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Osteoarthritis Health Center

When Aches & Pain Disrupt Sleep

It's a vicious cycle -- pain keeps you awake, and sleeplessness makes pain worse.
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Using Medicines

Medication, either to ease pain or help sleep -- or a combination of both -- can be invaluable to people who have their sleep disturbed by pain.

For mild, temporary pain, over-the-counter painkillers -- like Tylenol, Advil, or Motrin -- may be enough. Some over-the-counter painkillers are sold with an antihistamine to help with sleep, such as Advil PM or Tylenol PM. However, over-the-counter medicines are not designed for long-term self-medication.

For more severe or chronic pain, your doctor may recommend prescription painkillers, like Ultram or opioids -- such as OxyContin, Vicodin, codeine, and morphine. Other drugs can also help with pain, such as some antidepressants and anticonvulsants.

To help with sleep, your doctor might recommend drugs typically prescribed for anxiety, called benzodiazepines (like Ativan, Klonopin, and Halcion.) A newer type of medicine called nonbenzodiazepine hypnotics are particularly helpful for sleep and appear to be better for longer-term use than benzodiazepines. They include Ambien, Lunesta, and Sonata.

Clearly, there are a lot of medicines out there that can help. But there's a nasty catch: Some medicines used to reduce pain or aid sleep can, in fact, have a bad effect on your sleep patterns.

"The painkillers morphine and codeine can interrupt your sleep pattern and decrease the amount of deep sleep you get," says Lavigne. There's evidence that benzodiazepines and nonsteroidal anti-inflammatory drugs -- like Advil and Motrin -- can also interfere with your sleep cycle.

However, don't despair. The fact is that all medicines have pros and cons. The key is to find the treatment that works for you. While it may take a few tries, you and your doctor will probably find the right approach that will ease your pain and get you some sleep.

Even if you get prescribed a medicine, don't give up on good sleep hygiene. A combination approach may be best.

"It's just like having high cholesterol," Roth tells WebMD. "You don't choose between going on a diet and taking a statin. You do both. You keep working on the sleep hygiene even if you're taking medicine."

Taking Action

Experts agree that you must take chronic pain and sleep problems seriously.

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