Exercise during the day so you feel physically tired at night and commit to good sleep hygiene. Get checked for physical problems like sleep apnea that may be contributing to sleep problems. Review your medications with your doctor or pharmacist to see if they affect sleep. We really need to treat the sleep problem - independent of pain and depression,” urges Parmelee.Ī good night’s sleep will improve your pain and ability to manage it. “We know that sleep problems drive pain, depression and disability in people with OA. “Pain did not predict increased depression over time, but sleep disturbance did predict depression.” Sleep disturbance can predict increased depression and disability, explains Parmelee. Your sleep troubles may not only be making your pain worse, but research shows it could also be increasing your depression and disability. Poor sleep behaviors - especially in people with chronic disease – can put them on a slippery slope to further illness and increased pain,” explains Goodin, who specializes in pain-related behavioral medicine. “For many patients, their problematic sleep patterns predate their chronic pain. Goodin believes, “this clean experimental design shows that sleep deprivation - particularly sleep fractionation - can lead to central sensitization.” But those with interrupted sleep became even more sensitive to pain. Identical pain stimuli were given at the beginning and end of the experiment, and all volunteers were more sensitive at the end. Others were woken up every hour throughout the night but had the same total sleep time as the delayed sleep group. Some had their sleep hours cut by being kept awake past their normal bedtime for a few nights. All volunteers were tested for pain sensitivity at the beginning of the experiment. He describes a pain experiment done with healthy volunteers at Johns Hopkins University. Burel Goodin, PhD, associate professor of psychology at University of Alabama at Birmingham, explains that sleep deprivation can promote central nervous system sensitization. Why osteoarthritis pain becomes centralized in some people may depend on their sleep patterns. Research shows that the joint pain of OA can become “centralized.” This means that pain pathways become over-excited and pain is amplified beyond what would be typical for the amount of damage found in the joints. Poor sleep makes it harder to cope with the next day’s pain, which can lead to more pain catastrophizing, less sleep and perhaps a magnification of your pain called central sensitization. “Anxiety and hypervigilance are terrible enemies of getting to sleep and staying asleep.” “You lie in bed thinking about how awful the pain is and think that it’s never going to get any better,” explains Parmelee. Catastrophizing has two forms: assuming that something bad will happen and expecting that it will be as bad as possible. And for people with OA, it can be “pain catastrophizing,” says Parmelee. “It works both ways, but the stronger direction is that sleep problems - whatever their cause - can make your experience of pain worse.”Īnxious and worried thoughts often keep people tossing and turning. Parmelee, PhD, director of the University of Alabama Research Institute on Aging at Tuscaloosa. “It’s less about pain keeping you awake at night than it is about a bad night’s sleep leaving you more vulnerable to pain,” explains Patricia A. Why OA keeps you lying awake may seem obvious - your pain prevents you from getting comfortable or it wakes you up in the night. Pain is an important part of the equation, but researchers are finding that pain and insomnia feed off one another. Troubles range from having problems falling or staying asleep to waking up earlier than desired or full sleep insomnia. About 70% of people with OA have some kind of sleep disturbance. If your osteoarthritis (OA) keeps you up at night, you’re not alone.
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