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The link between sleep and chronic pain

Updated: Jan 12

The Journal of Practical Pain Management recently published their findings on the link between sleep and chronic pain.

Sleep is already one of our most ignored determinants of health. In fact, humans are the only mammals that intentionally neglect sleep. We are not always the smartest of the animal kingdom...

Jonathan Elliott, PhD, came right out and said,

poor sleep is a known risk factor for chronic pain, and there is general consensus about this relationship in both the clinical and scientific community

But what is that connection exactly?

Researchers found hyperactivity in nerves of the central nervous system during wakefulness and during nonrapid eye movement (NREM) sleep, but not during rapid eye movement (REM) sleep. This hyperactivity is actually occurring away from the site of injury which furthers the mind-body connection to chronic pain!

Furthermore, this hyperactivity was found to be more pronounced during NREM sleep than during periods of quiet wakefulness! Did you catch what that implies? Getting poor sleep is detrimental to chronic pain sufferers!

Even scarier, is that this hyperactivation of nerves gets worse as time goes on and treatments neglect the causes of chronic pain. A hyperactive nerve is not a cause of pain, so why are nerves hyperactive to begin with? That's a question that can only be answered on an individual basis.

Hyperactivity was also noted in the anterior nucleus basalis (aNB) of the basal forebrain during NREM sleep. This is an area of the brain is rich in acetylcholine which is an excitatory neurotransmitter. This is how your pain feels worse despite there not being any more physical damage!

What does this mean for you?

Getting not only enough sleep but enough good quality sleep is hard to come by these days. Even if our busy lives allow for enough sleep we still stigmatize sleeping as being lazy. You hear people all the time state how little sleep they got last night almost as if they are bragging about it. But even if you prioritize getting enough sleep at night is it good quality sleep? There are 4 stages of sleep, with REM sleep being the most beneficial. This is the period of the night where you get the deepest sleep and the most benefits from it. This is where dreams occur most vividly and the more you remember your dreams the deeper into REM sleep you got. As stated above, REM sleep is when hyperactive nerves calm and pain diminishes.

But REM sleep is not guaranteed just because you got your 8 hours. Humans should be getting 7-9 hours of sleep a night but an emphasis needs to be put on getting the highest quality sleep possible because poor quality sleep actually makes pain worse. Supplementing melatonin isn't going to get you here either. In order to get good quality sleep a few basics must be met:

  1. You have to prioritize sleep

  2. You have to go to bed at the same time every night and wake at the same time every morning

  3. You must live more in accordance with the Earth's circadian rhythm (light-dark cycle)

These are just the basics. A highly trained chronic pain specialist will be able to help you achieve good quality sleep as part of your treatment plan.

Sleep is actually a major component of the learning and memory areas of your brain. During the day we learn things but it is is very fragmented. Like the individual frames of a video. When we sleep, we replay our day in our minds over and over and actually stitch those frames together to make sense of them, to make a fluid video. During poor sleep the learning and memory areas of your brain put focus on the pain you experienced that day. This is how pain actually becomes a learned memory. Because of this, when your body starts to heal, your pain remains, if not intensifies because it is an actual memory! The mind-body connection to pain can be one of the largest drivers of your pain. Is your doctor addressing it?

Making good quality sleep a priority is a must. You can either have good quality sleep and all of the benefits of it, or you can have poor quality sleep and all the consequences of it. It is simple, it is free, and it is a crucial step to getting out of chronic pain.

Learn more about the chronic pain - sleep connection and how to improve your sleep by clicking the link below!

You can read the full article here

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