Estimates suggest that more than one in five Australians live with a sleep disorder, with Obstructive Sleep Apnoea (OSA) and insomnia accounting for the majority of these cases.

As well as the immediate effects of sleepiness and fatigue, sleep disorders may also contribute to other health conditions, such as: diabetes, obesity, mental illness and cardiovascular disease.

In addition to the above, chronic pain can have a direct impact on the quality of your sleep.

Many people report their painful symptoms are alleviated after a better night’s sleep. For those living with chronic pain, prioritising sleep may be a key component in the path to recovery.

How Does Sleep Affect Pain?

Researchers have found that short sleep times, fragmented sleep, and poor sleep quality often causes heightened sensitivity to pain6 the following day in chronic conditions like rheumatoid arthritis.

Encouragingly, many studies have also found that in the long term, quality sleep may improve chronic pain.

Common Sleep Disturbances in those With Chronic Pain

Chronic pain can affect sleep differently depending on the nature of the pain.

Some conditions may flare up at night or be provoked by certain sleeping positions. Others may cause persistent pain that does not ease at night. A hospital or long-term care facility may pose additional challenges, such as a noisy environment or an uncomfortable bed.

In addition to shorter overall sleep time, chronic pain can also cause frequent nighttime wakings, the most common sleep complaint in people with chronic pain.

As we sleep, we cycle through light sleep, slow-wave sleep, and rapid eye movement (REM) sleep. In order to feel well-rested we need a balance of all these sleep stages, especially slow-wave sleep and REM sleep. Disrupting this cycle interferes with the progression of the sleep stages, and leads to less restful sleep and next-day tiredness.

Pain can also be accompanied by anxiety, stress, or depression. These conditions can cause sleep problems in their own right, and should be treated as part of an overall health plan.

Although treatment and prevention will depend on what type of sleep problem you're having, good sleep habits (sometimes referred to as “sleep hygiene”) can help.

Some good sleep hygiene habits that can improve your sleep are:

• Be consistent. Go to bed at the same time each night and get up at the same time each morning, including on the weekends
• Get some exercise. Being physically active during the day can help you fall asleep more easily at night
• Don't nap during the day
• Avoid large meals, caffeine, and alcohol before bedtime
• Stop stressful chores or discussions long before you go to bed
• Relax before bedtime. Try deep breathing, prayer, gentle stretching, meditation, or journaling
• Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature
• Remove electronic devices, such as TVs, computers, and smart phones, from the bedroom
• If you can't sleep, go into another room and read, or do something relaxing and quiet
• Quit smoking - Research shows that smoking is associated with increased insomnia severity and shorter sleep duration, particularly nightly smoking.

Pain and Sleeping Positions

When learning how to sleep with pain, the type of pain may dictate your sleeping position. Those with hip, knee, or shoulder pain — as in the case of rheumatoid arthritis — may need to avoid sleeping on their side.

People who are sensitive to pressure build-up in the lower back may need to be careful when sleeping on the back or stomach. A mattress and pillow designed to cushion pressure points and support the natural curvature of the spine may help alleviate some of the pain.

Other conditions cause diffuse pain, such as multiple sclerosis. These conditions attack the nerves, which means people may need to switch sleeping positions more frequently to avoid numbness and tingling. These sleepers may need a more responsive mattress that facilitates movement on top of the bed.

References:

Parliament of Australia: Sleep Awareness Report

Sleep Health Foundation https://www.sleephealthfoundation.org.au/