Science has shown that quality sleep has an impact on almost every aspect of health and well-being, from performance to the prevention of disease. But there is also evidence of a direct link between sleep and pain. That doesn’t come as a surprise. If you are suffering from a sports injury, it is likely to hurt more if you’ve been awake half the night. And it’s a vicious cycle; if you are in pain, it’s harder to fall asleep. Professional athletes have been using sleep as a method of healing for several years, and it’s a page you can take out of their book for your own pain and recovery challenges. A recent study on the pain/sleep connection shows that getting your seven or eight hours of recommended shut-eye can reduce the intensity of your pain, whether it stems from a broken arm or backache.
“Sleep loss not only amplifies the pain-sensing regions in the brain, but blocks the natural analgesia centers, too,” says Matthew Walker Ph.D., author of Why We Sleep, professor of neuroscience and psychology at U.C. Berkeley, and the senior author of the study. (In other words, if you don’t sleep well, you can’t unlock your body’s natural painkillers.) “The optimistic takeaway is that sleep is a natural analgesic that can help manage and lower pain,” he notes.
Walker’s colleague, Adam Krause, a Ph.D. candidate in cognitive neuroscience at Berkeley, and the study’s lead author, took a group of 25 healthy volunteers in their early to mid 20s and deprived them of a whole night’s sleep. “In the morning, when they had been awake for 25 or 26 hours, we put them in an MRI scanner and tested how their brains responded to moderate heat pain on the leg, using a device that delivers controlled temperature pulses,” Krause tells Thrive.
The participants felt more pain when they were sleep-deprived, compared to when they had a normal night of sleep (they were tested twice, once after a good night’s sleep, the next time after they’d been up all night). “We found that the pain-processing regions of the brain were acting differently after sleep deprivation,” explains Krause. “We already knew that these regions would be overactive; so with increased pain, they were on overdrive,” he says.
The surprising discovery, Krause continues, “is that the story about sleep and pain is more interesting than we’d thought. We found that while some regions of the brain were more active, other regions were less active after sleep deprivation.” What that means, Krause explains, is that some parts of the brain register pain from the body, and others deal with that pain, for example, using the body’s natural pain killers. “Think about these ‘natural pain killers’ as chemicals like endorphins that the brain releases in response to pain,” says Krasue. “They let you know you need to remove your hand from a hot stove for example. When you are sleep deprived, it takes less heat when you touch the stove to cause pain, and that pain is even more unpleasant when haven’t slept, because the region of the brain that normally helps you cope with pain is not fully functioning. It is normally there to protect you, and in some cases inhibit pain, but it has essentially fallen asleep at the wheel.”
The study’s findings confirm that pain is a ‘whole-body’ phenomenon, says Krause, which could have an impact on treatment. “What we found explains the self-perpetuating cycles that contribute to the overlapping global epidemics of sleep loss, chronic pain, and even the opioid addiction. If patients sleep well, doctors may be able to reduce the dosage of these powerful but dirty drugs that have ugly side effects,” says Krause, adding that the drugs can also impact sleep adversely because they may create a pain-reinforcing loop. Sleep deprivation follows, which blocks the natural resolution of pain and keeps it going until it becomes chronic.
Rather than always prescribing drugs, says Krause, doctors could prescribe sleep in some cases. He notes that pain is a natural part of life and it’s impossible to eliminate it. But research shows that when people have long-term pain, their brains have changed in ways that make it almost impossible for the pain to resolve itself. “In certain cases, pain begets more pain,” says Krause. “This is known as sensitization and can lead to chronic pain, which is hard to treat with traditional painkillers.” The Berkeley team report that improving quality sleep is one new approach to prevent the transition from an acute injury to chronic pain. “It works by recruiting the brain’s natural pain-killing response and helps with treatment-resistant chronic pain,” Krause says.
They also observed that because the “higher level brain” is affected by sleep loss, If people get more sleep, they could improve their resilience to pain. “If you lose sleep, you hurt more; so logically, if you sleep more, you hurt less.”
Here are Krause’s suggestions to lessen pain through better sleep:
Dark, cool, screen-free, caffeine-free, alcohol-free nights
If you’re in pain and having trouble getting enough sleep, make sure you have a dark bedroom and keep the temperature relatively low (60-67 degrees according to the National Sleep Foundation). Stay away from screens at least an hour before bed. And remember, no caffeine or alcohol close to bedtime.
A hot shower at night
Taking a hot shower an hour before bedtime can be effective if you don’t feel sleepy. It sounds simple, but there’s actually science behind this. The hot water paradoxically cools down the inside of your body — your core body temperature. It is relaxing, but also signals to the body that it’s time to go to sleep, so the body starts recruiting its natural sleep-promoting hormones and chemicals.
A mindfulness meditation for pain and sleep can be effective, particularly for chronic pain, and some people find it helps to make meditation part of their evening ritual as they prepare for a restful night’s sleep.
On that note, regularity of bedtime and wake up times are important. Go to bed and wake up at the same time every day, including weekends. Sleeping in on the weekend may seem nice, but it doesn’t do anything to help you recover from lack of sleep during the week.
Make sleep a priority
Protect your sleep at all costs, because it’s going to help you recover from injuries faster, and make you more resilient. Sleep is powerful. Not only can it help release your body’s own natural painkillers, it can heighten your psychological ability to tolerate pain and adversity in all sorts of forms, while also helping you be at your most productive, whether you struggle with pain or not.