Sleep loss increases pain, the fix is surprising


Quality sleep is vital to your overall health and well-being. I’ve previously written about how a poor night’s sleep starts you on a vicious cycle of weight gain. One night of poor sleep increases your appetite, increases your likelihood of storing fat, and weakens your willpower which makes you more likely to chose unhealthy foods. These unhealthy foods then disrupt your next night of sleep and the cycle continues. Research also shows another consequence of poor sleep - chronic pain.

Flushing adenosine

Your body uses ATP (adenosine triphosphate) to transfer energy to the cells that need it. As you go about your day, adenosine molecules break off of the ATP and build up in the brain and nervous system as a waste product. It can interfere with proper function, and the only way to flush all the ATP out of your brain is by getting 7 to 8 hours of restorative sleep. That’s why another purpose of adenosine is to signal sleepiness.

If you don’t get enough sleep or your sleep quality is low (interrupted or non restorative), adenosine can build up in your nervous system and cause issues. One side effect is increased pain sensitivity and reduced pain tolerance. Persistently high adenosine levels has also been shown to promote inflammation and damage tissue. This can turn chronic sensitivity to pain into actual long-term damage.

Sleep loss-induced pain not relieved the same way

Obviously the best way to counter the effects of pain caused by sleep deprivation is to improve your sleep. I’ll provide some suggestions on how to do that later, but first I wanted to address what can relieve pain the next day and more importantly, what won’t work.

Strangely, adenosine can act as an analgesic (pain killer) when it binds to certain receptors. In the case of prolonged adenosine build up due to sleep deprivation however, it binds to different receptors and increases pain. Why does this matter? Because one study found that this unique cause of pain meant the effectiveness of other analgesics like ibuprofen and even morphine were reduced. This means anyone trying to reduce the pain caused by sleep loss would likely increase the dose to overcome the decreased efficacy. This can lead to a host of complications, side effects, and in the case of opioids, addiction.

The researchers discovered the most effective pain reliever from both short-term and chronic sleep loss was adenosine blockers like caffeine or eugeroics (wakefulness-promoting agents) like modafinil. Modafinil increases dopamine levels in the brain (as does caffeine) so this could be another mechanism to successfully manage this type of pain sensitivity.

One of the primary reasons why caffeine improves exercise performance is because it diminishes feelings of pain and discomfort and allows you to push yourself harder, so it makes sense to me that it also helps relieve the pain from sleep deprivation.

Sleep is the best medicine

Improving alertness with caffeine during the day is fine, but to really improve chronic pain, you need to strive for 7 to 8 hours of quality sleep each night. By quality, I mean try to reduce the things that interrupt sleep and prevent you from achieving deep, restorative sleep.

  • As I’ve mentioned before, saturated fat and refined sugar too close to bedtime jet-lags your circadian rhythms and impacts the quality of your sleep. Increasing your fiber intake from fruits and vegetables has also been shown to improve the quality of your sleep in as little as 5 days, even if you don’t lose any weight.

  • Alcohol will interrupt your sleep quality. It can help you fall asleep but once it’s metabolized and out of your system 4 hours later, you’ll be more alert. Your body adjusts its chemistry to counteract the depressant effects of alcohol, and once it’s gone, you’re unbalanced in the opposite direction.

  • Control the light to reset your circadian rhythms. We do have an internal clock and light helps adjust it properly. Try to start your day with about 10 minutes of morning sun (ideally with an energy-boosting walk) and then try to get another dose of daylight when the sun is at it’s highest point. Contrast this by getting your bedroom as dark as possible and limiting (or eliminating) the screen time.

  • Keep it cool. Your body slowly cools down your temperature to prepare for sleep. Try to keep your bedroom below 70 degrees (21 degrees Celsius) improve your ability to fall asleep and stay asleep. Digestion raises your temperature as well, so avoid eating too close to bedtime and let your body cool itself down to prepare for bedtime.

No one adapts to less sleep

We still see chronic sleep deprivation as a badge of honor and sign of dedication. Most chronically sleep-deprived people believe that their body adapted to reduced sleep, but they’ve really just learned to accept increased pain, increased appetite, poorer judgment, and diminished cognitive ability as normal. We are adaptive, but in this case, we simply adapt to feeling lousy and learn to live with it. It’s once again my frog in the pot analogy:

They say if you put a frog in a pot of boiling water, it will leap out right away to escape the danger. But, if you put a frog in a room temperature pot and then gradually heat it until it starts boiling, the frog won’t become aware of the danger until it’s too late.

People don’t become better at clearing out damaging adenosine by reducing the activity that removes it. They simply adjust to the feelings of increased pain, blame it on something else, and try to numb it with medications. If you look at how people do on performance and alertness tests when they’re chronically sleep deprived, they never come back to the performance they had at rested levels. They feel like they get to a state of equilibrium but the tests show otherwise. Don’t assume you’re one of the few people that can handle lack of sleep. Just because we have an amazing ability to accept suffering doesn’t mean you need to suffer. Work on correcting your sleep behaviors and you’ll once again get your body’s chemistry working for you instead of against you.

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