The difficulty in sleeping is a common source of frustration that I often hear from patients. While pain often causes insomnia, studies suggest that the opposite may also be true: Fewer Sleep means feeling not better and more pain. In fact, some researchers now believe that a good night’s sleep can serve as a powerful painkiller.
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It seems that there is a correlation between how well we sleep on a given night and how sensitive we are to feel pain the next day. Consider a Norwegian study that found insomniacs were more likely to take their hands out of a bucket of ice water before those without sleep problems, suggesting greater sensitivity to pain. The less they slept, the faster their hands were removed. The most surprising finding was that those who had insomnia and chronic pain were more than twice as likely to remove their hands from cold water ahead of time.
Studies have also shown that lack of sleep can cause significant changes in pain thresholds, and even suggest that the same stimulus can be painful for a person with a lack of sleep, but not for someone who had a good night’s rest. A recent study by Mariana observed the brain activity of sleep deprived participants who experienced pain to learn more about the connection between sleep and pain, and they found some interesting findings. They saw an increase in activity in an area of the brain known as the somatosensory cortex, where sensations are processed throughout the body and pain sensitivity can be increased. But they also found that lack of sleep alters the natural circuits to relieve the pain found in the reward pathways and in the feedback loops, which depend on dopamine, our neurotransmitter to feel good.
Fatigue during the day, that feeling of slowness and little energy that comes the day after a bad night’s sleep, can also cause a greater sensitivity to pain. The Harvard researchers looked at pain sensitivity in sleep deprived mice and found that they could improve the pain of mice by increasing their daytime alertness by providing caffeine. In fact, the study authors reported that doing it worked better than giving mice morphine.
It’s good to know that better sleep can help reduce pain, but what happens if the pain is preventing you from falling asleep in the first place? and the best way to remedy them. A movement specialist, such as a physiotherapist, can sometimes help with sleep position or work on parts of the body that seem to be most active when they try to sleep. For example, padding around an elbow or wrist can relieve pressure points if the nerves in that area are prone to irritate when lying down. We also talk about habits that increase the chances of sleep, such as avoiding caffeine after noon and dimming or turning off the lights one hour before bedtime.
My behavioral health team is also well versed in cognitive behavioral therapy (CBT) for sleep. CBT is a form of talk therapy that involves working with a trained therapist to focus on the thoughts and behaviors that interfere with the dream and then develop strategies to eliminate them. Research suggests that CBT may be a more effective tool than any other form of treatment for sleep disorders. Although CBT treatment can not directly eliminate underlying pain, studies show that it can still help improve sleep patterns, even with chronic pain.
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