Crying children, noisy neighbors, a weak bladder – the things that can wake us up at night are numerous. But for some, there is another worrying cause – pain.
Painsomnia is a medical condition where people go to sleep relatively comfortably, but while sleeping, the pain builds up and awakens.
The number affected is unclear, but a 2014 study in the Journal of Pain found that up to 88 percent of those with chronic pain have difficulty sleeping, while 50 percent of insomnia suffer from chronic pain.
Painsomnia is a medical condition where people go to sleep relatively comfortably, but while sleeping, their pain is built up and awakened.
And the problem is that it can become a vicious circle. In addition to causing depression, anxiety, poor memory and concentration, a lack of sleep can also increase the sensitivity to pain, which increases the chances of waking up.
Why this is not clear, although one theory is that sleep deprivation causes the increased production of inflammatory chemicals called cytokines, which have a direct effect on nerve cells, thus increasing pain.
But why will pain build up when we sleep? In fact, there are many reasons why pain can wake us up, explains dr. Ilan Lieberman, a consultant in pain medicine at the Manchester University Hospital Foundation Trust, ‘from the way we sleep to an underlying health problem’.
Inflammation strikes at night
In some cases, it is the result of the body clock, which not only affects our sleep but controls other bodily mechanisms, including inflammation.
In certain inflammatory conditions, such as rheumatoid arthritis (caused by the body’s immune system attacking joints), inflammation works according to a scheme for the body clock, explains dr. Julie Gibbs, a chronobiologist at the University of Manchester.
“Ironically, there seems to be more active inflammation in the resting phase (ie while you sleep), but it is not clear why.”
The pain signals transmitted between the nerves and the brain overwhelm the brain pathways, which usually reduce or suppress our consciousness to enable us to sleep, and shake us awake.
In certain inflammatory conditions, such as rheumatoid arthritis (caused by the body’s immune system attacking joints), 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 controls other bodily mechanisms, including inflammation.
Gout attacks – a type of arthritis that causes sudden, severe joint pain that is also associated with inflammation – occur twice as often at night and early in the morning as during the day, according to a 2014 study by Harvard Medical School.
One theory here is that a nocturnal dip in the hormone cortisol is to blame. “High levels of cortisol can suppress inflammation,” explains Dr. Gibbs. Using an anti-inflammatory drug before going to bed or as soon as you wake up can help overcome the pain before it gets worse.
When you lie down, the muscles ache
The fact that we are going to lie in bed can encourage pain.
Joint pain can be a persistent cause of night pain, especially if it stems from a condition that already exists, explains Steven Allder, a neurologist at the Re: Cognition Health Clinic in London, and who sometimes wakes up from pain from a cartilage. tear in his left knee.
‘If you have joint pain at night, it could be because the joint is stiff so as not to move. ‘I tore my cartilage while running too much and the pain woke me up around 04:00 and I had to take painkillers,’ he says.
“If I can’t straighten my knee at night because I’m asleep, it’s causing the pain.”
Sciatica (where the hip nerve, which runs from your lower back to your feet, is irritated or compressed) can occur at night like when you lie down, it can put pressure on the already irritated nerve that causes shooting 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 cause throbbing, which is facilitated by moving around.
“During the day, you move the affected joint so that it remains flexible,” he says. ‘But at night the irritated tissue becomes stiffer. This increases the pressure in and around the joint, causing pain.
‘Sleeping positions can make things worse – you can press on an irritated joint or twist in your sleep and it can cause pain that can wake you up. This is why shoulder patients sleep with a pillow to take pressure off the shoulder. ‘
Sciatica (where the hip nerve, which runs from your lower back to your feet, is irritated or compressed) can occur at night like when you lie down, it can put pressure on the already irritated nerve that causes shooting pain in the lower back or buttocks and legs the next morning. It can help to use ice and anti-inflammatory drugs before bed.
Headache in the early morning hours
Sometimes pain gets worse at night, even if it does not bother us during the day. This is the case with toothache – when we lie down, it causes more blood to rush to our heads, which puts pressure on the areas in our mouths, says Dr Charles Ferber, a dentist in London.
A less well-understood reason for waking up at night is the so-called ‘alarm’ headache, supposedly because it strikes at the same time – usually between 01:00 and 03:00 – which tends to affect those over 50. women. This can take from 15 minutes to several hours.
Although doctors are not sure of the cause – one theory is that it is related to the dream stage of sleep – some studies suggest that drinking strong caffeine in the evening may help counter-intuitively, but 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 the so-called ‘alarm’ headache, supposedly because it strikes at the same time – usually between 01:00 and 03:00 – which tends to affect those over 50. women
Cluster headaches are even more painful because they can wake you up for weeks at the same time, says Dr. Andy Dowson, clinical head of East Kent Headache Service. ‘It mostly affects men and causes throbbing pain, usually behind one eye.
“O-counter painkillers are not strong enough, so consult your doctor for a more effective remedy.”
Nocturnal headaches can also be a sign of dehydration, because if the tissues that surround your brain (and which mostly consist of water) shrink, it can put pressure on the brain.
‘If the night headache came out of the blue, go to your GP to see if you do not have a secondary headache. [caused by] a primary issue such as increased pressure in the brain or in the back of the eyes, ‘adds dr. Allder by.
Meanwhile, a sudden, severe stomach ache that wakes you up at night can mean that the gallbladder is inflamed or that a gallstone – small stones, usually of cholesterol, that form in the gallbladder – passes, as it usually does at night. ‘ a few hours after a heavy meal.
A new pain at night that is persistent should be investigated. ‘Short-term safe medications such as paracetamol are good 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 with your GP. ‘
Happy hour
Everyday activities that increase your happiness. This week: laugh more
It is known that we can make ourselves feel good by laughing – this is because it causes the release of mood-enhancing chemicals called endorphins, according to a study published in the 2017 Journal of Neuroscience.
“There are three possible mechanisms by which everyone can be involved,” explains Professor Robin Dunbar, a psychologist at the University of Oxford and one of the authors.
Laughter can cause the skin to move across the chest wall, causing neurons in the hair follicles to release endorphins. The inner ear is full of these neurons, which can be stimulated as our head moves. Finally, emptying the lungs while we are laughing can activate the endorphin system.
To maximize the release of endorphins, you need to experience a proper tummy tuck – watch a comedy with friends where possible. “You are between thirty and five times more likely to laugh at a comedy video if you watch it with others,” says Professor Dunbar.
Rude health
According to Imperial College London, a new stitch can make it easier for women. The jab contains an agent that increases the production of the hormone kisspeptin, which stimulates other reproductive hormones. The jab increased these hormones four times longer than kisspeptin alone, so the conception window could be expanded.
5-per-day shortcut
Only a 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 yourself like zucchini – (one-and-a-half servings) with sausage, tomato and a vegetable sauce (two-and-a-half servings) and’ one side of carrot and apple salad (one serving) = five servings.
How to do it: Spoon four sausages for two and stir-fry the meat for five to ten minutes; set aside. Saute half a chopped onion, a chopped pepper, half a chopped zucchini and 160 g mushrooms in the fat.
Add a can of tomatoes, balsamic vinegar and season, then simmer for ten minutes. Add the sausage, heat it and serve with 300 g cooked butternut squash noodles. Serve with grated apple and carrot salad with mayo.