Many people pride themselves on their ability to get through life on minimal sleep, but research has made it clear that rest is crucial to health. The Centers for Disease Control and Prevention calls insomnia — insufficient sleep that affects a person’s day-to-day functioning — a “public health crisis.” What is not so clear is how insomnia leads to pain-related consequences.

In a first-of-its-kind study, Burel Goodin, Ph.D., an associate professor in the UAB Department of Psychology and co-director of the Center for Addiction and Pain Prevention and Intervention, will investigate this question in one particularly vulnerable population: persons living with HIV. The prevalence of insomnia in this group is estimated at from 30% up to 73%, whereas chronic insomnia is seen in 10%–15% of the general population, according to the National Heart, Lung and Blood Institute. The NHLBI began funding Goodin’s research in HIV and insomnia in 2019 with a $667,930 R01 grant.

“Research has shown that insomnia promotes enhanced pain sensitivity,” Goodin said. Insomnia is seen as a key risk factor for new pain symptoms and the worsening of pain and physical functioning, he explained.

Insomnia promotes inflammation throughout the body and aggravates the inflammatory reaction to pain and other physical stressors. Goodin points out that research has shown that inflammation can substantially increase sensitivity to painful stimuli in laboratory tests of participants without HIV. Now there is a need to unravel the mechanisms involved in sleep disorders in persons living with HIV, and to understand how these sleep disturbances play a role in other HIV-related comorbidities.

Preliminary studies in Goodin’s lab suggest that insomnia promotes pain and inflammation in persons living with HIV. Goodin’s new study, The Impact of Insomnia on Pain, Physical Function, and Inflammation in HIV, has two primary goals. The first is to determine whether insomnia promotes increased sensitivity to pain and exaggerated inflammatory reactions to painful stimuli in laboratory conditions in participants living with HIV. The second is to determine whether the presence of insomnia, which tends to fluctuate over time, drives inflammation and pain in participants’ everyday lives and affects their physical functioning.

“If our hypotheses are confirmed, we will identify insomnia as a major driver of pain and physical functioning in the lab and in everyday life for persons living with HIV, and identify inflammation as an important insomnia-related mediator of pain for this population,” Goodin said.