14 remedies for sleep apnea and pain
By Jason Wooden, PhD | September 20, 2019
If sleep apnea and pain is making it extra hard to get good sleep, you’re not alone. Over 50% of obstructive sleep apnea patients deal with chronic pain.
Pain makes it harder to fall asleep and stay asleep during the night. Poor sleep can increase your sensitivity to pain resulting in a vicious cycle of pain and poor sleep.
For better sleep, start with improving your sleep hygiene and making sure you keep your sleep apnea under control. For pain management, you can try pain meds, medical procedures, physical therapy, exercise, massage, and a variety of natural remedies.
Sleep apnea and pain, a two headed monster
Living with sleep apnea can be hard enough, but sleep apnea and pain together can make it almost impossible to get sleep.
Recently, I’ve was tossing and turning at night due to severe shoulder pain. It’s one of those annoying ergonomic injuries caused by sitting in front of a computer too long.
Prior to this, life was getting better with my sleep apnea mainly under control. For the past months, however, radiating pain has made it harder to fall asleep and sometimes wakes me up during the night.
If this sounds familiar, you’re not alone.
Did you know that over 100 million Americans suffer from chronic pain and over 70% of them have sleep issues?
The 2015 Sleep in American poll found that 57% of Americans experience chronic or occasional pain.
There are many different types of night time pain – headaches, back pain, neck pain, hip pain, arthritis, injuries, post-surgical pain, fibromyalgia, nerve damage, cancer, or other medical conditions.
They can all cause problems for sleep and make it harder to manage your sleep apnea. You also run the risk of getting into a downward spiral of poor sleep and pain if you’re not careful.
That’s a problem for the 18 million sleep apnea sufferers in the US and the nearly 1 billion sufferers worldwide.
Let’s take a look at what we know and what you can do about it.
To understand why sleep apnea and pain are so bad together, we first have to look at what pain does to sleep.
First off, pain makes it harder to relax and fall asleep. It can also cause you to wake up during the night as you toss and turn to get more comfortable, especially if you move in a way to cause a flare up.
Making matters worse, poor sleep can increase your sensitivity to pain.
So, if you’re not careful, you can enter a vicious cycle – poor sleep leads to more pain and more pain leads to poorer sleep.
Did you know that over 50% of obstructive sleep apnea patients deal with chronic pain issues?
You probably know from personal experience that morning headaches are more common in sleep apnea patients.
Regardless of which pain your dealing with, it’s makes it harder to keep your sleep apnea under control because maintaining good sleep hygiene is an important part of recovering from a sleep disorder.
(Sleep hygiene is the things you do during the day and at bedtime to set the stage for good sleep.)
Ongoing night pain issues can lead to more anxiety, depression, and stress which can make it tougher to fall asleep. This in turn can also lead to more inflammation which can worsen pain and sleep apnea symptoms.
It’s because of these many complications that sleep apnea and pain can become a two headed monster.
Other things you that can make your pain worse
Did you know you may be unwittingly making it harder to manage your sleep apnea and pain? There are lots of things you do every day that can aggravate pain symptoms.
Inactivity – A sedentary lifestyle can increase your risk for chronic pain.
Junk food – Some of your favorite foods and snacks unfortunately can cause inflammation and aggravate your pain. This includes dairy, nightshade vegetables, processed meats, sugar, and other refined carbs.
Stress – Feeling stressed out can trigger the body’s “fight-or-fight” response which can cause more inflammation and aggravate pain. Learn more
Smoking – It may bring short-term relief, but over the long-term worsen pain. Nicotine can slow healing and cause degeneration in parts of the body. Learn more
Okay, what can I do about my sleep apnea and pain?
Now, we get to some good news – there’s actually quite a bit you can do to deal with your sleep apnea and pain.
Start with sticking with your sleep hygiene and doing everything you can to keep your sleep on schedule. That includes avoiding stimulants and electronics in evening, maintaining a bedtime routine, and having an optimal bedroom environment for sleep.
You should also make sure you have a sleep apnea treatment that’s working for you. Some people have a hard time with CPAP, the most common obstructive sleep apnea treatment, and give up. That’s for sure to keep you in the cycle of pain and poor sleep.
Today, there are plenty of options to pick from including positioning devices, innovative neural therapies, and surgical implants. (Go here for a quick rundown of all your options.)
Don’t forget talk to your doctor or a pain specialist. They can check for other things that worsening your symptoms and recommend pain management options.
And here’s what you can do for your pain:
1) Pain meds
Your options include popular over the counter relievers such as acetaminophen (Tylenol) and ibuprofen (Advil). There are also powerful prescription painkillers such as codeine, morphine, oxycodone, and Vicodin. Learn more
2) Medical procedures
Electrical stimulation, nerve blocks by injection, and acupuncture are the most commonly performed procedures. Surgery may be done to fix injuries that healed wrong and contribute to pain. Learn more
3) Check your ergonomics
Humans aren’t designed to sit in front of a desk and computer 8 hours a day. The result is injuries to the shoulder, wrist, elbows, neck, back and hands. Make sure you have an ergonomic setup. Learn more
Likewise, if you’re doing heavy lifting or other repetitive tasks make sure you’re doing it properly. Learn more
5) Improve your bed support
An old “out of shape” mattress can lead to more aches and pains. Find a mattress that works better for your body type and the way you sleep. Learn more
(Here’s a website with reviews of the best ones for hip pain and lower back pain. They also have reccommendations for side and back sleepers.)
6) Physical therapy
Physical therapy is good for strengthening muscles and increasing flexibility which can help keep you from aggravating old injuries and getting new ones. It’ll also increase blood flow and reprogram your nervous system to make it less sensitive to pain. Learn more
7) Physical activity
Contrary to what you may think, studies have found exercise can help people manage their pain. Gentle activities such as walking or swimming can help improve your pain threshold. Learn more
8) Try an anti-inflammatory diet
These diets have grown in popularity as a natural way to help the body heal. They focus on avoiding specific foods shown to increase inflammation in the body and consuming more foods believed to be fight inflammation. Learn more
Did you know that pain has biological, psychological, and emotional factors? Psychotherapy can change the way you cope with their pain and change the stress response in the brain responsible for the release of chemicals that make pain worse. Learn more
12) Tai chi
Studies have shown Tai chi can help people manage pain. It uses breath control, meditation, and gentle movements to stretch and strengthen muscles. It can also relax the body and reduce stress. Learn more
Why medications aren’t the best long-term answer for your sleep apnea and pain
Okay, let’s be honest…popping a pill is a quick and convenient option when dealing with sleep apnea and pain. There are lots of choices over the counter or through a doctor.
However, you should keep in mind that the more powerful prescription painkillers have pretty serious downsides.
In particular, opioids such as codeine, morphine, oxycodone, and Vicodin have been linked to other health problems. The side effects include confusion, nausea, constipation, sexual dysfunction, low blood pressure, and itching.
Also, they are highly addictive and over time you need higher amounts to get the same effect. After 4 or more weeks of use, they may actually make you more sensitive to pain!
And, recent research has shown that opioids can hurt respiratory function which may cause problems for obstructive sleep apnea patients. If you’re not careful, they can also disturb sleep and worse sleep apnea symptoms.
Because of all these potential downsides, pain meds may be best used as a short-term remedy, making it important to figure out other ways to help manage your sleep apnea and pain.
5 Things to remember about sleep apnea and pain:
- Many obstructive sleep apnea patients deal with chronic pain
- Pain can wreck sleep, poor sleep can increase pain
- Stick with your sleep hygiene and sleep apnea treatment
- Medications, medical procedures, and natural remedies can be used for pain
- Use opiates with caution
1. The prevalence and awareness of sleep apnea in patients suffering chronic pain: an assessment using the STOP-Bang sleep apnea questionnaire. Nat Sci Sleep. 2018; 10: 217–224.
2. 2015 Sleep in America™ Poll Finds Pain a Significant Challenge When It Comes to Americans’ Sleep. National Sleep Foundation website
3. Nearly 1 Billion People Worldwide Have Sleep Apnea, International Sleep Experts Estimate, 2018, Sleep Review Magazine
4. Sleep and Pain: How Pain Contributes to Sleep Loss, 2019, Alaska Sleep Clinic website
5. Frontline Medical Communications
6. Breaking the Cycle of Chronic Pain and Disturbed Sleep, Neurology Reviews. 2014 August;22(8):30.
7. Upper airway and systemic inflammation in obstructive sleep apnoea, Eur Respir J. 2016, 48(4):1108-1117.
8. Why Smoking Will Worsen Your Chronic Pain, 2017, Health Essentials website
9. How does physical activity modulate pain?, Pain. 2017 Mar;158(3):369-370
10. Here’s How Stress and Inflammation Are Linked, 2018, Everyday Health website
11. Benefits and Risks of Opioids for Chronic Pain, 2019, Verywell website
12. Why opioids make pain worse, HealthPartners website
13. Opioids for Acute Pain Management in Patients With Obstructive Sleep Apnea: A Systematic Review, Anesth Analg. 2018;127(4):988-1001.
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