Depressive Symptoms and Sleep Efficiency Sequentially Mediate Racial Differences in Temporal Summation of Mechanical Pain.
BACKGROUND
Racial differences in endogenous pain facilitatory processes have been previously reported. Evidence suggests that psychological and behavioral factors, including depressive symptoms and sleep, can alter endogenous pain facilitatory processes. Whether depressive symptoms and sleep might help explain racial differences in endogenous pain facilitatory processes has yet to be determined.


OBJECTIVE
This observational, microlongitudinal study examined whether depressive symptoms and sleep were sequential mediators of racial differences in endogenous pain facilitatory processes.


METHODS
A total of 50 (26 African American and 24 non-Hispanic white) community-dwelling adults without chronic pain (mean 49.04 years; range 21-77) completed the Center for Epidemiological Studies Depression Scale prior to seven consecutive nights of sleep monitoring with actigraphy in the home environment. Participants subsequently returned to the laboratory for assessment of endogenous pain facilitation using a mechanical temporal summation protocol.


RESULTS
Findings revealed greater depressive symptoms, poorer sleep efficiency, and greater temporal summation of mechanical pain in African Americans compared to non-Hispanic whites. In a sequential mediation model, greater depressive symptoms predicted poorer sleep efficiency (t = -2.55, p = .014), and poorer sleep efficiency predicted enhanced temporal summation of mechanical pain (t = -4.11, p < .001), particularly for African Americans.


CONCLUSIONS
This study underscores the importance of examining the contribution of psychological and behavioral factors when addressing racial differences in pain processing. Additionally, it lends support for the deleterious impact of depressive symptoms on sleep efficiency, suggesting that both sequentially mediate racial differences in endogenous pain facilitation.
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Hailey W
HW
Bulls
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Mary K
MK
Lynch
College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA.
Megan E
ME
Petrov
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Ethan W
EW
Gossett
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Michael A
MA
Owens
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Sarah C
SC
Terry
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Kate M
KM
Wesson-Sides
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA. bgoodin1@uab.edu.|Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, University of Alabama at Birmingham, 1300 University Boulevard, Campbell Hall, Room 328, Birmingham, AL, 35294, USA. bgoodin1@uab.edu.
Burel R
BR
Goodin
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods; D059227:Postsynaptic Potential Summation; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology*; D044465:White People / Q000523:psychology*; D055815:Young Adult
Depressive symptoms; Hailey W. Bulls and Mary K. Lynch have equal contributions.; Race; Sleep efficiency; Temporal summation of pain