Why Sleep Is Important When You Have Chronic Back Pain
The inability to get a good night's sleep hurts -- literally. Chronic back pain prevents you from getting a good night's sleep. You wake up hurting even more.
Pain interferes with the normal cycles of light and deep sleep you need in order to wake up refreshed. The disruption is called "alpha delta sleep disorder." When back pain prevents you from getting adequate deep, or delta, sleep, you awaken in the morning tired and hurting.
Causes of Sleep Problems
Of course, the chronic back pain itself may cause a sleep problem. Here are some other causes:
Anxiety and depression can result in the inability to fall asleep or stay asleep which will aggravate pain. Anxiety and depression increase a person’s sensitivity and awareness of pain and the lack of proper sleep only serves to aggravate both the pain and any depression with anxiety.
Breathing-related sleep disorders associated with obesity -- such as obstructive sleep apnea -- can further aggravate pain by causing you to wake frequently throughout the night and interfering with normal sleep patterns.
Limb movement disorders -- such as restless leg syndrome -- may further disrupt the normal sleep pattern. These conditions may be related to anxiety and depression as well as stress.
Self-medicating with alcohol may help you fall asleep, but you'll probably wake up tired, cranky, and hurting.
Some prescription medications can impair the quality of your sleep.
Medications That Improve Sleep and Reduce Chronic Back Pain
Some medications can help you get sleep while helping with your chronic back pain.However, some of these drugs have side effects and the potential for addiction. They should be used as part of a more comprehensive and widespread program of pain management.
Newer sedatives, including zolpidem tartrate ( Ambien) do not have a negative effect on your sleep.
Over-the-counter pain relievers, such as aspirin, acetaminophen ( Tylenol or Tylenol PM), or ibuprofen ( Aleve or Motrin), can be effective for short-term use. Use them only as directed and let your doctor know what you are taking.
Prescription drugs for severe back pain include antidepressants, such as doxepin ( Sinequan), or a combination antidepressant and pain reliever, such as amitriptylene ( Elavil), or a muscle relaxant, such as cyclobenzepine HCL (Flexoril).
Medication should not be used longer than two to three months except in rare cases. Long-term use can result in dependence on the drug. The goal of medication should be to help you develop a more normal sleep pattern.
Lifestyle Changes for Chronic Back Pain and Sleep Problems
Here are some tips for getting a good night's sleep with chronic back pain:
Avoid stress. Stress is the major cause of insomnia. It is also associated with chronic back pain.
Limit or eliminate caffeine. Even moderate caffeine use can cause insomnia and sleep disturbances.
Avoid eating heavily before bedtime. A heavy meal can cause acid reflux ( heartburn) and keep you awake. And although there are no studies to show that warm milk can induce sleep, go ahead and have a glass if it comforts you. The placebo effect can be very powerful.
Don't self-medicate with alcohol. It's worth restating that alcohol impairs the quality of sleep.
Do some soothing exercises. Do these three exercises for several minutes while lying in bed unless it hurts to do them:
- Bring both knees toward your chest (as if doing a cannonball).
- Alternate bringing first one knee, then the other, toward your chest (as if doing a jackknife).
- Bring both knees to your chest and twist from one side to the other.
Choose a comfortable mattress and pillow. You don't have to spend thousands of dollars on a mattress. Studies show that a medium-firm mattress is best for most people. The key is to use whatever is comfortable for you. If your mattress is too firm, you can add an egg crate mattress pad. Pillows come in all shapes and sizes. Find the one that's right for you.
Sleep in a comfortable position. Do not sleep on your stomach, as it causes you to arch your back, and bending backwards often worsens chronic back pain. To break the habit, wear a sleep shirt with a pocket in front and put a tennis ball in it. For most people, the best position is to lie on your side in a fetal position with a pillow between your legs. If you prefer to lie on your back, put a pillow under your knees.
Establish a bedtime routine. Try to go to bed at the same time each night. Follow a routine, such as setting the alarm, putting on your pajamas, and brushing your teeth, etc. Do not read, work, or watch TV in bed.
Get Rid of Chronic Back Pain
While the best way to get a good night's sleep is to get rid of chronic back pain, this is not always possible. Other factors such as stress, anxiety, and depression that affect sleep and pain may need attention and treatment. Many people put up with pain, when in fact most back pain can be helped and treated successfully -- usually without surgery. Don't give up on finding a treatment that can work for you.
(webmd medical reference)