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Chronic pain is difficult enough on its own. When compounded by sleep difficulties, you get a recipe for absolute misery. So, it’s not surprising that those affected by both problems have greater levels of disability than those dealing with either one or the other.
The double whammy of chronic pain and insomnia is very common, with up to 88% of chronic pain sufferers reporting sleep problems and 50% of insomnia sufferers reporting chronic pain problems. Each of these problems affects and magnifies the other. To break this vicious cycle of not being able to sleep due to pain and feeling worse pain because of having trouble sleeping, here are 5 science-backed tips.
You probably know that being relaxed is a prerequisite for feeling sleepy. But when in pain, it can be difficult to get the body and mind into a relaxed state that’s conducive to sleep. That's where relaxation techniques come in handy. They can help train your mind to “ignore” the pain and get some restful shut-eye.
Mindfulness meditation, breathing exercises, or guided imagery are examples of relaxation techniques you could try. Research on the effectiveness of these techniques shows promising results. For example, an analysis of baseline data from a trial in fibromyalgia patients published in the International Journal of Rheumatic Diseases found that those who practice mindfulness sleep better.
Sleep hygiene refers to healthy habits that promote sleep. Examples of habits that are frequently part of good sleep hygiene include:
A small study involving 7 women with fibromyalgia found that the group of women that received sleep hygiene instructions had less pain and better sleep by the end of the study. More specifically, the women had less pain and fatigue, higher quality sleep, and had less trouble falling back asleep when woken up in the middle of the night.
Quality mattresses are expensive, but the investment can be worthwhile if you’re dealing with chronic pain. Back pain is one of the most common causes of chronic pain as are arthritis and fibromyalgia. Sleeping with these conditions can be so much easier with the right choice of mattress.
According to a recent literature review, medium-firm mattresses and those with integrated temperature control are best for lower back pain. The same holds true for other types of musculoskeletal pain, including that caused by arthritis and fibromyalgia.
Pain medication, hypnotics, or a combination of both can be used to treat sleep problems and pain, but these do come with side effects and need to be taken only occasionally. A safer and side-effect-free alternative is aromatherapy. Aromatherapy, also called essential oil therapy, is simply inhaling evaporated essential oils.
Lavender was found to be especially effective in treating neurological conditions, which pain and sleep issues are. Research on lavender in aromatherapy has found it to help reduce lower back pain, migraine headaches, menopausal pain, and more. It was also found to help insomnia patients fall asleep and sleep longer. Lavender compounds seem to work by influencing the brain’s cholinergic system and GABAA receptors — both involved in pain processing.
Besides insomnia, those dealing with chronic pain may suffer from other types of sleep problems. Simple snoring and sleep apnea are two fairly common problems seen in people dealing with chronic pain. Sleep-disordered breathing can exacerbate chronic pain since they disrupt normal sleep, and lack of normal sleep makes a person more sensitive to pain.
To know if your sleep is disrupted by sleep apnea or snoring, you may need to undergo a sleep study. Your doctor may recommend several options, including convenient snore solutions like anti-snoring mouthpieces. The Good Morning Snore Solution tongue-stabilizing device is an example of a convenient mouthpiece that is clinically proven to prevent snoring to restore normal sleep.
References:
Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
Park M, Zhang Y, Price LL, Bannuru RR, Wang C. Mindfulness is associated with sleep quality among patients with fibromyalgia. Int J Rheum Dis. 2020;23(3):294-301. doi:10.1111/1756-185X.13756
Orlandi AC, Ventura C, Gallinaro AL, Costa RA, Lage LV. Improvement in pain, fatigue, and subjective sleep quality through sleep hygiene tips in patients with fibromyalgia. Rev Bras Reumatol. 2012;52(5):666-678. https://pubmed.ncbi.nlm.nih.gov/23090368/
Caggiari G, Talesa GR, Toro G, Jannelli E, Monteleone G, Puddu L. What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature. J Orthop Traumatol. 2021;22(1):51. Published 2021 Dec 8. doi:10.1186/s10195-021-00616-5
Koulivand PH, Khaleghi Ghadiri M, Gorji A. Lavender and the nervous system. Evid Based Complement Alternat Med. 2013;2013:681304. doi:10.1155/2013/681304
