Living with chronic pain also means that you are trying to sleep with chronic pain too. You toss and turn all night just to try to find a less-painful, rarely comfortable, position to sleep in. Do you ever wonder how this lack of sleep is affecting your pain intensity? The latest research shows that poor sleep quality has a remarkable effect on pain.
Researchers at Johns Hopkins University studied people who have recently had a total knee replacement surgery and discovered that poor sleep was associated with poor outcomes after surgery. Both pre- and post-operative sleep quality seems to affect both pain and range of motion. Or is it just the reverse that is true? The fact that some people are doing well might be the reason they are sleeping well too. However, looking at how sleep impacts pain, another researcher has suggested that people that are not sleeping well are more likely to experience increasing amounts of pain because of central sensitization. So maybe there really is a mechanism that causes sleep quality to affect pain intensity. (1) (2)
Central sensitization is certainly a powerful pain amplifier because the body’s alarm system that signals pain becomes more and more sensitive to the point that everything hurts. Additionally, it is fairly well known that sleep quality also affects mood and emotions. People that have been deprived of sleep are more irritable, moody, and anxious. This deteriorating mental health can contribute to worsening physical health and chronic pain.
But once a person starts sleeping better, the process does tend to reverse. The nervous system becomes less sensitive. The person becomes less irritable. And the pain experience does not seem as bad. Because sleep has such a therapeutic value for the treatment of chronic pain, sleep quality should not be ignored. In fact, Dr. Campbell of Johns Hopkins University stated in her interview with Pain News that “anyone who has poor sleep three days per week for more than a month or two should seek professional help, because it might actually have implications for improving their pain”.
Next time you see your doctor, start the discussion about your sleep quality because it is just as important if not more important than your pain score. If you were to start getting better sleep, you will likely start seeing those pain scores go down over time.
Campbell, CM; et al; Sleep, Pain Catastrophizing, and Central Sensitization in Knee Osteoarthritis Patients with and without Insomnia; Arthritis Care and Research; October 2015: 67(10): 1387-1396
Gong, L; et al; Sleep Quality Effects Recovery After Total Knee Arthroplasty; The Journal of Arthroplasty; February 2015; pii: S0883-5403(15)00131-X