Sleep is key to your body’s overall health. But if you experience chronic pain, sleep can become problematic. In fact, sleep disturbances are present in 67%-88% of all chronic pain cases.
‘Sleep disturbances’ is a catchall phrase for any type of difficulty sleeping. The most common types of sleep problems for patients with chronic pain are insomnia, restless leg syndrome, hypersomnia, and sleep apnea. Having difficulty sleeping makes dealing with pain even harder, and it becomes a vicious cycle.
If a patient experiences sleep disturbances due to pain one night, it is more likely that he or she will experience more problems sleeping the next night, and so on. The lack of consistent sleep can make pain worse by putting stress on the nervous system. This kind of stress amplifies the pain signals to the brain.
How Does Chronic Pain Affect Sleep
An average of 50% of people who suffer from insomnia have reported chronic pain conditions. Insomnia is the problem of getting enough sleep on a consistent basis. People generally have issues either falling asleep or staying asleep. Occasionally, people suffer from both.
A few common causes for insomnia in pain patients is:
- Daytime sleeping
- Regulating body temperature
Daytime sleeping and regulating body temperature can be a side effect of medications that are prescribed to help patients get relief from their pain.
The most effective treatment for insomnia is cognitive behavioral therapy (CBT). This is a psychotherapy practice that breaks the cycle and creates new associations with going to sleep. CBT is often in conjunction with chronic pain rehabilitation programs that are designed to help patients learn how to self-manage pain, return to daily activities, and improve their current quality of life. A key component of therapy is to reduce any stressors that are a result of living with chronic pain, such as anxiety and depression.
Restless Leg Syndrome
Restless Leg Syndrome is a neurological disorder that gives a patient an uncontrollable, overwhelming urge to move their legs. This makes it very difficult to get comfortable enough to fall asleep.
In patients who suffer from chronic pain conditions, restless leg syndrome is often associated with central sensitization. This is a condition of the nervous system that is often related to the development and maintenance of chronic pain.
Many times, when someone thinks about a sleeping disturbance, they associate it with lack of sleep. However that is not entirely true. For patients who experience chronic pain, it is not uncommon to experience hypersomnia. This condition means the patient gets too much sleep. Typically, this is caused by certain medications or depression.
Depression in pain patients is overwhelmingly common. Because the pain can be debilitating and interfere with someone’s quality of life, limit their ability to live independently, or prevent them from doing activities they love, depression is often a result of chronic pain. Depression is fatiguing, which is why hypersomnia is an issue for chronic pain patients.
Sleep apnea is a sleep disorder that causes people to temporarily stop breathing while asleep. The most common form is obstructive sleep apnea syndrome (OSAS). Is it mostly associated with snoring, being overweight, having type II diabetes, or having a heart disease.
Studies have shown that 55.4% of patients who experience OSAS have chronic widespread pain, and the correlation between OSAS and chronic pain in females was much higher. Females who have chronic pain and OSAS reportedly have higher pain and lower quality of life.
Treatments for sleep apnea include lifestyle changes (losing weight, avoiding alcohol, quitting smoking), mouth pieces, or devices like C-PAP’s. It is important to treat sleep apnea because it can drastically affect your quality of life. In cases when a pain patient is taking pain medication, sleep apnea be especially dangerous.
If you experience sleep disturbances due to your chronic pain, talk to your doctor today.
Institute for Chronic Pain: Pain Sensitization
Institute for Chronic Pain: Sleep Disturbance
Sleep Foundation: Pain and Sleep
NCBI: The Association of Sleep and Pain
NCBI: Chronic Widespread Musculoskeletal Pain in Patients with Obstructive Sleep Apnea Syndrome and the Relationship Between Sleep Disorder and Pain Level, Quality of Life and Disability