Chronic Pain Awareness, Sleep Disorders, and RLS

Last updated: November 2021

September was chronic pain awareness month. I am very painfully aware of chronic migraine disease and fibromyalgia. I am also aware that chronic pain complicates sleep in many ways.

In fact, my joint hypermobility was the first pain issue that caused sleep issues for me in childhood. Perhaps this is what made me more vulnerable to comorbid fibromyalgia and migraine disease, worsening sleep quality, and sleep disorders later on.

Chronic pain and sleep

Most people with chronic pain report poor sleep quality, and 1 in 4 people with chronic pain have a sleep disorder.1

Frequently waking up at night can be a common complaint with chronic pain and certainly is one of my major complaints. It makes sense that because of the pain, we have problems getting comfortable and that the pain itself wakes us up and we have to find a way to get comfortable again.

Then sleep disorders like restless legs syndrome (RLS) really complicate that. I wake up for the RLS and frequently have to actually get out of bed to deal with that whole issue which leads to extremely fragmented sleep.

How common are sleep disorders among people living with chronic pain?

A 2018 meta-analysis study on adults living with chronic pain found that the pooled prevalence of sleep disorders was 44 percent, with insomnia (72%), restless legs syndrome (32%), and obstructive sleep apnea (32%) being the most common diagnoses.2

I have collected all of the above. Perhaps that is because pain and sleep just do not seem to mix that well. Or perhaps because, specifically, fibromyalgia has some serious sleep dysfunction all on its own. Or more pain, more sleep dysfunction.

Restless legs syndrome and chronic pain

Specifically, widespread chronic pain has been studied along with RLS in Sweden. A study found that:3

  • RLS subjects who had enduring pain had shorter sleep duration, a longer time for sleep onset, more frequent wakings during sleep, and more daytime sleepiness.
  • When pain duration was longer, with more widespread and severe pain, these results were increased in intensity.

I have found this to be quite accurate for me when it comes to my severe RLS and chronic pain. Not only frequently waking up but also completely unable to get back to sleep due to symptoms. Often I manage 4 to 5 hours of sleep a night, to be honest. And this leads to significant daytime sleepiness and napping.

Sleep issues, pain, and painsomnia

Painsomnia is what people with chronic pain call the cycle of trying to sleep when in too much pain, which causes insomnia. This leads to more pain the next day – which leads to more difficulty sleeping – and more pain and more problems sleeping. You get the point. It is a serious pain problem.

However, continuous lack of sleep may actually be a significant factor in our pain problem as well. Not just a factor that interferes with our sleep, but also a factor that contributes to our pain and perhaps to comorbid pain disorders. In other words, the lack of sleep may make us more sensitive to pain. Getting quality sleep for an extended time may help with pain management.4

Either way, we all know the value and importance of quality sleep on overall health. I can tell you that living with chronic pain and being constantly sleep-deprived impacts pain and my capacity to cope with that pain significantly.

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