Coping with a chronic illness or health condition can be stressful. Nearly all chronic illness results in some level of disruption to "normal" daily life and routines.
Another all-too frequent problem for people with chronic health problems? Poor and insufficient sleep. The sleep problems associated with illness are an aspect of health management and treatment that isn't discussed nearly enough.
Patients Like Me, a patient network and research organization, has released preliminary results of a survey of its members that indicate that sleeplessness is a persistent problem among people coping with medical conditions. Patients Like Me provides a network for people with chronic illnesses to connect with others who share their conditions, and allows patients to share information for use as data in clinical research. Their sleep survey included 5,256 patient-members with a range of health conditions, and many reported chronic difficulties with sleep:
- 30 percent of respondents said they "rarely" or "never" got a good night's sleep
- 53 percent of those who believed they had a sleep problem had been dealing with their sleep difficulty for at least a year
It's not surprising that patients coping with illness would report difficulties with sleep. The relationship between sleep and pain is a complicated one. Pain creates significant challenges to sleep, making it difficult to fall asleep and hard to stay asleep. At the same time, being short on sleep can make us more sensitive to pain. Many medications also can interfere with sleep. Some common prescription and over-the-counter medications, including anti-depressants, blood pressure medication, and antibiotics, can be disruptive to sleep. The stress and anxiety associated with coping with chronic illness can cause frequent interruptions to sleep.
Yet the issue of sleep among patients with chronic illnesses often remains overlooked. In the Patients Like Me survey, fewer than 15 percent of respondents had received a diagnosis of insomnia. However, a majority of respondents reported experiencing symptoms of insomnia, including difficulty falling asleep and difficulty staying asleep, as well as waking feeling un-refreshed. Research has shown that insomnia and other sleep disorders are significantly under-diagnosed among patients with chronic diseases including cancer and diabetes. Physicians need to pay greater attention for signs of sleep problems among all patients, but particularly among patients being treated for other conditions. Patients themselves must remember to talk to their doctors about their sleep and any difficulties they experience.
Patients Like Me expects to make additional results and further analysis available from their sleep inquiry, and I will be interested to see their findings. Surveys like this one help raise awareness about the frequency of sleep problems among people coping with chronic conditions, and about the critical importance of sleep as part of treatment and recovery from illness and disease. All of us, practitioners and patients both, need to be thinking about -- and talking about -- sleep as an essential component of both wellness and of treatment for health conditions of all kinds.
Michael J. Breus, PhD
The Sleep Doctor®
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