It's 3 a.m. and you're staring at the green glow of your digital clock,
wondering if you'll get any shut-eye before the alarm blasts in a few short
hours. After several sleepless nights, you're feeling cranky and lethargic. Is
it safe to start taking a sleep medication?
Many people turn to sleep aids because insomnia and sleep shortage have
become commonplace in this country, leading to potentially serious
consequences. In a 2008 National Sleep Foundation poll, 29% of respondents --
“Pain and sleep are integrally connected,” he says. “Chronic pain is very
common in the population and even more common in people who have poor sleep,
and it sort of becomes a vicious cycle.” Pain affects your ability to sleep,
and the lack of sleep makes the pain seem worse.
The Link Between Pain and Sleep Problems
Exactly how the two conditions are connected varies from person to person.
“You have to determine what is the chicken and what is the egg,” he says. “Is
pain a manifestation of, or made worse by, a sleep disorder or is pain causing
the poor quality of sleep?”
Charles Bae, MD, a neurologist in the Sleep Disorders Center at the
Cleveland Clinic in Ohio, puts it this way: “Pain can be the main reason that
someone wakes up multiple times a night, and this results in a decrease in
sleep quantity and quality, and on the flip side, sleep deprivation can lower
your pain threshold and pain tolerance and make existing pain feel worse.”
“If you have arthritis and roll or turn while you are sleeping, pain can
wake you up,” says David S Kloth, MD, the founder, medical director, and
president of Connecticut Pain Care in Danbury, and a past president of the
American Society of Intervention Pain Physicians.
The first step is to figure out if the lack of sleep is causing pain or if
the pain is causing a lack of sleep, and then you treat whichever came first,
The Pain-Reducing Benefits of Better Sleep
Pain may not be the only problem interfering with your sleep. Some people
may also have an underlying sleep disorder, such as sleep apnea. Neumeyer
recommends an evaluation by a sleep specialist to be sure there is not
underlying sleep disorder.
Once you’re correctly diagnosed, sleep experts say good treatment can
significantly help those living with chronic pain.
Getting better quality sleep -- and more of it -- may improve your pain
threshold so you will ache less, says Neumeyer.
“People in pain don’t sleep, and people who sleep have less pain,” agrees
Michael Breus, PhD, author of Beauty Sleepand the clinical director of
the sleep division for Arrowhead Health in Glendale, Ariz.
Treating Pain-Related Sleep Problems
Improving sleep in people with chronic pain such as low back pain,
arthritis, fibromyalgia, and diabetic nerve pain is difficult because these
individuals often don’t want to take any more drugs, says Breus.
These individuals are often already taking several medications to treat
their pain disorder. What’s more, certain prescription sleeping pills may
interact with their pain medications, so they couldn’t take them even if they
wanted to, says Breus.
In essence, Breus becomes the Sherlock Holmes of sleep problems. He looks at
each individual’s sleep habits and bedroom environment. “I have to investigate
how old their mattress and pillows are, and make sure they are offer proper
support,” he says. He asks about their diet and habits. Do they avoid beverages
with caffeine after 2 p.m.? Do they exercise regularly? Do they use the bedroom
only for sleep and sex? All these things may also help people in pain get their
The bottom line, according to Cleveland Clinic’s Bae, is “if you have
chronic pain and trouble sleeping, bring it up to your doctor to see if
anything can be done to help your sleep while getting your pain treated.”