Why Does Pain Increase At Night
When you’re in pain, there are a lot of things that can make it worse — stress, noise, temperature, movement. But what if the thing causing you pain is also part of an adjustment your body makes to help you feel better? As your body prepares itself for sleep, your hormone levels, metabolism, and many other biochemical processes adjust. These adjustments may heighten your pain.
For instance, as we get older our bodies produce less melatonin. Melatonin is a hormone produced by the pineal gland, which regulates the circadian rhythm (the internal biological clock.) It’s also thought to be involved in regulating mood, memory, and sexual activity. Since melatonin production declines with age, older people have more difficulty sleeping than younger people do. In addition, since melatonin decreases inflammation, its decline may contribute to increased pain sensitivity. Similarly, cortisol, another hormone, reduces pain sensitivity and swelling, and increases tolerance to pain. So while aging may decrease pain threshold, it may actually increase pain intensity at night when cortisol levels are low.
These hormonal changes occur naturally during sleep, so they aren’t necessarily caused by getting enough or too much sleep. That said, if you experience severe pain, especially at night, talk to your doctor about whether changing your sleep habits could improve your symptoms. For some people, this might mean taking medication such as steroids to combat inflammatory diseases like arthritis and multiple sclerosis. And then there are those who believe that sleep deprivation causes migraines and fibromyalgia; one study found that women who slept fewer than five hours per day had double the risk of developing migraine headaches compared to women who got seven or eight hours of sleep each night.
Sleep problems cause pain, but not all pain increases at night. Read on to find out why different types of pain behave differently.
Pain Types and Why They Feel Different During Sleep
If you wake up in the middle of the night with back pain, you probably won’t need a prescription from your doctor to figure out how to go back to bed. The same isn’t true with other types of pain. Here are just a few examples of pain categories and their typical patterns.
Nerve pain: Nerves carry messages between parts of the body. When nerves become inflamed due to injury or infection, nerve cells send messages faster and stronger to avoid damage. This results in greater pain signals reaching the brain. Because nerves function during sleep, the brain gets more information than usual, making it harder to fall asleep.
Neck pain: If your head hurts during the day, the reason may be muscle spasms. However, if you hurt your neck at night, the problem may be disk degeneration. Disk degeneration occurs when disks lose water and begin to dry out and shrink. While this process normally happens over time, trauma or sudden movements can compress fluid inside the disk, resulting in bulging and herniated discs. A similar condition called cervical stenosis affects the spinal column. Both conditions affect the spine’s ability to support weight or protect the spinal cord. Although both types of disk disorders usually cause pain during the day, patients with bulging or herniated disks typically report pain at night.
Joint pain: Arthritis sufferers don’t always feel pain immediately after moving a joint. Instead, they may notice stiffness, soreness, or even burning sensations before feeling any actual pain. Joints also often swell before becoming painful. Osteoarthritis suffers, however, tend to feel pain right away because cartilage breakdown releases chemicals into joints that promote inflammation. Like disk disease, osteoarthritis mostly occurs in the hip, knee, and hand areas, where bones rub against other bones.
Muscle aches: Muscle pain tends to occur at night, although it doesn’t follow regular cycles. Muscles grow bigger when you move them, so muscles work harder when you exercise. Overuse leads to injuries, sprains, strains, and tearing. All of these factors create inflammation in muscles, which explains why you’ll feel pain right after exercising. Inflammation in muscles can also happen during periods of disuse, such as sitting still for long stretches of time. Even lifting weights may lead to minor tears in muscles.
Because sleeping helps restore balance, most bodily functions change during sleep, including pain. But sometimes, pain feels different at night simply because something else is happening. Learn more about this next.
Sometimes pain feels different at night because something else is happening. You wake up suddenly and your leg seems to weigh a ton. Or perhaps you stubbed your toe last night, and now it throbs whenever you take a step. Sometimes pain follows a pattern, but other times it appears without warning and disrupts normal activities.
In either case, the best way to relieve pain is to treat the underlying cause. See your doctor or physical therapist.
Waking Up With Pain is Normal
Some people think that waking up with pain means your body is trying to tell you something important. However, having pain wake you up at night happens frequently, yet doctors rarely consider it to be abnormal. After all, pain wakes us up every morning. Doctors call this phenomenon hyperpathia. Hyperpathia refers to the fact that no matter where you are in your sleep cycle, your brain receives sensory stimuli even though your eyes are closed. This includes light, sound, touch, smell, and motion.
Your brain interprets these stimuli as external events. Your brain processes these stimuli during four stages of sleep, referred to as REM, deep, lighter, and nonREM sleep. Each stage carries unique responsibilities. NonREM sleep restores the body and mind for the following day. REM sleep occurs only at night and is necessary for dreaming. Deep sleep restores muscles and organs. Lighter sleep regulates breathing, heart rate, blood pressure, and digestion.
While your brain recognizes these stimuli as coming from within your own body, your subconscious does not differentiate. Thus, your brain perceives pain as a threat, regardless of whether it comes from within or outside your body. Your brain reacts to pain by releasing adrenaline and cortisol, hormones known to increase heart rate and blood pressure.
To prevent your brain from interpreting pain as harmful, try to relax throughout the night. Try meditation, yoga, tai chi, biofeedback, hypnosis, or guided imagery. If you wake up with pain, see your doctor or physical therapist for treatment.
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