Chronic Pain & Sleep Apnea: Is There A Link?

July 18, 2011

Here’s a shocking statistic put out by the National Academy of Sciences—that 116 million Americans (37%) suffer from chronic pain. That’s more than diabetes, heart disease, and cancer combined. The article in the New York Times emphasizes the importance of more recognition of this condition by doctors. However, I doubt we’re ever going to make a significant dent in treating chronic pain unless we deal with their sleep issues.

It’s easy to argue that chronic pain can negatively affect your sleep quality. However, you can also argue that poor sleep can predispose you to chronic pain, once you experience a trigger (such as an accident, trauma, weight gain, or an operation). It’s been shown that poor sleep can lower your pain thresholds: Sleep deprived people were found to pull their fingers from a hot environment much quicker than people who had normal sleep. What this means is that the less quality or quantity of sleep you have, the more likely you’ll sense pain at very low levels.

If you think about the total number of people with obstructive sleep apnea (and even UARS), it’s probably about 1/4  to 1/3 of the population. Coincidence?

One general concept that Dr. Christian Guilleminault of Stanford describes is that sleep apnea patients have diminished nervous systems, whereas upper airway resistance syndrome (UARS) patients have intact nervous systems. In fact, I would argue that people with UARS have hypersensitive nervous systems. These are also the people who are overly sensitive to weather changes, chemicals, fumes, perfumes, odors and smoke. So perhaps people who are predisposed to chronic pain also have UARS.

Is it just coincidence that most of the patients that I see who have some sort of chronic pain also can’t sleep on their backs, have had excessive dental extractions, or have a parent that snores heavily? Most people with UARS can’t (or prefer not to) sleep on their backs, since that causes the tongue to fall back from gravity. Excessive dental extractions (usually from modern orthodontics) contracts the oral cavity space, leaving less room for the tongue, especially when in deep sleep, causing more frequent obstructions and arousals. As the person with UARS moves up the continuum, they’re more likely to progress into obstructive sleep apnea (like one or both parents).

If you’re truly committed to treating chronic pain patients, you have to simultaneously treat any underlying sleep-breathing problems. Giving sleeping pills just won’t cut it.

 

Written by Steven Park · Filed Under Blog | 3 Comments 

Surprising News About Alternative Medicine

July 31, 2009

Americans spent $34 billion in a single year on alternative and complementary medicines. "Natural" products, not including vitamins and minerals, made up the bulk of self-care spending. This estimate was found in a recent survey sponsored by the CDC’s National Center for Health Statistics. Almost $50 billion was spent on out of pocket for doctor’s visits and $48 billion on prescription medications. Compared to 10 years prior, overall visits to complementary practitioners dropped about 50%, but visits to acupuncturists increased significantly. 
 
The biggest surprise was that chronic pain, especially back pain, was the most common reason for people to use alternative treatments. Without getting into the complicated reasons for chronic pain, one important issue that’s often ignored when it comes to this issue is the importance of good sleep. It’s been shown that lack of a good night’s sleep can lower your pain thresholds. In other words, you’ll sense pain a lot earlier and at more magnified levels than if you got a good night’s sleep. Ultimately, it doesn’t matter what comes first. Once it starts, it’s a vicious cycle. This is why both the cause of the pain as well your sleep issues must be addressed simultaneously. 
 
I’m going to address some of these issues on September 15th, when I interview Dr. Jacob Teitelbaum, who’s a renowned expert in chronic fatigue, fibromyalgia, and chronic pain and sleep. Check my Upcoming Events calendar for up to the minute registration information.
 
 

Written by Steven Park · Filed Under Blog | Leave a Comment 

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