Pain often causes sleep problems. Sleep problems occur in over 50 percent of patients with chronic pain. Sleep disruption can worsen pain and affect your whole life. Patients will often feel rundown, tired, depressed and very stressed. Relationships with your family, your spouse, and at work may be affected. Solving sleep problems is complex and may take significant time.

Sleep problems can be divided into 4 categories:

• Difficulty falling asleep
• Troubles staying asleep
• Inability to achieve deep restorative sleep
• Waking up and being unable to fall back asleep

Each type of problem may need a different solution. A person with chronic pain may have multiple problems with their sleep cycle.

Sleep Hygiene

Good sleep hygiene is the most important initial treatment of sleep problems. Activities that cause problems prior to sleeping include drinking caffeinated beverages and alcohol. Alcohol may initially cause tiredness, but later in the night it often disrupts sleep cycles. Another activity you should avoid before bed is exercise. Physical activity can stimulate the body and keep you awake. The bedroom should be considered a place for sleeping and not for watching TV or doing work related activities. The bedroom should be considered a calming and relaxing place. Other helpful habits include trying to wake up at the same time each day and if awake in the middle of night, don’t spent significant time lying in bed but get up and do another activity until tired again.

When simple tweaks and conservative treatment does not help improve sleep, working with your physician for a more comprehensive treatment strategy is beneficial. A sleep study is often especially helpful in determining the issues preventing good sleep. Sleep studies are also helpful in planning a treatment strategy to solve all related problems.

Multiple medications are available to help with sleep, but many can actually interfere with parts of this sleep cycle. Narcotic medications and other antidepressants may help with pain at night but often interfere with portions of the deep sleep cycle. Newer medications like Ambien and Lunesta are helpful in allowing the patient to fall asleep, but may not be helpful in keeping a person asleep. Recently, melatonin at doses of 5-10 mg has been found to be helpful in maintaining good sleep cycles and reducing pain.

Chronic pain often interferes with sleep, which can lead to worsening pain. Improving your sleep cycle can often greatly improve the quality of life. Sleep problems can be simple, but often with chronic pain they are complex. The solution to a good night sleep may require multiple changes and routines, but with the help of a pain specialist and a sleep expert, relief can be found.