Chronic Pain and Sleep – The Vicious Cycle

Sleep Problems from Pain

Sleep problems are common in people with arthritis and chronic pain. Additionally, people with rheumatoid arthritis and other autoimmune forms of arthritis and rheumatic diseases may need more sleep than the average adult. Some RA patients need as much as 10 hours of sleep per night, whereas a “healthy” adult typically needs 7-8 hours per night. Sleep is important in the healing process, and sometimes lack of sleep can worsen pain. It is a vicious cycle!

That being said, TOO MUCH sleep can actually worsen your condition. Though fatigue is a hard battle to win, it doesn’t mean we should nap every single time we feel tired. Being sedentary for too long can actually cause our joints to further stiffen, worsening the problem. Additionally, laying down for more than 9-10 hours can actually start to have negative cardiovascular effects on the body.

So, it is important to get enough rest, so that your body can heal and restore itself — after all, sleep is crucial for pain management — but, like with ANYTHING: don’t overdo it. Sleep does have an important purpose in our biology, and, too much sleep can simply be, too much.

Here are some tips, though, to sleep better with arthritis!

Dr. Joanne Jordan, a rheumatologist, tells Arthritis Today that improving sleep disruption is key in managing arthritis. “The best way to do that depends on the individual patient, but may include taking medications like antidepressants to promote deep sleep; improving bedtime habits like going to bed at the same time every night; and avoiding foods such as those containing caffeine that may keep you awake.”
Try investing in a sleep monitoring tool, like the Fitbit for example, which tracks your sleep quality & efficiency.
Livestrong.com suggests, “Avoid strenuous activity before you go to bed. The University of Washington explains that mild hip arthritis can be managed with proper rest. Excessive hip strain can aggravate your arthritis, so try to engage in physical activity early in the day, allowing for at least an hour of relaxation before bed.”
Apply ice to your affected joint for 10 minutes or so before laying down. Ice helps reduce swelling and pain for a more comfortable night’s sleep.
Try a hot bath before bed to relax your muscles, your body, and your mind.
Invest in a comfortable mattress. You want good support when it comes to your pillow, too. The Arthritis Foundation recommends Tempur-Pedic products.
Try a sleep study to break the insomnia, if that is part of your problem. According to spine-health.com, “in a recent study, it was found that approximately 2/3 of patients with chronic back pain suffered from sleep disorders. Research has demonstrated that disrupted sleep will, in turn, exacerbate the chronic back pain problem. Thus, a vicious cycle develops in which the back pain disrupts one’s sleep, and difficulty sleeping makes the pain worse, which in turn makes sleeping more difficult, etc.” It is a tough cycle to break but will be very beneficial to your mental and physical health if the insomnia/pain cycle can be stopped.
The Sleep Foundation also notices a link between pain and sleep quality. They suggest avoiding alcohol before bedtime, taking a brief 15-20 minute “power nap” in the afternoon, not abusing pain medications, and, learning relaxation techniques such as deep breathing and biofeedback.
The Sleep Foundation also states, “It is time to seek professional help when pain causes sleep problems two to three times a night, and you are unable to fall asleep again. There are a variety of treatments available to ease the sleep problems of chronic pain sufferers, including medication and physical therapy. Doctors may also recommend seeing a psychiatrist or psychologist.”
About.com also suggests maintaining a routine, steady sleep/wake schedule to help you sleep better and more efficiently.
Ask your rheumatologist about medications or natural supplements to help you sleep if it is an ongoing problem. Bear in mind, though, that some “sleeping pills” can worsen the problem and cause dependency. As with anything, be aware of all side effects and potential risks before beginning a new plan of treatment, and always consult with your doctor.