Chronic Pain and Sleep Disorders

Chronic Pain Infographic

In a recent study, it was found that 2/3rds of chronic pain patients suffer with significant sleep disorders. Chronic pain is common and affects many as they age, but also can affect the athletic injured starting in the teen years. There are approximately 100 million people suffering with chronic pain in the US alone (i.e. 30% of the population).Most common types of pain are low back, severe headaches, neck pain, and joint/arthritic types of pain.

When trying to fall asleep at night it is a common practice to eliminate as many distractions as possible (noise, excessive light, create a slightly “cool “ environment, comfortable bed,etc).However, the “quieting” of one’s environment can cause problems for the pain sufferer , because now the one thing left to focus on is the experience of pain. Your ability to distract yourself from the pain ( eg watching TV or a movie, talk to a friend, read a good book, play a video game , go on FB,etc) is now eliminated and your body is alerting you to your pain.

Chronic pain (means you’ve suffered more than 6 months) is different from acute pain, in that it is not requiring that you address a wound or injury medically, but is like a loud alarm bell that refuses to become silent long after the crisis is over.

Chronic pain patients often experience less deep sleep, more arousals and awakenings during the night as well as less efficient sleep. This non-restorative sleep pattern can cause a decrease in energy, depressed mood, fatigue, compromised concentration and memory the next day, and worsen the pain. A vicious downward spiral. Pain leads to poor sleep which leads to more pain.

It is not clear why poor sleep worsens pain, but some studies show that sleep deprivation causes an increase in the production of inflammatory chemicals in the body called cytokines. Inflammation increases many types of pain which is why many pain medications are anti-inflammatories or the use of ice and cold packs temporarily relieves or reduces the sensation of pain.

Pain medications interrupt sleep and some like codeine and morphine can cause insomnia. The opioid pain medications can cause apnea, brief pauses in breathing, during sleep. Sleep medications can help initiate and maintain sleep, but often at the price of being addicting and affecting next day energy level, mood, alertness and ability to concentrate and memorize new information.

Improving sleep as a pain patient can be enhanced by also using nonmedication sleep aids, soothing sounds or music, avoiding caffeine 3 hours before bedtime, avoiding alcohol at night, and avoiding long naps ( greater than 40 min) in the afternoon.

Source: WebMD, 2011 and  Sleep Medicine Reviews, October 2006


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