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. Here’s how sleep and pain are connected, as well as ten ways to improve your sleep.
Why are we so focused on sleep and pain?
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.
For example, 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.”
Sleep and osteoarthritis patients
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.
Osteoporosis and sleep
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.
How to improve your sleep to reduce your pain
Because of the connection between sleep and chronic pain it is important for pain patients to get a better understanding of the effects of sleep and how to improve the quality of it in their lives. The vicious cycle can seem never-ending: pain makes it difficult to sleep, but the lack of sleep makes pain much worse during waking hours.
Worrying about the lack of sleep increases the likelihood that sleep won’t happen or, when it does, that it will be fitful. How can you stop this cycle? There are a number of ways, from medical to behavioral, that you can change your own sleep patterns to get better quality sleep each and every night.
1. Make sleep a priority
You’ve probably heard plenty of advice to make lots of things in your life a priority. Experts say you should carve out time for exercise and make sure you’re eating right. In the workplace the “work life balance” is a big topic to encourage employees to make their personal lives as much of a priority as their professional lives.
In all of these conversations, no one ever seems to mention sleep. The first thing everyone should do to ensure that their quality of sleep begins to improve is to give it the priority it deserves. Learn not to make excuses to avoid sleep and over time it will become easier.
2. Establish bedtime routines
This tip might be cheating because it is actually several tips in one. A bedtime routine has proven successful across the board. People who have good bedtime habits see significant better sleep quality than those who do not.
No two bedtime routines are the same but some common ones include:
- Turning off the television at the same time every night
- Avoiding any blue light from cell phones, computers, or tablets
- Putting on pajamas
- Brushing your teeth
- Crawling into bed and reading in silence for about a half an hour before turning off the light
If this sounds simplistic, that’s because it is. These techniques are tried and true.
3. Create a regular sleep schedule
In conjunction with a good bedtime routine is the need for a regular sleep schedule. While there may be exceptions for special events, these really do need to be the exceptions not the rule when it comes to sleep.
Instead, start your bedtime routine at approximately the same time every night. Wake up at the same time every morning with the help of an alarm. Do this even on the weekends if you can so you avoid negatively affecting your internal sleep clock.
4. Nap when necessary
People do not embrace napping nearly enough in our hectic Monday through Friday schedules. It sounds like a luxury only afforded to a small, elite minority of people or kindergarteners. However, napping has a number of restorative benefits.
Napping has been shown to help people relieve stress and boost the immune system of individuals who do not get very much sleep at night. If it can do all that for people who get as little as two hours sleep at night, imagine what it can do to improve even a minor sleep debt without infringing on quality of sleep at night.
5. Improve your mattress
Of course, it is no secret that your mattress has as much to do with your sleep quality as your night time routines and your body’s physiology. You don’t even have to break the bank to buy a brand new mattress to improve the problem.
A comfortable mattress topper, such as a pillow-top or memory foam topper, can do almost as much to help you get a better night’s sleep as investing in an entirely new bed. While you’re at it, consider replacing your pillow more often than you do to make sure it is still comfortable. And use the right pillow for your sleep style.
6. Make it dark
There is quite a bit of research that shows that backlit electronic devices are disturbing our sleep cycles. Well, that isn’t the only culprit.
Many people don’t sleep well at all even if there is a sliver of light in their bedroom. This means obscuring all clocks and other small lights and using black-out shades to block out ambient light from your neighborhood.
7. Turn down the heat
Temperature has as much to do with sleep quality as darkness. You’ve probably experienced restless nights where you find yourself in an endless loop of throwing the covers off of you throughout the night because you’re simply too hot.
A lower temperature in the house actually helps your brain understand that it is time for bed. Plus, you’ll save a little extra in energy costs when you’re not actively heating the rest of your home.
8. Don’t eat before bed
Midnight snacks and late dinners are also a big problem when it comes to finding sleep. In fact, that is literally what late night meals do. Because your body is focusing energy on digestion it causes you to have less restful sleep.
Don’t eat anything after a normal dinner time if you can. If not, make sure to have your last snack before 8 p.m. This applies to alcohol as well. While you might feel sleepy after a glass or two of wine, your sleep will actually be disrupted.
9. Drink non-caffeinated tea
If you do want to add comforting refreshment to your bedtime routine there is nothing better than non-caffeinated tea. Whether it is some blend of herbal teal that promotes sleep or the soothing flavors of South African rooibos, tea can be a very relaxing ritual.
10. Don’t hit snooze
Finally, there is one more thing that can help you improve your overall sleep quality. When your alarm goes off in the morning, don’t give into the temptation to hit snooze. In fact, that extra nine minutes of sleep does nothing to make you feel more refreshed and awake at all and will leave you tired and sluggish as you struggle through your morning routine.
Alarm clocks aren’t all that healthy to begin with but they are necessary for many working professionals, so don’t make the experience worse by giving into the snooze button temptation. If you think you might, put your clock on the other side of your bedroom so you have to get out of bed to turn it off.
What tips have worked to help you improve your sleep and pain levels?
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