[The Circadian Rhythm: What Role do Sleep Disorders Play in Pain Management and Palliative Care?]

Abstract

The circadian rhythm regulates key biological processes such as sleep, hormone balance, and immune defence. Sleep disorders are particularly prevalent among patients with chronic or advanced diseases and are associated with significant physical and psychological consequences. They impair quality of life, increase morbidity, and negatively affect the immune system. Diagnosis involves a thorough medical and sleep-specific history, supplemented by sleep diaries and screening questionnaires. Polysomnography remains the gold standard, while wearables can provide useful indications but cannot fully replace comprehensive diagnostics. Treatment should primarily focus on non-pharmacological interventions and addressing underlying conditions, with medications used only as adjuncts. Chronic pain and sleep deprivation interact, worsening patient outcomes. In critically ill patients, especially in intensive care settings, sleep disorders are common and increase the risk of delirium and mortality. Light therapy and consideration of circadian rhythms in pain management may improve treatment outcomes. Overall, sleep disorders represent a central and often underestimated symptom in pain management and palliative care, necessitating targeted diagnostics and individualized therapy. This article summarizes the current findings in this field.