MSWA Bulletin Magazine Summer 2022

PAIN & PAIN MANAGEMENT SERIES
Welcome to the third instalment in our series of articles on pain and pain management.
Below, Senior Occupational Therapist Lina Ghulami and Neurological Liaison Nurse
Bronwyn Innes, who has a speciality background in pain management, explore the
relationship between pain and sleep.
Future editions will explore more strategies to combat pain.
If you would like to read the previous articles in our Pain & Pain Management series,
all previous editions of Bulletin can be viewed online at publications.mswa.org.au
SLEEP AND PAIN
Sleep and pain appear to have a two-way relationship. There is an unquestionable link
between sleep and pain, but emerging evidence suggests that the effect of sleep on pain
may be even stronger than the effect of pain on sleep.
SLEEP SIMPLIFIED
Chronic pain may lead to a self-perpetuating cycle, illustrated here:
During sleep, we cycle through:
/ light sleep,
/ slow-wave sleep, and
/ rapid eye movement (REM) sleep.
Sleep
Pain and anxiety make it hard to
sleep. Lack of sleep makes pain
worse and decreases energy.
To feel well-rested, we need a
balance of all these sleep stages,
especially slow-wave sleep and
REM sleep. Disrupting this cycle
interferes with the progression of
the sleep stages and leads to less
restful sleep and next-day tiredness.
Chronic pain can affect sleep
differently, depending on the nature
of the pain. Some conditions may
flare up at night or be provoked by
certain sleeping positions. Others
may cause persistent pain that does
Energy
Coping with pain
drains energy.
Lack of energy
makes it hard to
be active and
stay in shape.
Activity
Pain and lack of energy
make it hard to be
active. Lack of exercise
worsens pain.
THE
SELF-PERPETUATING
CYCLE
OF
PAIN
Mood
Chronic pain and
the limits it puts on
your life can lead
to depression,
anger and anxiety.
These feelings
make coping with
pain harder.
not ease at night.
Some people with chronic pain also
experience other disorders, such as
/ obstructive sleep apnoea or
/ restless legs syndrome.
Someone who is in pain may
become anxious when they cannot
sleep. They may sleep poorly and
wake up feeling depressed, which
increases their sensitivity to pain.
The next night, they are in pain
again, so they cannot sleep well,
and the cycle continues. Over time,
this negative cocktail may worsen
existing conditions and even have
an influence on a person’s level
of disability. People with chronic
pain may feel fatigued during the
day. Depending on their level of
disability, they may be less likely
to exercise or follow a healthy diet,
both of which are important for
getting a good night’s sleep.
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