The complex relationship between sleep and pain: Insights from sleep expert Dr Alison Bentley

The relationship between pain and sleep has been a subject of scientific inquiry, as they often exert a profound influence on each other.

Scientific studies consistently highlight the disruptive impact of pain on sleep. Chronic pain conditions, such as arthritis or fibromyalgia, can lead to difficulties falling asleep, maintaining sleep continuity and experiencing restorative sleep.

Additionally, insufficient sleep may worsen the experience of pain, creating a harmful cycle.

Pain disrupts sleep in a variety of ways. It is common for anyone in excruciating pain to wake up frequently during the night, making it difficult to fall asleep again. Secondly, pain-related distress, anxiety or depression can also contribute to sleep disturbances.

Dr Alison Bentley, a renowned sleep expert, sheds light on the intricate connection between sleep and pain.

Explaining that while it's widely known that pain can lead to insomnia, the relationship between the two is far more complex than commonly understood.

According to Dr Bentley, extensive research has been conducted on the link between sleep and pain, with nearly half of patients reporting insomnia in a recent survey.

However, she clarifies that insomnia encompasses more than just difficulty falling asleep.

It also encompasses insufficient sleep duration, waking up frequently during the night, struggling to fall back to sleep, and experiencing poor sleep quality even after adequate hours of sleep.

The crux of the issue lies in the fact that while pain disrupts sleep, a lack of quality sleep exacerbates pain, creating a vicious cycle.

She claims that all sleep disorders, including sleep apnoea and restless legs syndrome (RLS) are more prevalent among individuals experiencing pain.

This suggests that the sleep disorder itself may contribute to the onset or worsening of the painful condition, particularly if the pain is muscle-related.

However, Dr Bentley highlights that not all pain has the same impact on sleep. Waking up with back or neck pain may simply indicate an inadequate and unsupportive mattress.

Other discomforts, such as headaches or jaw pain, may be indicative of underlying issues like obstructive sleep apnoea.

Comment: The Wiki explains:

Sleep apnea, also spelled sleep apnoea, is a sleep disorder in which pauses in breathing or periods of shallow breathing during sleep occur more often than normal.^[1]
[...]
Sleep apnea may be either obstructive sleep apnea (OSA), in which breathing is interrupted by a blockage of air flow, central sleep apnea (CSA), in which regular unconscious breath simply stops, or a combination of the two.^[1] OSA is the most common form.^[1

She adds: "Assuming you don't sleep alone, ask your bed partner if you snore and appear to stop breathing, as these symptoms may indicate obstructive sleep apnoea - a condition where you stop breathing temporarily, and your body wakes you up so you can start breathing again.

"The repeated waking from apnoea can cause headaches and treating the sleep apnoea often relieves the headaches as well."

In managing the intricate interplay between sleep and pain, she points out that doctors often focus on treating the pain, assuming that the sleep problem will resolve itself.

However, this approach fails to consider sleep disorders like sleep apnoea or restless legs syndrome, which require specific diagnoses and targeted treatments. Proper diagnosis and treatment of these sleep disorders can directly improve sleep quality.

Dr Bentley advises individuals grappling with the sleep-pain combination to ensure that their pain management plan includes a specific strategy to address sleep issues, particularly by identifying and treating any underlying sleep disorders.

Recognising the complexity of this connection and addressing both sleep and pain issues simultaneously, individuals can strive for improved well-being and a better quality of life.