Chronic Back Pain and Sleep

When chronic back pain disturbs your sleep night after night, you might despair of ever getting a good night's sleep. But experts say that with proper treatment, the chances are very good that you can get relief from chronic back pain and enjoy normal sleep.

Why Sleep Is Important When You Have Chronic Back Pain

The inability to get a good night's sleep hurts -- literally. Chronic back pain prevents you from getting a good night's sleep. You wake up hurting even more.

Pain interferes with the normal cycles of light and deep sleep you need in order to wake up refreshed. The disruption is called "alpha delta sleep disorder." When back pain prevents you from getting adequate deep, or delta, sleep, you awaken in the morning tired and hurting.

Causes of Sleep Problems

Of course, the chronic back pain itself may cause a sleep problem. Here are some other causes:

Anxiety and depression can result in the inability to fall asleep or stay asleep which will aggravate pain. Anxiety and depression increase a person’s sensitivity and awareness of pain and the lack of proper sleep only serves to aggravate both the pain and any depression with anxiety.

Breathing-related sleep disorders associated with obesity -- such as obstructive sleep apnea -- can further aggravate pain by causing you to wake frequently throughout the night and interfering with normal sleep patterns. 

Limb movement disorders -- such as restless leg syndrome -- may further disrupt the normal sleep pattern. These conditions may be related to anxiety and depression as well as stress.

Self-medicating with alcohol may help you fall asleep, but you'll probably wake up tired, cranky, and hurting.

Some prescription medications can impair the quality of your sleep.

Medications That Improve Sleep and Reduce Chronic Back Pain

Some medications can help you get sleep while helping with your chronic back pain.However, some of these drugs have side effects and the potential for addiction. They should be used as part of a more comprehensive and widespread program of pain management.

Newer sedatives, including zolpidem tartrate (Ambien) do not have a negative effect on your sleep.

Over-the-counter pain relievers, such as aspirin, acetaminophen (Tylenol or Tylenol PM), or ibuprofen (Aleve or Motrin), can be effective for short-term use. Use them only as directed and let your doctor know what you are taking.

Prescription drugs for severe back pain include antidepressants, such as doxepin (Sinequan), or a combination antidepressant and pain reliever, such as amitriptylene (Elavil), or a muscle relaxant, such as cyclobenzepine HCL (Flexoril).

Medication should not be used longer than two to three months except in rare cases. Long-term use can result in dependence on the drug. The goal of medication should be to help you develop a more normal sleep pattern.