Most people will have had trouble sleeping at some time and understand the common consequences this has. However, research estimates that up to 90% of us have suffered with sleep deprivation at some point, and up to 30% of us meet the diagnostic criteria for insomnia. This means a large percentage of the population have had issues with maintaining regular sleep. A lack of adequate sleep has been strongly linked to depression, anxiety, stress and weight gain due to the increase in the hormone, ghrelin, which makes you feel hungrier and crave foods high in saturated fat and sugar. Lack of sleep is clearly not good news if you’re on a diet, but does it have anything to do with pain?
The links between sleep and pain
Surprisingly enough, a plethora of evidence shows that sleep and pain are interlinked. One such way, is that increased pain levels reduce the quality of our sleep, which will be obvious to anyone who has suffered with a bad back! More importantly, is that the chronicity of pain (how long you’ve suffered with it) also seems related to the length of time and the severity of the sleep disturbance. In other words, the longer your pain persists, the higher the likelihood of you having sleepless nights, or even developing insomnia.
The scale of the problem is so great, that as many as 9 out of 10 people who have had pain for 3 months or more, will also develop problems with their sleep. It has also been shown that individuals with sleep problems have an increased risk of suffering an injury or re-injuring themselves. One study showed that athletes who slept less than 8 hours per night were almost twice as likely to get an injury as those who slept for more than 8 hours. This risk increased the longer the athlete had suffered with sleep problems. The research in this area is very interesting, but it seems obvious that pain and a lack of sleep should be related. However, the research goes on to demonstrate that sleep disturbance may not just be a consequence of pain, it could also be the cause of it.
Chicken or the egg?
Several scientific studies have suggested, especially in people with persistent pain, that sleep disturbances have more of an effect on pain, than pain has on sleep disturbance. In other words, if the sleep can be improved, this will help the pain, whereas improving the pain doesn’t necessarily help the sleep disturbance. So, the next important question is which comes first, the sleep problem or the pain? Well believe it or not, it’s a complex question to answer. Several mechanisms are thought to be at play here, including functional changes in the way the brain and central nervous system process information, and the production of chemicals such as dopamine and opioids. However, complex this may be, the most commonly accepted conclusion is that the two problems are related, so it is definitely a good idea to address any issues with sleep as part of the treatment for any painful condition.
What can I do?
The good news is that sleep and pain can be improved with some changes to your normal routine, these include:
Keep a sleep diary, noting the duration and quality of sleep, then making associations with possible causes of a good or bad night’s sleep.
Relaxation techniques, such as mindfulness meditation.
Exercise, particularly mind & body exercise such as yoga or tai chi.
Controlling external stimuli, such as de-cluttering the bedroom and avoiding phone or computer screens late at night.
Hopefully, these simple steps will help, but if you or anyone you know could benefit from a comprehensive approach to pain management, please get in touch.