Why is Sleep So Important?
Sleep is your body’s way of letting the brain rest. Getting the recommended 8 hours of sleep a night has a number of positive effects: improved concentration, metabolism, immune system functioning, reduced depression, and inflammation. Lack of sleep can block signals in the nociceptive pathways, which increases the perception of pain1.
In chronic pain conditions, sleep is even more important because the body is working harder than usual to maintain functioning2. The body needs to recover from yesterday and build resources for tomorrow. Long-term lack of good quality sleep increases experienced pain, which leads to feeling more unable to function properly3, 4.
The key to managing sleep in chronic pain conditions is not the duration of sleep, but the quality of it.
What Should I do if I Can’t Sleep?
Frustratingly, getting sleep can be difficult if you are in chronic pain. Sleep disorders and chronic pain go together. Sleep and chronic pain can form a negative cycle where poor sleep will increase pain, leading to poor sleep and more pain.
Meds and Pain
Some medications can negatively impact sleep. Some painkillers contain stimulants that reduce pain experience but stimulate the nervous system, keeping you up at night. Beta-blockers and other medications that target blood pressure suppress REM sleep, the phase in which the brain actually rests. Medications that make you drowsy, such as opioids, can throw your circadian rhythm off, making you more tired during the day but awake at night.
Bottom line: Read the list of side effects on your meds and adjust your timing to minimize the downside for sleep. Caffeine helps many people with migraines and makes some pain killers work faster. Take them EARLY in the day, not late.
What Can I do to Improve My Sleep?
For better sleep quality, mindfulness can help train the mind to be more relaxed. Acknowledge your thoughts and stressors, and let them flow away as you are preparing to fall asleep to reduce the cognitive load on your brain.
Body-centric meditation or biofeedback can also help relax the body. Systematically slow your breathing. Tense up concentrated areas of muscle, then relax them.
What you do before going to bed impacts how well you can fall asleep. Limit stimulating activities such as playing video games and watching TV to about half an hour before going to bed, as the brain will be less stimulated.
National Sleep Foundation: United States’ national authority on sleep research. Has up to date research and resources for getting better sleep.about:blankEmbed URLPaste a link to the content you want to display on your site.EmbedLearn more about embeds(opens in a new tab)Sorry, this content could not be embedded.Try again Convert to link
1 Kukushkin, M. L., & Poluektov, M. G. (2018). Current Views on Chronic Pain and Its Relationship to the State of Sleep. Neuroscience and Behavioral Physiology, 49(1), 13–19. https://doi.org/10.1007/s11055-018-0684-3
2 Tham, S., Daley, L., & Palermo, T. (2019). (113) Sleep Deficiency and Disability in Adolescents with Chronic Abdominal Pain. The Journal of Pain, 20(4), S5. https://doi.org/10.1016/j.jpain.2019.01.032
3 Evans, S., Djilas, V., Seidman, L. C., Zeltzer, L. K., & Tsao, J. C. I. (2017). Sleep Quality, Affect, Pain, and Disability in Children With Chronic Pain: Is Affect a Mediator or Moderator? The Journal of Pain, 18(9), 1087–1095. https://doi.org/10.1016/j.jpain.2017.04.007
4 Sardi, N. F., Lazzarim, M. K., Guilhen, V. A., Marcílio, R. S., Natume, P. S., Watanabe, T. C., … Fischer, L. (2018). Chronic sleep restriction increases pain sensitivity over time in a periaqueductal gray and nucleus accumbens dependent manner. Neuropharmacology, 139, 52–60. https://doi.org/10.1016/j.neuropharm.2018.06.022
5 Yamada, K., Kubota, Y., Shimizu, Y., Shibata, M., & Morotomi, N. (2019). Association of sleep sufficiency and duration with chronic pain prevalence: A population-based cross-sectional study. Journal of Psychosomatic Research, 120, 74–80. https://doi.org/10.1016/j.jpsychores.2019.03.005