The Link Between Nighttime Sleep and Daytime Pain

Patients who live with daily, chronic pain often report sleep disturbances. In this study, researchers from Johns Hopkins School of Medicine look at the relationship between nighttime sleep and daytime pain.

The study was done by telephone survey asking questions about daily pain, symptoms, and sleep periods. General health and body mass index were also measured. The data was used to assess daily pain as a function of the number of hours slept the night before.

Most of the patients reported sleeping between six and nine hours each night. Pain levels increased when the number of hours of sleep was less than six or more than nine. Pain levels predicted sleep and sleep effected pain the next day.

These findings may seem self-evident. But this is the first study to look at the day-to-day relationship between sleep and pain. The study also showed that younger patients with a higher BMI had higher levels of daily pain. So did patients with other chronic conditions or emotional disorders. Patients taking prescription drugs were also more likely to report higher daily pain ratings.

Some may wonder which came first? The pain causing poor sleep or poor sleep raising pain levels. The authors analyzed the data just to answer this question. They found that both pathways are important. But current sleep and next day pain levels had the greater significance.

There are several ways this information can be used. First, doctors may be able to use sleep patterns to predict who will have a good or poor outcomes after treatment for chronic pain syndromes. Second, finding ways to improve a person's sleep may help relieve the pain.

And third, physicians may want to look at a patient's report of increased pain more carefully. It could be nothing more than a poor night's sleep. Thinking the condition is getting worse and ordering more and expensive tests may not be the best answer.

We still don't know the specific mechanisms behind poor sleep and increased pain. More studies are needed to find the links between these two things. For the moment it seems important to ask each chronic pain patient a little bit about sleep patterns and work toward improving sleep.

Robert R. Edwards, et al. Duration of Sleep Contributes to Next-Day Pain Report in the General Population. In Pain. June 2008. Vol. 137. No. 1. Pp. 202-207.

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