Insomnia and Back Pain

Back pain, like insomnia, has been a rival of mine for decades. My mild scoliosis didn’t bother me much in my teenage years. But by adulthood, low back pain was an intermittent feature of my life. It got harder and harder to find a comfortable position for sleep.

Back pain and insomnia go hand in hand. But literally by accident, I finally found my way to pain-free nights.

body-pillowBack pain, like insomnia, has been a rival of mine for decades. My mild scoliosis didn’t bother me much in my teenage years. But by adulthood, low back pain was an intermittent feature of my life. It got harder and harder to find a comfortable position for sleep.

The fabulous stomach sleep-a-thons I remember during adolescence, when I awoke hugging my pillow, were the first thing that had to go. Then I had to give up sleeping on my back. (But while sleeping, I’d sometimes flip to my back and wake up to a backache). Finally there was nothing to do except sleep on my side curled up in fetal position. But even this was no guarantee of a pain-free night.

A Relationship between Insomnia and Back Pain

Research now shows that back pain and insomnia go hand in hand. Two studies published just this year, one conducted in Morocco and the other in the UK, show the prevalence of moderate to severe insomnia in people with back pain is 44 to 47 percent—quite a bit higher than the prevalence of chronic insomnia in the general population.

Insomnia, in turn, increases sensitivity to pain. In a recent study in the European Journal of Pain, insomnia subjects had lower pain thresholds than healthy control subjects and less ability to inhibit pain. It looks like back pain increases the risk of insomnia, which can then make back pain worse.

Steering Clear of Pain

By trial and error I found ways to hold the pain at bay. The rules I now live by at night are simple:

  • Never sleep on a too-soft mattress. If friends offer me a bed with a soft mattress, I ask to sleep on the sofa instead. Never take a hotel room without first checking the mattress.
  • Avoid hard mattresses as well. Inflatable camping mattresses spell doom.
  • Use a pillow that provides just enough support so the spinal cord feels straight. When a pillow loses its loft, get a new one.

But following the rules and making other adaptations didn’t allay my back pain completely. Frequent low-level pain was something I resigned myself to, thinking I had no other choice.

An Accident with a Silver Lining

Then last year I tried rollerblading with an 8-year-old friend, and I fell and broke my wrist. The pain was so bad I passed out. But it was short-lived compared to the shoulder pain I developed from wearing a heavy cast, which forced me to sleep on my back—and then my back pain returned with a vengeance. I was a mess!

Fortunately I got a referral to a good physical therapist. First, she dealt with my shoulder pain. Then she started on my back. She had me lie on my right side in the same position I use for sleeping.

“That’s not quite right,” she said. “Can’t you feel the torque in your spine? Try propping your left leg up on a pillow,” she said, sliding a pillow under my knee. “Doesn’t that feel better?”

It DID feel better—a whole lot better. In fact, propping my knee up on a pillow night after night led to months and months of pain-free living, and also probably helped to consolidate my sleep. Who knew such a simple change could have such a profound effect?

Have any small changes you’ve made led to marked improvements in your sleep or your sense of wellbeing? Please share for all to see.

An Insomniac Goes Camping

For me sleep is fairly dependable almost anywhere after a marathon hike or bike ride, when it’s hard to do anything except pass out.

But some of the most miserable nights of my life have been spent inside a tent. Camping is where my two biggest nemeses—insomnia and a bad back—conspire to make the night a trial.

sleep-outside-tentThe renowned sleep scientist William Dement is big a fan of the great outdoors. In his book, The Promise of Sleep, he compares camping under the stars to the nighttime experience of our ancestors: “With the stars as our only night-light,” he writes, “we are rocked in the welcoming arms of Mother Nature back to the dreamy sleep of the ancients.”

Huh? The idea of spending the night outdoors does have a certain earthy appeal, and for me sleep is fairly dependable almost anywhere after a marathon hike or bike ride, when it’s hard to do anything except pass out. But some of the most miserable nights of my life have been spent inside a tent. Camping is where my two biggest nemeses—insomnia and a bad back—conspire to make the night a trial.

Disturbances in the Wild

I’m very temperature sensitive at night, and this can be a problem outdoors. In mid-range temperatures, I’m either roasting inside my sleeping bag or freezing under a sheet.

Quietness can also be hard to come by. Nighttime is dinnertime for many creatures, starting with mosquitoes. The nasty things are always buzzing a hair’s width away from my ear, and burying my head under a sheet to escape them creates that temperature problem, not to mention near suffocation. And how about the bigger scroungers of the night, the raccoons and the bears? Can anyone sleep with these creatures snorting and slavering around the campsite? I can’t.

The noise factor can be even worse in campgrounds. It may be easy enough to persuade the kids with the radio to turn the volume down. But what about the knife-toting bruisers across the way, who with keg and girlfriends get down to seriously noisy partying till 3 a.m.?

Bodily Discomfort

Then there’s the other question of what to DO when it’s dark and everyone else is sleeping. Reading is now easier with my Kindle and headlamp, but this is when my back problem comes into play. No matter how thick, those camping mattresses are a pain, literally. Finding a comfortable position for reading is a real challenge.

Then comes the moment when I’ve had enough of reading and fussing with positions and decide, finally, to turn off my headlamp and hang it up. Now the quest for comfort becomes a search for the Holy Grail. Trying to find a pain-free option, I flap from side to side like a tuna in a trawler struggling mightily for life: thwap, thwap, thwap. And I almost always wake up in the morning to a backache.

I like the idea of camping, and when I hear people like Dr. Dement rhapsodize about the stars and Mother Nature I feel envy that a night outside could inspire such appreciation for the wonders of the great outdoors. Me, I get stuck on the pedestrian discomforts of my body. I’ll pass on nights in the open and leave the camping to loftier, hardier folk.

How does camping affect your sleep?