Effects of Psychoactive Drugs on Sleep Quality and Pain Sensitivity

Abstract

Sleep is an essential part of every person’s life. Many drugs initially prescribed and then abused for pain management, such as nicotine, cocaine, and opioids, can have lasting effects on sleep modulation, a relationship that we explore in this review. We specifically examine nicotine and caffeine’s effects on sleep and pain. In addition, the most commonly used stimulant, caffeine, which affects the adenosine A2A receptor, can also have lasting impacts on pain. Previous research by Foo et al., (2003), Chen et al., (2013), and De Biasi et al., (2011) has demonstrated that these drugs alter many neurochemical and neurobiological systems in the brain, such as dopaminergic pathways, adenosine receptors, and the sympathetic nervous system. Nicotine decreases pain through the release of dopamine short-term, but long-term use can exacerbate pain. Nicotine also alters sleep quality because it reduces REM and wave sleep through the prefrontal cortex, leading to a later onset of sleep and increased daytime sleepiness. Caffeine can aid in pain when used in moderation and sometimes with other pain-relieving drugs, but when used in excess can lead to headaches and more pain. Caffeine alters sleep by reducing total sleep time and altering the 24-hour circadian rhythm. Therefore, these drugs, commonly used to aid pain, may also worsen pain, doing the opposite of their intended effects.