Crying children, noisy neighbors, a weak bladder – the things that can wake us up at night are many. But for some, there is another troubling cause: pain.
Painsomnia is a medical condition in which people go to bed relatively comfortably, but while they sleep their pain increases and they wake up.
The number of people affected is unclear, but a 2014 study in the Journal of Pain found that up to 88 percent of people with chronic pain have sleep problems, while 50 percent of insomniacs suffer from chronic pain.
Painsomnia is a medical condition in which people go to bed relatively comfortably, but while they sleep their pain increases and they wake up
And the problem is, it can turn into a vicious cycle – because in addition to causing depression, anxiety, poor memory and concentration, lack of sleep can also increase sensitivity to pain, increasing the chance of waking up.
Why isn’t clear, although one theory is that sleep deprivation causes the increased production of inflammatory chemicals called cytokines that directly affect nerve cells, increasing pain.
But why should the pain increase when we sleep? In fact, there are many reasons why pain can wake us up, explains Dr. Ilan Lieberman, a pain medication consultant at Manchester University Hospital Foundation Trust, “from the way we sleep to an underlying health problem.”
The inflammation strikes at night
In some cases, it is the result of the body clock, which not only affects our sleep, but also regulates other bodily mechanisms, including inflammation.
In certain inflammatory conditions, such as rheumatoid arthritis (caused by the body’s immune system attacking the joints), the inflammation works according to a body clock schedule, explains Dr. Julie Gibbs, a chronobiologist at the University of Manchester.
“Ironically, there seems to be a more active inflammation in the resting phase (ie while you are asleep), but it is not clear why.”
The pain signals passed between the nerves and the brain overwhelm the brain pathways, which usually diminish or suppress consciousness to allow us to sleep and wake us up.
In certain inflammatory conditions, such as rheumatoid arthritis (caused by the body’s immune system attacking the joints), the inflammation works according to a body clock schedule, explains Dr. Julie Gibbs, a chronobiologist at the University of Manchester.
In some cases, it is the result of the body clock, which not only affects our sleep, but also regulates other bodily mechanisms, including inflammation
Gout attacks – a type of arthritis that causes sudden, severe joint pain that’s also related to inflammation – are twice as common during the night and early morning than during the day, according to a 2014 study from Harvard Medical School.
One theory here is that a nighttime dip in the hormone cortisol is to blame. “High cortisol levels can suppress inflammation,” explains Dr. Gibbs. Taking an anti-inflammatory before going to bed or as soon as you wake up can help reduce pain before it gets worse.
Lying down hurts muscles
The mere fact that we are in bed can encourage pain.
Joint pain can be a persistent cause of night pain, especially if it stems from a pre-existing condition, explains Steven Allder, a neurologist consultant at the Re: Cognition Health clinic in London, who himself sometimes wakes up with pain from a cartilage. . tear in his left knee.
If you have joint pain at night, it could be because the joint is stiff from not moving. I tore my cartilage because I was running too much and the pain woke me up around 4am and I have to take painkillers, ” he says.
‘I can’t straighten my knee at night because I’m asleep, that’s what causes the pain. ‘
Sciatica (in which the sciatic nerve running from your lower back to your feet is irritated or compressed) can occur at night, such as when you lie down, this can put pressure on the already irritated nerve and cause pain in the lower back or buttocks and legs the next morning
Tony Kochhar, an orthopedic surgeon at London Bridge Hospital and a professor of sports science at the University of Greenwich, says hip, shoulder and knee pain often produce a low throbbing sound, which is relieved by movement.
“During the day, you move the affected joint to keep it flexible,” he says. ‘But at night, the irritated tissue tightens. That increases the pressure in and around the joint, causing pain.
Sleeping positions can make things worse – you can press or twist an irritated joint in your sleep and that causes pain that can wake you up. That is why shoulder patients sleep against a pillow to relieve the pressure on the shoulder. ‘
Sciatica (where the sciatic nerve running from your lower back to your feet is irritated or compressed) can occur at night, such as when you lie down, this can put pressure on the already irritated nerve and cause pain in the lower back or buttocks and legs the next morning. It may help to use ice and anti-inflammatory drugs before going to bed.
Headache in the early hours
Sometimes the pain gets worse at night, even if we don’t have it during the day. This is the case with a toothache – when you lie down, more blood flows to our head, which puts pressure on areas in our mouth, says Dr. Charles Ferber, a dentist in London.
A less well understood reason for waking up at night is what’s known as “ alarm clock ” headaches, so called because they strike simultaneously – usually between 1 a.m. and 3 a.m. – which is more common in women over 50. These can last from 15 minutes to a few hours.
Although doctors are not sure of the cause – one theory is that they are related to the dream phase of sleep – some research suggests, counterintuitively, that drinking strong caffeine in the evening may help, although again it is not clear why . If the pain is severe, your doctor may prescribe the drug naproxen.
A less well understood reason for waking up at night is what are known as ‘alarm clock’ headaches, so called because they strike at the same time – usually between 1am and 3am – which is more common in over 50s Women
Cluster headaches are even more painful because they can wake you up for weeks at a time, says Dr. Andy Dowson, clinical chief of East Kent Headache Service. ‘It mainly affects men and causes throbbing pain, usually behind one eye.
“Over-the-counter pain relievers aren’t strong enough, so you should see your doctor for a more effective drug.”
Nighttime headaches can also be a sign of dehydration, because when the tissues surrounding your brain (which are mostly water) shrink, they can put pressure on the brain.
If nighttime headaches come out of the blue, see your doctor to make sure you don’t have a secondary headache [caused by] a primary problem such as increased pressure in the brain or the back of the eyes, ”adds Dr. Allder.
Meanwhile, a sudden, severe stomach pain that wakes you up at night can mean that the gallbladder is inflamed or that a gallstone – small stones, usually made of cholesterol, that form in the gallbladder – is passing, as this happens at night, usually several hours. after a heavy meal.
A new nocturnal pain that persists needs to be investigated. Safe, short-term medications, such as acetaminophen, are fine to take at night if you think you know the cause of the pain, ”says Dr. Lieberman. If you wake up every night, you need a diagnosis. So start by seeing your doctor. ‘
Happy hour
Daily activities that increase your happiness. This week: laugh more
Laughter is known to make us feel good – that’s because it triggers the release of mood-boosting chemicals called endorphins, according to a study published in the Journal of Neuroscience in 2017.
“There are three possible mechanisms that could all be involved,” explains Professor Robin Dunbar, a psychologist at Oxford University and one of the authors.
Laughter can cause the skin to move across the chest wall, causing neurons in the hair follicle to trigger the release of endorphins. The inner ear is full of these neurons, which can be stimulated when our head moves. Finally, emptying the lungs while we laugh can activate the endorphin system.
To maximize the release of endorphins, you should experience a good belly laugh – watch a comedy with friends if possible. “You’re five to thirty times more likely to laugh at a comedy video when you watch it with others,” says Professor Dunbar.
Rude health
A new shot could make it easier for women to conceive, Imperial College London said. The injection contains a drug that stimulates the production of the hormone kisspeptin, which stimulates other reproductive hormones. The shot kept these hormones elevated four times longer than kisspeptin alone, so may extend the window of conception.
5-a-day shortcut
Only one-third of us eat our recommended five servings of fruits and vegetables a day. Here, nutritionist Angela Dowden shows you how to do it in one delicious meal.
What to Eat: Butternut squash ‘noodles’ – you can make your own like zucchini – (one and a half servings) with sausage, tomato and a vegetable sauce (two and a half servings) and a side of carrot and apple salad (one serving) = five servings.
How to do it: For two, peel four sausages and stir-fry the meat for five to ten minutes; put aside. Fry half a chopped onion, a chopped bell pepper, half a chopped zucchini and 160 g sliced mushrooms in the fat.
Add a can of tomatoes, balsamic vinegar, season and simmer for ten minutes. Add the sausage, heat and serve on 300 g of cooked pumpkin noodles. Serve with grated apple and carrot salad with mayonnaise.