The comorbidity of insomnia, chronic pain, and depression: Dopamine as a putative mechanism

Summary Epidemiological, cross-sectional, and prospective studies suggest that insomnia, chronic pain, and depression frequently co-occur and are mutually interacting conditions. However, the mechanisms underlying these comorbid disorders have yet to be elucidated. Overlapping mechanisms in the cent...

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Bibliographic Details
Published in:Sleep medicine reviews 2013-06, Vol.17 (3), p.173-183
Main Authors: Finan, Patrick H, Smith, Michael T
Format: Article
Language:English
Subjects:
Affect
Affect - physiology
Arousal - physiology
Brain - physiopathology
Chronic pain
Comorbidity
Cross-Sectional Studies
Depression
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Depressive Disorder - physiopathology
Dopamine
Dopamine - physiology
Humans
Insomnia
Limbic System - physiopathology
Mesencephalon - physiopathology
Neural Pathways - physiopathology
Neurology
Opioids
Pain Threshold - physiology
Sleep Initiation and Maintenance Disorders - diagnosis
Sleep Initiation and Maintenance Disorders - epidemiology
Sleep Initiation and Maintenance Disorders - physiopathology
Sleep Medicine
Sleep Wake Disorders - diagnosis
Sleep Wake Disorders - epidemiology
Sleep Wake Disorders - physiopathology
Stress
Stress, Psychological - complications
Stress, Psychological - physiopathology
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Summary:Summary Epidemiological, cross-sectional, and prospective studies suggest that insomnia, chronic pain, and depression frequently co-occur and are mutually interacting conditions. However, the mechanisms underlying these comorbid disorders have yet to be elucidated. Overlapping mechanisms in the central nervous system suggest a common neurobiological substrate(s) may underlie the development and interplay of these disorders. We propose that the mesolimbic dopamine system is an underappreciated and attractive venue for the examination of neurobiological processes involved in the interactions, development, exacerbation, and maintenance of this symptom complex. In the present article, studies from multiple disciplines are reviewed to highlight the role of altered dopaminergic function in the promotion of arousal, pain sensitivity, and mood disturbance. We argue that studies aiming to elucidate common factors accounting for the comorbidity of insomnia, chronic pain, and depression should evaluate functioning within the mesolimbic dopaminergic system and its effect on common processes known to be dysregulated in all three disorders.
ISSN:1087-0792
1532-2955
DOI:10.1016/j.smrv.2012.03.003