The Vicious Cycle between Pain and Chronic Insomnia
Whether it is the sore muscles after a heavy training session or the premenstrual abdominal cramping, we have all experienced that disturbed night of sleep as a result of pain. Whatever the source of pain, it has the ability to intrude sleep, reducing both its depth quality. Not only does this cause us to wake up feeling very unrefreshed the next day but chronic sleep deprivation can have devastating effects on your health.
However, the link between poor sleep and pain is not as obvious as first. Whilst poor sleep is well documented as a side effect of pain, like many other mental and physical health disorders, insomnia is now thought to play a significant role in increasing pain!
Why is pain disrupting my sleep?
Whether it is acute or chronic pain, the physical and mental stress of pain massively impacts one’s ability to sleep well. Even worse, the less you sleep, the more pain you will feel the next day.
Even in a completely pain-free healthy individual there is increased pain sensitivity after sleep deprivation. This is because when you sleep less, your body produces more inflammatory chemicals in the body, called cytokines. These cytokines prevent the production and action of sleep-promoting substances, creating a highly inflammatory environment that seriously disrupts your ability to sleep well. This status also causes you to have increased sensitivity of pain during the following day and as one problem exacerbates the other, it starts to become a vicious cycle.
When pain persists for more than 3 months it is termed ‘chronic pain’. Oftentimes the cause of one’s pain may be very clear, such as from an initial injury or a back sprain. However, for many individuals the root may be not as clear.
Over time, the anxiety and physical stress of pain may cause countless nights of difficulty in falling asleep. They may also experience frequent awakenings due to constant, intense the number of micro-arousals (a shift to the lighter stage of sleep) per hour of sleep, which further exacerbate the feelings of pain.
This difficulty in carrying out important and enjoyable activities during the day, as well as the anxiety around the difficulty of sleeping can lead to disability and despair. Such negative emotions are themselves intruders to good quality sleep.
There is also strong evidence supporting the role of poor sleep and poor mood. In fact, insomnia is increasingly being seen as a ‘canary down the neurological mine’, where it is recognised as an early warning sign for many mental health disorders such as depression and anxiety.
1. Keep your sleep on time.
Go to bed and get up at roughly the same time every day. This will help keep your body clock on time and help avoid any ‘jet lag type’ stress. A regular sleep/wake schedule will help strengthen the association between the night time and sleep, increasing sleep quality. Furthermore, it will boost your immune system and reducing inflammatory chemicals, which we now know is important for creating an environment that promotes sleep!
2. Take a power nap.
Taking a power nap during the day will help you manage daytime energy after a poor night, as well as lessen your pain levels. New research suggests that a 30-minute snooze can help relieve stress and boost the immune system by restoring hormones and proteins to normal levels. Aim to keep it less than 30 mins and not after 3 pm.
3. Be mindful.
Practising mindfulness both in the day and night can help untangle you from the unwanted thoughts and feelings that keep you awake at night. Regular practice has been proven to reduce the time taken to fall to sleep and increase overall sleep quality. It has also been shown to be an effective way of managing chronic pain.
If you need help overcoming insomnia , we recommend our Sleep School for Insomnia App. It contains proven tools to help you fall asleep quicker, stay asleep and wake up feeling refreshed.