Cell phone blares out reveille. Your eyes open reluctantly and also you understand it's morning, having only slept 4 hours before as a consequence of a late night party. As you roll away from bed to get yourself ready for work, the arthritic joints hurt greater than usual. Still a painful day ahead after taking ibuprofen. Does this sound familiar? If so, you should not alone. About 70% of Americans report getting insufficient sleep regularly, and about 20% of Americans suffer from chronic pain. Recently, the intersection between these two terms has become more clear.
The relationship between lack of sleep or poor quality sleep and increased pain perception from various medical conditions is well-known. Poor sleep quality predicts greater pain intensity from conditions corresponding to back strain, arthritis, and fibromyalgia. In many cases, the connection is bidirectional. For example, my colleagues and I actually have documented that heartburn is worse after a nasty night's sleep, and conversely, heartburn can result in sleep disturbances.
Recent studies now provide a greater understanding of why pain increases after poor sleep. In brain imaging studies using magnetic resonance imaging (MRI), brain regions controlling pain perception are more lively after a poor night's sleep. In addition, the activity of brain regions answerable for reducing the feeling of increased pain decreases. The net effect is that the perception of pain is heightened after a poor or insufficient amount of sleep. Importantly, this statement will not be limited to the laboratory. In a survey of individuals with chronic pain, an evening of poor sleep predicted worse pain.
The association between poor quality sleep and worsening pain has necessary implications for people who experience each acute and chronic pain. More or higher sleep can reduce the pain they're experiencing.
There can also be a possible public health message that can not be ignored. The opioid epidemic is spreading within the United States, linked to the over-prescription of opioids for chronic pain. Unfortunately, addiction and inadvertent overdose have gotten increasingly common. How many opioid-related deaths could possibly be prevented if an intervention to enhance sleep were implemented? The answer will not be known. However, Better Sleep is inexpensive and frequently doesn't require a prescription. Among other measures to combat the opioid epidemic, Communicating the benefits of sleep Public health investments in reducing pain perception could also be effective.
references
Sleep disturbances and acute stress as glial activators: key targets for the treatment of central sensitization in chronic pain patients?Expert opinion on treatment goalsAugust 2017.
Sleep and pain sensitivity in adults. PainAugust 2015.
Relationships between sleep quality and pH monitoring outcomes in individuals with gastroesophageal reflux disease. Journal of Clinical Sleep MedicineAugust 2007.