You’re far from alone. According to a recent study published in the Journals of Gerontology, approximately 3 out of 5 aging adults experience some form of sleep dysfunction. This statistic increases when pain is involved.
Has this lack of sleep caused…
Inability to focus and/or perform tasks at work due to pain?
Approximately 70 percent of people suffering from chronic pain have significant sleep problems. What is a significant sleep problem? If you wake up three or more times a night, that is significant. If you wake up in the middle of the night and cannot return to sleep for an hour or more, that is significant. Even if you seem to be sleeping enough hours and don’t wake up a lot, but you frequently wake up in the morning feeling unrefreshed and like you haven’t slept, that means you have a sleep problem. A sleep dysfunction has as much to do with the quality of a person’s sleep as it does with the quantity. The reason for this has to do with the way in which sleep is constructed.
The Cycles of Sleep
There are five stages of sleep. Each stage, starting with stage 1, becomes progressively deeper. The first stage is made up primarily of alpha waves. These are brain waves vibration at a frequency of about eight to ten hertz (Hz) or cycles per seconds. This is about half the frequency of our brain wave activity when we are awake, which is about 20 Hz.
At each successive stage of sleep, the brain waves become slower until we finally reach stage 4, which is made up primarily of delta waves, which move at about one-half to one hertz. In other words, in stage 4, brain-wave activity is about one-tenth the speed of stage 1. At the end of stage 4, we enter REM (rapid eye movement) sleep, the stage where most dreaming takes place.
A complete cycle lasts approximately 90 minutes, so we cycle through the different stages of sleep several times a night The percentage of stage 4 sleep is actually greater in the earlier part of the evening and diminishes as the night progresses.
The deep stages of sleep are important to people with chronic pain. Stage 3 and 4 sleep is often referred to as slow-wave sleep, or restorative sleep. During this time, scientists have found that the body completely unwinds, and deep healing takes place. In fact, recent research has demonstrated that the growth hormone is almost exclusively released during deep sleep. Growth hormone is important for tissue growth in youth and tissue healing in adults.
What happens if we are deprived of deep sleep?
Harvey Moldofsky, an ingenious psychiatrist and researcher working in the 1970s at the Clarke Institute of Psychiatry in Toronto, performed an experiment in which people in a sleep lab were attached to an EEG (electronencephalogram) so their brain waves could be measured during sleep. Every time they reached deep sleep (defined as the appearance of four delta waves, or slow-waves), a variety of auditory stimuli sounded and continued to make noise until they pulled the sleeper out of deep sleep. In most cases, the sounds were not disturbing enough to wake the person; the sounds just put him or her in a lighter stage of sleep.
What was the result?
After a few days, the people became irritable and developed aches and pains that resembled fibromyalgia. In another experiment, Moldofsky showed that fibromyalgia patients had a specific type of sleep dysfunction, called an alpha-delta sleep dysfunction, in which higher frequency alpha waves (eight to ten cycles per second) would suddenly intrude upon the slower waves (one-half to one cycle per second) and render the sleep lighter and less restful.
Last, Moldofsky showed evidence that the alpha-delta sleep dysfunction was connected to a serotonin deficiency that he found in the blood of fibromyalgia patients. He tried to restore the serotonin by giving people L-tryptophan, an amino acid that turns into serotonin when it crosses into the brain. Although the dose Moldofsky used of L-tryptophan did not succeed in restoring deep sleep, he was able to reverse some of the sleep dysfunction with serotonin reuptake blockers, which are medications that increased the available serotonin in the brain.
Treating sleep Dysfunction
Sleep dysfunction is best treated by first identifying why it’s happening. Once the underlying cause of one’s sleep dysfunction has been determined, an effective, customized course of treatment can be constructed accordingly to address all elements of this cause.
If you’re suffering from sleep dysfunction, we can help.