Neuropathy And Lack Of Sleep

Today's post from chronicpainandyou.com (see link below) takes a look at the influence of chronic pain on sleep quality. To long-suffering neuropathy sufferers, broken sleep patterns are a no-brainer - of course they stem from the pain and discomfort. However, this article asks the chicken and egg question as to whether pain disrupts sleep, or sleep problems make the pain worse but sensibly concludes that pain is the root of lack of sleep, when the two are concurrent. It's important to mention here that sleep apnoea is often linked to neuropathy and vice versa but sleep apnoea is a distinct condition on its own and can be caused by a number of reasons outside nerve damage. The article also offers some tips for improving your night rest and as such is worth a read.

Sleep and chronic pain news
May 25, 2015 by Kerima

Sleep impairments are a stronger and more reliable predictor of pain than pain is of sleep impairments.

Insomnia is an important topic for pain management and I found three good sources today. Check out the info graphic below and read on for tips and helpful info.
Pain and sleep: a preventable cycle

“When pain becomes a problem, it can be a vicious cycle. If someone experiences poor sleep due to pain one night, he or she is likely to experience more problems the next night and so on. It gets worse and worse every night.

Also we know that pain triggers poor sleep. For instance, someone experiencing lower back pain may experience several intense microarousals (a change in the sleep state to a lighter stage of sleep) per each hour of sleep, which lead to awakenings… Pain is a serious intrusion to sleep. Pain is frequently associated with insomnia and these coexisting problems can be difficult to treat. One problem can exacerbate the other.”

“Those with acute or chronic pain are more likely to have sleep problems impact their daily lives. Among people who’ve had sleep difficulties in the past week, more than half of those with chronic pain say those difficulties interfered with their work. That drops to 23 percent of those without pain. People with pain are also far more apt than others to report that lack of sleep interferes with their mood, activities, relationships and enjoyment of life overall.

People with pain also feel less control over their sleep, worry more about lack of sleep affecting their health and exhibit greater sleep sensitivity. They’re more likely than others to say environmental factors make it more difficult for them to get a good night’s sleep. These factors include noise, light, temperature and their mattresses alike, suggesting that taking greater care of the bedroom environment may be particularly helpful to pain sufferers.

While both chronic and acute pain relate to lost sleep, the survey indicates that chronic pain is an especially powerful problem. Indeed, nearly one in four people with chronic pain, 23 percent, say they’ve been diagnosed with a sleep disorder by a doctor, compared with just 6 percent of all others..”

Both quotes are from the National Sleep Foundation.




The good news is… people with chronic pain who said they were motivated to make sure they had enough time for sleep, and who had a bedtime routine did sleep more.” 

Sleep, pain and exercise

“ Sleep deprivation causes various physiologic and behavioral changes in the body. It has been shown that total sleep deprivation (2013) or sleep deprivation of a specific stage of sleep … cause hyperalgesia (exaggerated sensitivity to pain). In addition, people who sleep less than 6 hours or more than 9 hours seem to have increased frequency of self-reported pain” “A recent review … (2013) points to the fact that sleep impairments are a stronger and more reliable predictor of pain than pain is of sleep impairments.” “Physical exercise is able to improve sleep patterns in healthy individuals… Particularly in insomnia patients, regular exercise leads to benefits over time, being comparable to pharmacotherapy and behavior therapy (2015). Pilates, for example, improves muscle flexibility and strength and also improves life quality and has been shown to be able to improve sleep quality” Yoga and other exercise was also mentioned in this article by Marcele Siegler, physiotherapist, and her colleagues.
Research and tips for better sleep

Finally a few notes from an interview with my favorite sleep specialist Gregg Jacobson on Huffington Post. Read my review of his book here. The information below has helped me normalize and not feel upset about night-time awakening, and has probably prevented me from having insomnia.

According to Jaboson,”prior to … (night-time lighting), humans likely went to sleep soon after dusk and awakened at dawn in longer sleep periods that consisted of alternating bouts of sleep and wakefulness. This non-continuous sleep pattern is characteristic of virtually all mammals and is also the pattern we experience early and late in life. It is only in adult life, and the last 350 years of human history, that a more consolidated nocturnal sleep pattern is apparent. However, many adults still experience polyphasic sleep in the form of insomnia, and regular intervals of waking are still experienced in normal sleepers today, as evidenced by six to 12 brief awakenings per night (which most of us don’t recall, for they are too short). Evidently, this polyphasic sleep pattern lies dormant in our physiology, met an evolutionary need, and therefore may be adaptive rather than a sleep disorder.”

Jacobson has found that CBT cognitive-behavioral interventions can work as well or better than sleeping pills. Here are some of his suggestions.

Minimise:
Negative, distorted thoughts and beliefs about insomnia such as “I must get eight hours of sleep” or “I did not sleep a wink last night.”
Going to bed too early or sleeping too late and spending excessive time in bed.
Irregular arising times.
Trying to control sleep rather than letting it happen.
Lying awake in bed, frustrated and tense.
Using the bed and bedroom for activities other than sleep.
Use of electronic devices before bedtime.

You can find more information and an affordable online course (pdf and guided relaxations –I have not tried it, but I found the book the best on the market) at Gregg Jacob’s website.

http://www.chronicpainandyou.com/?p=1945