How to sleep easier with Chronic Pain
Chronic pain is persistent pain that has lasted for more than 12 weeks despite medication or treatment. It is estimated that 29 million people in the UK are living with chronic pain.
Unsurprisingly, as many as two-thirds of people with chronic pain have sleep disorders. In one study alone, 75% of participants had insomnia and 84% reported the presence of at least one sleep problem.
People in pain also report that when they don’t sleep well, they tend to hurt more. But why exactly? New research is finding that pain and insomnia may have a reciprocal relationship and coexist as symptoms together.
With this in mind, let’s explore the close relationship between pain and insomnia, and furthermore the strategies on how you can improve your sleep pattern and cope better with persistent pain.
Here, our resident sleep and wellbeing expert, Natalie Pennicotte-Collier, offers her specialist advice on how to sleep a little easier and manage chronic pain in the process. Natalie’s young son suffers from chronic pain due to Spina Bifida and she has a specialist interest in supporting patients with long term chronic pain (LTC) working alongside Integrative GP’s to provide Mindfulness Based Cognitive therapy for Sleep therapy & emotional wellbeing.
“So, does poor sleep equal more pain? It’s a fascinating area of new sleep research. There have been lots of recent studies which demonstrate insomnia can heighten your perception of discomfort the next day. Poor sleep will make you extra sensitive to the sensation of pain and increase associated emotional suffering.
Research studies find that quality of sleep versus the amount of hours of sleep can make a difference, for example, if you get six hours of sleep, whilst not ideal, those six hours will be more refreshing if they are not disrupted and your brain has had the chance to cycle through all the natural stages of sleep.
“Chronic pain can frequently make you experience ‘sleep disturbances’. The most common forms in patients with chronic pain include:
- Insomnia; a sleep disorder in which people have trouble sleeping, including falling asleep, or staying asleep.
- Hypersomnia; struggling to stay awake during the day caused by excessive sleepiness, where naps do not help to refresh you. Those with Hypersomnia will often still sleep for long hours each night and may fall asleep during usual daytime activities such as talking or eating.
- Sleep apnoea; occurs when there are pauses in breathing or periods of very shallow breathing during sleep. Pauses can last between a few seconds and a few minutes and occur frequently throughout the night.
- Restless leg syndrome; causes uncomfortable sensations in the legs and an irresistible urge to move them. Symptoms are often most severe at night when a person is resting, such as sitting or lying in bed.
“Sleep disturbances such as these can make chronic pain feel worse. An on-going lack of refreshing sleep can stress the nervous system meaning it consequently becomes more reactive. This reactivity then amplifies the pain signals in the body, making pain worse.”
Strategies to help
First and foremost, try to focus on a regular sleep/wake schedule that will help strengthen the association between the night time and sleep, increasing sleep quality.
Mindfulness techniques, Cognitive Behavioural Therapy (CBT & MBCT ), and adopting a breathing practice both before and after sleep can make a real difference. Using these techniques can support you in managing the sensations of pain alongside micro periods of relaxation and recovery during the day.
“For example, a mindful exercise I recommend involves closing your eyes, focusing your attention on your breath and repeating in your mind the following words; (BREATHE IN) I do my best to rest, (BREATHE OUT) I let go of all the pain and stress.
“This breathing technique, with practise, anchors the feeling of acceptance and relaxation which can help to support fractured sleep as the body responds to discomfort and pain.
“For those really struggling to get a good night’s rest, CBT for insomnia is a common first-line treatment because it addresses the thoughts and feelings that act as barriers to getting a fully restorative sleep.
“With chronic pain you can be kept awake by anxiety and other worries. This therapeutic approach can improve sleep by changing the behaviours and negative thoughts that interfere with quality sleep. CBT for insomnia has shown promising results, with reports of success in as many as 80% of patients who pursued the treatment.
“Another approach that may help ease chronic pain related insomnia is called relaxation training. In relaxation training, you learn how to progressively relax your muscles and meditate to achieve body relaxation, helpful to ease a racing mind and any pain irritation and improving your focus away from sleep-stealing thoughts.
- You can try Natalie's pain management meditation below:
“In addition, moving towards two blocks of 4 hours’ sleep across 24 hrs can significantly aid the body and mind to cope when an episode of pain or insomnia arises.
“Furthermore, some find that moving towards a Polyphasic sleep schedule; whereby instead of one long sleep each night, sleepers take small sleeps in short bursts throughout the day, can be beneficial too. Adjusting to this can help you to cope better and support you emotionally in your overall wellbeing.”
If you’re suffering for insomnia or chronic pain and you would like more information on any of the treatments Natalie has mentioned, you can find this in our links below.