title: Selective REM Sleep Deprivation Improves Expectation-Related Placebo Analgesia.
abstract: The placebo effect is a neurobiological and psychophysiological process known to influence perceived pain relief. Optimization of placebo analgesia may contribute to the clinical efficacy and effectiveness of medication for acute and chronic pain management. We know that the placebo effect operates through two main mechanisms, expectations and learning, which is also influenced by sleep. Moreover, a recent study suggested that rapid eye movement (REM) sleep is associated with modulation of expectation-mediated placebo analgesia. We examined placebo analgesia following pharmacological REM sleep deprivation and we tested the hypothesis that relief expectations and placebo analgesia would be improved by experimental REM sleep deprivation in healthy volunteers. Following an adaptive night in a sleep laboratory, 26 healthy volunteers underwent classical experimental placebo analgesic conditioning in the evening combined with pharmacological REM sleep deprivation (clonidine: 13 volunteers or inert control pill: 13 volunteers). Medication was administered in a double-blind manner at bedtime, and placebo analgesia was tested in the morning. Results revealed that 1) placebo analgesia improved with REM sleep deprivation; 2) pain relief expectations did not differ between REM sleep deprivation and control groups; and 3) REM sleep moderated the relationship between pain relief expectations and placebo analgesia. These results support the putative role of REM sleep in modulating placebo analgesia. The mechanisms involved in these improvements in placebo analgesia and pain relief following selective REM sleep deprivation should be further investigated.
authors.affiliation: Faculties of Dental Medicine and Medicine, Université de Montréal, Montreal, Quebec, Canada.|Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.
authors.forename: Florian
authors.initials: F
authors.lastname: Chouchou
authors.affiliation: Emergency Department, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chauny
authors.affiliation: Faculties of Dental Medicine and Medicine, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Rainville
authors.affiliation: Faculties of Dental Medicine and Medicine, Université de Montréal, Montreal, Quebec, Canada.|Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.|Emergency Department, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada.
authors.forename: Gilles J
authors.initials: GJ
authors.lastname: Lavigne
mesh_terms: D000328:Adult; D000698:Analgesia / Q000523:psychology*; D059031:Anticipation, Psychological; D001794:Blood Pressure; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000523:psychology; D015990:Placebo Effect; D017286:Polysomnography; D011597:Psychomotor Performance; D012890:Sleep; D012892:Sleep Deprivation / Q000523:psychology*; D055815:Young Adult