Chronic Pain Video

How Chronic Pain Affects Sleep

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What it is
The relationship between pain and sleep is bidirectional. That means they feed off each other. If you sleep badly, pain increases. Sleep well and the pain decreases.
Prevalence
Chronic pain is categorised as persistent pain that lasts for three months or longer and it affects 10 to 15 per cent of UK adults. Sleep complaints are present in up to 88 per cent of chronic pain disorders.

When it comes to insomnia, the most commonly diagnosed sleep disorder, up to 50 per cent of people who had it also reported chronic pain. Research suggests that people who experience poor sleep have a higher risk of developing pain conditions such as migraines, back pain and fibromyalgia.

Symptoms
Different types of pain exist including neck and back pain, arthritis, fibromyalgia, MS and migraines. How pain affects your sleep depends on the type of pain and how it manifests itself.

One study found that fibromyalgia patients had nearly double the amount of nighttime awakenings compared to healthy patients.

The most common sleep complaint reported by pain sufferers is frequent nighttime awakenings. They also took longer to fall asleep, slept less and spent less time in bed asleep compared to healthy people.

Causes
Poor sleep increases the intensity of pain, making poor sleep and insomnia a risk factor for chronic pain. A study carried out in Turkey found that 41 per cent of chronic pain patients were poor sleepers. They also reported pain intensity levels that were 15 per cent higher than chronic pain patients who were good sleepers.

Lack of sleep caused by pain makes the body produce more cytokines. Cytokines are inflammatory chemicals that stop the production of sleep-inducing substances in the body, keeping you awake longer than you’d like to be.

Lack of sleep also causes a decrease in dopamine and serotonin activity in the brain, as well as a decreased reaction to pain relief. The changes in chemical production in the body result in increased sensitivity to pain the next day, leading to a vicious cycle of intense pain and sleep deprivation that it’s hard to get out of.

Constant worry about ongoing sleepless nights and pain fuels anxiety and depression, which only worsens sleep and pain.

Further help
If you want to learn how to achieve better sleep when suffering from chronic pain watch the ‘Sleep better with chronic pain’ video.
References
Taylor, D. J., Mallory, L. J., Lichstein, K. L., Durrence, H. H., Riedel, B. W., & Bush, A. J. (2007). Comorbidity of chronic insomnia with medical problems. Sleep, 30(2), 213-218.

Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The association of sleep and pain: an update and a path forward. The journal of pain, 14(12), 1539-1552.

Diaz-Piedra, C., Catena, A., Sánchez, A. I., Miró, E., Martínez, M. P., & Buela-Casal, G. (2015). Sleep disturbances in fibromyalgia syndrome: the role of clinical and polysomnographic variables explaining poor sleep quality in patients. Sleep medicine, 16(8), 917-925.

Mathias, J. L., Cant, M. L., & Burke, A. L. J. (2018). Sleep disturbances and sleep disorders in adults living with chronic pain: a meta-analysis. Sleep medicine, 52, 198-210.

Karaman, S., Karaman, T., Dogru, S., Onder, Y., Citil, R., Bulut, Y. E., … & Suren, M. (2014). Prevalence of sleep disturbance in chronic pain. Eur Rev Med Pharmacol Sci, 18(17), 2475-81.

Amtmann, D., Askew, R. L., Kim, J., Chung, H., Ehde, D. M., Bombardier, C. H., … & Johnson, K. L. (2015). Pain affects depression through anxiety, fatigue, and sleep in multiple sclerosis. Rehabilitation psychology, 60(1), 81.

Haack, M., Simpson, N., Sethna, N., Kaur, S., & Mullington, J. (2020). Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology, 45(1), 205-216.

Taylor, D. J., Mallory, L. J., Lichstein, K. L., Durrence, H. H., Riedel, B. W., & Bush, A. J. (2007). Comorbidity of chronic insomnia with medical problems. Sleep, 30(2), 213-218.