• Anne Nisenzon, PhD

Sleeping through the Pain



Anyone living with chronic pain can tell you that restful sleep often feels nearly impossible to come by. Between waiting for medications to kick in and shifting all the time to find a semi-comfortable position, it’s a wonder how people with pain can sleep at all! Furthermore, some medications people use for pain, such as morphine and methadone, can interfere with healthy sleep patterns and reduce time spent in deep sleep. Even worse, poor sleep can contribute to pain. Studies have shown that people with insomnia have a higher risk of developing chronic pain conditions such as fibromyalgia and tension headaches. It’s a no-brainer that poor sleep at night and living with chronic pain 24/7 can affect your health, mood, and general sense of well-being over time.


It can be tricky to treat insomnia in individuals with chronic pain, but it is possible. Addressing sleep problems using behavior-based methods, as opposed to medications, can significantly improve sleep quality even in the presence of pain. Some studies also show that improving your sleep can lead to less pain-related disability, meaning you feel like you can do more even if the pain is still there.


The “gold standard” behavioral treatment for insomnia is Cognitive Behavioral Therapy, which takes a look at how your thoughts about sleep and bedtime behaviors may be contributing to poor sleep. Especially when you’re struggling with pain, you can have catastrophic thoughts such as “It would be a miracle if I could sleep tonight!” or “I know I can’t function when I don’t sleep, and my pain will never let me sleep.” Many also try to compensate for poor sleep by taking naps throughout the day or spending a lot of time in bed, both of which make it harder to sleep well at night. Working with a therapist who is trained in Cognitive Behavioral Therapy for Insomnia (CBT-I) and who also knows the unique challenges that come with chronic pain can help you tackle this two-headed beast.


To start working on improving your sleep, you can begin with changing some of your sleep habits. Taking small steps such as cutting out caffeine in the afternoon, avoiding alcohol and nicotine before bed, and setting a regular wake time even on weekends can set you up for healthier sleep patterns. Another important change to make, especially if you have chronic pain, is to reduce wakeful time in bed. A lot of people with chronic pain lounge in their beds during the day because it is more comfortable. However, this actually makes it harder to fall and stay asleep in your bed at night. Finding a comfortable chair to lounge in when awake can help make your bed a special place for sleeping.


These sleep hygiene suggestions are necessary but not sufficient to treat long-term insomnia, especially with pain complications. It is best to work with a therapist to learn and practice all the steps of Cognitive Behavioral Therapy for Insomnia. Optimal Health Therapy can finally help you get the sleep of your dreams without relying on sleep medications. Call to schedule an appointment and make an important investment in your comfort and well-being.

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