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Chronic Pain and Insomnia

What is chronic pain

Chronic pain is pain that continues for 3 months or longer. Chronic pain may be triggered by a disease or injury, or “may have a life of its own”

Chronic pain can also develop even though you have not had an injury or illness. But the vicious cycle is same—a cycle of sleeplessness, inactivity, irritability, depression and more chronic pain.

Symptoms of chronic pain may include:

  • No recovery from mild to severe pain
  • Shooting, burning, aching, or electrical pain
  • Soreness, tightness, or stiffness, mere discomfort

Treatment of chronic pain:

  • Pill power vs Skill power
  • Pain medicine specialists usually prescribe pain pills and
  • anti-depressants.
  • Behavioral therapy
  • and physical therapy
  • Complementary therapies such as acupuncture, massage, or yoga also may be used to treat chronic pain.

Sleep and chronic pain are bi-directionally connected. For example, micro-arousal due to chronic pain causes sleep fragmentation, and thereby does not allow enough of sleep consolidation to allow for REM sleep. New research shows that lack of REM sleep leads to hyperalgesia (the volume control of pain perception is turned to high level)

Fibromyalgia is an example of chronic pain and sleep disorder.

Sleep quality predicts next day pain, pre-sleep pain does not predict sleep quality.

“The counter-intuitive finding reported by Tang et al.—that while measures of sleep quality predict next day pain, pre-sleep pain does not predict sleep quality—was also recently reported in a very different chronic pain population”

http://www.journalsleep.org/ViewAbstract.aspx?pid=28502

Presleep Cognitive Arousal, Not Pain, was a Reliable Predictor of Subsequent Sleep.

Despite the potentially sleep-interfering properties of pain,pain reported during the presleep period was not found to be a reliable predictor of subsequent sleep in this sample. Although presleep pain was a significant predictor of poorer sleep efficiency it did not predict sleep quality.

Afternoon nap, sleep and pain

Good sleep at night relieves chronic pain significantly during the first half of the next day. If you take a nap in the afternoon, you can revive this neurotransmitter mechanism to relieve more pain.

Furthermore, if you have primary sleep disorders like sleep apnea, consolidating sleep at night or during your nap would be an effective intervention to reduce your chronic pain.

References:

Tang NKY; Goodchild CE; Sanborn AN; Howard J; Salkovskis PM. Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study. SLEEP 2012;35(5):675-687.

Sleep quality and presleep arousal in chronic pain.

Smith MT,
Perlis ML,
Smith MS,
Giles DE,
Carmody TP.

Source

Department of Psychiatry, University of Rochester Medical Center, New York 14642, USA.

http://www.ncbi.nlm.nih.gov/pubmed/10749008