The Sleep-Reward-Pain Pathway Model: an Integrative Review

Purpose of Review In this review, we provide the basis of a mechanistic model, the sleep-reward-pain pathway, which might explain the relationship between sleep disruption and chronic pain. Recent Findings The origin of chronic pain is typically viewed as a multifactorial process involving multiple physiological, cognitive, and psychological pain-regulatory pathways. Recent evidence suggests that sleep disturbances may contribute to the development of altered hedonic capacity, which subsequently disrupts pain regulatory mechanisms, potentially providing a novel mechanism by which chronic sleep disruption results in chronic pain. Summary Future research should move toward a more integrative approach combining assessments of sleep, reward and pain, and leverage existing or novel interventions designed to target the reward system with the goal of improving pain outcomes.