home
RSS
Why you can't sleep when you're in pain
January 17th, 2012
11:14 AM ET

Why you can't sleep when you're in pain

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Patients often come to me with symptoms they describe as "fatigue" or "tiredness." The first task is to tease out exactly what they mean. To a sleep doctor, fatigue and tiredness usually mean the body needs or wants to rest, whereas "sleepiness" suggests that the mind wants to rest.

Patients with any pain syndrome often come in complaining of fatigue or tiredness. Their bodies have trouble falling and staying asleep. Sleep and pain are both ultimately controlled by the central nervous system. Poor sleep and pain form a vicious cycle - uncontrolled pain makes sleep difficult (if not impossible) and, in turn, the resulting poor sleep makes it more difficult to adequately control the pain.

Most physicians know very well that poorly controlled pain will cause difficulty sleeping. But they often don’t think about the patient having a separate sleep disorder that may be fueling the pain.

For this reason, it is important for people with chronic pain to first have a thorough sleep evaluation in order to determine if there is an underlying cause. If a patient has something like sleep apnea or restless legs syndrome, then the diagnosis and treatment of these disorders can make a huge impact on  sleep and, as a result, on his or her quality of life.

Unfortunately, many times people with chronic pain syndromes do not have sleep disorders that are easily diagnosed, but they do have sleep disruptions of unknown origin.

They also tend to spend a lot of time in the light stage of sleep and have a characteristic, but non-specific, finding on their EEG (electroencephalogram, which measures the brain's electrical activity) during the sleep study. This finding is called "alpha intrusion." The cause of this particular brain wave pattern is not known, but it has been associated with different disorders that lead to chronic fatigue or chronic pain. There are no specific treatments that are aimed at alpha intrusions - we just try to treat the underlying pain syndrome and any primary sleep disorder that patients have.

The question remains whether sleep disturbances can actually lead to fatigue or pain syndromes. In fact, recent research has shown that people who complain that their sleep is disturbed or not refreshing have three times the risk of developing fibromyalgia. Fibromyalgia is poorly understood, but there is a specific pattern of musculoskeletal pain with the involvement of common anatomic sites, or trigger points, that can be tested on physical exam.

The persistent myalgia, or muscle pain, and the fatigue are thought to result from a disturbance in the functions of the central nervous system. Since sleep is a function of the central nervous system, it makes sense that the CNS dysfunction might start with sleep and then affect pain receptors and pain perception. And it is often the case that the healing can’t really begin until the patient can get the right amount of good quality sleep.

The take-home message here is this: If you have chronic pain, for whatever reason, and feel tired or sleepy in the daytime, get a sleep evaluation. Pain doesn't explain everything.

Post by:
Filed under: Sleep

soundoff (667 Responses)
  1. RV Renovation Near Me

    http://old.daliedu.cn/url.asp?url=https://sublimedir.net/Society/Relationships/?p=651

    May 22, 2021 at 14:03 | Report abuse | Reply
  2. rv toilet parts near me

    You made some really good points there. I looked on the net for more info about the issue and found most individuals will go along with your views on this web site.

    https://sc.hkex.com.hk/gb/ocrvcenter.com/rv-repair-shop-seal-beach-california/

    May 22, 2021 at 23:06 | Report abuse | Reply
  3. SEO Marketing Service

    http://www.daddysdesire.info/cgi-bin/out.cgi?req=1&t=60t&l=OPEN03&url=https://affordableranking.com

    May 23, 2021 at 00:31 | Report abuse | Reply
  4. Video Marketing Company

    http://www.bemidji.bigdealsmedia.net/include/sort.php?return_url=http://affordableranking.com/&sort=a:3:s:9:”direction”;s:3:”ASC”;s:5:”field”;s:15:”Items.PriceList”;s:5:”label”;s:9:”value_asc”;

    May 23, 2021 at 03:15 | Report abuse | Reply
  5. RV Alignment Orange County

    This site was... how do you say it? Relevant!! Finally I've found something which helped me. Appreciate it!

    /

    May 23, 2021 at 04:25 | Report abuse | Reply
  6. box truck repair parts

    After exploring a handful of the blog articles on your web page, I seriously like your way of writing a blog. I added it to my bookmark site list and will be checking back in the near future. Take a look at my web site too and tell me what you think.

    http://weekly.chosun.com/protect_weekly/redirect.asp?url=https://ocrvcenter.com/fleetstar-collision-repair-shop-near-me

    May 23, 2021 at 21:49 | Report abuse | Reply
  7. slot online

    Way cool! Some very valid points! I appreciate you writing this article plus the rest of the site is also really good.

    May 24, 2021 at 03:00 | Report abuse | Reply
  8. camper repair shops near me

    Good post. I learn something totally new and challenging on blogs I stumbleupon everyday. It's always helpful to read through articles from other writers and practice a little something from other sites.

    https://he-web.com/rank.cgi?mode=link&id=6111&url=https://ocrvcenter.com/motorhome-couch-repair-near-me

    May 24, 2021 at 09:46 | Report abuse | Reply
  9. travel trailer inspection near me

    http://p4trc.emv2.com/DTS?url=https://ocrvcenter.com/rv-repair-shop-norwalk-california&emv_key=F9X7CqqshZGf8SA9MKJi8NUY54O102IMNfcStGb5lw8W0bBhOG5mpqVsje_HhdA0lliq

    May 24, 2021 at 17:32 | Report abuse | Reply
  10. RV Slide Out Los Angeles

    Very good article. I will be experiencing a few of these issues as well..

    /

    May 24, 2021 at 21:47 | Report abuse | Reply
  11. Digital Marketing Specialists

    May I simply say what a relief to find someone who genuinely understands what they're talking about on the net. You certainly realize how to bring a problem to light and make it important. More and more people need to look at this and understand this side of your story. It's surprising you are not more popular because you certainly have the gift.

    https://wsweedscience.org/?wptouch_switch=desktop&redirect=http://www.affordableranking.com

    May 25, 2021 at 06:31 | Report abuse | Reply
  12. Forklifts Orange County

    http://haibao.dlszywz.com/index.php?c=scene&a=link&id=273020&url=https://forkliftswildwestlifttrucks.com/orange-forklifts/

    May 25, 2021 at 06:46 | Report abuse | Reply
  13. Forklift Repair

    Having read this I thought it was extremely enlightening. I appreciate you spending some time and effort to put this information together. I once again find myself personally spending way too much time both reading and leaving comments. But so what, it was still worthwhile!

    https://slack-redir.net/link?url=https://forkliftswildwestlifttrucks.com/los-alamitos-forklifts/

    May 25, 2021 at 07:29 | Report abuse | Reply
  14. Used Forklift Repair California

    I’m amazed, I have to admit. Seldom do I come across a blog that’s both equally educative and interesting, and without a doubt, you've hit the nail on the head. The problem is something not enough people are speaking intelligently about. I am very happy that I stumbled across this during my hunt for something relating to this.

    https://worldlunghealth2020.theunion.org/index/out/?type=sponsor&url=http://forkliftswildwestlifttrucks.com/cushion-tire-forklift-repair-orange-county-california/

    May 25, 2021 at 08:16 | Report abuse | Reply
  15. Video Marketing Services

    Can I simply say what a comfort to uncover an individual who actually understands what they're discussing on the web. You actually know how to bring an issue to light and make it important. A lot more people need to read this and understand this side of your story. I was surprised you're not more popular because you definitely possess the gift.

    http://www.ea-nosazimadares.ir/IFrame.aspx?url=http://www.affordableranking.com

    May 25, 2021 at 10:04 | Report abuse | Reply
  16. Digital Marketing Businesses

    http://nlcontent.springernature.com/d-redirect/TIDP573067XE64F89F12A754A878801A4909C3C0A1AYI4/?url=http://affordableranking.com

    May 25, 2021 at 21:12 | Report abuse | Reply
  17. Google Marketing Experts

    https://www.roundstrading.com/__media__/js/netsoltrademark.php?d=https://affordableranking.com

    May 25, 2021 at 21:59 | Report abuse | Reply
  18. Nereida Mensinger

    Where can I find free images?. Which images are usually considered free?. When is it ok to insert a picture from a website?.

    https://twitter.com/katekdesigns

    May 25, 2021 at 22:39 | Report abuse | Reply
  19. RV Dashboard California

    Hello there! I could have sworn I’ve been to this web site before but after browsing through a few of the posts I realized it’s new to me. Nonetheless, I’m definitely delighted I found it and I’ll be book-marking it and checking back frequently!

    https://www.trucktown.ru/go.php?https://reflexologie-aubagne.fr/wordpress-tutorial-german-with-impreza

    May 25, 2021 at 23:12 | Report abuse | Reply
  20. RV Windshield Orange County

    http://twpusc.org/Redirect.aspx?destination=http://johnvorhees.com/gbook/gbook.php?page=1506

    May 25, 2021 at 23:40 | Report abuse | Reply
  21. RV Seats Los Angeles

    https://www.bad.org.uk/for-the-public/patient-information-leaflets/androgenetic-alopecia/?showmore=1&returnlink=https://amberandjordanburr.blogspot.com/2019/08/custom-rv-awning.html

    May 25, 2021 at 23:53 | Report abuse | Reply
  22. rv slide out repair parts

    https://clixgalore.com/NoRedirect.aspx?ID=11387&AfID=225385&BID=111815&ER=1&RU=https://discordoba.com/index.php/envases-tapas-valvulas/item/19-cristaleria?start=347160

    May 25, 2021 at 23:59 | Report abuse | Reply
  23. RV Camera Orange County

    /

    May 26, 2021 at 08:56 | Report abuse | Reply
  24. orange county trailer repair

    Excellent article! We are linking to this great post on our website. Keep up the good writing.

    /

    May 26, 2021 at 12:22 | Report abuse | Reply
  25. RV Collision Repair Riverside

    &_ltra=dab4d1d3b7718c2c9e91a686f3ff7361.ltra.1613.12

    May 26, 2021 at 12:36 | Report abuse | Reply
  26. RV Maintenance Orange County

    Very good post! We will be linking to this great content on our website. Keep up the good writing.

    https://sc.hkexnews.hk/TuniS/ocrvmotorsports.com/box-truck-collision-repair-shop-near-me

    May 26, 2021 at 13:04 | Report abuse | Reply
  27. RV Tires Riverside

    I absolutely love your site.. Very nice colors & theme. Did you develop this site yourself? Please reply back as I’m trying to create my own personal site and would love to find out where you got this from or what the theme is called. Appreciate it!

    https://www.domainsherpa.com/share.php?site=https://ocrv.world/renegade-rv-collision-repair-paint-shop-near-me-orange-county

    May 26, 2021 at 13:17 | Report abuse | Reply
  28. rv windshield replacement near me

    After I originally left a comment I seem to have clicked the -Notify me when new comments are added- checkbox and now whenever a comment is added I recieve 4 emails with the same comment. Perhaps there is a way you can remove me from that service? Many thanks!

    http://www.ric.edu/Pages/link_out.aspx?target=https://ocrv.biz/rv-repair-shop-escondido-california

    May 26, 2021 at 13:20 | Report abuse | Reply
  29. Digital Marketing Specialists

    bookmarked!!, I love your site!

    http://zdorov.online/goto.php?l=http://postfallsbootcamp.com/

    May 26, 2021 at 18:46 | Report abuse | Reply
  30. RV Windows California

    https://ssp.send.microad.jp/cc?ep=3WkB-sR7-kgCUB3oC4dc3s608eSsloN9K9NHq6iY9RsN0FgxwNmpck0T4k-9LLI9yuidcEtEYotIEUzjREa-S5R4v2nHvcF0QtXiQsDdubYMYrJ_XftQVRNkmURGNS6aGMDFcsiCQl_lNKo507iRUEbVxoJ8HW2yDEKqX54dvXTI&r=https://ocrv.pro/motorhome-lighting-repair-near-me

    May 26, 2021 at 22:42 | Report abuse | Reply
  31. body shop orange ca

    https://www.domainsherpa.com/share.php?site=https://ocrv.vip/commercial-vehicle-collision-repair-shop-near-me

    May 27, 2021 at 01:28 | Report abuse | Reply
  32. RV Restoration Orange County

    https://www.iaai.com/VehicleInspection/InspectionProvidersUrl?name=AA Transit Pros Inspection Service&url=https://ocrv.org/motorhome-fabrication-repair-near-me

    May 27, 2021 at 02:16 | Report abuse | Reply
  33. horse trailer restoration

    Hello there! I just wish to offer you a huge thumbs up for the great information you have right here on this post. I will be coming back to your website for more soon.

    http://sc.hkeaa.edu.hk/TuniS/ocrvcenter.net/rv-repair-shop-palos-verdes-estates-california

    May 27, 2021 at 03:30 | Report abuse | Reply
  34. truck modification shop near me

    Having read this I thought it was really informative. I appreciate you spending some time and energy to put this content together. I once again find myself spending a significant amount of time both reading and posting comments. But so what, it was still worth it!

    http://haibao.dlszywz.com/index.php?c=scene&a=link&id=273020&url=https://ocrv.info/rv-repair-shop-irvine-california

    May 27, 2021 at 11:04 | Report abuse | Reply
  35. rv renovation companies near me

    http://nudewwedivas.forumcommunity.net/m/ext.php?url=https://ocrv.xyz/rv-cabinet-repair-near-me

    May 27, 2021 at 14:15 | Report abuse | Reply
  36. rv furniture outlet store near me

    http://shp.hu/hpc_uj/click.php?ml=5&url=https://ocrv.art/rv-repair-shop-indio-california

    May 27, 2021 at 17:14 | Report abuse | Reply
  37. Forklift Maintenance Near Me

    https://mitsui-shopping-park.com/lalaport/ebina/redirect.html?url=https://forkliftswildwestlifttrucks.com/santa-ana-forklifts

    May 27, 2021 at 18:49 | Report abuse | Reply
  38. RV Toilets California

    This site definitely has all the information and facts I needed about this subject and didn’t know who to ask.

    https://www.bookforum.com/ads/www/delivery/ck.php?ct=1&oaparams=2__bannerid=967__zoneid=1__source=ad__cb=01bb4cc389__oadest=https://ocrv.rocks/medical-truck-collision-repair-shop-near-me

    May 27, 2021 at 20:45 | Report abuse | Reply
  39. RV Lighting Near Me

    Hi, I do think this is an excellent web site. I stumbledupon it 😉 I'm going to come back once again since i have book marked it. Money and freedom is the best way to change, may you be rich and continue to help others.

    https://trends.gab.com/visit?url=https://ocrvshop.com/rv-repair-shop-temple-city-california

    May 27, 2021 at 21:34 | Report abuse | Reply
  40. rv parks orange county california

    This is a topic that's close to my heart... Cheers! Where are your contact details though?

    http://southampton.ac.uk/~drn1e09/foaf/visualizer.php?url=https://ocrvcenter.info/motorhome-upgrade-near-me

    May 27, 2021 at 22:20 | Report abuse | Reply
  41. sbobet

    For hottest information you have to visit world-wide-web and on world-wide-web I found this web
    page as a most excellent web page for newest updates.

    May 28, 2021 at 00:26 | Report abuse | Reply
  42. Cours anglais Lyon

    Hi mates, its great post on the topic of teachingand completely defined, keep it up all the time.

    May 28, 2021 at 00:34 | Report abuse | Reply
  43. RV Shades Los Angeles

    http://mytown.ie/log_outbound.php?business=118705&type=website&url=http://inflatabledepot.com/blog/19_go-play-guam.html

    May 28, 2021 at 00:55 | Report abuse | Reply
  44. RV Camera Orange County

    An interesting discussion is definitely worth comment. I do think that you need to write more on this subject matter, it may not be a taboo subject but typically folks don't discuss these topics. To the next! Many thanks!!

    https://publishing.brookes.ac.uk/?URL=www.topragists.com/dont-eat-sugar-as-a-cancer-patient/

    May 28, 2021 at 01:22 | Report abuse | Reply
  45. RV Restoration Los Angeles

    An impressive share! I've just forwarded this onto a friend who was doing a little homework on this. And he in fact ordered me breakfast because I found it for him... lol. So let me reword this.... Thanks for the meal!! But yeah, thanks for spending time to discuss this topic here on your blog.

    http://lav.it/template/redirect.php?id_news=804129&url=https://maxmade.com.au/up-close-and-personal-with-super-model-fashion-designer-gail-elliott/

    May 28, 2021 at 01:34 | Report abuse | Reply
  46. frame repair shop near me

    /

    May 28, 2021 at 01:40 | Report abuse | Reply
  47. Local Marketing Consultant

    http://chaosns.com/link.php?url=cdaseo.com/

    May 28, 2021 at 06:20 | Report abuse | Reply
  48. RV Steps California

    I’m impressed, I must say. Rarely do I encounter a blog that’s both educative and amusing, and without a doubt, you've hit the nail on the head. The issue is an issue that not enough folks are speaking intelligently about. Now i'm very happy I found this during my hunt for something concerning this.

    http://ecare.unicef.cn/edm/201208enews/url.php?url=https://fotoobrobka.pl/events/world-famous-places-exhibition/

    May 28, 2021 at 10:18 | Report abuse | Reply
  49. rv mechanics near me

    /

    May 28, 2021 at 12:53 | Report abuse | Reply
  50. RV Couches Riverside

    http://sns.lilyenglish.com/link.php?url=https://www.revistadovilla.com.br/2020/02/09/conheca-a-nova-filial-do-bullguer-em-ipanema-no-rio/

    May 28, 2021 at 13:21 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Post a comment


 

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

Advertisement
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.