The victims of severe burns suffer so much that the pain
can disrupt their sleep and haunt their dreams. In her master’s
thesis, Isabelle Raymond, a student in the Department of
Anesthesiology of the Faculty of Medicine, assessed the
quality of sleep and its influence on the intensity of pain
in major burn victims. The researcher, who is currently
completing her doctoral thesis on the same subject, reports
the case of a patient who feared his bandage changes so
much that he dreamed he was a thermometer. “He became
completely red, because the pain was so intolerable,”
she says.
We still don’t know why humans dream, but some studies
have shown that lack of sleep can impede tissue healing.
The better you sleep, the faster you recover. However, the
sleep of major burn victims is frequently disrupted and
not very restful, while they often have nightmares. “It
doesn’t help them heal,” the 27 year-old researcher
admits. She recommends better control of the disruptive
factors in hospitals, such as noise, bright lights and interruptions
by nursing staff.
Sleep disruptions seem to exacerbate pain which, in turn,
disturbs sleep. Isabelle Raymond can’t say for sure
whether this is a cause and effect relationship. But patients
are caught in a vicious circle: their pain prevents them
from really sleeping and their lack of sleep slows healing.
However, nightmares seem to have a positive effect on the
perception of pain the following day. “Because the
bad dreams come from long uninterrupted periods of paradoxical
sleep, they may be the indirect result of a consolidation
of paradoxical sleep, or even of a more general consolidation
of sleep, all indicators of better rest,” the specialist
suggests.
In the scientific journal Sleep, the researcher
has published data collected over 140 nights recently from
28 patients treated in the Major Burn Centre at the CHUM
Hôtel-Dieu hospital. The patients, aged from 17 to
50 years, participated in a structured interview protocol
when they woke up on five consecutive mornings during the
first week of hospitalization. The survey showed that patients
who dream about pain sleep worse than those who don’t
dream about pain. The subjects also reported more intense
pain and nightmares, a problem the researcher fears could
evolve into a vicious circle of pain-anxiety-insomnia.
She suggests relieving pain more effectively during the
night, when the sensation of intense pain is greatest.
Researcher: Isabelle Raymond
Telephone: (514) 890-8000, extension 14053
Email: isabelle.raymond@umontreal.ca
Funding: Canadian Institutes of Health Reseach, Fonds de
la recherche en santé du Québec
