Better sleep and Chronic Pain
Chronic pain is a pain that goes on for more than six months and fails to respond to conventional pain medication.
Today, chronic pain is known to affect an estimated 30 to 50 million Americans. It can result from a vast range of factors including injuries that did not heal properly and unsuccessful surgeries to lower back problems and systemic conditions like arthritis and fibromyalgia.
Sleep Disorders and Chronic Pain – Key Aspects
Research shows that patients suffering from chronic pain often find that their problems are compounded by the additional difficulties of insomnia and sleeping disorders. Out of the total population suffering from chronic pain, almost 65% also report experiencing sleep disorders.
Insomnia is a term that is used to describe all types of sleeping problems, including difficulty in falling asleep, staying asleep and awakening earlier than desired.
Pain is often referred to as the most significant cause of insomnia. In the condition of chronic pain, sleep disorders become all the more pronounced.
Sleep disorders might occur due to one or more of the below listed reasons:
- Back pain
- Facial pain caused by TMJ
- Musculoskeletal pain, from conditions such as arthritis an fibromyalgia
- Abdominal pain in women
- Cancer pain
The Vicious Cycle
Loss of sleep which occurs due to an inadequately managed pain can further lead to a cycle of fatigue, depression and irritability. The most common signs of a sleeping disorder are inability to sleep and waking up tired.
Sleep disorders are both the cause as well as effect of chronic pain. The viscous cycle begins with the onset of chronic pain which gives birth to sleep disorders. The abnormal pattern, in turn aggravates the pain, thus forming a vicious cycle of chronic pain.
Such disrupted sleep patterns further lead to an exacerbation of chronic pain, which in turn lead to a disturbed sleep.
For instance, an individual has neck pain that turns chronic and does not resolve. This condition further leads to the development of chronic insomnia in the patient. This insomnia causes a decrease in the body’s ability to repair itself. This eventually causes the pain to move to other parts of the body and aggravate the condition of insomnia itself.
Impact of Chronic Pain
Chronic pain can affect both the quantity and well as quality of sleep. According to a research report, atleast 62% of those with pain-related sleep problems complain that they are awakened during the night because of pain, while 62% of them report waking too early.
The two main ways in which the chronic pain affects an individual’s sleep are:
Problems in falling asleep
Research shows that chronic pain often worsens at bedtime. The logic behind this is that at sleep time, the brain of an individual quitens down in preparation of sleep. Unfortunately, as the brain slows its activity, the only focus remains on the pain, which in turn leads to an increased perception of the same.
Since distraction from the pain is one of the key pain management tools, the single focus on pain further aggravates the sleeping disorders.
Difficulty in staying asleep
The second most critical form of impact is the difficulty in having restorative sleep. A majority of individuals suffering from chronic pain complain about the inability to stay asleep at night. Bouts of severe pain often waken up the patient in the night and severely affect the quality of sleep.
A series of painkillers and sleep medications are administered to help with the case of sleep disorders arising from chronic pain.
The most common painkillers might include Advil PM. Ultram, OxyContin, Vicodin, codeine and morphine. Medications advisable for sleep disorders include benzodiazepines, like Ativan, Klonopin and Halcion.
However, a section of experts point out that some of the medication to reduce pain or induce sleep can actually interrupt the sleep pattern and decrease the actual amount of sleep. Drugs like the benzodiazepines and NSAIDs might also interfere with the normal sleep cycles.
The best solution is to take proper medical advice and avoid self-medication in such cases.
There are a series of steps that can be taken to ensure a good sleep. Here we list the main amongst them.
- Soft and comfortable mattress
- Proper sleeping posture
- Appropriate medication
- Stress reduction
- Reduced intake of caffeine
- Minimize daytime naps
- Reduced consumption of alcohol