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What it is
Chronic pain affects up to 15 per cent of the population – 88 per cent report experiencing some form of sleep complaint.

The relationship between pain and sleep is bi-directional meaning they feed off each other. Pain disturbs sleep; poor sleep leads to increased pain sensitivity.

Many studies have shown that improving long term sleep quality can improve chronic pain.

Recommended advice
Here are some clinically proven ways to sleep better when suffering from chronic pain:

Sleep Essentials - Given the impact of sleep deprivation on pain it’s important to prioritise sleep and stick to a regular sleeping pattern. If you have a poor night’s sleep because of pain, don’t try to catch up on lost sleep. This only confuses the body’s internal body clock and sets you up for another poor night the next night.

Lifestyle - If you’re not sleeping well it’s easy to fall into unhelpful lifestyle habits to keep yourself going. Getting the basics right is important here. Lead a healthy lifestyle by eating well, limiting alcohol and caffeine and implementing a good wind down routine at night.

Therapy - Research has found that Acceptance and Commitment Therapy or ACT helps treat chronic pain and improves sleep. ACT helps people accept and experience the mental, emotional and physical challenges they face when they’re unable to sleep. Paradoxically, when we become more accepting of the challenging symptoms connected to poor sleep and pain, people report reduced levels of alertness and pain sensitivity, as well as less anxiety.

Physicalising is an ACT tool you can practice if you find yourself awake at night struggling to sleep due to pain. Here’s how to practice:

Focus on the movement of your breath - this brings you back to the present. Don’t change your breath’s rhythm. Simply watch as you breathe in and out. If it feels comfortable, close your eyes.

Now focus your attention onto where you feel pain in your body and describe it objectively in your mind. For example, “I feel pain in my back”.

Use your imagination to describe the pain further, as if it’s an object inside you and you’re simply noting down its characteristics, such as shape, size, weight, colour, temperature and texture.

For example, you could say, “The pain in my back feels like a red hot sharp knife that’s stabbing and twisting”.

There are no right or wrong answers, you’re just using your imagination to describe your pain as a physical object.

Practice for a few minutes then come back to resting in bed.

Be as neutral as possible. This lessens the emotional pain and heightened alertness connected to it, opening up the potential for sleep to arrive naturally.

Further help
If you struggle with insomnia as a result of your chronic pain, watch the insomnia videos.
References
Vitiello, M. V., McCurry, S. M., Shortreed, S. M., Baker, L. D., Rybarczyk, B. D., Keefe, F. J., & Von Korff, M. (2014). Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia. PAIN®, 155(8), 1547-1554.

McCracken, L. M., Williams, J. L., & Tang, N. K. (2011). Psychological flexibility may reduce insomnia in persons with chronic pain: a preliminary retrospective study. Pain Medicine, 12(6), 904-912.

Daly-Eichenhardt, A., Scott, W., Howard-Jones, M., Nicolaou, T., & McCracken, L. M. (2016). Changes in sleep problems and psychological flexibility following interdisciplinary acceptance and commitment therapy for chronic pain: an observational cohort study. Frontiers in psychology, 7, 1326.
Illustration: Ben O'Brien - www.ben-obrien.com