The importance of a good sleep in relationship with the pain

It is estimated that several chronic pain conditions are related with poor sleep.

Epidemiological studies indicate that poor sleep quality is a risk factor for the development of chronic widespread pain among an otherwise healthy population, further supporting the hypothesis that sleep dysfunction is a pathogenic stimulus of fibromyalgia.

Sleep quality is a prognostic factor in patients with neck and/or back pain.

It is estimated that 64% of people with non-specific low back pain have sleep disturbances.

It means that a good quality of sleep will predict better outcomes in terms of pain and disability.

What is the relationship between pain and sleep?

Who experiences impaired sleep with daytime consequences, usually has poor outcome from the treatment received.

Sleep deprivation has been found to increase pain experience, also several longitudinal studies convincingly demonstrate that insomnia symptoms significantly increase the risk of developing future chronic pain disorders in previously pain-free individuals.

These studies also found that a poor night’s sleep was related to greater next day negative affect, and pain catastrophizing, as well as lower positive affect.

Thus, a person with low back pain following a night of poor sleep may be expected to have a day in which he or she is more irritable, sad and nervous than usual, spends more time resting due to pain than usual, and may ruminate more about pain and view pain as more overwhelming and uncontrollable than usual.

Instead, following a night of better than average sleep, on the other hand, patients reported a good morning of relatively lower pain intensity, negative affect and pain catastrophizing, even though the result would be temporary, suggesting the needs of a continuous good sleep.

Why this happen?

Thank to advances in quantitative sensory testing, has been demonstrated that sleep disturbance may impair pain processing at multiple levels of the

Neuraxis ( axis of the central nervous system), including those that regulate descending pain modulation.

A hypothesis of the mechanism behind impaired sleep, it is suggested to be on the central level of the nervous system, involving the serotonergic and dopaminergic neurotransmission.

What to consider when analyse insomnia?

• The time needed for falling asleep,
• Frequency of waking up in the night,
• Experiencing sleep as recovering,
• Presence of daytime consequences

• Frequency and severity of insomnia are related with increased pain sensitivity, worse is the insomnia more will increase the pain sensitivity.

• Mental disorders, such as depression and anxiety are highly associated with sleep disturbances in patients with chronic pain this fact is in line with previous literature.

Tired of feeling without energy?

Tired of feeling that you are not getting enough sleep?

Tired of waking up as you never gone to bed?

How can we help you?

At 5 STAR CLINIC LTD, after the first visit, where you will be asked targeted questions about your sleep problem and any symptoms related, we will build an acupuncture treatment which will suit your needs.

The use of acupuncture could make a real difference in the quality of your sleep.

What the science says about it?

• Acupuncture compared to sham/placebo and pharmacotherapy showed statistically significant results
• Polysomnographic evaluation was performed at baseline and 3 months, and 1 year after acupuncture treatment. All outcome measures substantially improved. Moreover, during the observation period, the patient’s sleep quality did not worsen.
• Clinical trials of pharmacological and nonpharmacological therapies have shown that improving sleep quality can reduce pain and fatigue,
• Acupuncture treatment effectively improved the quality of sleep and the quality of life for these chronic haemodialysis patients.

References:

Paanalahti K et al(2016), Spinal pain–good sleep matters: a secondary analysis of a randomized controlled trial.

doi: 10.1007/s00586-015-3987

Shergis JL et al(2016), A systematic review of acupuncture for sleep quality in people with insomnia

doi: 10.1016/j.ctim.2016.02.007

Zhang W,(2017), Acupuncture as a primary and independent treatment for a patient with chronic insomnia: One-year follow-up case report.

doi: 10.1097/MD.0000000000009471.

Cao H et al, (2009), Acupuncture for Treatment of Insomnia: A Systematic Review of Randomized Controlled Trials

doi: 10.1089/acm.2009.0041

Jank R et al, (2017), Chronic Pain and Sleep Disorders in Primary Care

doi: 10.1155/2017/9081802

Gerhart JI et al, (2017), Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects

doi:10.1007/s12160-016-9860-2.

Sivertsen B et al, (2015), Sleep and pain sensitivity in adults

doi: 10.1097/j.pain.0000000000000131

Keilani M, (2017), Sleep quality in subjects suffering from chronic pain

doi: 10.1007/s00508-017-1256-1

Finan PH et al, (2013) The association of sleep and pain: An update and a path forward

doi:10.1016/j.jpain.2013.08.007

Widjaja JA, (2017) The effect of acupuncture treatment for insomnia in chronic hemodialysis patients

doi :10.1088/1742-6596/884/1/012130

Choy EHS, (2015), The role of sleep in pain and fibromyalgia

doi: 10.1038/nrrheum.2015.56