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 (666 Responses)
  1. RV Fabrication Riverside


    June 3, 2021 at 10:59 | Report abuse | Reply
  2. Mercedes Sprinter Repair Shops Near Me


    June 3, 2021 at 11:26 | Report abuse | Reply
  3. Sprinter Door Rust Repair


    June 3, 2021 at 11:58 | Report abuse | Reply
  4. Google Marketing Agency

    This page certainly has all the information and facts I wanted about this subject and didn’t know who to ask.


    June 3, 2021 at 12:40 | Report abuse | Reply
  5. windshield repair around me

    An outstanding share! I have just forwarded this onto a colleague who has been doing a little homework on this. And he actually bought me breakfast due to the fact that I found it for him... lol. So allow me to reword this.... Thanks for the meal!! But yeah, thanx for spending time to talk about this topic here on your web page.


    June 3, 2021 at 15:02 | Report abuse | Reply
  6. Sprinter Repair Shops Near Me

    The very next time I read a blog, Hopefully it won't disappoint me as much as this one. I mean, Yes, it was my choice to read, but I actually thought you'd have something interesting to talk about. All I hear is a bunch of complaining about something you can fix if you were not too busy seeking attention.


    June 3, 2021 at 17:41 | Report abuse | Reply
  7. mobile rv generator repair near me


    June 3, 2021 at 18:12 | Report abuse | Reply
  8. RV And Truck Repair Near Me


    June 3, 2021 at 18:23 | Report abuse | Reply
  9. Handicap Van Ramp Repair

    Good article! We are linking to this great article on our site. Keep up the great writing.


    June 3, 2021 at 18:26 | Report abuse | Reply
  10. Frightliner Sprinter Repair Shop

    Very good post. I absolutely love this website. Stick with it!


    June 4, 2021 at 03:02 | Report abuse | Reply
  11. Social Media Marketing Service


    June 4, 2021 at 03:18 | Report abuse | Reply
  12. places hiring near me

    There is definately a lot to find out about this issue. I like all the points you've made.


    June 4, 2021 at 03:35 | Report abuse | Reply
  13. RV Repair Near Me

    Excellent blog post. I certainly appreciate this site. Thanks!


    June 4, 2021 at 03:35 | Report abuse | Reply
  14. Repair Van

    Wonderful article! We will be linking to this particularly great post on our website. Keep up the good writing.


    June 4, 2021 at 05:46 | Report abuse | Reply
  15. https://j-website.net

    Best view i have ever seen !


    June 4, 2021 at 07:14 | Report abuse | Reply
  16. rv restoration near me


    June 4, 2021 at 10:52 | Report abuse | Reply
  17. windshield repair orange ca

    I could not refrain from commenting. Perfectly written!


    June 4, 2021 at 15:01 | Report abuse | Reply
  18. outlets near me


    June 4, 2021 at 15:05 | Report abuse | Reply
  19. Sprinter Van Repair

    Howdy! I simply want to offer you a big thumbs up for your great information you have got here on this post. I will be coming back to your web site for more soon.


    June 4, 2021 at 15:27 | Report abuse | Reply
  20. Ecu Repair 2017 Mercedes Sprinter Van Remove Speed Limiter

    You made some decent points there. I checked on the net to learn more about the issue and found most people will go along with your views on this web site.


    June 4, 2021 at 16:18 | Report abuse | Reply
  21. Beck's Vapor Lounge

    I manage a vape shop submission site and we have had a listing from a vape shop in the USA that also markets CBD products. A Month afterwards, PayPal has contacted use to claim that our account has been restricted and have requested us to remove PayPal as a payment solution from our vape store submission site. We do not offer CBD products like CBD oil. We solely offer marketing and advertising services to CBD companies. I have checked out Holland & Barrett– the UK's Reputable Health and wellness Retailer and if you take a good look, you will witness that they sell a pretty extensive variety of CBD products, primarily CBD oil and they also happen to accept PayPal as a payment solution. It seems that PayPal is applying twos sets of rules to different firms. Due to this limitation, I can no longer accept PayPal on my CBD-related online site. This has limited my payment options and currently, I am heavily reliant on Cryptocurrency payments and straightforward bank transfers. I have gotten in touch with a lawyer from a Magic Circle law firm in London and they explained that what PayPal is doing is totally unlawful and discriminatory as it should be applying an uniform standard to all firms. I am yet to get in touch with yet another lawyer from a US law firm in London to see what PayPal's legal position is in the United States. Meanwhile, I would be very appreciative if anyone here at targetdomain could offer me with alternative payment processors/merchants that deal with CBD firms.


    June 4, 2021 at 17:16 | Report abuse | Reply
  22. Prestige Collision Sprinter Repair Mission Viejo


    June 4, 2021 at 18:41 | Report abuse | Reply
  23. Repair 2005 Sprinter Ecm


    June 5, 2021 at 04:26 | Report abuse | Reply
  24. toy hauler california

    Excellent post. I'm going through a few of these issues as well..


    June 5, 2021 at 04:28 | Report abuse | Reply
  25. spectrum near me

    You're so interesting! I do not suppose I've truly read through something like this before. So nice to discover someone with some unique thoughts on this subject. Really.. thank you for starting this up. This website is something that is required on the web, someone with a bit of originality!


    June 5, 2021 at 04:40 | Report abuse | Reply
  26. rv insurance near me

    I need to to thank you for this wonderful read!! I absolutely enjoyed every bit of it. I have you bookmarked to look at new things you postÖ


    June 5, 2021 at 05:25 | Report abuse | Reply
  27. Sprinter Repair Shops


    June 5, 2021 at 06:14 | Report abuse | Reply
  28. Mercedes Benz Sprinter Service Center Near Me

    Hey there! I simply wish to offer you a big thumbs up for your excellent information you have here on this post. I'll be coming back to your website for more soon.


    June 5, 2021 at 22:44 | Report abuse | Reply
  29. horse trailer repair near me


    June 5, 2021 at 23:33 | Report abuse | Reply
  30. ophthalmologist near me


    June 6, 2021 at 02:42 | Report abuse | Reply
  31. Conversion Van Repair

    An impressive share! I've just forwarded this onto a co-worker who had been conducting a little research on this. And he actually bought me lunch because I stumbled upon it for him... lol. So let me reword this.... Thank YOU for the meal!! But yeah, thanx for spending some time to discuss this matter here on your web page.


    June 6, 2021 at 08:37 | Report abuse | Reply
  32. rv sales orange county ca


    June 7, 2021 at 01:20 | Report abuse | Reply
  33. rv air conditioner repair near me


    June 7, 2021 at 06:53 | Report abuse | Reply
  34. Sprinter Repair Shops Near Me


    June 7, 2021 at 08:03 | Report abuse | Reply
  35. Sprinter 2500 Front Glass Repair


    June 7, 2021 at 23:23 | Report abuse | Reply
  36. best body shop in orange county


    June 7, 2021 at 23:33 | Report abuse | Reply
  37. indoor rv storage orange county


    June 7, 2021 at 23:43 | Report abuse | Reply
  38. RV Parts Near Me


    June 7, 2021 at 23:43 | Report abuse | Reply
  39. rv solar near me


    June 8, 2021 at 16:57 | Report abuse | Reply
  40. Repair Fuel Pump Mercedes Sprinter Dodge 3500 2010

    An impressive share! I've just forwarded this onto a coworker who had been doing a little research on this. And he actually bought me dinner because I found it for him... lol. So let me reword this.... Thanks for the meal!! But yeah, thanks for spending some time to talk about this matter here on your web page.


    June 8, 2021 at 17:57 | Report abuse | Reply
  41. RV Storage Orange County

    Great blog you have here.. Itís hard to find quality writing like yours nowadays. I really appreciate people like you! Take care!!


    June 8, 2021 at 19:36 | Report abuse | Reply
  42. bus repair shops near me


    June 8, 2021 at 20:59 | Report abuse | Reply
  43. Digital Marketing Specialist


    June 9, 2021 at 06:02 | Report abuse | Reply
  44. Odis Sartell

    I truly love your blog.. Very nice colors & theme. Did you make this website yourself? Please reply back as Iím looking to create my own site and would love to know where you got this from or exactly what the theme is called. Thanks!


    June 9, 2021 at 12:08 | Report abuse | Reply
  45. Cinda Masero


    June 9, 2021 at 12:48 | Report abuse | Reply
  46. Erlinda Pia

    I blog quite often and I really appreciate your information. This article has really peaked my interest. I'm going to bookmark your blog and keep checking for new information about once a week. I subscribed to your RSS feed too.


    June 9, 2021 at 12:51 | Report abuse | Reply
  47. Zenia Sandra


    June 9, 2021 at 12:51 | Report abuse | Reply
  48. Video Marketing Service

    Very good article. I'm dealing with a few of these issues as well..


    June 9, 2021 at 17:29 | Report abuse | Reply
  49. Casey Zehnpfennig


    June 9, 2021 at 19:33 | Report abuse | Reply
  50. Emilia

    can hemp gummy bears


    June 9, 2021 at 21:30 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Leave a Reply to trailer service near me


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.

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.