More than 10 million Americans with arthritis have regular sleep disturbances. National survey data shows an especially high rate among arthritis patients – nearly 23 percent. Only about 16 percent of people without arthritis have sleep-related complaints.
The study published in the October issue of Arthritis Care & Research analyzed findings from the 2007 National Health Interview Survey. More than 23,134 American adults answered a variety of health-related questions. Topics ranged from diet and exercise, to substance use, sleep and chronic health problems.
Nearly 1 in 5 survey respondents said they had been diagnosed with arthritis. The study did not differentiate the two types of arthritis, inflammatory and non-inflammatory. Non-inflammatory arthritis is more common and is most often caused by aging and injury.
Patients with uncontrolled pain, depression and anxiety had the highest risk, the study found. Complaints included inability to fall asleep, interrupted sleep and daytime fatigue. The authors suggest pain and joint mobility limitations related to arthritis may predict sleep problems, rather than just a diagnosis.
Sleep disturbances are often neglected as symptoms of arthritis, the study concluded. The authors contend that doctors should ask arthritis patients about sleep problems, and provide treatment.
Showing posts with label pain. Show all posts
Showing posts with label pain. Show all posts
Monday, October 18, 2010
Monday, August 30, 2010
Study: Medical Pot Helps Chronic Pain Patients Sleep
Managing sleep can be difficult when you’re in constant pain. A small amount of medical marijuana appears to help patients with chronic neurological pain sleep through the night.Patients with damaged nerves may experience seemingly unexplainable pain caused by a faulty signal in the body’s central nervous system. The initial pain may begin with a painful accident or medical condition. Untreated pain worsens by causing pathological changes to the brain and spinal cord.
One well-known example is the “phantom limb”, when an amputee feels pain located in a limb that no longer exists. There are several treatments for the physical anguish and sleeplessness from the condition, but there is no cure. The Sleep Education Blog reports cognitive-behavioral therapy can help patients manage pain and get to sleep at a regular bedtime.
The study on medical marijuana and chronic neurological pain appears in the August issue of the Canadian Medical Association Journal.
A group of 23 pain patients smoked three types of medical-grade marijuana with different levels of tetrahydrocannibinol (THC), the chemical compound that can cause a euphoric high. The potencies included 2.5%, 6% and 9.4% THC, as well as a placebo.
Participants were instructed to smoke the drug from a small pipe three times a day for five days. They did not know which type of pot they were smoking. They had a nine-day break before switching potencies.
Patients said they fell asleep faster and had better quality of sleep after they smoked more potent marijuana. Some experienced minor side effects including headaches, coughing, dizziness and dry eyes.
The study is among the first clinical trials investigating the uses and benefits of smoking medical marijuana. Most prior research uses THC extract to test marijuana’s medical effectiveness.
Marijuana is generally not recommended as a sleep aid. The drug can worsen your quality of sleep by reducing the amount of time spent in REM sleep. Regular users may become dependent on marijuana to sleep. Withdrawal from the drug can cause insomnia and strange dreams.
The American Academy of Sleep Medicine has not released a position statement on the use of marijuana as a sleep aid.
Image by Troy Holden
Sunday, February 21, 2010
Chronic Pain: Cognitive Behavioral Therapy Improves Sleep
A new study found that cognitive behavioral therapy (CBT) can significantly improve sleep for people with chronic neck or back pain.Many people living with chronic pain have poor sleep hygiene. Common mistakes include sleeping when they are not tired, sleeping in places other than the bedroom and watching TV in bed. These habits may lead to insomnia.
People taking medicine for their pain may be unwilling or unable to use sleep aids to treat their sleep problems. CBT provides a safe and effective alternative.
The study involved 28 people who experience chronic pain. Participants received eight weeks of therapy from a trained nurse therapist.
Therapy sessions established a set number of hours in bed, focused on negative thoughts about sleep and addressed unhealthy sleep behavior. Sleep diaries were used to track sleep. Pain and mood were measured throughout the study. Patients were followed for six months after treatment.
Patients who are interested in CBT but have limited access to face-to-face sessions can receive treatment online. Last year the Sleep Education Blog reported that online CBT programs have the potential to provide long-lasting effects for people who suffer from chronic insomnia.
The AASM recommends CBT as an effective treatment for chronic insomnia in adults. Consult a board-certified sleep expert at an AASM-accredited sleep center if you are suffering from an ongoing sleep problem.
Monday, August 17, 2009
Osteoarthritis: CBT for Insomnia Improves Sleep & Pain
A study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine involved 51 older adults with osteoarthritis and insomnia.
Twenty-three people received cognitive behavioral therapy for insomnia; they had an average age of 69 years. Each of the eight weekly CBT sessions lasted two hours; class sizes ranged from four to eight people.
CBT uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep. One common technique is relaxation training.
Results show that CBT improved self-reported sleep quality in people with osteoarthritis and insomnia. After treatment they fell asleep faster; they also spent less time awake during the night. Overall their sleep was much more efficient.
CBT also had a long-term effect; they were still sleeping better at a one-year follow-up. They also were sleeping more than 30 minutes longer each night.
Another finding was that people with osteoarthritis reported less pain after CBT for insomnia. The pain reduction was strongest during the month after the CBT sessions ended; a mild reduction in pain was reported one year later.
“Improvement of sleep may lead to improvement in co-existing medical or psychiatric illnesses, such as osteoarthritis or depression,” lead author Michael V. Vitiello, PhD, told the AASM. “These additional benefits can be seen in the long term.”
The NIAMS reports that osteoarthritis is the most common type of arthritis. It involves the loss of cartilage around the joints. It affects an estimated 27 million people in the U.S.; most often it occurs in older adults.
Last week the Sleep Education Blog reported that studies have linked sleep and pain sensitivity. Treatments that improve sleep quantity and quality may make a person less sensitive to pain.
This can be helpful for people with a chronic pain condition. But it is unlikely to solve the problem of pain for them.
“Pain may be an outcome that has only a limited range to change,” wrote Patricia L. Haynes, PhD, in a commentary that followed the study. “The pain is not going to go away.”
Learn more about insomnia due to medical condition on SleepEducation.com.
Twenty-three people received cognitive behavioral therapy for insomnia; they had an average age of 69 years. Each of the eight weekly CBT sessions lasted two hours; class sizes ranged from four to eight people.
CBT uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep. One common technique is relaxation training.
Results show that CBT improved self-reported sleep quality in people with osteoarthritis and insomnia. After treatment they fell asleep faster; they also spent less time awake during the night. Overall their sleep was much more efficient.
CBT also had a long-term effect; they were still sleeping better at a one-year follow-up. They also were sleeping more than 30 minutes longer each night.
Another finding was that people with osteoarthritis reported less pain after CBT for insomnia. The pain reduction was strongest during the month after the CBT sessions ended; a mild reduction in pain was reported one year later.
“Improvement of sleep may lead to improvement in co-existing medical or psychiatric illnesses, such as osteoarthritis or depression,” lead author Michael V. Vitiello, PhD, told the AASM. “These additional benefits can be seen in the long term.”
The NIAMS reports that osteoarthritis is the most common type of arthritis. It involves the loss of cartilage around the joints. It affects an estimated 27 million people in the U.S.; most often it occurs in older adults.
Last week the Sleep Education Blog reported that studies have linked sleep and pain sensitivity. Treatments that improve sleep quantity and quality may make a person less sensitive to pain.
This can be helpful for people with a chronic pain condition. But it is unlikely to solve the problem of pain for them.
“Pain may be an outcome that has only a limited range to change,” wrote Patricia L. Haynes, PhD, in a commentary that followed the study. “The pain is not going to go away.”
Learn more about insomnia due to medical condition on SleepEducation.com.
Thursday, August 13, 2009
Daytime Sleepiness Can Be a Pain
A study in the Aug. 1 issue of the journal Sleep reports that healthy people may be more sensitive to pain if they are sleepy.
The study involved 27 healthy, pain-free adults between 18 and 35 years of age. A physical exam, drug screening and lab tests confirmed that they were in good health. An overnight sleep study verified that they didn’t have a sleep disorder such as obstructive sleep apnea.
Participants were grouped as “sleepy” or “non-sleepy” based on the results of a multiple sleep latency test (MSLT). The 14 people in the sleepy group fell asleep after an average of less than five minutes during the four daytime nap sessions; it took an average of about 13 minutes for the 13 non-sleepy people to fall asleep.
All participants then spent eight hours in bed during a night at a sleep center. The following day another MSLT was conducted. Results show that the healthy, sleepy people remained sleepy even after spending eight hours in bed. They still fell asleep in less than five minutes during MSLT nap sessions.
The day after the eight-hour night in bed also involved two tests for pain sensitivity; tests were conducted at 10:30 a.m. and again at 2:30 p.m. Participants placed their index finger on a radiant heat source; then they withdrew their finger when they felt pain.
For each person a pain threshold was determined; this was the heat intensity that produced a finger withdrawal in less than 21 seconds. Then both index fingers were tested at five different heat intensities.
Sleepy people showed increased pain sensitivity – or “hyperalgesia.” At all five heat intensities they withdrew their finger faster than non-sleepy people. They also had a lower pain threshold than non-sleepy people: 83 degrees versus 90 degrees. People in both groups were more sensitive to pain in the afternoon than in the morning.
Previous studies also have linked sleep and pain sensitivity. A 2007 study in the journal Sleep found that disrupted sleep increases spontaneous pain. A 2006 study in the journal Sleep showed that the loss of four hours of sleep promotes hyperalgesia. In 2000 a study reported that 40 hours of total sleep deprivation increased pain sensitivity.
The study involved 27 healthy, pain-free adults between 18 and 35 years of age. A physical exam, drug screening and lab tests confirmed that they were in good health. An overnight sleep study verified that they didn’t have a sleep disorder such as obstructive sleep apnea.
Participants were grouped as “sleepy” or “non-sleepy” based on the results of a multiple sleep latency test (MSLT). The 14 people in the sleepy group fell asleep after an average of less than five minutes during the four daytime nap sessions; it took an average of about 13 minutes for the 13 non-sleepy people to fall asleep.
All participants then spent eight hours in bed during a night at a sleep center. The following day another MSLT was conducted. Results show that the healthy, sleepy people remained sleepy even after spending eight hours in bed. They still fell asleep in less than five minutes during MSLT nap sessions.
The day after the eight-hour night in bed also involved two tests for pain sensitivity; tests were conducted at 10:30 a.m. and again at 2:30 p.m. Participants placed their index finger on a radiant heat source; then they withdrew their finger when they felt pain.
For each person a pain threshold was determined; this was the heat intensity that produced a finger withdrawal in less than 21 seconds. Then both index fingers were tested at five different heat intensities.
Sleepy people showed increased pain sensitivity – or “hyperalgesia.” At all five heat intensities they withdrew their finger faster than non-sleepy people. They also had a lower pain threshold than non-sleepy people: 83 degrees versus 90 degrees. People in both groups were more sensitive to pain in the afternoon than in the morning.
Previous studies also have linked sleep and pain sensitivity. A 2007 study in the journal Sleep found that disrupted sleep increases spontaneous pain. A 2006 study in the journal Sleep showed that the loss of four hours of sleep promotes hyperalgesia. In 2000 a study reported that 40 hours of total sleep deprivation increased pain sensitivity.
The authors state that the solution can be simple for healthy, sleepy people: Spend more time in bed each night to get more sleep. But managing sleep can be more complex in people with chronic medical problems. In this case the authors suggest that a medication or cognitive behavioral therapy (CBT) may be needed to increase sleep time.
Tuesday, April 21, 2009
Sleep Problems Increase Cancer Pain
A new study in the Journal of Clinical Sleep Medicine shows that sleep problems may lead to increased pain and fatigue in cancer patients.
Previous research has shown that sleep problems are common in people who have cancer. A 2007 study in the journal Sleep found that 41 percent of people with cancer reported having chronic insomnia.
So why are the results of this new study surprising? It was expected that pain would be a cause of sleep problems. But instead the evidence pointed in the other direction; the study found that sleep problems may lead to an increase in pain.
“We believed we would find a bi-directional relationship between insomnia and pain,” study author Edward J. Stepanski told the AASM. “But instead…trouble sleeping was more likely a cause, rather than a consequence, of pain in patients with cancer.”
The study involved 11,445 cancer patients. About 74 percent were women; 29 percent had breast cancer. More than half of the study subjects reported having trouble sleeping; 26 percent had moderate or severe sleep problems. Increases in depressed mood also led to increased ratings of pain.
The average age of participants was 61.5 years. Younger people were more likely to have trouble sleeping. The authors suggest that this may be a treatment effect since younger patients often receive more aggressive chemotherapy.
Stepanski said that cognitive behavioral therapy (CBT) can help cancer patients who have insomnia. Improving their sleep may reduce their pain and fatigue.
A 2007 study in the journal Sleep showed that disturbed sleep can affect your pain threshold. It can impair how the body inhibits pain. It also can increase spontaneous pain.
Previous research has shown that sleep problems are common in people who have cancer. A 2007 study in the journal Sleep found that 41 percent of people with cancer reported having chronic insomnia.
So why are the results of this new study surprising? It was expected that pain would be a cause of sleep problems. But instead the evidence pointed in the other direction; the study found that sleep problems may lead to an increase in pain.
“We believed we would find a bi-directional relationship between insomnia and pain,” study author Edward J. Stepanski told the AASM. “But instead…trouble sleeping was more likely a cause, rather than a consequence, of pain in patients with cancer.”
The study involved 11,445 cancer patients. About 74 percent were women; 29 percent had breast cancer. More than half of the study subjects reported having trouble sleeping; 26 percent had moderate or severe sleep problems. Increases in depressed mood also led to increased ratings of pain.
The average age of participants was 61.5 years. Younger people were more likely to have trouble sleeping. The authors suggest that this may be a treatment effect since younger patients often receive more aggressive chemotherapy.
Stepanski said that cognitive behavioral therapy (CBT) can help cancer patients who have insomnia. Improving their sleep may reduce their pain and fatigue.
A 2007 study in the journal Sleep showed that disturbed sleep can affect your pain threshold. It can impair how the body inhibits pain. It also can increase spontaneous pain.
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