Node Smith, ND

Two studies recently have underlined the role of sleep in chronic pain. One, looked at whether sleep problems can predict future chronic pain issues, and the second looked at chronic pain and anxiety associated with sleep in adolescents. The papers were presented at the Annual European Congress of Rheumatology (EULAR 2018).

No surprise seeing studies chronicling the relationship between sleep disturbances and chronic pain

We know that the role of sleep in health is very widespread and complex. It should come as no surprise that we are seeing these studies that are building a relationship between sleep disturbances and chronic pain. Also, chronic pain can dictate sleep quality as well, so the relationship is bi-directional.

First Study

In this study, all four parameters of sleep quality were measured – difficulties initiated sleep, maintaining sleep, early morning waking, and non-restorative sleep were measured. It was found that all of the aspects of sleep quality, except early morning waking, were associated with chronic widespread pain after five years. This was regardless of age, gender, socio-economic status or mental health status. In other words, not sleeping well for a prolonged period of time takes its toll, and people are more likely to develop chronic pain conditions.

Second Study

The second study showed that students suffering from chronic multi-site pain are much more likely to report severe sleeping problems as well as anxiety. The study looked at 254 students from a Swedish school. Questionnaires were completed on chronic pain, stress, anxiety/depression and sleeping problems. The average age of the students was 16 years and two-thirds were girls. Chronic pain was identified in 10 percent of participants, and was associated with significant sleep disturbances.


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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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