When Aches & Pain Disrupt Sleep

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

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 unconsciousness.

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."

Recommended Related to Osteoarthritis

Arthritis Pain and Sleep

The pain of arthritis makes it tough for many people to get a good night’s sleep. Worse yet, tossing and turning at night can actually increase the perception of pain. “There’s a reciprocal relationship between pain and poor sleep. The poorer people sleep, the more pain they tend to be in,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. “If people with arthritis can improve the quality of their sleep, they can usually reduce their day-to-day pain.” Here...

Read the Arthritis Pain and Sleep article > >

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 are:

Headaches

Back pain

TMJ pain, which is pain in the temporomandibular joint of the jaw

Arthritis

Fibromyalgia, which can cause pain throughout the body's muscles, ligaments, and tendons

Neuropathy, or nerve pain

Premenstrual cramping

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."

Answer:

0-6

7-8

Your level is currently

You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or other conditions affecting your sleep.

Sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's good that you usually do get more sleep, since sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's good that you usually do get more sleep because sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping or have insomnia or other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's important to keep your bedtime and routine consistent every night and wake up around the same time every morning.

Click here to read more about the importance of sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep this amount, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep longer, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's also important to keep bedtime consistent and wake up around the same time every morning.

Although sleep is crucial for optimal health, some research suggests that sleeping too much can have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia, another sleep disorder, or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

Since you usually get less sleep, talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or another sleep disorder or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

SOURCES:

Centers for Disease Control and Prevention (CDC). Effect of short sleep duration on daily activities--United States, 2005-2008. MMWR Morb Mortal Wkly Rep 2011; 60:239.

Carskadon, MA, Dement, WC. Normal Human Sleep: An Overview. In: Principles and Practices of Sleep Medicine, Fifth, Kryger, MH, Roth, et al. (Eds), Elsevier Saunders, St. Louis, MO 2011. p.16.

Harvard University: "Sleep, Performance, and Public Safety."

Today in Sleep Disorders