Getting to Sleep With Chronic Pain
Chronic pain can often have the unfortunate side effect of causing sleep problems, too. Find ways to get better sleep with these insomnia treatments.
Medically Reviewed by Pat F. Bass III, MD, MPH
If you're living with chronic pain, sometimes your only respite is when you're asleep. But people with chronic pain are often so uncomfortable that they develop sleep problems.
This vicious cycle can not only result in overtiredness, but can also cause your chronic pain to be even worse, says Biral Patel, MD, an anesthesiologist and pain managementspecialist with Scott and White Hospital in Temple, Texas. "During the sleep cycle, the body replenishes its energy reserves, trying to heal from things that occur through the course of the day," Dr. Patel says. "When you're not able to obtain effective levels of sleep, your pain can be worse."
Even if you are able to get to sleep, your chronic pain may cause you to wake up tired. This may be because your pain is causing frequent "microarousals" — shifts to lighter, less restful phases of sleep.Fortunately, there are ways you can sleep better even if you're living with chronic pain. Reinforcing your chronic pain treatment with insomnia treatments or strategies can ease both problems. Try these steps if you're tossing and turning at night:
- Get your pain under control. When your pain is controlled or subdued, your chances of getting restful sleep are improved. Most patients who find effective chronic pain treatment usually find that it helps their sleep patterns too, Patel says. Your chronic pain treatments will depend on what is causing the pain in the first place. Medications, acupuncture, relaxation techniques, and even surgery are all used to help treat various forms of chronic pain. For more information, consult your doctor or a physician who specializes in chronic pain. Then you may want to try some of the following insomnia treatments in conjunction with your pain therapy.
- Consider sleep aids. If you're having trouble sleeping, your doctor may recommend a prescription insomnia medicine that works by slowing activity in the brain and causing sleepiness. Antidepressants like trazodone are also often used to treat insomnia. Most sleep aids, however, are only intended for short-term use, so don't plan on using them for more than a few weeks at a time.
- Cut the caffeine. Found in coffee, tea, and some sodas, caffeine is a stimulant that can block sleep-inducing chemicals in the brain, keeping you feeling alert when that's the last thing you want. To minimize caffeine's negative effects on your sleep, stop consuming caffeinated drinks by afternoon or earlier; this will allow time for their effects to wear off.
- Practice good sleep hygiene. Good sleep hygiene means healthy habits that can help minimize sleep problems. One good sleep habit to develop is to avoid napping during the day. Going to bed and waking up at the same time each day can help, too. You may also find it helpful to develop a sleep ritual, like taking a warm bath, eating a light snack, or reading for a short time just before bedtime.
- Exercise regularly. It may sound counterintuitive, but exercising four to eight hours before bedtime has been shown to help improve sleep quality for people with insomnia. Physical activity may help reduce anxiety, which can be a factor in sleeplessness. Some forms of chronic pain, such as fibromyalgia, can be lessened with regular exercise. However, be sure to allow plenty of time between your workout session and your bedtime, since exercising too late in the day can keep you awake.
- Check your medications. Some prescription medications can actually contribute to insomnia. Cortisone, a steroid hormone used for inflammation, is a drug that can keep you awake. Some thyroid medications, over-the-counter cough and cold medications, and levodopa (a drug used to treat Parkinson's disease) can also cause insomnia. If you believe your medications may be interfering with your sleep, talk to your doctor about alternative therapies.