chornic pain and sleep - Colorado Pain Care

If you are suffering from a chronic pain condition, it is not surprising that you will also have some difficulty falling asleep, remaining asleep, or enjoying restful sleep.  The discomfort from the pain condition can be enough to disrupt your sleep cycle, but many chronic pain patients also struggle with anxiety and depression related to their pain condition which can also interfere with sleep.

According to the National Sleep Foundation, almost 21 percent of Americans suffer from at least one chronic pain condition, while 36 percent have experienced acute pain in the past week. With more than half of the U.S. population in pain at any given time, it is not surprising that there is a strong relationship between problems with sleep and chronic pain.

Why Healthy Sleep Is Important

Most of us lead frantic lives that include work, family and social responsibilities.  When we find our schedules full, we often sacrifice something less “important” like sleep. However, losing out on sleep is a losing proposition in the long run. Sleep is vital to our health, and this is doubly important for people with chronic pain.

Sleep is much more than merely a period of lost consciousness; it is also a critical time when our bodies repair damage incurred during the day. Critical healing functions like tissue repair, protein synthesis and muscle growth happen primarily during sleep. Without proper sleep, and chronic pain conditions could take much longer to resolve.

Another key benefit of sleep is to your emotional health.  Studies have shown that people who go into sleep debt are much more likely to have higher stress levels. Stress can aggravate many pain conditions and make pain symptoms more intense.

Finally, sleep is important in maintaining many bodily operations.  People who are deprived of sleep suffer from poor coordination, making them more susceptible to falls and injury.  They are also at greater risk of chronic conditions like diabetes and high blood pressure that may aggravate existing pain issues or lead to new ones.

The Relationship between Sleep and Chronic Pain

Between 50 and 80 percent of people in chronic pain also struggle with sleep issues. From 25 to 40 percent of those with a chronic pain condition suffer from insomnia. Although there are many obvious ways that chronic pain can interfere with sleep, there are others that are more subtle.

Of course, there is the most apparent way that chronic pain disrupts sleep—it causes enough discomfort that it inhibits rest. Pain impulses may inhibit the process of falling asleep as well as prevent you from remaining somnolent or enjoying restful sleep. Studies involving sleeping patients have found that pain may even be incorporated into dreams if applied during sleep. In some cases, the pain experienced in a dream can be even more intense than that experienced while awake.

Many people who suffer from chronic pain use opioid pain killers to find relief.  An unfortunate side effect of opioid medications is that it inhibits REM sleep.  REM sleep is critical to feeling rested after sleep as well as pain suppression, so many opioid takers may find themselves more sensitive to pain while on these drugs.

Besides pain symptoms and opioid use, other factors that can inhibit sleep are:

  • Noise
  • Advanced age
  • Emotional distress
  • Uncomfortable sleeping conditions

How to Improve Sleep

If you are struggling with a sleep disorder related to your chronic pain, you should discuss your condition and symptoms with your physician.  Truly restful sleep should be a priority for you, so that you can speed your recovery process as much as possible. Your doctor may recommend one or more of the following options to improve your sleep:

  • Relaxation techniques—many people with chronic pain find it difficult to relax certain muscle groups, making it problematic to fall asleep. There are techniques like mindful meditation and guided imagery that may aid you in relaxing. It may take some time and instruction to master these techniques, so you may want to talk to a cognitive training specialist.
  • Adopt good sleep hygiene—although your pain may be the primary reason why you are having difficulty sleeping, it may not be the only factor. In order to optimize your ability to fall asleep, institute good sleeping practices like
    • No caffeine or alcohol in the evening
    • No electronic device usage before bedtime
    • Set a regular time to sleep
    • Don’t nap during the day
    • Take pain medication before sleep (if your doctor approves)
  • Remain active during the day—it can be difficult to put in a full day’s work if you are fatigued and in pain, but remaining active will help you fall asleep. If at all possible, try to maintain a regular exercise schedule; this should help ease you into sleep and help mitigate your pain symptoms.
  • Regulate use of pain killers—if you are taking morphine or codeine for your pain, discuss possible alternatives that won’t affect your sleep.  Many patients find that aspirin, Tylenol or Advil are as effective as opioids in managing their pain without disrupting their sleep.
  • Keep a sleep log—although this may not directly improve your sleep, keeping a record of when and how you sleep can help provide insights into your sleep issues for your physician.  If you need to consult with a sleep specialist, these logs may be especially helpful.
  • Maintain a comfortable bedroom—optimize your sleeping environment for restfulness. Make sure that noise levels are kept at a minimum and that the temperature is ideal for sleep. Remove anything that produces light or distraction.
  • Get a restful bed—most people rarely buy a new bed, but with a host of new sleeping products coming to market recently, you may find something that is perfect for sending you off to sleep and keeping you under the entire night. You may want to ask for your doctor’s recommendation if you have issues like joint pain or back problems.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information.

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