Low back Pain and Sleep

Low back pain (LBP) can arise from a lot of causes, most commonly from bending, lifting, pulling, pushing, and twisting. However, there are other possible causes, including sleep. This not only includes sleeping in a crooked or faulty position, such as falling asleep on a couch, in a chair, or while riding in a car, but also from the lack of sleep. So the question is, how much sleep is needed to feel restored and how much sleep is needed to avoid low back pain?

It’s been shown that lack of sleep, or chronic sleep loss, can lead to serious diseases including (but not limited to): heart disease, heart attack, heart failure, irregular heartbeat, high blood pressure, stroke, and diabetes. Sleepiness can also result in a disaster, as was the case in the 1979 nuclear accident at Three Mile Island, the oil spill from the Exxon Valdez, as well as the 1986 nuclear disaster at Chernobyl. With sleep deprivation, our reaction time is slowed down, and hence, driving safety is a major issue. The National Highway Traffic Safety Administration estimates that fatigue causes more than 100,000 crashes per year with 1,500 annual crash-related deaths in the United States alone. This problem is greatest in people under 25 years old. Job-related injuries are also reportedly more frequently, especially repeat injuries, in workers complaining of daytime sleepiness—which also results in more sick days. It’s also well published that sleep plays a crucial role in thinking and learning. Lack of sleep impairs concentration, attention, alertness, reasoning, and general cognitive function. In essence, it makes it more difficult to learn efficiently. Also, getting into a deep sleep cycle plays a critical role in “consolidating memories” in the brain, so if you don’t get to a deep sleep stage (about 4 hours of uninterrupted sleep), it’s more difficult to remember what you’ve learned. An interesting study (U. of Pennsylvania) reported that people who slept less than 5 hours/night for 7 nights felt stressed, angry, sad, and mentally exhausted. As shown in another study of 10,000 people, over time, insomnia (the lack of sleep) increases the chances for developing clinical depression by 5-fold. Other clinical studies have published many other negative effects of sleep deprivation, some of which include aging of the skin, forgetfulness, weight gain, and more.

Regarding low back pain, what comes first? Does LBP cause sleep interference or does sleep deprivation cause the LBP (or both)? It’s been shown that sleep loss can lower your pain threshold and pain tolerance, making any existing pain feel worse, so it works both ways. Specific to LBP, in a 28-year, 902 metal industry worker study, sleep disturbances (insomnia and/or nightmares) predicted a 2.1-fold increase in back pain hospitalizations with one and a 2.4-fold increase with both sleep disturbance causes (insomnia and nightmares). Other studies have shown patients with chronic LBP had less restful sleep and more “alpha EEG” sleep than controls. Similar sleep pattern differences using EEG (electroencephalogram – measures brain waves) have been shown when comparing chronic LBP patients with vs. without depression compared to controls (non-LBP, non-depressed subjects).

So the BOTTOM LINE is: talk to your chiropractor about how chiropractic helps reduce LBP, stress, and facilitates sleep. There are also nutritional benefits from Melatonin, valarian root, and others that he or she can discuss. Now, go to bed and get a good night’s sleep!

This discussion continues in Part 2...

Author
Austin McMillin Chiropractor

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