Authors
Eder Moreira de Freitas, Andressa Silva, Andrea Maculano Esteves
Published in
Pain management. Pages 1-13. Oct 20, 2026. Epub Oct 20, 2026.
Abstract
Sleep disturbance, inflammation, and persistent pain may reinforce one another, compromising musculoskeletal rehabilitation.
To synthesize evidence on mechanisms linking sleep, inflammation, and pain and identify relevant non-pharmacological interventions.
This structured integrative review examined peer-reviewed studies published from January 2010 to December 2025, identified through PubMed, Scopus, PEDro, and SciELO. Reporting and synthesis were guided by SANRA and EQUATOR recommendations.
Fifty-seven studies were included: 24 experimental or observational studies, 17 systematic reviews or meta-analyses, and 16 narrative or integrative reviews. Sleep restriction was associated with changes in interleukin-6, tumor necrosis factor-α, and C-reactive protein, with responses varying across populations and protocols. Prostaglandins and bradykinin may promote nociceptive sensitization, while disrupted sleep may impair descending pain inhibition. Exercise, manual therapy, neuromuscular electrical stimulation, low-level laser therapy, and sleep-focused behavioral interventions showed mechanistic plausibility, although confirmatory trials remain limited.
Sleep assessment and sleep-focused interventions should be considered within multimodal musculoskeletal pain management, while further controlled research clarifies clinical effectiveness.
PMID:
42902543
Bibliographic data and abstract were imported from PubMed on 21 Oct 2026.
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