Sleep is an integral part of our lives. Not only does it help to balance our mood but it is necessary to feel refreshed and ready for the new day. Good sleep acts as a buffer to the days stressors. Without it we are left feeling tired, moody and unable to cope with the stress that the new day brings. Quality sleep is vital for our general health.
Insomnia is defined as the inability to obtain sufficient sleep; difficulty in falling or staying asleep; sleeplessness. Sleep must also be restorative. Some people are naturally short sleepers and require less sleep than the general population ie 4-6 hours. While other people are naturally long sleepers and require more than 8 hours of sleep in order to wake up feeling refreshed.
Pain interferes with our ability to get a good nights rest. It can either cause trouble falling asleep (initial insomnia) or it can interfere with our ability to stay asleep (middle insomnia) or a mixture of both which results in sleep being non-restorative. Chronic pain can interfere further by decreasing both slow wave and REM sleep.
The relationship between sleep and pain occurs in both directions. Poor sleep influences our perception of pain and severe pain worsens the quality of our sleep.
People who have a range of sleep disorders from obstructive sleep apnoea to Willis-Ekbom disease (previously known as Restless Legs Syndrome) experience increased pain. In fact, up to one fifth of people with Willis- Ekbom disease complain of chronic pain.
The quality of a person’s sleep has been shown to be a strong predictor of pain the next day. The poorer the quality of sleep, the worse the person’s pain will be the next day.
Insufficient sleep, in both quality and quantity, has been shown to be predictive of pain three years into the future. In other words, chronic insomnia now can lead to pain in three years time.
Treating insomnia has been proven to improve the experience of pain.
Getting good quality sleep not only can prevent pain in the long term but it plays an important role in pain management. Restorative sleep helps in tolerating pain better and in so doing helps to improve the quality of life of the person who is living with chronic pain.
If you are experiencing sleep problems, a full sleep history will be obtained by the psychiatrist. Where necessary, you will be referred for a polysomnogram. A polysomnogram gives information such as time spent sleeping, time spent in the different stages of sleep, frequency of wakenings as well as the presence of Obstructive Sleep Apnoea, Upper Airway Resistance Syndrome and Periodic Limb Movement Disorder.
Depending on the cause of your insomnia or sleep problem, you will be prescribed the necessary treatment for this as well as being given advise on how to improve the quality of your sleep.