Sleep, stress and environmental factors for chronic pain

Chronic pain can vary from day to day and can sometimes flare-up dramatically (see also ‘Coping with flare-up‘). Those we talked to explained how pain could affect their sleep patterns. They also discussed the impact that fatigue and everyday stresses had on their pain. Pain could also be affected by other illnesses and environmental factors such as temperature.

Living with pain and coping with daily life can be tiring and many people that we talked to complained of fatigue. Getting to sleep and being disturbed at night were big issues for most people. Lack of sleep could often lead to increased pain.

Pain disturbs her during the night and if she doesn’t get enough sleep the pain will be bad the…

Age at interview 51

Gender Female

Age at diagnosis 39

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Some found that taking sleeping tablets or pain medication at night was helpful while others preferred to use relaxation techniques (see also ‘Pain management’ relaxation and distraction‘). Having a good bed was important and several people said that their electric blankets were ‘indispensable’.

A woman who found it painful to get up at night said that she avoided drinking anything after 8 o’clock so that she wouldn’t need to use the toilet until morning.

Some people said that if their pain disturbed them at night, they found it was better to get up and find something to distract them. A woman said this was the time she felt most isolated and wished there was someone she could phone.

Is often disturbed by pain at night and finds it a lonely time and wishes there was someone to…

Age at interview 47

Gender Female

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Another person recorded TV programmes and watched them during the night, others found it better to read. Some people rested or slept in the afternoon, although one man found that this could disturb his sleep pattern.

Often wakes with pain in the night so tapes programmes to watch at night.

Age at interview 49

Gender Female

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Says pain and fatigue go hand in glove but feels that it is better not sleep during the day.

Age at interview 49

Gender Male

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In order to make it easier to sleep at night, it is often recommended that people with pain avoid stimulants later in the evenings and try to minimise the naps they take during the day. During the night it is best to avoid stimulants like coffee or tea and things like the television or computer games as these are tiring rather than restful.

People were at their best at different times of day. Several people found getting up in morning particularly painful because they had stiffened up overnight, and found it helpful to have a bath or hot shower in the morning. Many said that they went to bed earlier because coping with pain tired them out.

Everyday stresses and strains of life had an impact on people’s pain. Some said that they were now less able to cope with stressful situations. Examples given included family arguments, bereavement, dealing with difficult tradesmen, Christmas or other family events, being late for an appointment, being stuck in traffic, the car breaking down or being let down by other people.

Some people noticed that their pain increased when they were stressed, upset or angry, and many felt they did not have enough energy left to deal with their pain which effectively lowered their pain ‘tolerance’.

Finds that her pain tolerance is lower if she has to deal with other stressful events.

Age at interview 49

Gender Female

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Explains that stressful events like Christmas, bereavement and dealing with young children can…

Age at interview 42

Gender Female

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Sometimes it was not until after an event that people realised how much their pain had increased. Pain itself could cause anxiety and frustration and some recognised it was important to break the cycle of stress and pain. (See also ‘Coping with the emotional impact of pain‘).

Describes how dealing with his first wifes illness and death resulted in increased pain.

Age at interview 66

Gender Male

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Realises that the anger and frustration he feels with his pain and limitations can make his pain…

Age at interview 54

Gender Male

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Coping with another illness such as flu or a cold could make pain more difficult to manage, particularly when people took to bed and stopped their usual stretching and exercises.

A few people reflected that their pain got worse during cold weather which was something they had thought only older people experienced. Several people commented on the need to keep themselves and their houses warm.