Back pain is the most prevalent medical disorder in industrialized societies, affecting at least 80% of American adults at some time during their lives. One in every 50 American workers suffers a back injury and low back pain disables 5.4 million Americans each year. It is estimated that over $80 billion is spent on back pain each year. The personal cost is all too familiar to back pain sufferers. While most people with back pain (70%) recover in less than two weeks, some last longer. However, back pain can return and worsen. The more severe the pain, the more likely it is to interfere with sleep. A recent study found that about two-thirds of patients with chronic back pain suffered sleep trouble. This same study suggests that disrupted sleep seems to make the pain feel worse. Some pain medication, such as analgesics, may alter sleep patterns and make sleeping more difficult.
Headaches
Headache is the second most common pain. Of those who experience the onset of headaches during sleep, 55% report having sleep disorders. In particular, there is a sleep connection with tension or migraine headaches (throbbing pain with blood vessels tightening and opening.) For example, migraine headaches can occur following sleep deprivation or too much sleep. Headaches have also been associated with such sleep disorders as sleep apnea, (frequent pauses in breathing accompanied by loud snoring during sleep), especially upon awakening and sleep movement disorders. In some cases, (e.g. snoring and sleep apnea) treatment of the sleep disorder reduced the headaches. Another type of headache that is even worse, cluster headaches, strike one after another in cycles. Blood vessel activity appears to play a role too. Cluster headaches may be related to sleep and sleep disorders as well.
Arthritis and Other Disorders
Of people with rheumatic or arthritic disorders, as many as 75% often suffer from sleep problems. For example, people with osteoarthritis, especially of the hips and knees, tend to sleep lighter or have restless sleep. People with rheumatoid arthritis often have disturbed sleep with morning stiffness along with a decrease in energy, weakness and function. Flares, or an increase in inflammation and tenderness, can lead to sleep arousals. Individuals with fibromyalgia, a condition of aches and pains throughout the body and many tender points, usually report light and unrefreshing sleep, daytime fatigue, and difficulty with thinking and mood. Frequently, such people share many similar features with people that have chronic fatigue syndrome. They may suffer from chronic headaches, irritable bowel syndrome, and sometimes jaw pain or temporomandibular disorder. Often they have an arousal disturbance in their brain wave pattern during sleep, which may accompany restless legs (an unpleasant, tingling feeling in the legs) and sometimes sleep apnea (pauses in breathing during sleep accompanied by snoring). Because the poor quality of sleep can be associated with persistent muscle pain, tenderness and low energy of rheumatic illnesses, people with osteoarthritis, rheumatoid arthritis and fibromyalgia might require evaluation for primary sleep disorders.
Poor sleep effects on Disease
In general, there is a high prevalence of sleep problems in various medical conditions with pain often altering the sleep process, and at the same time, the sleep problem interacts with the disease process. For example, patients with heart disease tend to have less deep sleep, more fragmented and less efficient sleep. This poor sleep can affect their well-being. Gastrointestinal problems, such as heartburn, ulcers and irritable bowel syndrome with their associated discomfort, often lead to difficulty obtaining a good night's sleep. In a recent Gallup poll, 75% of respondents reported that nighttime heartburn made it difficult to fall asleep and wakes them during the night. All of these problems may be associated with psychological distress, which also contributes to poor, inadequate sleep.
from The Sleep Foundation
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