Reviewed by: Mark Queralt, MD
Written by: Lauryn Feil
Can’t sleep because your back hurts? But your back hurts even more when you can’t sleep? Issues regarding sleep and pain are not uncommon. According to the Centers for Disease Control and Prevention (CDC), approximately 20% of adults in the United States experience chronic pain, and of those experiencing pain, between 67-88% also have sleep issues. It may seem endless, but the truth is, getting better sleep may be the best pain killer out there. Let’s break down the relationship between pain and sleep and how you can successfully manage both.
What exactly are we dealing with?
Pain is an unpleasant physical or emotional signal of bodily harm that strongly motivates behavior. While sleep is a behaviorally driven action that serves to maintain homeostasis and optimize function across the body’s multiple physiological systems. Humans require both pain and sleep to survive; however, chronic impairments in the systems that regulate pain and sleep can have a broadly negative impact on overall health and well-being.
So, what came first, the chicken or the egg? It can sometimes be hard to determine if the cycle of chronic pain and sleep disturbances began with a lack of sleep or the onset of pain, but, to get closer to a pain-free life, with more restful nights, it’s key to address sleep AND pain.
Healthy sleep promotes healing of the mind and body.
When you’re tired, that’s your body telling you it’s time to rest, repair, and regain the energy you need to carry you through the next day. The way your body feels when you’re awake depends in part on what happens while you sleep.
While you’re catching Z’s, your heart can take a break, allowing for your heart rate and breathing to slow, your blood pressure to drop, and other muscles in the body to relax. If there are areas that need to heal, your brain can trigger the release of hormones during deep sleep to encourage tissue growth and repair. This process helps restore sore or damaged muscles and reduces inflammation throughout the body – a key in decreasing pain. Your immune system also relies on sleep to make more white blood cells to fight harmful viruses and bacteria that may cause inflammation, which can hinder the healing process.
Lack of sleep can also have a significant impact on your mood and psychological health. Chronic sleep disturbances can increase agitation, feelings of worry, and stress that can lead to mood disorders such as anxiety or depression. Many patients with chronic pain and sleep disturbances develop anxiety or depression, which can then aggravate the pain experience, and lead to a vicious cycle. Getting a good night’s sleep helps adjust hormone, energy, and stress levels to make for a more positive start to the day. A positive, less anxious mood can boost recovery and lower overall sensitivity to pain.
How to use sleep to manage pain.
So, if sleep is so important in managing chronic pain, how can you break free from the vicious cycle? It starts with making lifestyle adjustments that can go a long way. Improving sleep hygiene helps get your body into a pattern that will help you more easily fall and stay asleep. If your mind races from thought to thought preventing you from sleeping, practicing relaxation or cognitive-behavioral techniques can help keep you calm so you’re able to drift off to sleep. And regular exercise is, well we all know, good for everything; it reduces stress, lifts mood, promotes alertness during the day and relaxation and restful sleep at night.
It comes down to figuring out what works best for you and sticking to it. Research shows that for most adults, seven to eight hours of sleep per night appears to be the best for overall health, but you know you, so you may need more or may function better with less. But starting with these tips can help you find out which techniques work best for you:
Sleep hygiene. Developing habits that are conducive to consistent quality sleep can work wonders for your mental and physical health and help you get into a pattern of regular sleep. We have a list of seven clinician approved sleep hygiene tips to help you sleep better and wake up feeling your best, read them here.
Relaxation techniques. Meditation, guided imagery, deep breathing exercises, yoga, and progressive muscle relaxation (alternately tensing and releasing muscles) can counter anxiety and racing thoughts allowing for you to drift into sleep more easily.
Cognitive-behavioral therapy. Through the use of cognitive behavioral techniques, psychotherapists can guide patients through identifying sleep interfering behaviors associated with chronic pain. Patients then develop a better understanding of how these behaviors are impacting their sleep and are guided through identifying behavior modifications which can be made to help improve sleep. You can also try new techniques on your own before bed using the CBT-I Coach app that can be downloaded on iOS or Android.
Regular exercise. Behaviorally speaking, exercise is the gold standard for decreasing pain and aiding in restful sleep. Regular, moderate exercise reduces stress levels, decompresses the mind, increases slow-wave sleep (deep sleep that is rejuvenating for the mind and body), and promotes general health. Even going for a 30-minute walk each day can help!
Talk to your doctor. If your pain flares up when you lay down in bed, you may need to adjust your mattress or pillows, but if you have already tried that and nothing seems to help, then you may need to talk to your doctor about options available help you get a better night’s sleep. Your doctor will evaluate your pain experience to help determine the best treatment option for you.
For more information about the Back and Neck Pain Center, visit here, or call 1-833-UT-CARES to make an appointment.