Sleep and chronic pain.
The relationship between sleep and chronic pain is both obvious and intriguing.
Pain will frequently damage sleep. A painful ankle, back or knee will make getting to sleep much harder. The pain flaring up in the early hours will further disrupt sleep. Our experience with acupuncture patients is that shoulder pain is especially damaging to sleep.
But can the relationship work the other way round. Can insomnia or poor sleep cause chronic pain?
Researchers at Massachusetts General Hospital believe that the relationship can work this way round. And they have identified the neurotransmitter that they believe is responsible. N-arachidonoyl dopamine (NADA) is found in thalamic reticular nucleus (TRN) of the brain. And it results in heightened pain sensitivity. Reduced sleep , especially REM sleep appears to disrupt the flow of NADA to and within the TRN. This, the researchers, believe leads to heightened pain sensitivity.
The theory was tested in mouse-based experiments but the results are believed to be applicable to humans.
Arguably the key take away is that pain is experienced in the brain. And sleep if it is anything is a brain function. So poor sleep resulting in heightened pain levels is entirely plausible.
If your sleep is suboptimal, you are potentially exposing yourself to significant pain issues. You may well be pain free now. But now is the time to resolve your sleep before you are not pain free. Because once the pain kicks in- be it your shoulder, back or knee- then resolving your poor sleep will become much harder.
An estimated 10% of UK adults suffer from some level of insomnia. So, sleep improvement clearly offers massive potential for reducing chronic pain at a population significant level. Sleep improvement techniques could offer a realistic means of reducing the cost to the NHS of dealing with endemic levels of chronic pain. And improving sleep has only positive side effects unlike pharmacological pain solutions.