Your back is killing you. You can’t move, let alone get out of bed. The pain has been keeping you awake for weeks.
That scenario is not unique. Pain is a major contributor to sleep problems, according to the experts.
About 11 to 17 per cent of the general population suffers chronic pain, according to Dr. Gilles Lavigne, PhD, Canadian Research Chair in Pain, Sleep, and Trauma, and Professor of Dentistry and Medicine at University of Montreal.
“We’re not supposed to be able to sleep when we’re in pain because pain is an alert that tells us that something is wrong.”
People in pain tend not to enter deep sleep phases as often as other people do and to have “frequent arousals” or changes from a deeper sleep to a lighter stage of sleep, says Lavigne. “It’s like your brain is revisiting external milieu too often. You’re sleeping, but your brain is trying to push you to wake up and then you fall asleep, and then your brain pushes to wake up again.”
Patients with pain conditions are also more likely to report difficulty falling asleep or problems going back to sleep after middle of the night awakenings.
This contributes to a “viscous cycle,” says Lavigne. Not only can pain exacerbate sleep problems by waking you up multiple times in the night, but lack of sleep can make existing pain feel worse and even lower your pain tolerance.
That pain and sleep problems occur together makes a lot of sense, says Dr. Atul Khullar, Medical Director, Northern Alberta Sleep Clinic (MedSleep Edmonton).“We’re not supposed to be able to sleep when we’re in pain because pain is an alert that tells us that something is wrong.”
The most common pain-related complaints, says Khullar, are low back pain, musculoskeletal pain (including arthritis and fibromyalgia) and headaches, amongst others..
Getting comfortable when you’re in pain can be challenging, but here are a few tips that can help you get comfortable:
- Explore relaxation techniques like yoga, message and deep breathing.
- Do muscle strengthening exercises to help the healing process if your pain is from an injury, says Khallar.
- If your partner snores, and this is interfering with your own sleep and sleep aids haven’t helped your partner, consider sleeping in a separate bedroom.
- Don’t do heavy exercises before bedtime as this will delay sleep onset and reactivate the waking system, says Lavigne.
- Consider changing your sleep position. If you have tennis elbow on one side, sleep on the opposite side. If you have low back pain, sleep on your side or stomach. Some people swear that sleeping in the fetal position does wonders for their back. Others find putting a cushion between their knees eases their pain.
- Choose pillows that offer you the most comfort. It might just be a matter of getting an extra pillow. Or check out the memory foam or orthopedic pillows available online and in sleep stores that may help align your body and ease any pain. A pillow that extends your neck to relieve pressure on your spine may prevent neck pain.
- Check the condition of your mattress. You might need a new one that’s firmer, or a different type, says Khullar. He recommends that people go to a mattress store and actually lie down on different mattresses to find the one that best suits them. “If you’re waking up sore, it might be time to look at a different type or a new mattress.”
- Short-term over-the-counter medications can relieve your pain and help you sleep. An analgesic can temporarily ease the pain caused by conditions such as arthritis.
- Investigate combining physical therapy with cognitive behavioural therapy if you have suffered an injury. Patients report they get the best results with this combination, says Lavigne.
- Avoid migraine triggers (be they red wine, blue cheese, temperature changes or whatever) if you’re prone to these headaches, says Khullar.
- Ask your doctor about the medications you’re taking for other conditions; they may be contributing to your sleep problems.
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