Sleep is as fundamental as eating. Without the right amount of sleep you can actually increase your risk of a variety of medical conditions, including increased pain. It might be surprising to hear that sleep can be responsible for various levels of chronic pain but it is essential to understand that without sleep your body can’t regenerate and renew the way nature intended.

We believe in a holistic approach to treating chronic pain. This means it is critical to keep all aspects of a healthy body in mind when treating a condition. Sleep is part of this process and without a proper night’s sleep you may exacerbate existing pain or even experience increased or new pain. This is a problem that needs to be addressed and we want to pass this information on to our patients so they can make improvements in their routine to achieve better sleep patterns and stop the cycle of sleeplessness.

Recent research on the science of sleep and pain

In March of 2014 researchers at the University of Warwick in England determined that better sleep could help chronic pain patients stay more active and, in return, lessen their overall pain. There is a vicious circle when it comes to sleep and pain. Is the pain causing the insomnia or is the lack of sleep causing the pain? Physical activity is a common recommendation for someone with chronic pain but if the patient is too exhausted to exercise and unable to sleep at night they may unwittingly be causing more pain overall. Of course, it isn’t as easy as telling someone with pain-related insomnia to get more sleep. There needs to be better treatments to help patients get quality rest.

Lead researcher, Dr. Nicole Tang, says:

“The current study identified sleep quality, rather than pain and low mood, as a key driver of physical activity the next day. The finding challenges the conventional target of treatment being primarily focused on changing what patients do during the day. Sleep has a naturally recuperative power that is often overlooked in pain management. A greater treatment emphasis on sleep may help patients improve their daytime functioning and hence their quality of life.”

Later in the year, a study published in the journal Arthritis Pain & Care explored the way sleep affects chronic pain in osteoarthritis patients. They cited the cycle the medical community previously understood as lack of sleep, increased pain, depression, and disability and noted that it may not play out in a neat circle. Their findings demonstrated that sleep was associated with both pain and depression at the beginning of the study but disability was not linked to baseline sleep disturbances. High pain levels that were paired with poor sleep also increased rates of depression. However, after a one-year follow-up sleep disturbances successfully predicted increased depression and disability but did not correlate to increased pain.

In February of this year, another study in the Journal of Bone and Mineral Research demonstrated sleep problems may actually impact bone health which could have wider implications for individuals dealing with bone-related chronic pain issues, such as osteoporosis. Our bones are not made of the hard, rock-like substance that we know from museums. They regenerate daily and need healthy sleep to do so properly. The researchers suggest that sleep apnea may contribute to some cases of osteoporosis as it affects sleep duration, quality, and inflammation. This sleep disruption may impact natural bone metabolism.

Of course, these pain conditions are just the tip of the iceberg and there are more ways that lack of sleep can impact a patient’s quality of life.

Sleep and fibromyalgia

The pain condition fibromyalgia is still very much a medical mystery. While many studies have been conducted to determine the underlying cause to help find a cure, the medical community still doesn’t entirely understand what causes fibromyalgia. At this time, most of the treatments are for the symptoms, which can help patients have a better quality of life, but there is a lot of research that still needs to happen to effectively understand this pain condition better.

However, it is pretty clear that there is a correlation between fibromyalgia pain and quality of sleep. Fibromyalgia affects between 2 to 6% of people all over the world. The condition that was once assumed to be purely psychological has been getting more attention lately as researchers get a better, but still incomplete, understanding of the condition. One of the primary concerns is the sleep and pain cycle. The pain caused by fibromyalgia leads to lack of sleep or poor quality sleep which leads to increased fibromyalgia pain. But researchers have also found that improving quality of sleep, though a variety of methods, also improves the instances of pain.

For this reason, it is important that the community continue to study the way sleep affects this condition and make recommendations and improvements for fibromyalgia patients. In the meantime we can continue working with individuals to help improve their own sleep patterns one night at a time.

The cause of insomnia

Of course, there is also no clear consensus on why some people experience insomnia while others don’t. It is frequently caused by a disruption to the sleep pattern, such as travel, or stressful events. As people age they may also experience more sleep interruptions. The amount of sleep our bodies need doesn’t change at all, but we are far more likely to wake multiple times throughout the night and have a hard time falling back to sleep.

Sometimes insomnia is brought about by our own psychology. When you lay awake at night trying desperately to fall asleep, you could be talking your brain out of it all together. But there are other, more physical reasons as well. Pain of any level can cause sleep disruptions. Acute pain, however, eventually goes away. Chronic pain can make sleep much more complicated. When you wake multiple times in the night due to pain and discomfort your body isn’t getting the regenerative sleep it needs. This could lead to issues with your overall metabolism and digestion issues as well as possibly causing or exacerbating diabetes and, of course, increased pain.

There is good news. Later this week we will look at a few ways you can improve sleep and decrease pain.

Do you experience difficulty sleeping?

Image by Lee Nachtigal via Flickr

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