Thursday, June 16, 2011

Insomnia and Pain.

The sleep cycle is composed of 4 stages. Stage 1 is light sleep, Stage 4 is a deep sleep. Stage 4 is the most restful/restorative sleep. After Stage 4 we enter REM Sleep (Rapid eye Movement). This is the stage in which we dream. At night we go through this roughly 90 minute cycle multiple times spending less time in stages 3-4 and more time in REM sleep. How often one wakes up throughout the night varies by person and is not harmful unless it causes daytime sleepiness.

Pain can cause difficulty falling asleep and frequent awakenings throughout the night. This often limits the depth of the sleep cycle preventing the restful/restorative sleep and causing someone to wake up feeling tired despite having "slept" all night. Pain leads to decreased activity during the day which also hampers stage 3 and 4 restful sleep. For the patient in pain, less restful sleep causes more pain/anxiety/stress/depressed mood and less ability to cope with their pain.

Treatment for insomnia due to pain involves treating the pain, but also limiting factors that can make sleeping difficult for someone without pain. See "Rules for Sleep" and "Eating for Insomniacs" in future blog posts.

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