Sleep apnea and back pain: Sleep/health connection

Sleep apnea and back pain are commonly experienced together. Although medical experts don’t believe that one condition causes the other, the two health issues are found as co-symptoms often enough that the relationship between back pain and sleep apnea deserves to be explored.

Sleep apnea isn’t believed to specifically cause back pain. All the same, if you have problems with back pain, not getting enough sleep could make your condition even more painful, as some studies have pointed out.

The journal Sleep concluded in 2006 that “the loss of 4 hours of sleep and specific REM sleep loss are hyperalgesic the following day.”¹ (Wait, hyper-what? Merriam-Webster defines hyperalgesic as “increased sensitivity to pain or enhanced intensity of pain sensation.”) So, untreated sleep apnea can make any back pain you experience more, well, painful.

The reverse also seems to be true – chronic back pain can make it tough to get a good night’s sleep. “Difficulties such as falling asleep or frequent nighttime wakening often are related to poor pain control,” writes Mayo Clinic M.D. Jarrett Richardson.²

“Disturbed sleep is a key complaint of people experiencing acute and chronic pain,” a report published in the journal Seminars in Neurology pointed out.³ “These two vital functions, sleep and pain, interact in complex ways that ultimately impact the … individual.”

“Polysomnographic studies of patients experiencing acute pain during postoperative recovery show shortened and fragmented sleep,” the report continues, describing a scenario not far removed from what is experienced by sleep apnea patients. The report is careful to label these findings as non-definitive, but the connection seems to be there.

Chronic lack of sleep can make pain even more difficult to tolerate because of another, less expected factor. According to the journal Experimental and Clinical Psychopharmacology, painkillers like codeine aren’t as effective if the user is suffering from lack of sleep.⁴

And, again, a reversal of the relationship also seems to hold true — taking painkillers can cause lack of sleep in the first place. “Sleep apnea can also be caused or exacerbated by narcotic painkillers, which some people are prescribed for severe back pain,” as WebMD reports.⁵

Finally, there’s the issue of sleep position. Sleep problems can sometimes cause us to sleep in positions that can exacerbate back pain. Sleeping in the same position every night can also create back, neck or shoulder pain, The Wall Street Journal reports.⁶ “Consistently compressing the body on one side or stretching another side over time can create an imbalance and result in soreness or pain in that area or exacerbate an existing condition.”

Easing the trouble of back pain and sleep apnea

Taken together, what do these connections between sleep apnea and back pain mean? Broadly speaking, treating one condition could help ease the negative effects of the other.

Beyond medical treatment, there are everyday, do-it-yourself habits that can alleviate the more extreme effects of both back pain and sleep apnea. Writing for HealthandBeauty.com, Henry Smalls recommends the simple remedy of a hot bath. “A good hot bath is an excellent way to reduce tension and soothe away your aches and pains,” as well as reduce the tension and stress that can cause sleepless nights.

Maybe the most commonly cited connection between sleep apnea and back pain is that they’re both symptoms of obesity. The American Journal of Epidemiology published an analysis in 2009 that found that obesity was connected with an increase in lower back pain.⁷

Because of this obesity connection, exercise is also a useful tool in treating both back pain and sleep apnea. We discussed the sleep benefits of exercise last week (read “Sleep apnea and exercise: The health/sleep connection, part 1”), and Health‘s Jessica Girdwain points out that exercise in the form of developing “lower-back, abdominal and oblique muscles takes pressure off your spine and improves range of motion, both preventing and treating pain.”⁸

The comforts of a hot bath and regular exercise are proactive ways to stay healthy, but of course they’re not going to offer much relief from serious sleep apnea. If you think you have sleep apnea, consult your doctor to find the best remedy for your personal needs.

This blog post contains general information about medical conditions and potential treatments. It is not medical advice. If you have any medical questions, please consult your doctor.

References

1. Source: Roehrs T, Hyde M, Blaisdell B, Greenwald M, Roth T. Sleep loss and REM sleep loss are hyperalgesic. Sleep. 2006 Feb;29(2):145-51. https://pubmed.ncbi.nlm.nih.gov/16494081/ (accessed July 8, 2013)
2. Source: Richardson, Jarrett. 2011. Underlying Causes of Sleepless Nights are Often Treatable. Mayo Clinic Medical Edge Newspaper Column, December 30, 2011. (accessed July 8, 2013)
3. Source: Roehrs T, Roth T. Sleep and pain: interaction of two vital functions. Semin Neurol. 2005 Mar;25(1):106-16. https://pubmed.ncbi.nlm.nih.gov/15798943/ (accessed July 8, 2013)
4. Source: Steinmiller CL, Roehrs TA, Harris E, Hyde M, Greenwald MK, Roth T. Differential effect of codeine on thermal nociceptive sensitivity in sleepy versus nonsleepy healthy subjects. Exp Clin Psychopharmacol. 2010 Jun;18(3):277-83. doi: 10.1037/a0018899. https://pubmed.ncbi.nlm.nih.gov/20545392/ (accessed July 8, 2013)
5. Source: WebMD. Chronic Back Pain and Sleep. https://www.webmd.com/back-pain/guide-chapter-back-pain-overview (accessed July 8, 2013)
6. Source: Reddy, Sumathi. 2013. Find the Perfect Sleep Position. The Wall Street Journal. January 14, 2013. https://www.wsj.com/articles/SB10001424127887324595704578241642030220064 (accessed July 8, 2013)
7. Source: Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010 Jan 15;171(2):135-54. doi: 10.1093/aje/kwp356. Epub 2009 Dec 11. https://pubmed.ncbi.nlm.nih.gov/20007994/ (accessed July 8, 2013)
8. Source: Girdwain, Jessica. How to Fix Health Problems With Exercise. Health.com. https://www.health.com/ (accessed July 30, 2013)