The Importance of Sleep in Chronic Pain

Ross Hauser, MDRoss Hauser, MD

Xyrem Helps Chronic Pain Sufferers Sleep

Typically when a patient of mine is not progressing as they should the problem usually relates to them not sleeping because of their chronic pain. Chronic pain can induce adrenaline and cortisol to be secreted which can keep people up at night. Often in these scenarios I prescribe Xyrem, which is the sodium salt of gamma hydroxybutyrate (GHB). What surprises a lot of people is that GHB is a natural substance. GHB is a naturally occuring molecule that is produced in the brain and has specific receptors throughout the nervous system. Personally I think it is the main ‘sleep-inducing neurotransmitter’ in the body.

Xyrem is GHB. GHB is the possibly the substance that allows a person to sleep. It may be that people with chronic pain have a GHB deficiency because of their pain. Listen to these stories…

J was wracked with fibromyalgia pain. She received numerous Prolotherapy visits and this was helpful but still I couldn’t get her energy up. When talking with her further she was doing the whole natural medicine program I prescribed but definitely had poor sleep. She was placed on Xyrem. She came back in six weeks and looked great. I have seen it turn quite a few fibromyalgia patients around.

S had terrible osteoarthritic pain that was being helped by Prolotherapy. But I couldn’t get him over the hump. He seemed to plateau at 50% better. He was started on Xyrem because of years of poor sleep. It took us a couple of months to get the best dose down for him. With the combination of his previous Prolo and the good sleep his diffuse body osteoarthritis pain was relieved.

I could go on but here are the nuts and bolts:

  • Chronic pain often leads to poor sleep
  • Poor sleep leads to poor energy
  • Poor energy leads to more sorrow, depression, and more pain
  • Xyrem is a salt of a natural substance gamma hydroxybutyrate
  • Xyrem helps people with chronic pain sleep
  • The sleep is deep
  • When the sleep is deep hormones are made that help the body heal
  • When the body heals the pain goes away, especially if the person receives Prolotherapy

If you or a loved one are having a terrible time sleeping, come in to get an evaluation for Xyrem.

The Importance of Sleep in Chronic Pain

Upon falling asleep, a person enters stage one and stage two sleep, which is a very light sleep. After approximately 90 minutes, the person will enter stage four, or deep sleep. It is during deep sleep that hormones, like Growth Hormone, are secreted. Growth Hormone is one of the anabolic hormones that the body needs to repair itself. If a person does not enter the deep stages of sleep, the ability to repair injured tissue is hampered. More than 50 percent of body weight is muscle tissue. It is imperative that the body is able to repair this muscle tissue from its daily use. The body does its repair during the deep stages of sleep. If this is not accomplished, the end result is muscle aching. Do you see the cycle? A person has a localized pain, such as neck pain, that does not resolve. Eventually, the chronic pain causes chronic insomnia. The chronic insomnia causes a decrease in the body’s ability to repair itself. This causes pain to move to other parts of the body, causing more insomnia. A vicious cycle continues.

In a 1976 study, Harvey Moldofsky, M.D., solicited healthy volunteers and allowed them to sleep only in stages one and two. Dr. Moldofsky put electrodes on their heads and gave them a little zap, not enough to wake them but enough to keep them from achieving stage four sleep, the deep stage of sleep. Guess how long it took before the previously healthy volunteers had diffuse body aches and tender points? Seven days!

Chronic insomnia is the number one reason people have diffuse body aching. To cure diffuse body aching, the cause of the chronic insomnia must be found. If the chronic insomnia began because of a pain complaint at a particular part of the body, then there is an excellent chance that Prolotherapy can cure the problem. If the chronic insomnia is due to a marital problem, job stress, or other psychological issues, then this is the area that needs to be addressed. Everyone should find a way to reduce their stress level. Let’s face it, we all experience stress in our lives. Everyone should find some outlet to relieve stress in their lives – whether reading alone in front of a fire, bashing a racquetball against the wall, running until you can run no more, meditation, prayer, or whatever you feel you need.

What about depression? Many people with chronic pain are diagnosed with clinical depression as the cause of their chronic pain. We say the following to this: Follow the person who made that diagnosis and punch him in the back every five minutes. How long do you think it would be before he or she, too, is depressed? It would probably be similar to the study done by Dr. Moldofsky. After seven days of pain, a previously healthy person can show signs of clinical depression. If a previously healthy person develops chronic pain and is diagnosed with depression, it is logical that chronic pain relief will alleviate the depression. This is exactly what occurs. When Prolotherapy is given to the painful area, the chronic pain dissipates and the smile returns to the patient’s face. There have been many sour-faced individuals upon first arrival to our Oak Park office who later began to enjoy life again. It is amazing what pain relief can do to a person’s countenance.

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