Sleep’s Impact on Pain

Chronic pain management involves many different factors, and one of the most important factors to manage chronic pain is sleep. A large amount of research has shown that there is a strong correlation between the severity of sleep problems of people with chronic pain and the severity of their pain. When a person is not getting enough sleep, it can make their pain worse because the brain processes pain differently when a person is sleep-deprived. Research conducted by Haack et al. in 2020 found that when a person improved their sleep, they reported less pain. Therefore, sleep is an important factor in the pain of people with chronic pain.

Biological mechanisms also play a role in how sleep affects pain. Research by Nijs et al. (2018) demonstrated that sleep can influence pathways in the brain that are involved in pain processing. The chemicals produced by the body during sleep can decrease the perception of pain, and those who experience poor sleep can become more sensitive to pain. Sleep also plays a crucial role in the body’s healing processes. During deep sleep the body repairs damaged tissues and reduces inflammation, which is particularly important for individuals experiencing pain due to inflammation of tissues, such as those with arthritis or fibromyalgia.

Impact of pain on an individual’s psychological state cannot be ignored. The psychological impact of chronic pain can bring on about feelings of anxiety and or depression. This can affect an individual’s sleep pattern as they may find that they have difficulty falling asleep or they may have difficulty remaining asleep through the night as a result of pain. Poor sleep can affect an individual’s ability to cope with their pain as research has shown that as sleep worsens so does an individual’s ability to cope with their pain (Woo and Ratnayake, 2020). Thus, managing sleep is an important component to managing pain as well as treatment.

By putting to use these simple strategies, chronic pain sufferers can work to bring sleep back into their lives. Often simple changes to a person’s way of life can have a big impact, and sleep is no exception. By working to establish a consistent sleep schedule, creating a comfortable sleeping environment and attempting to relax before sleep, people can work to overcome their sleep difficulties and bring about relief from chronic pain.

Another way to influence your sleep is to engage in regular physical activity. Exercise, in general, can have a positive effect on people’s pain levels and stress levels, which in turn can help with sleep. However, for people in pain with chronic health conditions, it is always a good idea to speak with their healthcare provider before commencing with any new form of exercise. Reducing the amount of time spent by all individuals before going to bed staring at screens and the blue light that they emit can also help with sleep. By incorporating these positive changes to an individual’s daily routine they can see an improvement in their sleep which in turn can aid in their pain management.

Sleep plays a vital role in our health and can greatly affect how we feel pain especially for individuals experiencing chronic pain. Research by Husak and Bair (2020) and Selvanathan et al. (2022) demonstrated that lack of sleep can cause changes to the amount of certain chemicals the body produces. These chemicals are typically made up of neurotransmitters and hormones which manage our sensation of pain, so if we are experiencing sleep deficiency we may experience an increase in pain then we normally would when we are well rested.

In addition to these mechanisms that protect against feeling pain, sleep is also important for the body’s healing processes. In deep sleep the body repairs tissue and builds bone. Inflammation is also reduced during this stage of sleep, which is particularly important for people with conditions such as arthritis or fibromyalgia, where levels of inflammation increase pain. The extent to which the body is able to heal during sleep will affect the amount of pain a person feels when awake, as explained by Li et al. (2022).

Chronic pain also has an impact on sleep in people with chronic pain. Individuals suffering from chronic pain often have trouble falling asleep and/or staying asleep because of their pain. Lack of sleep as a result of chronic pain then worsens the pain, thus creating a cycle of problems. Recognizing the impact that sleep disturbances have on chronic pain and vice versa is essential for developing an effective treatment plan for people suffering from chronic pain (Nijs et al. 2024).

Addressing sleep and using it as part of a pain management plan is key to managing chronic pain. It is a simple yet crucial aspect of managing long-term pain and can help individuals with chronic pain manage their pain and achieve a better quality of life. There are many simple things that can be done on a daily basis to aid sleep and help individuals manage their chronic pain. Creating a relaxing bedtime routine is an important aspect to achieving sleep and addressing any underlying issues that may be affecting sleep are also vital to helping individuals with chronic pain achieve better sleep.

In summary, the relationship between sleep and pain is complex. By understanding how sleep affects pain, and how pain can affect sleep, it is possible to develop methods to improve both aspects.

There are many non-pharmacological interventions available for those that are experiencing problems with their sleep, and one of the most effective is Cognitive-Behavioral Therapy for Insomnia (CBT-I). CBT-I is a type of talking therapy that looks at the way a person thinks about sleep, and the things that they do before they go to bed. By making changes to the way that a person thinks about sleep, and by making small changes to their sleep routine, a person can work towards achieving better quality of sleep. A number of studies have proven that CBT-I not only increases the amount of sleep that a person has, but also decreases their perception of pain. As a result, CBT-I is an effective tool for people with chronic pain who are experiencing problems with their sleep.

However, there are a number of Mindfulness practices which can be very effective at improving sleep. Mindfulness involves paying attention to and experiencing the present moment, often without judgment. A number of studies have found that Mindfulness can be very helpful in reducing levels of anxiety and stress and in this way can help improve sleep. In order to be effective at promoting sleep, it is often recommended that Mindfulness practice is carried out on a regular basis. One of the most common ways of practicing Mindfulness is by sitting in stillness and focusing on the breath. This can help to calm the mind and to prepare the body for sleep. In order to help get to sleep, it is often recommended that Mindfulness practice is carried out in the evening, before going to bed. This can help to reduce the levels of anxiety and stress that can often make it difficult to get to sleep.

In addition to therapies and practices to assist sleep, it is often recommended that individuals make healthier lifestyle choices. This can begin with regular exercise or activity, as it not only provides natural pain relief in the form of endorphins but can also reduce the level of stress and anxiety that an individual experiences. However, it is also important to ensure that the amount of exercise that is completed does not have a negative effect on the body. Completing excessive amounts of exercise can cause a person to become fatigued, which in turn can worsen a person’s pain.

Good sleep hygiene includes going to bed and rising at the same time each day. A good sleep environment is also very important. This is one where the sleeper can rest in calm and comfort. This includes ensuring that the room is dark, cool and quiet so that the sleeper is able to fall asleep and sleep soundly all night.

Another thing to consider is the way in which stimulants can interfere with sleep. In particular, caffeine and nicotine are both known to have a number of negative effects on the body’s ability to fall asleep and to get a good quality of sleep once it is asleep. It is therefore recommended that people avoid these substances in the hours before bedtime. Instead, activities such as reading, listening to soothing music, or taking a warm bath can help to signal to the body that it is time for sleep.

By addressing sleep difficulties in a holistic manner, incorporating strategies into daily life, it is possible for people with chronic pain to go on to control their pain and lead a full and happy life. Although it can be difficult to accept that chronic pain is a long-term condition and that no cure exists for sleep difficulties, there are effective strategies to address both of these issues.

Citations:

Haack, M., Simpson, N., Sethna, N., Kaur, S., & Mullington, J. (2020). Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology, 45(1), 205-216. https://www.nature.com/articles/s41386-019-0439-z

Whale, K., & Gooberman Hill, R. (2022). The importance of sleep for people with chronic pain: current insights and evidence. Journal of Bone and Mineral Research Plus, 6(7), e10658. https://academic.oup.com/jbmrplus/article-abstract/6/7/e10658/7479011

Nijs, J., Mairesse, O., Neu, D., Leysen, L., Danneels, L., Cagnie, B., … & Goubert, D. (2018). Sleep disturbances in chronic pain: neurobiology, assessment, and treatment in physical therapist practice. Physical therapy, 98(5), 325-335. https://academic.oup.com/ptj/article-abstract/98/5/325/4841863

Nijs, J., Mairesse, O., & Tang, N. K. (2024). The importance of sleep in the paradigm shift from a tissue-and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain. Brazilian Journal of Physical Therapy, 28(1), 100594. https://pmc.ncbi.nlm.nih.gov/articles/PMC10877106/

Husak, A. J., & Bair, M. J. (2020). Chronic pain and sleep disturbances: a pragmatic review of their relationships, comorbidities, and treatments. Pain Medicine, 21(6), 1142-1152. https://academic.oup.com/painmedicine/article-abstract/21/6/1142/5698034

Li, M. T., Robinson, C. L., Ruan, Q. Z., Surapaneni, S., & Southerland, W. (2022). The influence of sleep disturbance on chronic pain. Current Pain and Headache Reports, 26(10), 795-804. https://link.springer.com/article/10.1007/s11916-022-01074-2

Whale, K., Dennis, J., Wylde, V., Beswick, A., & Gooberman-Hill, R. (2022). The effectiveness of non-pharmacological sleep interventions for people with chronic pain: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 23(1), 440. https://link.springer.com/article/10.1186/s12891-022-05318-5

Woo, A., & Ratnayake, G. (2020). Sleep and pain management: a review. Pain Management, 10(4), 261-273. https://www.tandfonline.com/doi/abs/10.2217/pmt-2020-0001

Cheatle, M. D., Foster, S., Pinkett, A., Lesneski, M., Qu, D., & Dhingra, L. (2016). Assessing and managing sleep disturbance in patients with chronic pain. Anesthesiology clinics, 34(2), 379-393. https://www.anesthesiology.theclinics.com/article/S1932-2275(16)00008-2/abstract

Selvanathan, J., Tang, N. K., Peng, P. W., & Chung, F. (2022). Sleep and pain: relationship, mechanisms, and managing sleep disturbance in the chronic pain population. International Anesthesiology Clinics, 60(2), 27-34. https://journals.lww.com/anesthesiaclinics/fulltext/2022/06020/sleep_and_pain__relationship,_mechanisms,_and.4.aspx