Is Pain Keeping You up at Night?

Sleep issues and pain are challenging issues that often show up together. Pain and sleep are basic body functions, needed for human survival. Sleep is necessary to maintain a balance across body organs, especially the nervous system. Pain is a physical and emotional state that helps us avoid harm.

An imbalance in your pain-sensing system or your sleep can interfere with your well-being. Sleep disturbances affect over 67-88% of people with chronic pain. Both chronic pain and sleep disturbances are linked to mental and health conditions, such as obesity, type 2 diabetes, and depression.

A pain specialist can treat your pain and help you achieve a restful sleep. Sleeping well can reduce your pain symptoms, increase your energy, and improve your memory and daytime functioning.

How pain influences the quality of your sleep

Most healthy adults need 7-9 hours of sleep a night. People with acute (sudden) or chronic (long-lasting) pain are at a higher risk for sleep problems.

While 65% of people without a history of pain reported “good” or “very good” sleep quality, only 45% of people with acute pain claimed the same. Only 37% of people with chronic pain reported having “good” or “very good” sleep.

Some facts about sleep:

• Sleep is just as important as diet and exercise.
• Insomnia (sleep problems) is the most common sleep problem in adults age 60 and older.
• Rates of insomnia increase in the elderly – most often due to an illness or chronic pain.
• Some medications, including those that are given for pain, can interfere with normal sleep patterns. These include antidepressants, opioids, and anti-anxiety medications given as sleeping aids.
• Chronic lack of sleep (due to pain or any other reason) changes the level of Leptin, a hormone that affects your appetite. Chronic lack of sleep increases your risk for obesity.
• Obesity increases the risk of snoring and sleep apnea (pauses in breathing while you sleep). It can be an additional cause for insomnia.

For more information on sleep problems, click here.

Is pain interrupting your sleep?

There appears to be a link between poor sleep and the ability to cope with pain. Experiments have been used to test the direct effect of sleep deprivation on pain levels.

Even after a single night of interrupted sleep, a person is more likely to feel pain during sensory tests. During these tests, a person is exposed to a painful trigger, such as a hot surface or a sharp object. If a person had chronic pain, they were very likely to feel increased pain during the testing.

The “insomnia-pain trap”

Poor sleep can increase your pain. Pain can prevent you from getting a good night’s sleep. This unfortunate cycle can lead to insomnia that can last for months or years at a time.

Lack of sleep in patients with pain, can impair their body’s ability to block pain signals. Blocking pain signals is an important way that your body has developed in dealing with painful conditions. When somebody suffers from a painful condition, such as fibromyalgia, the body is no longer able to efficiently block pain signals.

Scientific studies on sleep patterns have found that a night of poor sleep can reliably predict that a person will have increased pain the next day.

Sleep problems due to pain

If your sleep is interrupted by episodes of poorly controlled pain, you may experience the following:

• Difficulty falling asleep at night
• Waking up in pain during the night
• Waking up too early or waking up in pain
• Feeling tired and falling asleep during the day
• Feeling moody and anxious when awake
• Difficulty focusing on everyday tasks
• Forgetfulness (forgetting appointments, misplacing things

Types of pain that lead to sleep disruption

Pain, in any form, can disrupt sleep. It may be a sudden episode of back pain due to a recent disc herniation or it may be ongoing joint pain due to arthritis.

Examples of pain conditions that commonly disrupt sleep:

• Headaches. Common headaches like tension headaches and migraines can keep you from falling asleep or wake you up at night.
• Fibromyalgia. Widespread discomfort and muscle pain can impair sleep.
• Rheumatoid arthritis. This is a chronic joint inflammation due to an immune system disorder. It can cause neck pain and make sleep positions uncomfortable and painful.
• Burn injury. Surfaces of burned skin are excruciatingly painful. When the burned surface comes into contact with bedding, it can make sleep difficult.
• Facial pain. Face pain is often a result of nerve disorders (trigeminal nerve pain). A mere touch or the slightest pressure can trigger burning or electric-like sensations.
• Cancer pain. Cancer can spread to other organs, such as the bones. This is an extremely painful condition that can disrupt sleep.
• Multiple sclerosis. As part of this disease, your immune system attacks the nerve cells in your brain and spinal cord. It results in arm and leg weakness, eye pain, electric-shock sensations, and muscle spasms.

A pain specialist can address your pain-related sleep problems

The best way to keep pain from interfering with your sleep is to get the pain under control. A pain specialist can bring your pain to manageable levels so you can function better during the day and rest better at night.

There are several approaches a pain specialist will use to help you:

1. Medication management
2. Minimally invasive procedures
3. Referral to other healthcare providers for complementary treatments

Medication Management

Medications are often used early on during treatment. They can be used alone or alongside other treatments. Several common types of medications that treat pain, also cause drowsiness. While these medications can interfere with daytime activities such as work and driving, they are helpful if taken at night. These medications will make you drowsy and help you sleep. Ideally, sleep medications should not be used on an extended basis.

Minimally invasive procedures

These non-surgical procedures can be performed by your pain specialist in their office. They involve injecting numbing medicine around the spine, into achy joints, close to painful nerves, and into tense muscles. Some procedures with longer pain-relief effects involve placing current-emitting devices in your back (close to the spine). Minimally invasive procedures may be short (minutes) or may take a couple of hours to perform. They are usually offered by a pain specialist in their office or in a hospital setting. You are able to go home the same day.

Examples:

• Epidural injections,
• Spinal cord stimulation, dorsal root ganglion stimulation
• Facet joint nerve blocks
• Knee/hip joint injections
• Peripheral nerve stimulation
• Trigger point (muscle) injections

Referrals to other healthcare providers

Pain specialists may send you to other healthcare professionals for additional treatments: physical therapy, chiropractic care, massage, psychological counseling. A comprehensive and balanced approach can help you control your pain and have a more restful sleep.

Examples of complementary treatments that can help you sleep better:

• Massage
• TENS (transcutaneous electrical nerve stimulation)
• Acupuncture
• Relaxation techniques

For more information on how you can improve your sleep habits, click here.

Our pain specialists can help you to better control your pain and return to a more restful sleep.