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When Pain and Insomnia Conflict: How to Manage 'Insomnia'

August. August 8, 2022 – El-Ad Eliovson, 56, from Bergen County, NJ, wakes up multiple times a night with severe back and neck pain from multiple herniated discs.

According to a recent report from the Sleep Foundation, Eliovson is not alone. The report, based on an online survey of 1,250 U.S. adults, found that “insomnia” (insomnia caused by chronic pain) kept many counting sheep all night.

In fact, nearly 95% of respondents slept at least 1 hour for pain in the past week, and 85 slept at least 2 hours per night. More than half (57%) of respondents with regular pain woke up at least 3 times during the night.

Respondents who reported pain slept about 6.7 hours per night on average, which was less than the 7 to 9 hours recommended by the National Sleep Foundation.

“Pain certainly aggravates insomnia and disrupts sleep; but lack of sleep in turn increases people’s levels of distress,” Menlo Park, founder of Psychiatry and Sleep Medicine and said Alex Dimitriu, MD, a member of the Medical Review Board.

Back pain is most common

According to a 2018 CDC report, an estimated one in five U.S. adults (50 million people) suffer from chronic pain, with more than 7% saying they suffer from “high-impact chronic pain” that limits life or work activities.

The CDC found that people deal with a variety of pain – most commonly back pain, followed by lower extremity pain, upper extremity pain, headache or migraine, or abdominal, pelvic, genital , tooth or jaw pain.

Given that back pain is the most common, it’s no surprise that the Sleep Foundation’s survey found it to be the pain most likely to wake people up. Of all those who said pain disrupted sleep, 57% said it was because of back pain, 41% said it was neck pain, and 32% said they had headaches.

Severe pain can wreak havoc on sleep. One in five respondents said they slept 2 hours less in the past week, and more than 17% said they slept more than 10 hours less.

Eliovson’s pain is in the high impact category, preventing him from working or performing many daily tasks. “Can’t describe how unbearable my pain was and how it disrupted my sleep,” he said. “And not sleeping well can make an already difficult situation worse.”

But, Dimitriu says, pain doesn’t have to be severe to disrupt sleep. Even mild pain can make it difficult for you to fall asleep or stay asleep, and when you experience pain, sleep quality may be compromised.

Pain may exacerbate sleep disturbance

People with insomnia are often diagnosed with sleep disorders. Of those whose sleep was interrupted by pain at least 1 night per week, about one-third (32.7%) were diagnosed with insomnia, nearly one-quarter (23.8%) said they were diagnosed with sleep apnea, and one-fifth One (21%) said they had been diagnosed with restless legs syndrome.

Eliovson has been diagnosed with sleep apnea, a condition that causes people to stop and start breathing multiple times at night.

Being overweight is a risk factor for sleep apnea. “Because of my disability, I couldn’t exercise; because of my inactivity, I gained weight and developed sleep apnea,” Eliovson said. “I’ve never slept, and I haven’t dreamed for more than a year.”

When he was diagnosed with sleep apnea, he received a continuous positive airway pressure (CPAP) device that was pumped from a machine through a hose and a face mask out pressurized air.

“I slept 10 hours straight, 3 days straight after taking CPAP,” recalls Eliovson. “It’s like my body is drinking sleep. I’m dreaming again.”

The Sleep Foundation encourages people with sleep disorders to consult their healthcare professional and get treatment . Dimitriu says that treating sleep disorders not only helps improve sleep quality, it may actually help relieve pain. “Optimizing sleep can actually improve nighttime and daytime pain by improving sleep quality,” he said.

can do what?

Any pain reliever, from medication to physical therapy and even meditation, “has the potential to improve sleep,” Dimitriu said. He noted that certain prescription drugs, such as opioids and gabapentin, should be used with caution because they can “depress respiratory drive.”

Sleep Foundation survey finds that more than half of respondents (55%) have sought a healthcare professional for insomnia people’s care. Most people take some kind of medication for pain relief, prescription (59%), over-the-counter (54%) or both.

A large number of respondents (56%) ) have also tried sleep aids in the past month, with melatonin a popular choice, 49% of respondents have been used.

Eliovson took a range of prescription medications, some long-acting (at bedtime) and some at night as needed for breakthrough pain. But he also uses other methods because “sometimes, the drug just isn’t enough,” he said.

He tried to get the most comfortable mattress possible, but that never worked because “the mattress turned out to be a piece of junk”. On the other hand, he bought a good pillow after “buying a lot” which was “critical” to helping him sleep.

Eliovson found heat compresses and lidocaine patches and topical ointments containing arnica, cannabidiol (CBD) and other herbal blends to help. He received a prescription from a healthcare provider for medicinal marijuana, which helps with pain relief and sleep.

Although studies have shown that physical therapy and acupuncture can help people with pain and insomnia, Eliovson has not found this Happening. He did try self-hypnosis and guided visualization (both recommended by the Sleep Foundation), which “helped somewhat, but not enough.”

Some studies also support the use of yoga for certain types of pain and insomnia. Eliovson said certain yoga stretches he learned from physical therapy helped ease some of his pain, which in turn improved his sleep.

meaning and Connection

The Sleep Foundation survey found that nearly one in five respondents turned to pain-related support groups, and of those who did, 91% found they helped them manage, understand, or improve their sleep. Respondents found these groups through online searches or referrals from family, friends or healthcare professionals.

Eliofson, if able, conducts religious studies with others and volunteers to help his rabbis with writing assignments. “It takes A difficult situation and making it meaningful.”



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