There is an unquestionable link between sleep and pain, but emerging evidence suggests that the effect of sleep on pain may be even stronger than the effect of pain on sleep.
"Researchers have found that short sleep times, fragmented sleep, and poor sleep quality often causes heightened sensitivity to pain". – Sleep Foundation
For individuals managing chronic pain, a peaceful night's sleep can often feel like an elusive goal. Pain management clinics, occupational therapists, physiotherapists, and carers play a crucial role in supporting these individuals. In this blog, we'll delve into the intricate relationship between chronic pain and sleep and provide practical guidance for professionals and carers. We'll also explore how pressure care and pressure mapping can help identify problem areas and prevent future issues. Plus, we'll see how adjustable beds and mattresses can make a significant difference in improving sleep for chronic pain patients.
Understanding Chronic Pain and Sleep:
Chronic pain patients often struggle to find restful sleep due to an overactive nervous system. This increased neural activity can hinder their ability to both fall asleep and remain in a deep sleep. It's essential to recognise that healthy sleep doesn't follow a uniform pattern; it occurs in waves throughout the night.
Sleep comprises various stages, including lighter phases (1 and 2), deeper stages (3 and 4), and REM (rapid eye movement) sleep for dreaming. Sleep comes in waves, with more time spent in deep sleep early in the night and more time in lighter stages toward morning. Waking up multiple times during the night is common, but chronic pain can disrupt this cycle.
Common Sleep Disturbances in Chronic Pain:
The nature of pain and its impact on sleep can vary. Pain conditions may flare at night or be exacerbated by specific sleeping positions, leading to frequent nighttime awakenings. Disruptions in the sleep cycle can result in less restful sleep and increased daytime fatigue.
Chronic pain sufferers may also experience sleep disorders, such as sleep apnea or restless legs syndrome, which compound sleep disturbances. Medications for pain or chronic illnesses can have side effects affecting sleep. Furthermore, the relationship between sleep and pain is bidirectional.
The Connection Between Sleep, Pain, and Mental Health:
Quality of sleep can significantly influence pain perception in chronic pain patients. Poor sleep quality, short sleep duration, and fragmented sleep can increase pain sensitivity and worsen chronic pain conditions. This complex relationship extends to neurotransmitters like melatonin, vitamin D, and dopamine.
Depression often coexists with chronic pain, resulting in increased pain levels and sleep difficulties. Catastrophising, a cognitive factor that amplifies pain perception, can further complicate the relationship between pain, sleep, and mental health.
Practical Strategies for Better Sleep:
- Retraining the Brain: Encourage deep breathing, mindfulness, or guided imagery to help patients relax and redirect their focus from pain.
- Sleep Hygiene: Educate patients on good sleep habits, such as getting adequate sunlight, early exercise, and a healthy diet. Emphasise avoiding stimulants before bedtime and establishing a calming bedtime routine.
- Sanctity of the Bedroom: Stress the importance of using the bedroom solely for sleep and intimacy, maintaining optimal sleep conditions and adhering to a consistent sleep schedule.
- Active Wakefulness: Advise patients not to stay in bed when unable to sleep or experiencing pain. Suggest getting up, moving to another room, and engaging in a relaxing activity until sleepiness returns.
- Professional Guidance: Encourage patients to consult professionals, like occupational therapists or physiotherapists, who can provide additional therapies and guidance to improve sleep quality.
The Role of Adjustable Beds and Mattresses:
One critical element that can significantly improve sleep quality for chronic pain patients is the use of adjustable beds and specially designed mattresses. These beds allow for personalised positioning, making it easier for individuals to find the most comfortable sleep posture and reduce pressure on specific body areas like the lower back. Additionally, elevating the upper body helps to make breathing easier, and elevating the legs reduces swelling in the feet and ankles. If a patient’s mobility is impacted by pain, functions like Hi-Lo can be utilised to assist with getting in and out of bed, reducing strain and the need for potentially painful movements.
Suitable mattresses for pain management should offer pressure relief, working to distribute body weight evenly, reducing pressure on specific areas and helping to prevent pressure sores. They should also feature a fast recovery sleep surface that springs back to shape, to ensure easy movement across the mattress, minimising disturbances during the night. To aid with transfers, a strong edge support system will maintain a safe and stable position when sitting on the edge of the bed. Other factors can contribute to disturbed sleep like overheating in bed, so a mattress that’s designed with open-cell structures which promote breathability is recommended.
Incorporating Pressure Care and Mapping:
For chronic pain patients, the risks associated with poor sleep are compounded by the potential development of pressure sores. This is where services like pressure care and pressure mapping, offered through Home Care and covered by NDIS, become invaluable.
Pressure mapping technology helps identify areas at risk of pressure sores by assessing pressure distribution. By integrating pressure care strategies into the care plan, professionals and carers can ensure that these problem areas receive the necessary attention and support. Life Changing Beds utilises the mobile pressure diagnostics tool, ‘Reveal Compare’ by XSensor, exclusive to Life Changing Beds in Australia. This tool can be used in the showroom for new mattresses to test their viability or brought to client’s homes to pressure map existing sleep surfaces.
In conclusion, sleep plays a pivotal role in the well-being of chronic pain patients, and professionals and carers have a shared responsibility in addressing sleep-related issues. By using the insights provided here, incorporating pressure care and mapping, and considering adjustable beds and mattresses, we can make significant strides in enhancing the sleep quality and overall quality of life for those living with chronic pain.