To consider the connection, it’s important to understand that complaints around sleep, by some estimates, are present in upwards of 88% of chronic pain conditions. On the opposite end of the spectrum, approximately 50% of those afflicted by insomnia report chronic pain.
Studies on the impacts of sleep deprivation have demonstrated that participants tend to develop hyperalgesia, a hypersensitivity to pain stimuli in a dose-response relationship. As the sleep deprivation progresses over many nights, the sensitivity increases. In the more specific case of conditions characterized by joint pain, those diagnosed with rheumatoid arthritis feeling a greater amount of pain following a partial sleep deprivation, not to mention the impacts it had on their fatigue levels and experience of depression.
Unfortunately, the exact mechanism for why this occurs is unclear, but researchers have a few ideas including changes in the signaling of neurotransmitters such as dopamine or opioid peptides. Another thought is the impact that sleep deprivation has on our mood and the effect that this would have on sensitizing the sleepy individual to stimuli such as joint pain.
It’s a difficult question since there is no right answer. We all have our preferences for everything from the firmness of the bed to the pillow, to whether the window is opened or closed, and the eternal conflict about why a bed needs 10 or more decorative pillows. However, there are sleeping conditions that encourage a restful and rejuvenating snooze:
Sleeping on your front is the pinnacle of poor position. Unless you want to attempt breathing through a pillow, it forces your head and neck sideways. This extended rotation of the cervical spine can gradually contribute to misalignment as it flattens the natural curvature of the spine. Even lying on the back with a hand on the forehead recruits the scalene muscles and upper trapezius muscles and is associated with neck pain.
However, if you find that this is the only position that doesn’t contribute to the pain, then consider placing a small pillow underneath the hips to elevate them off of the bed in order to align the spine.
With neck and back pain, the goal is to align the spine and recruit the fewest muscles over the course of the night, leaving them relaxed and allowing you to wake up relatively pain-free. Sleeping on the side with a small pillow between the legs, or on the back with a pillow under the arch of the knees will help keep the spine aligned.