Crying children, noisy neighbors, a weak bladder – the things that can wake us up at night are many. But for some, there is another cause for concern – pain.
Painsomnia is a medical condition in which people go to bed in relative comfort, but while they sleep, the pain accumulates and wakes them up.
The number affected is unclear, but a 2014 study published in the Journal of Pain found that up to 88% of those living with chronic pain have difficulty sleeping, while 50% of insomniacs suffer from chronic pain.
Painsomnia is a medical condition in which people go to bed in relative comfort, but while they sleep, the pain forms and wakes them up.
And the problem is that it can become a vicious circle – because, in addition to causing depression, anxiety, poor memory and concentration, lack of sleep can also increase sensitivity to pain, increasing the chances of being awakened.
Why it is not clear, although a theory is that sleep deprivation increases the production of inflammatory chemicals called cytokines, which have a direct effect on nerve cells, thus increasing pain.
But why would the pain increase while 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 occurs at night
In some cases, it is the result of the body clock, which not only influences 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 the joints), the inflammation works according to the body’s clock program, 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’s not clear why.”
The pain signals transmitted between the nerves and the brain overwhelm the pathways of the brain, which usually reduce or raise awareness to allow us to sleep and shake us awake.
In certain inflammatory conditions, such as rheumatoid arthritis (caused by the body’s immune system attacking the joints), the inflammation works according to a body clock program, 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 influences our sleep, but also controls other bodily mechanisms, including inflammation.
Gout attacks – a type of arthritis that causes sudden, severe joint pain, also related to inflammation – occur twice as often during the night and early morning than during the day, according to a 2014 study by Harvard Medical School.
One theory is that guilt is a nocturnal dive into the hormone cortisol. “High cortisol levels can suppress inflammation,” says Dr. Gibbs. Taking an anti-inflammatory before bed or as soon as you wake up can help hit the pain before it gets worse.
The stretching hurts the muscles
The fact that we are lying in bed can encourage pain.
Joint pain can be a persistent cause of nocturnal pain, especially if it comes from a pre-existing condition, explains Steven Allder, a consultant neurologist at the Re: Cognition Health Clinic in London, who sometimes wakes up with cartilage pain. tear in his left knee.
“If you have joint pain at night, this may be due to the fact that the joint is stiff so that it does not move. I broke my cartilage while I was running too much, and the pain woke me up at about 4 in the morning and I have to take painkillers, “he says.
“The fact that I can’t straighten my knee at night because I’m sleeping triggers pain.”
Sciatica (if the sciatic nerve, which runs from the back to the feet, is irritated or compressed) can occur at night as when you lie down, this can put pressure on the already irritated nerve, causing pain in the lower back. of the back or buttocks and legs the next morning
Tony Kochhar, a consultant orthopedic surgeon at London Bridge Hospital and a sports science professor at the University of Greenwich, says hip, shoulder and knee pain often cause low-grade pulses that are relieved by movement.
“During the day, move the affected joint so that it remains flexible,” he says. But at night the irritated tissue tightens. This increases the pressure in and around the joint, which creates pain.
“Sleeping positions can make things worse – you can press on an irritated joint or twist in your sleep and this will cause you pain that can wake you up. Therefore, patients with a shoulder sleep embracing a pillow to relieve pressure on the shoulder.
Sciatica (if the sciatic nerve, which runs from the back to the feet, is irritated or compressed) can occur at night as when you lie down, this can put pressure on the already irritated nerve, causing pain in the lower back. of the back or buttocks and legs the next morning. Using ice and anti-inflammatory medications before bed can help.
Headaches in the first hours
Sometimes the pain gets worse at night, even if it doesn’t bother us during the day. This is the case with toothache – lying down causes us to rush more blood to the head, putting pressure on the areas of the mouth, says Dr. Charles Ferber, a dentist in London.
A less well-understood reason for waking up at night is what is known as the “alarm clock”, the so-called because they strike at the same time – usually between 1am and 3am – which tend to affect more than 50 years, more often women. These can last from 15 minutes to several hours.
Although doctors are not sure – one theory is that they are related to the dream stage of sleep – some research suggests, counter-intuitively, that heavy caffeine consumption in the evening can help, although again, it is not clear why. If the pain is severe, your doctor may prescribe naproxen.
A less well-understood reason for waking up at night is what is known as the “alarm clock”, the so-called because they strike at the same time – usually between 1am and 3am – which tend to affect more than 50 years, more often women
Even more painful are group headaches because they can wake you up for weeks at a time, says Dr. Andy Dowson, clinical head of the East Kent Headache Service. “It mainly affects men and causes throbbing pain, usually behind one eye.
Over-the-counter painkillers are not strong enough, so you should consult your doctor for a more effective medicine.
Nocturnal headaches can also be a sign of dehydration, because when the tissues around your brain (and which are mostly made of water) shrink, they can put pressure on your brain.
“If you have a headache at night, see your family doctor to see if you have a secondary headache. [caused by] a primary problem, such as increased pressure in the brain or in the back of the eyes, ”adds Dr. Allder.
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 made of cholesterol, that forms in the gallbladder – is passing because this is happening. at night, usually a few hours after a heavy meal.
A new nighttime pain that is persistent should be investigated. Safe short-term medication, such as paracetamol, is 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 seeing yourself. the family doctor.
Happy hour
Daily activities that stimulate your happiness. This week: laugh more
It is well known that laughter can make us feel good – because it triggers the release of mood-boosting chemicals called endorphins, according to a 2017 study in the Journal of Neuroscience.
“There are three possible mechanisms that could all be involved,” explains Professor Robin Dunbar, a psychologist at Oxford University and one of the authors.
Laughter can cause the skin to move over the chest wall, causing neurons in the hair follicles to trigger the release of endorphins. The inner ear is full of these neurons, which can be stimulated as our head moves. Finally, emptying the lungs while laughing can activate the endorphin system.
To maximize endorphin release, you need to experience a proper belly laugh – when possible, watch a comedy with friends. “You’re five to 30 times more likely to laugh at a comedy video if you watch it with others,” says Professor Dunbar.
Rude health
A new jab could make it easier for women to conceive, according to Imperial College London. Jabul contains a drug that stimulates the production of the hormone kisspeptin, which stimulates other reproductive hormones. The jab has kept these hormones up four times higher than kisspeptin alone, so it can expand the conception window.
Quick order for 5 days
Only a third of us eat the recommended five servings of fruits and vegetables a day. Here, nutritionist Angela Dowden shows you how to make it into one delicious meal.
What to eat: butternut squash “noodles” – you can make your own like zucchini – (half portions) with sausages, tomatoes and a vegetable sauce (two and a half portions) and a part of carrot and carrot (one portion) = five servings.
How to make: For two, clean four sausages and fry the meat for five to ten minutes; put aside. In the fat, fry half a chopped onion, a chopped pepper, half a chopped zucchini and 160g sliced mushrooms.
Add a can of tomatoes, balsamic vinegar and season, then simmer for ten minutes. Add the sausages, heat and serve on 300g of boiled pumpkin noodles. Serve with grated apple and carrot with mayonnaise.