Insomnia and Chronic Pain ~ Wicked Bedfellows

Many in Chronic Pain have tremendous difficulty sleeping…

And as we know, it’s a chicken-and-egg dilemma. Without proper rest it becomes significantly more difficult to manage one’s pain, in fact, research shows lack of proper sleep actually increases our pain, in as little as 3 days. Pain, with its hyperarousal and hypervigilant body and mind states, can make sleep extraordinarily challenging.

In addition, certain medications and the health issues that can accompany chronic pain (depression, PTSD) can also lead to issues with insomnia (defined as difficulty getting to, maintaining, or achieving quality deep sleep)…

The answers research have revealed are three-fold…

Begin with basic good sleep habits:

1. Be mindful of caffeine and alcohol intake, both of which can seriously impact sleep    2. Keep a regular sleep schedule, going to bed and waking at regular times      3. Ideally, we should only use our beds for sleeping and for making love      4. If you’re still awake after 30 minutes, get up and do a quiet activity like reading           5. Exercise early in the day-avoid exercising close to bed time     6. Follow a bed time routine that includes staying away from electronics and keep your bedroom dark and quiet

However, worth noting are Dr. Derup’s, with the Cleveland Clinic, cautionary words,

“This quiet environment can cause problems for people with chronic pain,” he says, “because then the only thing left for the person to focus on is the experience of his or her pain.” The sensation and experience then, without distractions, becomes all consuming. It starts the vicious mental dialogue that is the hallmark of insomnia- All the worries, catastrophizing and rumination that in the daylight can lie dormant; turn out the lights and yes, the monster in the closet does indeed reveal itself.

The second approach is using natural therapeutic methods. There are two that have proven to be effective for those with the co-morbidity of chronic pain and insomnia. The first is Cognitive Behavioral Therapy (CBT) which teaches you to recognize unhealthy thought patterns and to re-direct your thoughts, through such techniques as body scans and mindfulness practices. The term cognitive refers to the mind and in CBT you learn to replace negative, unhelpful mental habits, such as rumination, with more constructive, healthy ones and the behavioral aspect includes practicing good sleep habits (see above). The other therapeutic method for addressing insomnia is referred to as Sleep Restriction Therapy (SBT), and as the name implies, is based upon limiting the amount you sleep in the hopes of causing, by going without sleep, the body to re-set and sleep more deeply. PS-no napping allowed with SBT. Darn it!

Finally, medications can help with insomnia; keep in mind here the powerful connection between pain and sleep. Getting regular, sound sleep is crucial to help you deal with the toll on your mind and body due to living with constant pain. Why add any additional burden, especially if there’s a solution?

With all medications be sure to check with your Doctor! There are various natural things to try- like Melatonin and Magnesium. Prescription medications include some types of anti-depressants, anxiety medications (examples being Valium and Xanax) and actual sleeping medications, like Ambien and Lunesta. Sleeping medications can be quite powerful and should be used with great care however for many they represent the final refuge from insomnia, and importantly, they can be used simply in the short-term, to get you over-the-hump and a blessed sound night’s rest.

Author: ChronicPainDailyReflections

I manage a web-site, Chronic Pain Daily, created for and in support of those living in chronic pain. The site helps with the day-to-day spiritual, mental, emotional and physical needs of those with constant pain, whatever its source.