When aches and pains disrupt sleep

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. "Between 50% to 90% of people with chronic pain say that they don't sleep well. They wake up feeling like they never went to bed", says Professor Gilles Lavigne, an expert on sleep and pain.

The British Pain Society tells patients “Living with long-term or chronic pain can be a particular challenge. Pain can make a disability more challenging and sometimes make it more severe. Like a stone in a pond, pain can cause ripples throughout your life. The continuing pain can affect mood, mobility, self-confidence and sleep patterns which themselves can impact on your working life, home life and social life.”

The good news is that there's a lot that you can do, either on your own or with your GP, to break the cycle. By changing your lifestyle and possibly any medicines 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 or nerve pain
• premenstrual cramps

Acute injuries, surgery and more serious diseases such as cancer can also cause pain and sleeplessness.

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.

"If you have constant pain for six months, you figure out how to cope with it. But if the pain level goes up and down, if it's unpredictable, you can't get used to it and it can really interfere with sleep", says Lavigne.