Aches and pains give everyone a sleepless night now and then. It doesn't
take much -- a pulled muscle from an overenthusiastic workout or an afternoon
spent helping a friend move furniture. Next thing you know, you're lying in bed
at 3 a.m., staring at the ceiling above your bed, aching, and praying for
While most aches fade pretty quickly, painful and sleepless nights are the
norm for people living with chronic pain. "Between 50%-90% of people with
chronic pain say that they don't sleep well," says Gilles Lavigne, DDS,
MSc, FRCD, an expert on the connection between sleep and pain and a professor
of dentistry, physiology and psychiatry at the University of Montreal.
"They wake up feeling like they never went to bed."
Osteoarthritis (OA) causes joint pain and stiffness for 27 million Americans. Although there are many medications and treatments to ease OA symptoms, many patients with severe OA decide to have joint replacement surgery. In fact, nearly 700,000 Americans undergo hip or knee replacement each year. Another 23,000 have shoulder replacement surgery.
Not getting enough sleep can have a poisonous effect on your whole life,
says Penney Cowan, executive director of the American Chronic Pain Association.
It makes you feel rundown and depressed. Your job and family life can suffer.
If your sleeplessness is keeping up your spouse too, that can cause even more
problems. And that's not all.
"There's very good data that suggests that disturbed sleep can worsen
your pain," says Thomas Roth, PhD, director of the Sleep Disorders Center
at Henry Ford Hospital in Detroit. It's a vicious cycle: pain prevents you from
sleeping, and not sleeping makes the pain worse.
The good news is that there's a lot that you can do -- on your own, and with
your doctor -- to break the cycle. With changes to your lifestyle and possibly
medication, you can finally get the good night's sleep you crave.
Pain and Sleep
"During a normal night, we all go through cycles of light sleep, deep
sleep, and REM [rapid eye movement] sleep," Lavigne tells WebMD. "This
cycle is repeated three to five times a night." Getting enough deep sleep
and REM sleep are key to feeling refreshed in the morning.
The problem is that pain interferes with this cycle. Sudden severe pain can
make you bolt upright from a sound sleep. But even milder pain can cause
"microarousals," Lavigne says. These are periods when your pain breaks
through and bumps you back into the light sleep stage. You may not become
conscious, and the next day you won't remember waking up. But your fragmented
sleep can leave you feeling like you didn't get any rest at all.
Any pain can interfere with sleep. But some common causes of disturbed sleep
TMJ pain, which is pain in the temporomandibular joint of the jaw
Fibromyalgia, which can cause pain throughout the body's muscles,
ligaments, and tendons
Neuropathy, or nerve pain
Acute injuries, surgery, and more serious diseases, like
cancer, can also cause pain and sleeplessness.
It's not just the intensity of pain that can make it hard to
sleep. Lavigne says that pain that varies -- that is worse some days than
others -- is often the most likely to cause sleeplessness.
"It makes sense," he says. "If you have constant
pain for six months, you figure out how to cope with it. But if the pain level
goes up and down, if it's unpredictable, you can't get used to it and it can
really interfere with sleep."