If you have chronic back or neck pain and struggle with sleep, you might assume it’s the pain keeping you from sound slumber. Seems obvious, right? But the connection between chronic pain and insomnia is more complex than you may think. As many as two-thirds of people with chronic pain have sleep disorders, and researchers are finding that pain and insomnia have a reciprocal relationship and may coexist.
Managing chronic spine pain is hard enough, and adding poor sleep to the mix can truly hurt your quality of life. Below you’ll explore the close relationship between chronic pain and insomnia, along with strategies on how you can get your much-needed shut eye while managing your pain.
Insomnia is the most common sleep problem, but it’s easily misunderstood. First, insomnia isn’t just about difficulty falling asleep. It's also characterized by waking up in the middle of the night and causing troubled sleep. Second, insomnia is not an isolated disorder but rather a symptom.
To combat insomnia, you need to understand its root cause. In about half of cases, insomnia is a result of a mental or emotional condition, such as anxiety or depression (both of which are common in people with chronic back or neck pain).
Insomnia comes at a hefty cost—both to sleep quality and to the U.S. health care system. Lost work productivity linked to insomnia in the United States is estimated at $63.2 billion per year, as reported by the journal SLEEP. Insomnia also contributes to about $31 billion per year in work accidents, according to research in the Archives of General Psychiatry.
Insomnia and Chronic Pain: A Glimpse Into the Research
When exploring the relationship between chronic pain and insomnia, researchers have found it’s not as simple as pain causing insomnia (though pain certainly plays a big role). Below are findings from three studies to help illustrate the connection between chronic spine pain and insomnia.
Sleeping Easy with Chronic Pain
Insomnia treatments are largely broken into two groups: behavioral therapy and prescription medications. Behavioral therapy is the preferred treatment, as it provides a longer-term solution with no harmful side effects. If your doctor recommends prescription drug treatment for insomnia, it will likely be to treat occasional bouts of insomnia.
For those struggling to get a good night’s rest with chronic back or neck pain, cognitive behavioral therapy for insomnia is a common first-line treatment because it addresses the thoughts and feelings that act as barriers to restorative sleep. People with chronic pain can be kept awake by pain, anxiety, and other worries that those without chronic pain don’t experience. This therapeutic approach can improve sleep by changing the behaviors and negative thoughts that interfere with quality sleep.
Chronic behavioral therapy for insomnia has shown promising results, with reports of success in as many as 80% of patients who pursued the treatment. Also, a 2014 review in Annals of Internal Medicine reported that, on average, people who underwent chronic behavioral therapy for insomnia fell asleep nearly 20 minutes faster and spent 30 fewer minutes awake during the night compared with those who didn’t use the therapy.
Another approach that may help ease insomnia is called relaxation training. In relaxation training, a professional teaches you how to progressively relax your muscles and meditate to distract you from sleep-stealing thoughts.
Other tried-and-true tips for warding off insomnia with chronic spine-related pain include:
Having Chronic Pain and Sleeping Well Is Possible
As anyone with chronic back or neck pain will tell you, pain isn’t just physical—it’s mental and emotional, too. It’s all those layers of pain that can prevent chronic pain sufferers from sleeping well. The relationship between chronic pain and sleep is complex—as one gets worse, it affects the other. Fortunately, behavioral therapies exist to help you break the cycle of negative thoughts and feelings that keep you from the sleep you need. If you struggle with chronic pain and sleeping through the night, talk to your doctor about the options available to you.