The undeniable relationship between chronic pain and sleep disorders. Many people with chronic pain show sleep disturbances with more nighttime awakenings, less deep sleep, and feeling more tired during the day. They tend to have less restful sleep. This causes a greater feeling of fatigue, less energy and a more depressed mood, which in turn worsens the sensation of pain during the day. Studies show that both sleep and the nerve pathways that capture our pain share those pathways and many types of neurotransmitters. Both vitamin D and dopamine play a common role in sleep and pain. Sleep loss has an impact on our immune system and that makes our body more vulnerable to diseases and chronic pain.
Sleep and pain have a bidirectional and reciprocal relationship. It is known that people with chronic pain who manage to sleep well, have less pain the next day. Science tells us that sleeping well will make pain more manageable. In the same way, if we learn to manage pain, we will sleep better. Therefore, pain alters sleep, but studies show that the impact of poor sleep on the development or increase in pain is more intense than the opposite. That is, insomniacs or patients who sleep worse due to multiple other circumstances will be more likely to develop health problems that have to do with pain. That is, they will be more sensitive to arthritis, fibromyalgia and migraines. If we get quality sleep we will be avoiding suffering from diseases that involve chronic pain.
Sleep apnea and chronic pain:
Sleep apnea, characterized by pauses in breathing during sleep, can lead to fragmented sleep and daytime fatigue. Chronic pain conditions, such as fibromyalgia and arthritis, are often worsened by the poor quality of sleep associated with sleep apnea.
Recommendation:
Consult a healthcare provider for a sleep study to diagnose sleep apnea. Treatment options may include continuous positive airway pressure (CPAP) but this treatment can have side effects for our health. We can also find alternatives to this treatment. In addition to CPAP, therapy or lifestyle modifications can help to improve sleep quality.
Parasomnias and chronic pain:
Parasomnias, including sleepwalking, sleep talking, and night terrors, can disrupt sleep continuity and lead to daytime sleepiness. Individuals with chronic pain may experience heightened sensitivity to these disruptions, exacerbating pain symptoms.
Recommendation: Maintain a consistent sleep schedule and create a conducive sleep environment to minimize the occurrence of parasomnias. Cognitive-behavioral therapy for insomnia (CBT-I) may also be beneficial.
Narcolepsy and chronic pain:
Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, sudden muscle weakness (cataplexy), and vivid hallucinations. Chronic pain conditions can compound the challenges of managing narcolepsy symptoms, leading to decreased quality of life.
Recommendation: Work with a sleep specialist to develop a personalized treatment plan for narcolepsy, which may include medication, lifestyle adjustments, and scheduled naps.
Managing pain through medication, physical therapy, and relaxation techniques can also help
improve overall well-being.
Restless leg syndrome (RLS) and chronic pain:
RLS is characterized by uncomfortable sensations in the legs, often accompanied by an irresistible urge to move them. Sleep disturbances caused by RLS can exacerbate chronic pain symptoms, leading to further sleep disruption.
Recommendation: Practice good sleep hygiene habits, such as maintaining a regular sleep schedule and avoiding caffeine and alcohol before bedtime. Incorporate relaxation techniques, such as progressive muscle relaxation or meditation, to alleviate RLS symptoms. Consult a healthcare provider for medication options if necessary.
It is estimated that between 50-70% of patients with moderate-intense pain suffer from sleep disorders, this represents a significant decrease in their quality of life associated with the suffering of chronic pain itself. The quality of sleep is beginning to be considered as a critical factor and independent of the rest of the comorbidities associated with pain.
Greater pain intensity has been associated with a higher prevalence of sleep disorders. This reciprocal relationship perpetuates a vicious circle. Understanding the complex interplay between sleep disorders and chronic pain is essential for effective management and improved quality of life. By addressing both conditions simultaneously and implementing personalized treatment strategies, individuals can experience better sleep, reduced pain levels, and enhanced overall well-being.
Remember to consult healthcare professionals for comprehensive assessment and tailored recommendations based on individual needs and circumstances.
References:
1. https://www.drugwatch.com/health/sleep-apnea/
2. https://www.drugwatch.com/philips-cpap/
3. https://www.drugwatch.com/philips-cpap/alternatives/
4. https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pain
5. https://www.nhs.uk/conditions/sleepwalking/#:~:text=Sleepwalking%20is%20when%20someone%20walks,f
ew%20hours%20after%20falling%20asleep.
6. https://www.clinicaladvisor.com/home/the-waiting-room/sleepwalkers-dont-feel-pain-during-sleep/#:~:text=Of
%20the%20one%20100%20sleepwalkers,woke%2010%20of%20the%20patients.
7. https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168
8. https://www.sleepfoundation.org/physical-health/pain-and-sleep#:~:text=People%20with%20chronic%20pain
%20may%20suffer%20from%20a%20self%2Dperpetuating,increases%20their%20sensitivity%20to%20pain
