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Review
. 2013 Jun;17(3):173-83.
doi: 10.1016/j.smrv.2012.03.003. Epub 2012 Jun 29.

The comorbidity of insomnia, chronic pain, and depression: dopamine as a putative mechanism

Patrick H Finan  1 , Michael T Smith
Affiliations
Review

The comorbidity of insomnia, chronic pain, and depression: dopamine as a putative mechanism

Patrick H Finan et al. Sleep Med Rev. 2013 Jun.

Abstract

Epidemiological, cross-sectional, and prospective studies suggest that insomnia, chronic pain, and depression frequently co-occur and are mutually interacting conditions. However, the mechanisms underlying these comorbid disorders have yet to be elucidated. Overlapping mechanisms in the central nervous system suggest a common neurobiological substrate(s) may underlie the development and interplay of these disorders. We propose that the mesolimbic dopamine system is an underappreciated and attractive venue for the examination of neurobiological processes involved in the interactions, development, exacerbation, and maintenance of this symptom complex. In the present article, studies from multiple disciplines are reviewed to highlight the role of altered dopaminergic function in the promotion of arousal, pain sensitivity, and mood disturbance. We argue that studies aiming to elucidate common factors accounting for the comorbidity of insomnia, chronic pain, and depression should evaluate functioning within the mesolimbic dopaminergic system and its effect on common processes known to be dysregulated in all three disorders.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Vulnerability model of tonic/phasic DA dysregulation. Solid arrows represent putative bidirectional pathways through which abnormalities in the homeostatic regulation of tonic and phasic DA contribute to the comorbid triad of insomnia, chronic pain, and depression. Dashed arrows represent putative moderators of DA function in this model.
See this image and copyright information in PMC

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