Why does the disease and pain become more severe at night?

For a long time, scientists had no guesses or answers for one of the most basic human experiences, which is the intensification of physical pain during the night. In fact, from the very first days of the emergence of medicine and treatment, doctors always encountered patients who complained of severe pain at night. In this regard, most of the conducted research tried to link the aggravation of night pain with issues such as lack of sleep or sleep disorders, but the results in this direction were limited! Regarding this issue, a recent study conducted at the Lyon Neuroscience Research Center in France shows that the biological clock of our body strongly influences pain changes and the peak and fall of pain intensity according to this factor at different times from It changes day and night.

BingMag.com Why does the disease and pain become more severe at night?

For a long time, scientists had no guesses or answers for one of the most basic human experiences, which is the intensification of physical pain during the night. In fact, from the very first days of the emergence of medicine and treatment, doctors always encountered patients who complained of severe pain at night. In this regard, most of the conducted research tried to link the aggravation of night pain with issues such as lack of sleep or sleep disorders, but the results in this direction were limited! Regarding this issue, a recent study conducted at the Lyon Neuroscience Research Center in France shows that the biological clock of our body strongly influences pain changes and the peak and fall of pain intensity according to this factor at different times from It changes day and night.

What is the cause of pain intensification at 3-4 at night?

BingMag.com Why does the disease and pain become more severe at night?

Description of the interesting diagnosis test The cause of pain intensification at night

Of course, speculations and uncertainties in this field have continued for a long time, because it is difficult to prove the claim that anything is guided by the internal clock of the body and it requires a detailed and exhausting study design. . However, in order to prove this argument, Lance Kriegsfeld's team placed the volunteers for the experiment in a controlled laboratory environment so that they could eliminate any environmental or behavioral factors that could cause fluctuations or periodic changes; Such a research approach is called "constant routine protocol". According to this protocol, all factors (such as light, temperature, access to food at specific times, etc.) are kept constant so that it is impossible for test subjects to guess the time (what time is it?)!

In this research, in order to identify the cause of pain intensification at night and to understand its relationship with the circadian rhythm, the researchers used a controlled laboratory environment according to a fixed routine protocol. They are placed face down in a dimly lit room, so they are not allowed to sleep, leave the room or stand up to use the bathroom. Food is only given as small snacks at random on the hour, and subjects can chat with members of the study team, but staff are strictly prohibited from mentioning time-related items. Grunfier explains that under this protocol, nothing in the environment or people's behavior is rhythmic or periodic; Therefore, if researchers can detect a biological standard with a 24-hour rhythm, that pattern certainly originates from within and precisely from the circadian timing system of people. Rhythmic Pain recruited 12 healthy young men who were willing to undergo this protocol for 34 hours. Every two hours, the research team checked pain sensitivity using a device that was placed on the people's forearms, and by means of which they could slowly increase the temperature in the form of one degree (centigrade) until the person felt pain. to report Of course, people usually stopped the machine before it reached about 46 degrees Celsius (115 degrees Fahrenheit). Also, during these tests, the participants were asked to repeat the pain test with the device set at certain temperatures (42, 44 and 46 degrees Celsius) and evaluate their pain level by choosing one of the emoticons representing each level of pain.

BingMag.com Why does the disease and pain become more severe at night?

Evaluation of pain level by the participants in the experiment

Of course, before the research team looked for repetitive data (rhythms) in the results of this experiment, they first obtained an estimate of each person's biological clock. This means that although each person's body clock follows a normal daily cycle, some people fall asleep earlier or later; Therefore, there are people who have a normal sleep cycle, some people are night owls and stay up late, and some sleep until 11 pm. In order to investigate this factor, the researchers collected saliva samples from people every hour They evaluated the increase in melatonin (a hormone that is secreted about two hours before a normal person's sleep time!) and used this information to match the information according to people's body clock. It is interesting to know that after this stage a clear cycle of pain appeared! In fact, on average, pain sensitivity was at its peak between 3 and 4 in the morning and at its lowest at 12 noon!

The result of this experiment showed that the biological processes known as circadian rhythm , are adjusted in the body in such a way that they rise and fall at precise times during the day and night; These changes are also a factor for increasing the perception of pain at 3-4 in the morning!

Also, this research showed that the circadian rhythm factor is specific to painful stimuli. Because in another part of the experiment, the volunteers faced conditions where the temperature rose slowly. In this experiment, the slow increase in temperature continued until the person recognized the heat but was not at the painful threshold, and it is interesting to know that in such a process no rhythmic pattern was seen in relation to the increase in temperature!

On the other hand, Because the participants were not allowed to sleep through the night, the researchers could examine the relationship between increased pain and lack of sleep. Before the publication of this research, the prevailing theory about increased sensitivity to pain at night was related to lack of sleep. But researchers in this new paper show that any increase in pain sensitivity due to sleep deprivation increases linearly with increasing sleep pressure. Indeed, this pattern contrasts with the observed decrease (from 4 AM onwards) driven by the circadian system. According to these data, along with the use of mathematical modeling, an impressive victory was achieved for the researchers of this study, and 80% of the data was explained by the circadian rhythm and only 20% by the lack of sleep factor.

Using Analyzing the data from the experiment and mathematical modeling, 80% of the data explained the intensification of pain at night with a circadian rhythm!

Discussions around this interesting research

Of course, it is interesting to know that it is necessary to repeat the mentioned study with women, because since hormones such as estrogen can affect the circadian rhythm, the researchers may could not find a similar pattern of rhythmic sensitivity to pain in samples with other genders. Also, although this study was conducted with small samples, it is necessary to know that the effects of this factor on the feeling of pain were so strong that the researchers call it a discovery, although there is a need for older people and people with different ethnicities to be investigated and tested. be placed Of course, there is still no certainty about what literally increases and decreases pain; But clues suggest that nearly every cell in the body has its own molecular clock that listens to the signals our brains are telling us to guide. Therefore, Zameel Cader, a neuroscientist and neurologist at the University of Oxford, and his colleagues hypothesized that the amount of pain we feel may be due to the rhythm of the cells that detect pain!

In the end, perhaps the most important thing to remember is that whenever pain occurs in your body, the role of the circadian system is to bring what goes up (pain) down! So on the slow rollercoaster journey of understanding pain, you may be just hours away from pain relief without taking a single painkiller!

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