So sleep is devastatingly important. We all know this but unfortunately we don’t always value it. I know atleast for me I tend to put my career in front of sleep frequently and am probably paying the price in the long run.
After recently reading Matt Walker’s “Why We Sleep” (which you should definitely read) it became abundantly important how important sleep is for health. Matt talks a lot about sleep’s role in:
As a physical therapist it got me thinking about sleep and pain. Some of my favorite chronic pain mentors (like Adriaan Louw) have always mentioned that sleep is a game changer for rehabilitation of patients in chronic pain. Recently at the APTA orthopedic conference one of the speakers and prominent pain researchers Kathleen Slutka also mentioned just how closely linked the neurophysiology of pain and sleep are. I’ve always wanted to delve a bit more into the medical literature and see if we have some more evidence to support the importance of sleep in individuals with pain.
After a brief stint on pubmed.com I stumbled upon this gem of an article “The association of sleep and pain: An update and a path forward” The article was a literature update (Just what I wanted) that brought together some great information about sleep and pain. Turns out we have quite a bit of research to help us understand the link between sleep and pain. I’d recommend reading the study yourself (click the link above) but here are some extremely interesting tidbits from reading:
A large cross-sectional cohort study of cancer patients utilized structural equation modeling to suggest directionality in the sleep/pain association. In a series of analyses involving associations between depression, fatigue, sleep, and pain, the best fitting structural equation model included a path in which sleep predicted pain; inclusion of the reverse path—pain predicting sleep—produced a poorer fitting model that was dropped from final analyses.
So we have quite a bit of good information there. It seems that:
Wow, after reading this article it really solidified the importance of sleep for my patients. I’ve asked patients about sleep in the past but this reinforces it to another level. I should probably be asking about sleep more often! Do you talk to your painful patients about sleep and pain? If so, how do you integrate sleep hygiene into your rehabilitation or coaching practice?
Dan Pope DPT, OCS, CSCS
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