How can lack of sleep make pain worse?

Sleep affects pain. You may have noticed that when you sleep poorly and are tired your pain tends to be worse. Research shows that one of the most important predictors for pain intensity is the number of hours slept the night before. Bottom line: if you sleep poorly, your pain will be worse the next day.

Medication management should include sleep as well as pain. As sleep improves, the need for pain medications will decrease. Eventually the need for sleep medications will also decrease.

People with pain also feel less control over their sleep, worry more about lack of sleep affecting their health and exhibit greater sleep sensitivity. They’re more likely than others to say environmental factors make it more difficult for them to get a good night’s sleep. These factors include noise, light, temperature and their mattresses alike, suggesting that taking greater care of the bedroom environment may be particularly helpful to pain sufferers.

While both chronic and acute pain relate to lost sleep, the survey indicates that chronic pain is an especially powerful problem. Indeed, nearly one in four people with chronic pain, 23 percent, say they’ve been diagnosed with a sleep disorder by a doctor, compared with just 6 percent of all others.

Sleep Hygiene

How Much Sleep Do We Need?

The amount of sleep each person needs depends on many factors, including age. For most adults, 7 to 8 hours a night appears to be the best amount of sleep, although some people may need as few as 5 hours or as many as 10 hours of sleep each day.

If you feel drowsy during the day, especially during stimulating activities, you haven't had enough sleep. If you routinely fall asleep within 5 minutes of lying down, you probably have severe sleep deprivation, possibly even a sleep disorder. Micro-sleeps, or very brief episodes of sleep in an otherwise awake person, are another mark of sleep deprivation. In many cases, people are not aware that they are experiencing micro-sleeps. This may be a cause of accidents both on the road and at work. It will certainly reduce your ability to perform at your full potential.

Unfortunately many medications including those that are given for pain can interfere with normal sleep patterns. These include antidepressants, opioids and anti-anxiety medications, even those given as sleeping aids.

Obesity worsens sleep and increases the risk of snoring and sleep apnea (pauses in breathing while you sleep). Chronic lack of sleep also increases the risk of obesity by changing the level of certain hormones. In a study of American adults who slept fewer than 6 hours, 33% were obese compared to only 22% of those who had 6-9 hours of sleep.

Specific Sleep Issues

Some specific sleep problems may need specific treatments

• Sleep apnea: Observers say you snore loudly and often hold your breath while sleeping. It may make you grumpy, impatient, irritable, forgetful, or fall asleep while being active. You may experience hard-to-treat headaches. It tends to make obesity, depression and leg swelling worse.
• Restless leg syndrome: You feel a creeping, crawling, aching, or tingling sensation in your lower legs worse at night-time. It may last for 1 hour or longer. Sometimes it also occurs in the upper leg, feet, or arms. You feel an irresistible urge to walk or move your legs, which almost always relieves the discomfort.
• Periodic leg movement: This is a repetitive cramping or jerking of the legs during sleep.
• Depression and anxiety: These are also associated with poor sleep. These can be helped by non-medication methods as well as medications.

A restful night’s sleep is one of the top priorities in solving your chronic pain. The effectiveness of your other treatments is limited until you are regularly experiencing a full night’s sleep for at least six weeks. Usually medications are required for a while in the presence of pain. As your pain diminishes so will your need for sleep medicines.