Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis.
Michael R IrwinRainer H StraubMichael T SmithPublished in: Nature reviews. Rheumatology (2023)
Sleep has a homeostatic role in the regulation of the immune system and serves to constrain activation of inflammatory signalling and expression of cellular inflammation. In patients with rheumatoid arthritis (RA), a misaligned inflammatory profile induces a dysregulation of sleep-wake activity, which leads to excessive inflammation and the induction of increased sensitivity to pain. Given that multiple biological mechanisms contribute to sleep disturbances (such as insomnia), and that the central nervous system communicates with the innate immune system via neuroendocrine and neural effector pathways, potential exists to develop prevention opportunities to mitigate the risk of insomnia in RA. Furthermore, understanding these risk mechanisms might inform additional insomnia treatment strategies directed towards steering and reducing the magnitude of the inflammatory response, which together could influence outcomes of pain and disease activity in RA.
Keyphrases
- disease activity
- rheumatoid arthritis
- sleep quality
- oxidative stress
- systemic lupus erythematosus
- chronic pain
- ankylosing spondylitis
- rheumatoid arthritis patients
- pain management
- inflammatory response
- physical activity
- depressive symptoms
- neuropathic pain
- juvenile idiopathic arthritis
- immune response
- interstitial lung disease
- poor prognosis
- metabolic syndrome
- climate change
- spinal cord injury
- heat stress
- cerebrospinal fluid
- human health
- weight loss
- lps induced