ArticleArthritis and rheumatism2013
The role of sleep problems in central pain processing in rheumatoid arthritis.
Article in Arthritis and rheumatism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers.
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Who cites it
67 citing papers in PubMed, 140 citations in OpenAlex.
- Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial.The journal of pain · 2022Trial
- Effect of Milnacipran on Pain in Patients with Rheumatoid Arthritis with Widespread Pain: A Randomized Blinded Crossover Trial.The Journal of rheumatology · 2016Trial
- Cognitive-behavioral therapy for insomnia in knee osteoarthritis: a randomized, double-blind, active placebo-controlled clinical trial.Arthritis & rheumatology (Hoboken, N.J.) · 2015Trial
- Sleep measurement and clinical impact in osteoarthritis and inflammatory arthritis: a scoping review.Rheumatology (Oxford, England) · 2026Article
- Bidirectional associations between daily sleep and pain severity in adults with rheumatoid arthritis: A daily diary and actigraphy study.The journal of pain · 2026Article
- Towards an individualised approach to pain management in inflammatory arthritis.Therapeutic advances in musculoskeletal disease · 2026Review
- Assessment of Pain Types in Recently Diagnosed Patients With Inflammatory Arthritis.Arthritis care & research · 2026Article
- The Impact of Insomnia on the Clinical Course and Treatment Outcomes of Rheumatoid Arthritis.Biomedicines · 2025Review
- Altered somatosensory profiles in rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, and systemic sclerosis.EULAR rheumatology open · 2025Article
- Association Between Sleep Disturbance and Subsequent Pain Interference in Patients With Early Rheumatoid Arthritis.Arthritis care & research · 2025Article
- From fibrositis to fibromyalgia to nociplastic pain: how rheumatology helped get us here and where do we go from here?Annals of the rheumatic diseases · 2024Review
- Characterization of sleep disturbance in established rheumatoid arthritis patients: exploring the relationship with central nervous system pain regulation.BMC rheumatology · 2024Article
- Pain catastrophizing in rheumatic diseases: prevalence, origin, and implications.Rheumatology international · 2024Review
- A concept elicitation study to understand the relationship between sleep and pain in rheumatoid arthritis and axial spondyloarthritis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Impact of central sensitization on clinical parameters in patients with rheumatoid arthritis.Northern clinics of Istanbul · 2024Article
- Anti-cyclic citrullinated peptide antibody and pain sensitisation in patients with rheumatoid arthritis: a cross-sectional analysis.Annals of the rheumatic diseases · 2023Article
- Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis.Nature reviews. Rheumatology · 2023Review
- A randomized, placebo-controlled, double-blinded mechanistic clinical trial using endotoxin to evaluate the relationship between insomnia, inflammation, and affective disturbance on pain in older adults: A protocol for the sleep and Healthy Aging Research for pain (SHARE-P) study.Brain, behavior, & immunity - health · 2023Article
- Pain Mechanisms Associated With Disease Activity in Patients With Rheumatoid Arthritis Treated With Disease-Modifying Antirheumatic Drugs: A Regression Tree Analysis.The Journal of rheumatology · 2023Article
- Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveAmong rheumatoid arthritis (RA) patients, the intensity of pain may be out of proportion to the severity of peripheral inflammation. This observation suggests that mechanisms of central nervous system pain amplification, such as diminished conditioned pain modulation (CPM), may play a role in enhancing pain perception among some RA patients. This study was undertaken to examine the level of CPM, pressure-pain threshold, and pressure-pain tolerance among RA patients compared to healthy controls.
methodsFifty-eight female RA patients and 54 age-matched female control subjects without chronic pain underwent quantitative sensory testing (QST) to assess CPM levels, pressure-pain thresholds, and pressure-pain tolerance levels. CPM was induced using a cold water bath, and the pain threshold (when patients first felt pain) and pain tolerance (when pain was too much to bear) were assessed with an algometer. Associations between RA and each QST outcome were analyzed using linear regression. Sleep problems, mental health, and inflammation were assessed as mediators of the relationship between RA and QST outcomes.
resultsThe median CPM level was 0.5 kg/cm2 (interquartile range [IQR] -0.1, 1.6) among RA patients, compared to a median of 1.5 kg/cm2 (IQR -0.1, 2.5) among controls (P=0.04). RA patients, compared to controls, had a lower pain threshold and lower pain tolerance at the wrists (each P≤0.05). In addition, RA patients had greater problems with sleep, pain catastrophizing, depression, and anxiety (P<0.0001 versus controls). Results of mediation analyses suggested that low CPM levels might be attributed, in part, to sleep disturbance (P=0.04).
conclusionRA patients have impaired CPM when compared to pain-free control subjects. Sleep problems may mediate the association between RA and attenuated CPM.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.