of several pain measurements within a study, the average effect size of all measures was calculated.


RESULTS
Five eligible studies (N = 190) for the between-group analysis and ten studies (N = 266) for the within-group analysis were identified. Sleep deprivation showed a medium effect in the between-group analysis (SMD = 0.62; CI95: 0.12, 1.12; z = 2.43; p = 0.015) and a large effect in the within-group analysis (SMD = 1.49; CI95: 0.82, 2.17; z = 4.35; p <0.0001). The test for heterogeneity was not significant in the between-group analysis (Q = 5.29; df = 4; p = 0.2584), but it was significant in the within-group analysis (Q = 53.49; df = 9; p <0.0001).


CONCLUSIONS
This meta-analysis confirms a medium effect (SMD = 0.62) of sleep deprivation on pain perception. As this meta-analysis is based on experimental studies in healthy subjects, the clinical relevance should be clarified.
Department of Psychotherapy and Biopsychosocial Health, Danube-University Krems, Dr. Karl Dorrek Straße 30, A-3500 Krems, Austria.
Marlene
M
Schrimpf
Department of Psychotherapy and Biopsychosocial Health, Danube-University Krems, Dr. Karl Dorrek Straße 30, A-3500 Krems, Austria; Medical Clinic, Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
Gregor
G
Liegl
Department of Psychotherapy and Biopsychosocial Health, Danube-University Krems, Dr. Karl Dorrek Straße 30, A-3500 Krems, Austria.
Markus
M
Boeckle
Department of Psychotherapy and Biopsychosocial Health, Danube-University Krems, Dr. Karl Dorrek Straße 30, A-3500 Krems, Austria.
Anton
A
Leitner
Department of Psychiatry and Psychotherapy, University Hospital Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany.
Peter
P
Geisler
Department of Psychotherapy and Biopsychosocial Health, Danube-University Krems, Dr. Karl Dorrek Straße 30, A-3500 Krems, Austria; Department of Psychosomatic Medicine, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria. Electronic address: Christoph.pieh@donau-uni.ac.at.
Christoph
C
Pieh
D064368:Healthy Volunteers / Q000523:psychology*; D006801:Humans; D010147:Pain Measurement; D058748:Pain Perception / Q000502:physiology*; D012892:Sleep Deprivation / Q000523:psychology*
Meta-analysis; Pain perception; Reciprocal relation; Sleep deprivation