The Relationship Between Sleep and Pain
“Getting a good night’s sleep” is a saying that everyone has heard of, but is easier said than done. There are many factors that can influence sleep, some of which are under our control, such as caffeine intake and lack of physical activity or exercise. However, others are not as easily controlled, such as stress, anxiety, sleep disorders, and chronic pain. It is easy to imagine how chronic pain would affect daily life, but it may be more difficult to conceive how chronic pain would affect sleep.
According to the 2015 Sleep in America Poll, 21% of adults in America experience chronic pain. Pain has been found to be a major component in the difference between how much sleep Americans say they need and how much sleep they actually get. There is, on average, a forty two minute difference for adults with chronic pain. While forty two minutes does not seem to be much, this adds up to be about seven hours a week one is missing. The sleep one receives the night before makes a large impact on the person’s day, including mood and energy levels. It is therefore important to realize the impact chronic pain can make on sleep.
When pain is first experienced, its effects are not immediately prevalent in sleep. When the pain becomes chronic or exacerbates, it can lead to a vicious cycle in terms of sleep quality. If a person experiences poor sleep due to pain one night, it is likely that the same would occur the night after and so on, with the quality of sleep deteriorating with time. It is common to wake up frequently when sleeping due to the pain, disrupting sleeping states.
Those suffering from sleep disruption because of chronic pain naturally seek solutions and tips in hopes of getting a better night’s sleep. A seemingly obvious, and perhaps once again easier said than done, tip is to simply get back to sleep. If it is possible, taking pain medication right before bed may prevent frequent disruptions in sleep. Getting back to sleep may be assisted by trying “relaxing distraction”, with techniques including rhythmic breathing meditation and guided imagery (imagining a peaceful place). Another important tip is to maintain a fixed sleep schedule, so that one’s natural sleep cycle is regulated.
For some, the difficulties in sleeping may exacerbate and develop into insomnia; it is therefore quite common to find a person suffering from both chronic pain and insomnia. In these cases, it is important to make sure the proper medication is prescribed, as certain pain medications may improve sleep. On the other hand, opioid pain medications can disrupt sleep and prevent patients from entering deep sleep, or can cause sleep-related breathing disturbances. Another important fact to note is that people tend to remove distractions when attempting to fall asleep, such as turning off lights, putting away smartphones, etc. However, when the environment is too quiet, an awake person may have only his pain left to focus on. The pain therefore is perceived as stronger when attempting to fall asleep, although the actual pain may not have increased in intensity.
A form of therapy for people struggling with both chronic pain and insomnia is cognitive behavioral therapy for insomnia (CBT-I), which is designed to improve sleep quality and help those affected change their thoughts and behaviors in regards to sleep. It is a favored solution over medications as it not only has no side effects as medications would, but also because it has been shown to be effective in the long run. An aspect of CBT-I includes relaxation techniques, such as meditation, guided imagery, progressive muscle relaxation, etc. Through these therapy sessions, patients are also taught to control or remove negative thoughts related to sleep. Asides from these two main points, the standard and stereotypical guidelines for falling asleep are recommended, such as reducing caffeine intake, maintaining a sleep schedule, avoiding naps throughout the day, etc.
Struggling with sleep definitely affects one’s day and mood, and struggling with chronic pain also affects one’s daily life, so having the impacts of both will surely be difficult to handle and face. However, with the proper intervention, whether it comes in the form of medication, therapy, or behavioral changes, the effects can be partially, if not completely, eliminated. Although it may take time to find out what works for each person, as the degree to which one has pain and the quality of sleep one has varies significantly among people, the solution is out there.
References:
https://www.sleepfoundation.org/professionals/sleep-americar-polls/2015-sleep-and-pain
https://www.sleepfoundation.org/insomnia/treatment/cognitive-behavioral-therapy-insomnia
