Chronic Pain & Sleep Apnea: Is There A Link?
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. An 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 more quickly 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 or Upper Airway Resistance Syndrome), it’s probably about 1/4 to 1/3 of the population. Coincidence? One general concept that doctors at Stanford University describe is that sleep apnea patients have diminished nervous systems, whereas Upper Airway Resistance Syndrome (UARS) patients have intact nervous systems. In my experience, people with UARS have hypersensitive nervous systems. This means they 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 (but they may not recognize that this is the reason). 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).
The bottom line is…chronic pain patients should also be checked for sleep breathing problems. Taking sleeping pills can mask an dangerous underlying condition. For more information, contact our office for sleep disorder screening.