In 2015, a poll by the National Sleep Foundation found that pain played a major role in America’s inability to get enough sleep. On average, a “sleep debt” of 14 minutes was felt by those who had suffered from acute pain in the previous week, while one of 42 minutes affected those with chronic pain.
Significant numbers of people who haven’t recently experienced pain do still have sleep problems, but this group does not generally have an overall sleep debt. In those with no pain, around one in three had had trouble falling or staying asleep in the previous week, or did not always (or even often) get a “good” night’s sleep, or the amount of sleep they need to feel their best. In those who do have acute or chronic pain, these problems raised even higher.
Worse sleep quality and shorter sleep durations, according to the poll, often coincided with pain and/or two related concerns, stress and poor health. This sleep gap appeared to narrow sharply among those who made sleeping a priority, so there may be paths to resolving the problem.
As David Cloud, CEO of the National Sleep Foundation, explains, “Taking control of your sleep by being motivated, setting a routine bedtime and creating a supportive sleep environment are relevant even for those without pain… Sleep is a key marker of health, and good sleep habits are critical for improving the quality of life those living with chronic or acute pain.”
What Is Sleep Debt?
Also known as sleep deficit, sleep debt is the cumulative effect felt by someone who doesn’t get enough sleep. Mental or physical fatigue may occur as the result of a large sleep debt.
Sleep debt comes in two types: as the result of total sleep deprivation, and as the result of partial sleep deprivation. Total sleep deprivation occurs when someone is kept awake for more than 24 hours. When someone sleeps too little for a number of days or weeks, this can result in partial sleep deprivation. Sleep debt isn’t considered to be a disorder, and there is much debate in the scientific community over the specifics of the condition.
Understanding the Problem
It’s helpful to think about our bedtime routines before we can understand how chronic pain might make it difficult to fall asleep. From getting comfortable to turning off the lights and shutting out as much noise as we can, most of us will eliminate distractions before we can relax and fall asleep.
According to Dr. Michelle Drerup, PsyD, of Cleveland Clinic’s Sleep Disorders Center, “This quiet environment can cause problems for people with chronic pain, because then the only thing left for the person to focus on is the experience of his or her pain.” In many cases, a person’s perception of pain
(though not necessarily their actual experienced pain) will increase when falling asleep, as the lack of other distractions will leave them with little else to focus on.
The Vicious Cycle
Many patients with chronic or acute pain – and their doctors – fail to address insomnia directly, even though the incidence of insomnia is expected to be significantly higher in these patients. Symptoms of insomnia (trouble falling asleep and/or staying asleep) are estimated to be experienced by between 60 and 80% of pain patients.
Your sleep problems might not stem solely from chronic pain. Sleep apnea and other sleep disorders often make it difficult to get a good night’s sleep, and might go unnoticed if there’s a more obvious cause. If you don’t know for sure whether you have an underlying sleep disorder, it’s a good idea to seek an evaluation from a sleep specialist.
Good treatment by sleep experts can significantly help those living with chronic pain once they’ve been properly diagnosed.
You may find you ache less if you’re able to get a higher amount of better quality sleep, as this can improve your pain threshold.
As Dr. Michael Breus, author of Beauty Sleep, explains, “People in pain don’t sleep, and people who sleep have less pain.”
Sleep Suffers where Pain Is Prevalent
The 2015 Sleep in America poll aimed to establish the broad impacts of pain-related sleep loss on Americans, based on a national, random-sample survey. Given the sheer number of people in America who suffer from pain, the problem is a notable one. It was found that 36% had experienced acute pain in the previous week, while 21% experienced chronic pain.
The results of the poll should be taken into consideration by those of us in the UK. According to a study published in the British Medical Journal, “chronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults.”
Self-reported measures of stress levels and sleep quality underscore the effects of pain on sleep beyond sleep debt.
Can Cognitive Behavioural Therapy Help?
In a study published in Sleep Medicine in 2010, three previous studies were reviewed which involved patients who suffered from chronic pain and insomnia undergoing cognitive behavioural therapy. The results of theses studies strongly suggested that patients with chronic pain can successfully be treated for insomnia and other sleep problems using CBD.
Can Medication Help?
There are a range of medications designed to treat sleep problems, many of which you will have heard of; Zolpidem, alprazolam, clonazepam, diazepam, lorazepam, eszopiclone and zaleplon are just a few of the more common options.
While these can be very effective in the short term, it’s best not to rely on them for long periods of time. Dependency and side effects can come with all of these medications, and it’s best to avoid these if possible. Work with your doctor to figure out if one of these medications is right for you, and don’t be disappointed if they don’t solve all of your problems right away.
For more information about insomnia, check out The Essential Guide to Insomnia from Need2Know Books, which covers the sleep process and the symptoms of insomnia, allowing the reader to identify the key causes to their condition. Whatever the cause of your insomnia, you deserve to sleep soundly.