When you're in pain, it can be difficult to focus on anything else. Even sleep. Pain is one of the most common causes of disrupted, un-refreshing sleep. Nighttime pain has many root causes. In some cases, injury may cause temporary pain that interferes with sleep.
"Pain is one of the most common causes of disrupted, un-refreshing sleep"
Medical conditions involving chronic musculoskeletal pain include arthritis, and chronic fatigue syndrome. Patients who suffer from these conditions are more likely to face problems with their sleep than the general population.
For many people, nighttime pain is the result of aches and pains from daily exertion. Neck pain and lower back pain are two of the most frequent complaints heard from patients who have difficulty sleeping. Low back pain affects more than three-quarters of adults at some point in their lives.
Estimates suggest that at any given time, 20 to 30 percent of adults in the U.S. may be suffering from low-back pain, and rates of low-back pain are on the rise. Research confirms what many of us know from experience: this type of pain can make it difficult to sleep.
What's behind this sleep-pain connection? When the body experiences pain, awareness becomes heightened. When nighttime pain is present, it becomes difficult to relax the mind and body in preparation for a night of rest. Instead, you become focused and alert to your pain and discomfort. Anxiety about your pain—and about your inability to sleep—soon follows. The brain quickly learns to associate anxiety with pain. Before long, these two conditions — pain and anxiety — are fueling one another in a frustrating, sleep-depriving cycle.
"When the body experiences pain, awareness becomes heightened"
Nighttime pain diminishes both the quantity and quality of sleep. And sleeplessness deprives your body of a rest period that is critical to healing. Sleep is critical to physical recovery, whether from injury, illness, or daily activity.
Sleep is also essential to mental and emotional health. Lack of sleep makes us more reactive to stressful and emotionally-charged situations. Pain creates more than physical discomfort; it also can be mentally and emotionally draining. Insufficient sleep hinders the body's capacity to repair itself, and also makes us less well equipped to cope with the mental and emotional consequences of pain.
Lack of sleep does more than slow the healing process and leave you more susceptible to feelings of frustration associated with pain. Not sleeping enough can actually make pain feel worse. Research indicates that lack of sleep lowers pain thresholds, making you more sensitive to physical pain.
Insufficient sleep is also associated with elevated levels of inflammation in the body, which exacerbates sensitivity to pain. Even among individuals who are free of chronic or acute pain, a modest amount of sleep loss can trigger this heightened sensitivity to pain.
The good news? Getting enough rest—and making sure you're experiencing high-quality, restorative sleep—helps to diminish pain sensitivity. Recent breakthroughs in science suggest that extending sleep periods can elevate our thresholds for pain and reduce pain sensitivity. Tending to pain is an important part of protecting your sleep.
Consult your physician if you have pain that keeps you awake on a regular basis.
Michael J. Breus, Ph. D., is a Clinical Psychologist with a specialty in sleep disorders. He is the author of The Sleep Doctor's Diet Plan: Lose Weight Through Better Sleep (Rodale Books; May 2011) and BEAUTY SLEEP: Look Younger, Lose Weight, and Feel Great Through Better Sleep.