Evaluación del impacto de los gabapentinoides en la salud del sueño en pacientes con dolor neuropático crónico: revisión sistemática y metaanálisis: Publicado originalmente en la Revista Pain 2020; 161(3): 476–490 Traducción: Dra. Tania Acosta. Revista Neurotarget

Daniel Kapustin; Anuj Bhatia; Aidan McParland; Aditya Trivedi; Alexandra Davidson; Richard Brull; Mandeep Singh

doi:10.47924/neurotarget202120

Authors

Daniel Kapustin University of Toronto, Faculty of Medicine, Toronto, ON, Canada.
Anuj Bhatia Department of Anesthesia and Pain Medicine, Women’s College Hospital, Toronto, ON, Canada. Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada. Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Aidan McParland University of Toronto, Faculty of Medicine, Toronto, ON, Canada.
Aditya Trivedi Department of Chemistry, McMaster University, Hamilton, ON, Canada.
Alexandra Davidson University of Toronto, Faculty of Medicine, Toronto, ON, Canada.
Richard Brull Department of Anesthesia and Pain Medicine, Women’s College Hospital, Toronto, ON, Canada. Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Mandeep Singh Department of Anesthesia and Pain Medicine, Women’s College Hospital, Toronto, ON, Canada. Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

DOI:

https://doi.org/10.47924/neurotarget202120

Keywords:

Gabapentinoids, Neuropathic pain, Postherpetic neuralgia, Diabetic peripheral neuropathy, Sleep health, Sleep quality, Sleepiness, Quality of life

Abstract

Chronic neuropathic pain (NP) is debilitating and impacts sleep health and quality of life. Treatment with gabapentinoids (GBs) has been shown to reduce pain, but its effects on sleep health have not been systematically evaluated. The objective of this systematic review and meta-analysis was to assess the relationship between GB therapy dose and duration on sleep quality, daytime somnolence, and intensity of pain in patients with NP. Subgroup comparisons were planned for high- vs lowdose GBs, where 300 mg per day or more of pregabalin was used to classify high-dose therapy. Trial data were segregated by duration less than 6 weeks and 6 weeks or greater. Twenty randomized controlled trials were included. Primary outcome measures included pain-related sleep interference and incidence of daytime somnolence. Secondary outcomes included daily pain scores (numerical rating scale 0-10) and patient global impression of change. Significant improvement in sleep quality was observed after 6 weeks of GB treatment when compared with placebo (standardized mean difference 0.39, 95% confidence interval 0.32-0.46 P, 0.001). Increased daytime somnolence was observed among all GB-treated groups when compared with placebo. Treated patients were also more likely to report improvement of patient global impression of change scores. Pain scores decreased significantly in patients both after 6 weeks of treatment (P, 0.001) and in trials less than 6 weeks (P = 0.017) when compared with placebo. Our data demonstrate that GBs have a positive impact on sleep health, quality of life, and pain in patients with NP syndromes. However, these benefits come at the expense of daytime somnolence.

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