In Pain? Trying Sleeping More: the Sleep-Pain-Inflammation Connection

Cort

Founder of Health Rising and Phoenix Rising
Staff member

Sleep is turning out to be a bigger factor in pain that most people realized. Most people in chronic pain get poor sleep - that's understandable - but what's more surprising is that half the people who suffer from insomnia also suffer from chronic pain. It turns out that poor sleep is actually more predictive of having chronic pain than chronic pain is predictive of having poor sleep.

The takeaway is that if you want to reduce the pain you're in one good way to do that is to get better sleep. [fright]

Dog-Sleeping-With-Alarm-Clock--40123960.jpg
[/fright]Positive emotions are also very helpful. Studies indicate that you're a lot more resilient with regards to pain if you can maintain some sort of positive outlook.

Positive emotions confer resilience against chronic pain. When subjected to an acute stressor people who were able to maintain their positive outlookexperienced less pain than those who could not.

“Among patients with chronic pain, those who are able to generate positive emotions tend to adapt better to their pain conditions and have better outcomes, such as lower pain levels, better physical function, and more prosocial behavior,”
The downside is that if you're not getting enough sleep it's appears that it's doubly hard to generate positive emotions. Continual sleep disruption, in particular, appears to inhibit one's ability to generate positive emotions; i.e. positive effect.

"Several studies have shown that sleep loss leads to impaired positive affect, without appreciably changing negative affect, indicating that sleep loss might sap patients of good feelings and render people more vulnerable to pain.
Where does this "positive effect" come from? The dopaminergic reward system - a system that has been implicated in both chronic fatigue syndrome and fibromyalgia. Dopamine regulates arousal, sleep and reward. It turns out that fatigue is highly associated with reduced dopamine activity in ME/CFS. Throw together poor arousal and minimal reward plus sleep deprivation and you've got a real problem. Add in the pain sensitization that may result from poor sleep and you've got a multidimensional problem.

One researcher suggested that augmenting therapies like acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) (and yes, CBT) with a focus on helping people generate and maintain positive emotions could be helpful. There's little doubt about that but there is another problem...

Inflammation?

It appears that inflammation could start the whole sleep, pain, low reward (low dopamine) process. Miller found that increased levels of phenylalanine and reduced levels of tyrosine (the precursor to dopamine) were associated with increased fatigue (but not depression) in hepatitis C patients treated with IFN-a. That finding suggested that immune activation could be knocking down dopamine production in those patients and possibly in ME/CFS patients. Why ME/CFS patients? Because the same inflammation induced dopamine problems appear to be occurring in ME/CFS.

The low reward/increased pain scenario, then, probably has to include inflammation triggered dopamine reductions. That suggest that one key may be reducing inflammation. Supplements such as folic acid, L-methylfolate, and S-adenosyl-methionine (SAMe) that upregulate dopamine production could also be helpful. Other possibilities include new drugs being developed to block upregulated kynurenine pathways which whack dopamine production while raising hell with the microglia.

Meanwhile, creating a positive outlook which replaces frustration with what's been lost and fear at what might lie ahead with gratitude and acceptance can itself help to reduce inflammation at least somewhat. Above all try and get the best sleep you can.

The good news is that all these issues - increased pain, poor sleep, the difficulty in maintaining positive outlooks and the reduced dopamine/reward problems - may all be interlinked and the linkages are being uncovered.

Read more: Dopamine, the Basal Ganglia and Chronic Fatigue Syndrome #II – Treatments
 
Last edited:

Issie

Well-Known Member
There are herbals too that can help the kynurenine pathways. I've been trying them for a little less than a week and some other things to address possible pyroluria and today was a really good day.

Inflammation and pain are definite factors for me with sleep. I was using meds to address this and have been off for over 2 weeks now. The protocol I'm using is helping my pain too. I will write more about it when Im sure its not going to backfire or stop working after a few weeks. If you don't hear from me, I didn't get the long lasting results I was hoping for.

Issie
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
There are herbals too that can help the kynurenine pathways. I've been trying them for a little less than a week and some other things to address possible pyroluria and today was a really good day.

Inflammation and pain are definite factors for me with sleep. I was using meds to address this and have been off for over 2 weeks now. The protocol I'm using is helping my pain too. I will write more about it when Im sure its not going to backfire or stop working after a few weeks. If you don't hear from me, I didn't get the long lasting results I was hoping for.

Issie
Good luck with it!
 

Shannon

Member
I have had sleep debt for probably 25 some years now, maybe more. Even as a kid, I got mad as hell if I couldn't get the sleep I needed. I always wanted to sleep. As a child, my mother told me I could sleep anywhere, anytime. Now? Painsomnia rules. Did the severe sleep debt kick start worse symptoms than just the minor pain I experienced as a young adult who played tons of sports and was extremely active? Did the slept debt cause the minor pain I had from playing sports to increase until it became chronic pain? Is this what caused Fibromyalgia for me?

There have been no studies done (that I'm aware of) on sleep deprivation beyond a few years. So it would not surprise me a bit to find out how much of an impact sleep debt and continued poor sleep has on chronic pain. There is no wonder that studies now are finding exhausted T-cells, poor blood circulation, a lower blood level, and even blood that carries less oxygen are all indicative of a compromised immune system. Exhaustion is #2 on my list of symptoms, right after chronic pain. Sometimes I wonder if it shouldn't be #1.
 

Cort

Founder of Health Rising and Phoenix Rising
Staff member
I have had sleep debt for probably 25 some years now, maybe more. Even as a kid, I got mad as hell if I couldn't get the sleep I needed. I always wanted to sleep. As a child, my mother told me I could sleep anywhere, anytime. Now? Painsomnia rules. Did the severe sleep debt kick start worse symptoms than just the minor pain I experienced as a young adult who played tons of sports and was extremely active? Did the slept debt cause the minor pain I had from playing sports to increase until it became chronic pain? Is this what caused Fibromyalgia for me?

There have been no studies done (that I'm aware of) on sleep deprivation beyond a few years. So it would not surprise me a bit to find out how much of an impact sleep debt and continued poor sleep has on chronic pain. There is no wonder that studies now are finding exhausted T-cells, poor blood circulation, a lower blood level, and even blood that carries less oxygen are all indicative of a compromised immune system. Exhaustion is #2 on my list of symptoms, right after chronic pain. Sometimes I wonder if it shouldn't be #1.
I've heard of several people who made that switch from sleeping alot to being unable to sleep...It seems to be a pattern that occurs in these diseases...not a very good pattern! Nothing takes a toll like no sleep...
 

Kate

Member

Sleep is turning out to be a bigger factor in pain that most people realized. Most people in chronic pain get poor sleep - that's understandable - but what's more surprising is that half the people who suffer from insomnia also suffer from chronic pain. It turns out that poor sleep is actually more predictive of having chronic pain than chronic pain is predictive of having poor sleep.

The takeaway is that if you want to reduce the pain you're in one good way to do that is to get better sleep. [fright]

View attachment 490 [/fright]Positive emotions are also very helpful. Studies indicate that you're a lot more resilient with regards to pain if you can maintain some sort of positive outlook.

Positive emotions confer resilience against chronic pain. When subjected to an acute stressor people who were able to maintain their positive outlookexperienced less pain than those who could not.



The downside is that if you're not getting enough sleep it's appears that it's doubly hard to generate positive emotions. Continual sleep disruption, in particular, appears to inhibit one's ability to generate positive emotions; i.e. positive effect.



Where does this "positive effect" come from? The dopaminergic reward system - a system that has been implicated in both chronic fatigue syndrome and fibromyalgia. Dopamine regulates arousal, sleep and reward. It turns out that fatigue is highly associated with reduced dopamine activity in ME/CFS. Throw together poor arousal and minimal reward plus sleep deprivation and you've got a real problem. Add in the pain sensitization that may result from poor sleep and you've got a multidimensional problem.

One researcher suggested that augmenting therapies like acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) (and yes, CBT) with a focus on helping people generate and maintain positive emotions could be helpful. There's little doubt about that but there is another problem...

Inflammation?

It appears that inflammation could start the whole sleep, pain, low reward (low dopamine) process. Miller found that increased levels of phenylalanine and reduced levels of tyrosine (the precursor to dopamine) were associated with increased fatigue (but not depression) in hepatitis C patients treated with IFN-a. That finding suggested that immune activation could be knocking down dopamine production in those patients and possibly in ME/CFS patients. Why ME/CFS patients? Because the same inflammation induced dopamine problems appear to be occurring in ME/CFS.

The low reward/increased pain scenario, then, probably has to include inflammation triggered dopamine reductions. That suggest that one key may be reducing inflammation. Supplements such as folic acid, L-methylfolate, and S-adenosyl-methionine (SAMe) that upregulate dopamine production could also be helpful. Other possibilities include new drugs being developed to block upregulated kynurenine pathways which whack dopamine production while raising hell with the microglia.

Meanwhile, creating a positive outlook which replaces frustration with what's been lost and fear at what might lie ahead with gratitude and acceptance can itself help to reduce inflammation at least somewhat. Above all try and get the best sleep you can.

The good news is that all these issues - increased pain, poor sleep, the difficulty in maintaining positive outlooks and the reduced dopamine/reward problems - may all be interlinked and the linkages are being uncovered.

Read more: Dopamine, the Basal Ganglia and Chronic Fatigue Syndrome #II – Treatments
Just want to mention here that Dr. Ben Lynch, the doctor addressing the very common MTHFR DNA mutations and concomitant methylation issues absolutely hates folic acid as a supplement and recommends that all, especially the ill, avoid it. It is so far away from a usable form of folate (eight steps) that little is converted for use and the bulk of the excess that is unused can wreak havoc on the body over time and is suspect for the unborn. Folate is the natural form and folic acid is the cheaper synthetic. Unfortunately follic acid is a mandated food supplement in grain products to reduce neural tube defects. . Methylfolate in smaller, 400 mcg doses, is a place to start.

Many people with CFS also have the MTHFR mutation and should consider methylfolate and methyl B12 supplementation. The genome can be determined by running saliva through 23 and me for $100 and then runing the data through these sites. http://geneticgenie.org/ cost is a donation http://mthfrsupport.com/order-reports/ cost is now $30.

http://chriskresser.com/folate-vs-folic-acid/

http://mthfr.net/mthfr-c677t-mutation-basic-protocol/2012/02/24/ THis is Dr Ben Lynch's site. He has lots of free info, lots of products but he asks that much of the info be paid for to support his work.
 

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