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When aches and pains disrupt sleep

WebMD Medical Reference
Medically Reviewed by Dr Rob Hicks

Aches and pains can cause anyone a sleepless night now and then. It doesn't take much; a pulled muscle from an over-enthusiastic work-out or an afternoon spent helping a friend move furniture. The next thing you know, you're lying in bed at 3am staring at the ceiling, aching and hoping for sleep.

While most aches fade away quite quickly, painful and sleepless nights can be the norm for people living with chronic pain.

The good news is that there's a lot that you can do, either on your own or with the help of your GP, to break the cycle. By changing your lifestyle and possibly any medication you take, you may finally get the good night's sleep you crave.

Pain and sleep

During a normal night, we all go through cycles of light sleep, deep sleep and REM [rapid eye movement] sleep. This cycle is repeated three to five times a night.

Getting enough deep sleep and REM sleep are essential if you are to feel refreshed in the morning.

The problem is that pain interferes with this cycle. Sudden severe pain can make you bolt upright from a sound sleep. Even less severe pain can cause "micro-arousals". These are periods when your pain breaks through and bumps you back into the light sleep stage. You may not become conscious and the next day you won't remember waking up. Your fragmented sleep can leave you feeling like you didn't get any rest at all.

Any pain can interfere with sleep, but some common causes of disturbed sleep are:

  • Back pain
  • TMJ pain, which is pain in the temporomandibular joint of the jaw
  • Arthritis
  • Fibromyalgia, which can cause pain throughout the body's muscles, ligaments, and tendons
  • Neuropathy (nerve pain)
  • Premenstrual cramps
  • Acute injuries, surgery and diseases such as cancer

It's not just the intensity of the pain that can make it difficult to sleep. Pain that varies, where it is worse some days than others, is often the most likely to cause sleeplessness.

Finding solutions

Experts strongly recommend that people with chronic pain and insomnia practise good " sleep hygiene", which is a medical term for good sleep habits. This advice not only applies to people with chronic pain, but to anyone with sleep problems:

  • Cut back on or cut out caffeine . If you're overtired, coffee, tea and caffeinated drinks may help you get through the day. However, they are probably making the problem worse as they can disturb your sleep at night. So struggle through a few days without caffeine and see how you get on.
  • Avoid naps. Napping during the day just reduces the amount you can sleep at night.
  • Exercise, but not too late. While physical activity is good for everyone, intense exercise, especially in the late afternoon and evening, can rev up your body and make sleeping at night difficult. So try a more moderate exercise routine and make sure you do it before the evening.
  • Cut out alcohol in the evening. A nightcap might seem like the perfect way to put yourself to sleep. The problem is that alcohol can interfere with your sleep cycles and wake you up later.
  • Don't overeat in the evening. Feeling very full may make it harder to sleep.
  • Make your bedroom a calming place. It's very easy to let your bedroom become a multipurpose dumping ground. It might be filled with baskets of laundry, your children's toys and a TV. Experts say that you should make your bedroom a more neutral, soothing place. They recommend that you use your bedroom only for sleeping and sex. Get rid of the distractions.
  • Relax before bedtime. Don't do anything before going to bed that could make you anxious or excited. Avoid doing work in the evening or even getting into serious discussions with your spouse. Instead, try focused relaxation or breathing exercises.
  • If you can't sleep, don't lie awake in bed. Willing yourself to sleep won't work. You'll probably just make yourself anxious. So if you're not asleep within 15 minutes of lying down, get out of bed and do something else such as reading a book, having a bath or listening to relaxing music. Once you feel yourself getting tired, get back into bed
  • Get up at the same time every day regardless of when you went to sleep. It's one way of getting yourself into a routine.

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