How Chronic Pain And Sleep Affect Each Other

Chronic pain is something that affects about 25 percent of the Spanish population. In a study with 5,000 participants, 43 percent reported that they experienced pain during the past week, especially in the legs, back and head. Of these, about 54 percent stated that they suffered from long-term, chronic problems that had significant negative effects on their lives. In today’s article, we will discuss the relationship between chronic pain and sleep.

The most common causes of chronic pain are arthritis, rheumatism and migraine. More than 60 percent of patients said they used painkillers to manage their pain. However, these drugs can have many different side effects with long-term use and can also lead to conditions that aggravate the pain.

The link between chronic pain and sleep and adverse health effects

If you suffer from chronic pain, you know what negative effects it can have on people’s lives. And having to constantly endure physical pain is also something that causes considerable mental suffering. Some of the aspects that are most affected by chronic pain are the following:

• Sleep
• Social interaction
• Cognitive ability
• Physical activity
• Work performance
• Various daily activities (showering, shopping, cooking, driving, writing, etc.)

Chronic pain also results in an increased risk of mental disorders such as anxiety and depression. Furthermore, prolonged physical pain can unfortunately also lead to chronic stress.

How chronic pain and sleep disorders give birth to each other

The patient’s sleep quality is considered a fundamental factor in assessing whether or not a chronic pain treatment method works. About 50-70 percent of patients suffering from moderate to intense chronic pain have some form of sleep disorder. This is especially true for older people. The most common disorders are:

• Problems falling asleep
• Waking up during the night due to pain
• Restless sleep
• Fatigue during the day

The pain makes it very difficult for these patients to get a good night’s sleep. This in turn leads to hyperalgesia, which means a more intense experience of pain. Being more sensitive to pain makes it harder to sleep, which eventually becomes a vicious circle that is difficult to break.

How painkillers affect sleep

Medications prescribed for chronic pain can relieve the symptoms, but they also affect the quality of sleep. Here are some of the most commonly used preparations:

Non-steroidal anti-inflammatory drugs (NSAIDs)

These are among the most common painkillers for adults. They not only help reduce inflammation, but they also reduce fever, swelling and redness. Doctors prescribe them for chronic health problems, such as arthritis and SLE (Systemic lupus erythematosus).

Unfortunately, NSAIDs also make sleep less effective and you wake up more often during the night. There are three main reasons why this happens:

• A reduced production of prostaglandins.
• NSAIDs inhibit the secretion of melatonin.
• Irritation of the stomach during prolonged use.

Opioids

In order for these to constitute a safe treatment alternative, they may only be prescribed in the short term and under strict medical supervision. Prolonged use of opioids leads to addiction. If you do not use them properly, you risk an overdose that can be fatal. Therefore, doctors are careful to prescribe them.

Opioids reduce both REM sleep and ortho sleep (or NREM sleep), both of which are important for the physiological development of sleep cycles.

Corticoids

Doctors mainly prescribe corticoids to reduce inflammation that occurs in diseases such as joint inflammation, asthma, SLE, multiple sclerosis and certain types of cancer.

Prolonged use can lead to cataracts and osteoporosis, among other things. Consequently, it is something doctors usually only prescribe for shorter periods.

How do they affect sleep? In high doses, they work just like opioids. They reduce both REM and NREM sleep.

Summary: the link between chronic pain and sleep

The scientific literature points to a direct link between chronic pain and sleep disorders. Pain makes it difficult to get a restful sleep and lack of sleep leads to increased pain sensitivity.

It is important to keep in mind that sleep depends on various factors. Age plays a big role, as do the medicines you use. But one should not exclude other comorbidities or external circumstances that may prevent good sleep and increase susceptibility to pain.

If you are taking painkillers for chronic pain, it is a good idea to replace fast-acting tablets with long-acting drugs. Studies show that the latter can reduce the risk of sleep disorders associated with painkillers.