Chronic pain and problems sleeping often go hand in hand. In fact, experts believe between 50-80% of people with long-term pain have ongoing sleep problems. It can become a vicious cycle, with lack of sleep leading to worsening pain which in turn can make it increasingly difficult to sleep. A lack of restorative sleep hampers the body’s immune response and can also affect cognitive function.
How chronic pain affects sleep
Chronic pain causes sleep problems in a number of different ways. It can be difficult to fall asleep because, whereas during the day there are distractions to prevent you from focusing on the pain, at night there are not and your perception of pain can increase. The longer it takes you to fall asleep, the more stressed you might become.
Once you fall asleep, pain can make it hard to stay asleep due to a state called microarousal, which are shifts to a lighter state of sleep that can cause you to wake up. Because they experience less deep sleep and more periods of wakefulness during the night, people with chronic pain often feel less refreshed after a night’s sleep. A lack of restorative sleep may then lead to worsening pain during the day, fatigue, low energy and depressed mood.
Health impacts of poor sleep
Sleep disruption has several short-term and long-term implications for health. In the short term, people are more likely to suffer from stress, low mood, fatigue, diminished performance, and reduced memory and cognitive function. In the longer-term, sleep disruption is associated with a range of conditions including hypertension, unhealthy levels of LDL fat in the blood (dyslipidemia) cardiovascular disease, weight-gain, type 2 diabetes and colorectal cancer.
Does joint replacement surgery improve sleep?
A study published in The Journal of Arthroplasty in August 2020 (Improvement in Sleep Patterns After Hip and Knee Arthroplasty: A Prospective Study in 780 Patients) examined the sleep pattern in patients before and after undergoing total hip replacement and total knee replacement surgery (also called total hip/knee arthroplasty). This type of surgery is normally offered to people with severe degenerative conditions like arthritis or people with a serious injury.
Researchers reviewed data from 780 patients before and 12 months after undergoing total hip replacement or total knee replacement surgery, between July 2016 and June 2018. Before surgery, nearly one in two reported poor sleep quality or sleeping for fewer than six hours a night. Women were more likely than men to experience sleep problems and patients waiting for a total hip replacement were more likely (39%) than those awaiting a knee replacement (30%) to be sleeping badly.
A year after surgery, patients reported a significant improvement in the quality and duration of sleep. Nearly three quarters (74%) of those who had reported sleep problems experienced an improvement in sleep. Satisfaction levels among patients who did not experience sleep problems before surgery was 93% once they’d had their joint replacement. In patients who’d been experiencing sleep problems, satisfaction levels were 78%.
Joint replacement surgery improves sleep
Researchers linked these measures of improved sleep with positive changes in measures of pain, health and wellbeing. They concluded that hip and knee replacement surgery can improve sleep and lead to other positive impacts on overall health and wellbeing.
If you are experiencing severe hip or knee pain, hip or knee replacement surgery delivers a wide range of benefits, from relieving pain and increasing mobility to improving sleep and enhancing overall quality of life. This type of surgery is now routine and, in some cases, can be offered without the need for an overnight hospital stay. Contact us if you would like to discuss treatment options.
