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The ultimate guide to pain and sleep

Feb 01, 2023 | By Quietly Staff

Pain keeps you from sleeping. And when you do finally get some sleep, your pain wakes you up in the middle of the night. Then you feel worse from being tired. 

Well you're not alone.

About 72% to 70% of people with pain have sleep problems. In some studies this number is as high as 88%.

If you have chronic pain and sleep problems, you are more likely to have higher pain intensity, feel pain longer, have disabilities, and be less active. 

It can affect your mental health, leading to depression, debilitating anxiety, and thoughts of suicide.

People who have rheumatoid arthritis, osteoarthritis, and fibromyalgia are more likely to have sleep issues. 

What is pain?

Your pain is your alarm system telling you something is wrong and damaging your body. For example, when you get a cut on your finger.

The pain you feel is real. Anyone can experience pain, even children. 

Some people have chronic pain. Your alarm system goes off, even though nothing in wrong or damaging to your body. There's no clear cause. 

Arthritis, fibromyalgia, complex pain syndrome are some conditions that have chronic pain.

Whenever you get pain, your instincts will be to avoid the activity that brought you the pain. You may even have negative thoughts about it, even fear it.

If you stop moving, this leads to more pain because you're not moving as much. And if you focus too much on the pain this can lead to sleep problems. 


Pain and sleep 

Pain can keep you awake during the night, and even wake you up.

You might worry or stress about your pain, making it hard to relax and get comfortable enough to sleep.

One study found that if you loose sleep, your pain intensity increases the next day

Another study found that people with no pain and poor sleep, were at risk to developing chronic pain in 5 to 18 years.

Bottom line, pain is not the culprit, it's poor sleep.  

Medications and sleep 

Medications for sleep are like a bandaid.

They’re good for the short-term when you really are struggling and need sleep. 

But if pain is keeping you from sleeping, it’s usually not a short-term problem. 

Sleep medicines aren’t effective long-term since your body can build a tolerance and they don't give you a natural sleep either.

People that don't get a good night's rest, will rate their pain higher and use more pain medications.

So people with pain should get a good night's rest to to feel less pain in the day.

Medications for specific types of pain

Pain caused by injuries such as stubbing your toe, broken bones, or damage to body tissues are relived by traditional pain killers like Advil and Aleve.

Traditional pain killers like Advil and Aleve help people experiencing pain from damage to body tissue such as stubbing your tow or broken bones.

These pain killers offer little relief to people experiencing nerve pain, who can get relief from seizure medications.

Other pain conditions such as fibromyalgia that's potentially due to changes in how pain is processed by the central nervous system, is best treated with pain management including healthy sleep habits.

Always talk to your doctor before taking any medications.

Why do I wake up in pain throughout the night?

Most people think when you fall asleep you're in a deep sleep throughout the night. Then in the morning, you come out of the deep sleep to wake up.

But that’s not the case.

We wake up 4 to 6 time in a night. We come out of the deep sleep and go right into the awake stage. 

sleep cycle chart

When we wake up, most people go back to sleep.

But for people with pain, their pain wakes them up.

I've experienced this first hand. 

At first it feels like you're in so much pain, that the pain wakes you up.

But you could just be entering the awake stage, slowly waking up.

If your pain is intense, you’ll fully wake up. 

Once you wake up, it can be hard to fall asleep again.

Your body’s now alert and your nervous system is active again. So you have to relax and calm yourself down just enough to fall asleep again.

How much sleep do we need?

The longest time a human has gone without sleep is 11 days and 25 minutes. The world record was set by Randy Gardner in 1963.

This person was sleepy and irritable, but never had delusions. On the last day, when he finally went to sleep, they slept for 15 hours and felt fine, with no issues.

We don’t need 8 hours of sleep to feel rested. We can get away with 5.5 hours of sleep (about 70%) without affecting our performance the next day.

Anymore sleep lost, and you'll start to feel it.

So if you can't get sleep, that's okay, you can rest knowing our bodies can handle it.

How to get better sleep with pain

You may not have control over your pain, but you can control how you rest your mind and body, which helps reduce pain. 

Only stay in bed when you’re asleep 

Have you ever fallen asleep in front of the TV, but as soon as you move to bed you can’t sleep?

Or do you ever have nights where you can’t sleep no matter how hard you try, and that makes you more awake?

That’s because you associate your bed with not being able to sleep and being wide awake. 

People that sleep when they hit the bed, associate their bed with sleep. 

So if you’re in bed for 10 hours but you’re only sleeping 5 hours, then you’re in bed too long.

Try cutting back the amount of time you spend in bed one hour at a time. If your in bed for 10 hours, try 9 hours, then 8 hours, until you get closer to 5 hours. 

The longer you stay awake in bed, the more frustrated you get. You’ll associate your bed with being awake and pain.

So when you're in bed you should only be sleeping, so you associate your bed with sleep, not frustration and pain. 

Most people will want to stay in bed. It will be frustrating to get out of bed. But trust that this process works. 

Get up at the same time every day

When you don't get a good night’s sleep you may be tempted to sleep in. 

If you sleep in, you'll fall asleep later. 

You should get up at the same time every day, so you can fall asleep at a normal time, instead of having sleep problems. Expose yourself to light in the morning and get moving.

Practice deep relaxation techniques

You don't need to sleep, to get all benefits from sleep.

Rest is enough to rest your body and brain. This helps calm your nervous system.

If you have chronic pain, you have a more active nervous system, which can interfere with how quickly you fall asleep and how deep a sleep you get. 

So the next time you're lying in bed awake with pain, practice deep relaxation techniques, such as closing your eyes, listening to white noise, or deep breathing. 

Positive thoughts about sleep

Have you ever said "I didn't sleep last night, at all." 

That's a negative thought.

How do you feel when you make statements like that, tired and irritability?

The reality is you probably got some sleep, and you've under estimating how much sleep you got. 

Why is that?

We spend half the night in lighter stages of sleep. People may think they're awake when they're just in lighter sleep stages. 

As we get older we spend most of the night in lighter sleep stages.

So on night's when you can't sleep, and you lay in bed, remember that it's a natural stage of sleep and you'll fall asleep again. 

We get most of our deep sleep during the first half of the night. In the second half we get REM sleep.

As long as you get deep sleep, you will be able to function the next day.

If you don't get deep sleep, your brain will make sure you get it the next night.

When you have negative thoughts about your sleep, it will keep you awake, stimulate you, causing use sleep problems. And feel like you've been awake less than you think.

Replace your negative thoughts about sleep to relax and feel more rested. 

You've done it better, just remember times that you stayed up late on vacation and didn't get much sleep.

How did you feel? Not that bad?

You're getting more sleep than you think you need and you could benefit from positive thinking.

Practice meditation and breathing techniques help shift your focus away from negative thoughts.

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