PAIN AND SLEEP

When you can't sleep and your head aches, or back hurts, what do you lose? A lot of sleep! The consequences of sleep deprivation can be significant including lack of energy, bad mood, poor general health, and trouble handling stress. What is even worse is that many sufferers don't realize what can be done about the problem.

How pain affects sleep

When pain makes it hard to sleep, falling asleep is often the greatest problem. However, some may wake up intermittently at night due to pain and some may be waking up earlier than desired time. Such lack of sleep (Insomnia) may be a problem for only for a few nights or may persist for weeks or months. When it lasts for months, doctors consider the problem chronic. In addition, many people who experience pain wake up feeling unrefreshed.

Understanding your pain

In some of the large surveys conducted in USA, back pain was the most common reason for sleeplessness, followed by headaches and muscular aches and pains. Whatever the kind of pain you experience, chances are that it accompanies your sleep problem from time to time. Here are some question to help you try to understand your pain and find relief.

1. Is your pain there only once in a while (occasional), rather than most of the time (chronic)?

2. Is your pain minor (i.e., headache, backache, muscular aches and pains, menstrual cramps) rather than severe (pain that is worse than experienced before or comes on suddenly and doesn't ease or lessen)?

3. When you have pain, do you also have difficulty falling asleep, staying asleep or waking earlier than you'd like?

4. Is it affecting the way you feel, think, and/or behave at home, at work, or when you are with family and friends?

5. Do you want to take action to control your pain and/or improve your sleep?

If you answered yes to all five questions, keep reading. If you answered no to the first two questions, you should consult your doctor or a pain specialist. If you don't get enough sleep, or your sleep is troubled, you (and those around you) may pay the price. This includes the danger of falling asleep while driving or at work. The good news is that there are actions you can take and/or medications to try to manage you problems. What you can do depends on the type of pain, when it occurs, and how willing you are to try something new.

Back Pain

While most back pain cases last less than two weeks, ten percent last longer. Back pain can return and worsen. The more severe the pain, the more likely it is to interfere with sleep. A recent study found that about two thirds of patients with chronic back pain suffered sleep trouble. This same study suggests that disrupted sleep seems to make the pain feel worse. Some pain medication may also make sleeping more difficult.

Headache, Arthritis and Muscle Pain

Headache is the second most common pain. One study found a sleep connection in half of those with tension or migraine headaches. Migraines are marked by a throbbing pain and can last hours. Blood vessels tightening and opening give rise to the pain. Another type of headache is even worse. Cluster headaches, which as their name suggests, strike one after another in cycles. Blood vessel activity appears to play a role too. Cluster headaches may be related to sleep.

People with rheumatic or arthritic disorders often suffer from sleep problems. For example, people with osteoarthritis, especially of the hips and knees, tend to sleep lighter or have restless sleep. People with rheumatoid arthritis often have disturbed sleep with morning stiffness. Individuals with fibromyalgia, a condition of aches and pains throughout the body and many tender points, usually suffer from light and unrefreshing sleep, daytime fatigue and difficulty with thinking and mood. The poorer the sleep of those with fibromyalgia, the worse the pain and tenderness they feel.

Managing Pain & Sleep Problems

Pain is often considered one of the most poorly treated health problems. Sleep problems and disorders are often not recognized or treated properly either. Not surprisingly, there has not been much study of treatments for both sleep and pain. However, some studies suggest that proper medication, exercise and psychological approaches may help. Some of the psychological methods include:

· learning to relax one's muscles and free one's mind of stress (relaxation training)

· learning to control specific body functions involved in headaches or other sources of pain, such as temperature or muscle tension (biofeedback).

· therapies that focus on changing one's way of thinking about the pain experienced (cognitive therapy) or changing one's behaviour related to the pain (behavioural therapy).

The results on the impact of these methods for back pain, arthritis and fibromyalgia, specifically, remain mixed.

Medications

When pain is minor and occasional, doctors and patients alike frequently consider over-the-counter (OTC) products. These products are relatively low cost, easy to get, and often effective. When the pain is joined by sleep difficulty, more than one product, or a combination sleep and pain product, may be considered. When these methods don't help, you should discuss with your doctor visiting a pain specialist / clinic and / or sleep specialist / center. Pain clinics use psychological, physical or drug treatment procedures to manage pain. Sleep centers are useful for diagnosing and treating sleep disorders.

Is the pain related to stress or depression?

When emotional disturbance, such as stress or depression affects pain, a low-dose prescription drug aimed at depression (an antidepressant) may be effective even if you are not seriously depressed. Some of the newer antidepressants can cause or worsen insomnia. You should ask your physician or pharmacist for information about potential sleep problems that can be caused by any medications that you are taking.

What Drugs do you take?

Some drugs, such as transquilizers, can interact with your pain and sleep medications. This interaction can affect how either medication treats a specific problem (more or less effectively). And additional problem can develop when drugs interact with each other in your body. That's why individuals suffering from sleep problems should be sure to discuss with their physicians and medications they are taking. For example, some antithypertensives (medication to control high blood pressure) can trigger sleep problems.

Nicotine can also harm sleep. While there are better known hazards of smoking, this lesser known fact may help convince smokers to give up smoking. Alcohol, like nictoine, causes sleeping problems. Worse, drinking alcohol while taking aspirin or nonsteroidal anti-inflammatory agents has been connected with stomach problems. Another reason to avoid alcohol or drink only in moderation: Heavy abuse of alcohol and excessive use of acetaminophen appear to increase the risk of damage to the liver.