Am I sleeping enough?

Many people with pain will also tell you that they are not sleeping well at night, or that they do not have much time to sleep. In fact, the Center for Disease Control (CDC) published an article including average sleep behaviors in adults as reported by the National Institutes of Health (NIH). The data released by the NIH showed that 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007. In 2009, only 31% of high school students reported getting at least 8 hours of sleep on average. While these numbers may not seem staggering, this publication went on to show teenagers need 9-10 hours, and adults should get 7-8 hours of sleep each night1.

Is lack of sleep why I’m in pain?

Deficient sleep volumes could play a role in sustained pain. A 2013 systematic review (highest level of evidence for research studies) of sleep and pain causality2 by the NIH reported that disruption of normal sleep, including deficient continuous sleep hours, multiple times awakened per sleep, and other factors can increase prevalence and intensity of chronic pain, even if the deficit occurs for just one night. A 2008 article in “Pain” reported that those with less than 6 hours, as well as those with more than 9 hours of sleep per night had a higher frequency of reported pain the following day3. Moldofsky presented a clinical review that also cited the reciprocal relationship between decreased sleep and increased pain, suggesting that it becomes a cyclical negative event4.

Similarly, a study published in ‘Pain’ compared pain tolerance in persons with one night of total sleep deprivation5. This study found that those who experienced total sleep deprivation had a significant increase in hyperalgesia, or the perception that a non-painful stimulus is painful.

How can adults improve their sleeping habits, and/or have more fulfilling night’s sleep?

The National Sleep Foundation published healthy sleep tips6, included below:

  • Stick to a consistent sleep schedule, waking and going to sleep at the same time daily, including the weekends.
  • Practice a relaxing bedtime ritual.
  • Avoid naps, especially in the afternoon.
  • Exercise daily.
  • Evaluate your sleep space – avoid noises, distractions, and lighted areas in your bedroom.
  • Ensure you have the proper mattress and pillows for your sleep.

For more sleep tools, visit the National Sleep Foundation Sleep Tools website, here.

If you think your sleeping habits are a contributing factor to your pain, talk with your physical therapist about ways to improve your sleep, and/or available resources in your area.

Resources:

http://www.cdc.gov/features/dssleep/

Finan, P. H., Goodin, B. R., & Smith, M. T. (2013). The association of sleep and pain: an update and a path forward. The Journal of Pain, 14(12), 1539-1552.

Edwards, R. R., Almeida, D. M., Klick, B., Haythornthwaite, J. A., & Smith, M. T. (2008). Duration of sleep contributes to next-day pain report in the general population. PAIN®, 137(1), 202-207.Moldofsky, H. (2001). Sleep and pain. Sleep medicine reviews, 5(5), 385-396.

Schuh-Hofer, S., Wodarski, R., Pfau, D. B., Caspani, O., Magerl, W., Kennedy, J. D., & Treede, R. D. (2013). One night of total sleep deprivation promotes a state of generalized hyperalgesia: a surrogate pain model to study the relationship of insomnia and pain. PAIN®, 154(9), 1613-1621

https://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips