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Effects of Repeated Whole Body Heating on Sleep Architecture and Chronic Lower Back Pain

Chronic lower back pain (CLBP) is recognized as a critical public health problem, yet understanding and treating chronic pain conditions remains challenging. Poor sleep quality, including frequent sleep disturbances and prolonged sleep onset latency, are some of the most commonly reported complaints in individuals suffering chronic pain conditions. Our aim was to investigate the effects of repeated systematic, whole body heating (WBH) on sleep architecture and pain symptoms in individuals experiencing CLBP. Eight CLBP sufferers (49±7 yrs; 4 male, 4 female) with no known sleep disturbances completed baseline measures (BL) of sleep architecture utilizing an ambulatory sleep monitor (Sleep profiler™) and McGill Pain Questionnaires. Seven consecutive evenings of whole body heating (WBH) to a 0.8°C core temperature (Tcore) rise were conducted using a water perfused suit (48°C water). Two subjects completed a control protocol utilizing 34°C water, in randomized order and following a 3 month washout period. McGill pain questionnaires and ambulatory sleep measures were recorded each evening throughout the protocol, and 48 hours and 2 weeks following. Sleep architecture was assessed using stages N1, N2, N3 and REM. Pain scores were significantly reduced from 22 at BL to 14 after 5 day of WBH (p<0.05), and remained significantly lower for the remainder of the heating protocol and at the 48 hour follow‐up (p<0.05). Whilst pain was reduced following heating on all days, the initial 4 days and the 2‐week follow‐up were not significantly different from baseline. Sleep architecture showed a significant increase in REM from BL to day 1 of heating (1.20±0.3 Vs. 1.77±0.97 hrs; P=0.044), with all other days approaching significance. N3 approached significance following all heating days and at the 48h follow‐up (p>0.05). Stage N1 decreased from baseline to heating day 7 (0.40±0.23 Vs. 0.30 0.25 hrs, p=0.06), which was close to significance. Taken together these preliminary data suggest the potential for WBH as a non‐pharmacological method to improve sleep architecture and reduce pain symptoms in CLBP patients.