Chronic back pain and sleep

When chronic back pain disturbs your sleep night after night, you might despair of ever getting a good night's sleep. However, experts say that with proper treatment, the chances are very good that you can get relief from chronic back pain and enjoy normal sleep.

Why sleep is important when you have chronic back pain

The inability to get a good night's sleep hurts - literally. Chronic back pain prevents you from getting a good night's sleep and you wake up in even more pain.

Pain interferes with the normal cycles of light and deep sleep you need in order to wake up refreshed. This disruption is called ‘alpha delta sleep disorder’. When back pain prevents you getting adequate deep, or delta sleep, you wake up in the morning tired and sore.

Causes of sleep problems

The chronic back pain itself may cause a sleep problem. Here are some other causes:

• Anxiety and depression can result in the inability to fall asleep or stay asleep, which will aggravate pain. Anxiety and depression increase a person’s sensitivity and awareness of pain, and the lack of proper sleep aggravates both the pain and any depression with anxiety.
• Breathing-related sleep disorders associated with obesity - such as obstructive sleep apneoa - can further aggravate pain by causing you to wake frequently throughout the night and by interfering with normal sleep patterns. 
• Limb movement disorders - such as restless leg syndrome - may further disrupt the normal sleep pattern. These conditions may be related to anxiety and depression as well as stress.
• Self-medicating with alcohol may help you fall asleep, but you'll probably wake up tired, grumpy and in pain.
• Some prescription medications can impair the quality of your sleep.

Medications that improve sleep and reduce chronic back pain

Some medications can help you sleep while helping with your chronic back pain. However some of these medicines have side effects and the potential for addiction. They should be used as part of a more comprehensive and widespread programme of pain management.

• Newer sedatives may not have a negative effect on your sleep.
• Over-the-counter pain relievers such as aspirin, paracetamol or ibuprofen can be effective for short-term use. Use them only as directed and let your doctor know what you are taking.
• Prescription medicines for severe back pain include antidepressants such as doxepin and amitriptyline or a muscle relaxant such as diazepam and baclofen.

Medication should not be used for longer than two to three months except in rare cases. Long-term use can result in dependence on some drugs. The goal of medication should be to help you develop a more normal sleep pattern.

Lifestyle changes for chronic back pain and sleep problems

Here are some tips for getting a good night's sleep with chronic back pain:

Avoid stress. Stress is the major cause of insomnia. It is also associated with chronic back pain.