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Sleep-and-Pain (4)

17 Nov

Has managing your pain become a challenge when it comes to settling down for a restful night’s sleep? While sleep plays a critical part in our overall well-being, the good news is that even if you suffer from pain, there are many ways you can improve habits to help get the quality sleep your body needs. Before counting sheep, consider these easy tips:

1. Eat Healthy Throughout The Day:  Eating healthly throughout the day can be an important factor in how well you sleep at night. If you are someone who experiences hunger before bedtime, eat a small serving of carbohydrates and fat (berries and nuts) about 15 – 30 minutes before you go to bed. Be sure to avoid heavy, rich foods, alcohol and fatty foods 2 -3 hours before bed as these can cause indigestion and insomnia.

2. Nap Strategically: If you need to make up for lost sleep at night, it is ok to take short naps during the day rather than sleeping in late in the morning. This prevents disruption to your natural sleep – wake pattern. If insomnia is a problem for you, consider eliminating naps altogether.

3. Keep To An Evening Routine: Setting a bedtime and going to bed at the same time each night may prevent tossing and turning. If you must change your schedule on the weekends, try doing it in small increments. If you change your bedtime, help your body adjust by changing in small daily increments, such as 15 minutes earlier or later each day. It is also beneficial to incorporate relaxing rituals in the evening prior to going to bed such as taking a bath, reading or meditating. 

4. Exercise Most Days:  Physical activity, especially cardiovascular workouts, are known for improving the length and quality of your sleep. That said, it’s best not to exercise within 4 hours of going to bed because body temperature elevates. As you cool down, your brain receives signals to produce sleep-inducing melatonin.

5. Pay Attention To What You Drink: Watching what you drink in the late afternoon and evening hours has a number of implications on your ability to get a good night’s rest. Drinking too much before bed can cause disruptive, middle-of-the-night trips to the bathroom. Caffeine should be limited as it can keep you awake 10 to 12 hours after drinking it. After lunch, cut back on your overall intake or consider avoiding caffeine altogether. Be cautious when drinking alcohol as well – it can take hours to wear off and wreak havoc on your quality of sleep. 

6. Get Comfortable:  Create a comfortable room that is cool, dark and quiet. When sharing a bed with someone else, make sure it is big enough and at the comfort level for both of you. Set limits on how often children or pets share your bed or encourage they use their own beds most, or all of the time.

What tips do you have to help improve sleep?

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16 Nov

If you suffer from acute or chronic pain, especially back pain, the thought of a good night’s rest may be only a dream. Most adults need 7 to 9 hours a night for the best amount of sleep, although some people may need as few as 6 hours or as many as 10 hours of sleep each day. Oftentimes, individuals who suffer from pain associated from back conditions experience additional issues with insomnia and sleeping disorders. According to the National Sleep Foundation, pain and sleep problems are significant. In the adult population, about 15% of those surveyed reported experiencing chronic pain. In older adults, the number increases to over 50%. Among those with pain, 2/3 reported poor or disrupted sleep.

Sleep is one of the most critical ways that we renew our mental and physical energy on a daily basis. While there are many conditions and environmental factors that cause sleep problems, disturbances in sleep can intensify many conditions – including back pain. If you suffer from chronic pain or acute back pain and it is effecting the quality of your sleep, it is essential that you incorporate effective strategies and a treatment plan that will aid sleep deprivation from interfering with work, driving and social activities. 

Pain and Sleep Facts:

  • Each year, at least 40 million Americans suffer from chronic, long-term sleep disorders, and an additional 20 million experience occasional sleeping problems.
  • 2/3 of chronic pain sufferers have sleep problems.
    • Sleep deprivation accounts for an estimated $16 billion in medical costs each year, while the indirect costs due to lost productivity and other factors are much greater.
    • Sleep complaints and related daytime symptoms occur in 54–70% of adult rheumatoid arthritis patients.
    • One study estimated that the prevalence of sleep disturbance among people with low-back pain is 58.7%.
  • 75% of patients with fibromyalgia complain of sleep disturbances.

Causes Of Sleep Problems When You Are In Pain

If you live with pain, you know that sometimes your only relief is when you are asleep. However, some people’s pain prevents them from finding a way to become comfortable – oftentimes leading to the development of sleep problems. These problems not only result in overtiredness, but may cause pain to worsen. Here are a few conditions that may trigger a sleep problem to develop:

  • Anxiety and depression can make it hard to fall asleep or stay asleep. Consequent sleep loss can lead to increased pain. Anxiety and depression may also increase a person’s sensitivity to pain.
  • Some breathing related sleep disorders are associated with obesity – and obesity is also linked with back pain. Sleep disorders like sleep apnea interfere with normal sleep patterns, leading to insufficient sleep and poor sleep quality.
  • Limb movement disorders, such as restless legs syndrome, might further disrupt the normal sleep pattern.
  • Fibromyalgia can cause pain throughout the body. It is also linked with fatigue, anxiety and sleep problems.
  • Many prescription medications can impair the quality of your sleep. For instance, medications for conditions such as high blood pressure, epilepsy and ADHD may also cause sleep problems.

If you'd like more information on sleep and pain, take a look at the best sleep positions for back and neck pain.

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02 Nov

Pain and sleep are two things that, understandably, don’t go very well together. Whether it’s because of the pain itself, or the stress and worry that pain tend to cause, the detrimental effects on sleep are undeniable. Understanding the true state of sleep among pain sufferers – and what can be done to address it – may help everyone get a few more Zzzs.

The Issue

According to a study in The Journal of Pain, sleep complaints are present in 67%-88% of chronic pain disorders.[1] And among those with insomnia, more than 50% suffer from chronic pain.

The National Sleep Foundation’s 2015 poll determined that pain is associated with lower sleep quality more sleep problems and greater “sleep debt,” or the difference between how much sleep people think they need to function properly and how much sleep they are actually getting from night to night.[2] On average, those with chronic pain sleep only 6.7 hours, and the more severe the pain, the lower that number becomes. In addition, the sleep debt is 42 minutes a night for chronic pain sufferers and a full hour for those with severe pain.

The quality of sleep we get is also an issue for pain sufferers. Only 37% report good or very good sleep – meaning 63% are facing issues with their sleep quality.[2] This may be because, as the National Sleep Foundation found, environmental factors – like noise, light, temperature and even the mattress – affect those in pain to a higher degree than those not in pain.

It’s also the case that people in pain feel less in control of their sleep and tend to worry more about the effect that poor sleep will have on their health. This kind of stress, in turn, can actually lead to poorer sleep quality and greater sleep debt.[2]

Medications and Sleep

The question may arise: How do pain medications play into the interaction between pain and sleep? In theory, reduced pain levels would mean better sleep – but, unfortunately, that’s not the case. Among those experiencing chronic pain, only 32% of people who took pain medication during the past 7 days described their sleep as good or very good. In contrast, 47% of those with chronic pain who never took pain medication reported good or very good sleep quality.[2]

A similar outcome occurred for those taking sleep medications. Of all the respondents taking sleeping pills, only 33% of them described their sleep as good or very good and 66% of them reported sleep difficulties. On the other hand, 58% of those who never took sleep medications had good or very good sleep, with 42% of them experiencing no sleep difficulties whatsoever.[2]

Effects on Life

It’s no secret that lack of sleep can severely affect your life. But it seems this is even truer for those experiencing chronic pain. For instance, 52% of chronic pain sufferers have had their lack of sleep affect their work. In contrast, only 23% of those without pain have experienced the same. In all the categories measured by the National Sleep Foundation – mood, daily activities, enjoyment of life, relationships and work – those in chronic pain experienced significantly more difficulty.  And the problems were even worse for those with severe pain: 63% experienced problems completing daily activities, 59% had trouble at work and 54% had trouble simply enjoying their lives.[2]

The Sleep and Pain Cycle

Sleep and pain form a dangerous circle. According to a study in the journal Sleep Medicine Reviews, “Experimental studies … suggest that the relationship between sleep disturbance and pain might be reciprocal, such that pain disturbs sleep continuity/quality and poor sleep further exacerbates pain.”[3] In other words, pain leads to lack of sleep, which causes stress, fatigue and even more pain, which leads back to less sleep.

This can actually be seen on a daily basis. A study in the journal Pain discovered that those sleeping less than six hours a night had greater pain levels the next day.[4] This extremely close relationship between the two, the study concluded, illuminates “the importance of considering sleep when assessing and treating pain.”

Treating the Problem

From less sleep in general to more sleep disruptions, pain clearly has a widespread impact on our sleep and on our lives. Addressing both aspects are important when it comes to regaining quality of life.

The National Sleep Foundation found that those who made sleep a priority in their lives achieved 36 more minutes of sleep per night compared to those who weren’t motivated to get enough sleep. They also experienced better sleep quality and fewer sleep difficulties. Plus, those whose bedtime routine included going to bed at a suitable time each night got an average 18 minutes more sleep per night, with 60% of them reporting good or very good sleep quality.[2]

But addressing stress and pain are equally important aspects. That’s where a multidisciplinary approach comes in. The interventional treatment options available from physicians can decrease your daily pain levels, while a behavioral health provider can provide you with ways to cope with pain, stress and their effects on your life. Thus, an interdisciplinary treatment plan can provide both the pain relief and stress relief needed to reclaim your sleep and your life.

Get moving. Call (888) 901-PAIN (7246) or click to schedule a consultation now.

[1] Finan, Patrick H., Burel R. Goodin, and Michael T. Smith. "The Association of Sleep and Pain: An Update and a Path Forward." The Journal of Pain 14, no. 12 (December 2013): 1539-552.

[2] National Sleep Foundation. “2015 Sleep in America Poll: Sleep and Pain.” Washington, D.C.; The Foundation; 2015 Mar.

[3] Smith, Michael T., and Jennifer A. Haythornthwaite. "How Do Sleep Disturbance and Chronic Pain Inter-relate? Insights from the Longitudinal and Cognitive-behavioral Clinical Trials Literature." Sleep Medicine Reviews 8, no. 2 (April 2004): 119-32.

[4] Edwards, Robert R., David M. Almeida, Brendan Klick, Jennifer A. Haythornthwaite, and Michael T. Smith. "Duration of Sleep Contributes to Next-day Pain Report in the General Population." Pain 137, no. 1 (July 2008): 202-07.

01 Nov

It’s well known that pain and sleep are interconnected. Pain is associated with worsened sleep and lack of adequate sleep is associated with increased pain. But, according to a new study, it’s possible that for young adults, sleep problems may actually predict the onset or continuance of chronic pain.

Overview of Research

The study, titled “Sleep Problems and Pain: A Longitudinal Cohort Study in Emerging Adults,” was published in the journal PAIN, the official publication of the International Association for the Study of Pain. The researchers followed more than 1,750 men and women for three years. Their ages ranged from 19 to 22.

Emerging adulthood – a period typically defined as between 18-25 years old – is a period of both psychosocial and behavioral fluctuations, which include altered sleep patterns. In fact, around 30% of individuals in this age group experience at least one sleep problem (including needing sleeping pills, waking up hours early or not being able to fall asleep, among others). And while there have been studies showing the correlation between sleep problems and pain levels in adults, how these two factors correlate during emerging adulthood is less well known.

Study Findings

Researchers determined that sleep problems were clearly associated with chronic pain, musculoskeletal pain, headache and abdominal pain severity among young adults. Plus, sleep problems at the beginning of the study significantly increased the likelihood that participants would have new or persistent chronic pain three years later. Overall, 38% of those who had sleep problems at the study onset had chronic pain at follow-up. Only 14% of those without sleep problems exhibited chronic pain three years later. This relationship was seen more in women than in men.

The researchers also concluded that pain had a much smaller effect on sleep, with only abdominal pain sufferers reporting statistically significant sleep problems three years later. All of these findings mirror those in separate studies on both adolescents and middle-aged adults, meaning that sleep problems seem to predict pain – not just act as a precursor to it – regardless of age.

It was also found that depression, anxiety and a lack of physical activity were not significant factors in these relationships, although fatigue did play a part.

Implications for the Future

This research provides an important avenue for the treatment and prevention of chronic pain. By identifying at-risk young adults early – and by addressing their sleep problems before the onset or worsening of pain symptoms – we may be able to reduce future pain problems in some emerging adults, especially in women.  

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