WSU professor studying relationship between chronic pain and sleep

With millions of Americans addicted to prescription painkillers, federal and state agencies have stepped up efforts to limit the number of opioids prescribed by doctors over the past few years.

But those efforts can lead to patients who have chronic pain being stuck with few options for managing their condition.

Marian Wilson, an assistant professor in the WSU College of Nursing, is leading a study that hopes to give those patients more tools to manage their symptoms.

She’ll spend the next two years looking at the relationship between sleep and chronic pain to see whether addressing sleep disturbances might help reduce the pain patients are experiencing.

The effort just received a federal grant for $305,651 from the National Center for Complementary and Integrative Health, part of the National Institutes of Health.

Wilson said it’s been shown that chronic pain and poor sleep are linked, but there’s no research investigating whether one causes the other. Opioids commonly prescribed for pain also tend to disrupt sleep, she said.

If her study shows poor sleep worsens chronic pain, that could give health care professionals a new avenue to tackle symptoms.

“If we have an intervention that focuses on sleep, and we know when we improve sleep you improve pain, we can concentrate on sleep,” she said.

Wilson’s research is part of a larger University of Washington study that’s been underway for two years.

That study, led by Dr. Mark Jensen, a UW professor, and Dr. Rhonda Williams, a UW associate professor and psychologist with the U.S. Veterans Administration Puget Sound Healthcare System, is looking at how veterans with chronic pain respond to mindfulness treatment or hypnosis.

Jensen said the goal is to give chronic pain patients more self-directed options to control their care and manage their pain.

“There’s a variety of pain treatments but they can be roughly divided into those where something is done to the patient and those where the patient learns to do something themselves,” he said.

Even without the many problems associated with prescription opioids, Jensen said he’s interested in treatments that allow patients to be empowered.

Though hypnosis may bring up Hollywood images of people in deep trances being controlled by magicians, Jensen said the reality is far less dramatic.

The brain is at times more open to receiving new ideas and input, he said. The goal of hypnosis is to bring out that state in people and give them suggestions that allow them to better manage their pain.

“It’s a very natural thing,” he said.

Wilson said training in using the mind to control pain is also likely to help people sleep better.

“One of the main reasons people stay awake, they’ll tell you, is because their mind is racing,” she said.

Her study will collect additional data on sleep patterns from 135 of the 240 veterans who complete Jensen’s study. That data includes information from sleep monitoring devices and self-reported surveys about how well they slept.

Participants will log their sleep three times: once right before Jensen’s intervention, and twice after. Wilson’s co-investigator, Hans Van Dongen, will analyze the sleep data.

Van Dongen directs WSU’s Sleep and Performance Research Center, which has been involved in a number of studies on the link between sleep and various types of performance, including driving and decision-making.

Wilson said exploring alternatives to prescription drugs, including exercise, mindfulness and sleep interventions doesn’t mean getting rid of opioids entirely.

“I never want to give the impression that some people don’t need opioids. They’re wonderful drugs, and when people need them they should have them available,” she said.

But opioids tend to be best when prescribed for a limited time or in smaller doses, she said.

“Most of the studies are showing that that’s not the best way to manage pain long term,” she said.

Wilson is involved in other research interviewing people now receiving treatment for opioid addiction and said many of them started using opioids after a prescription for pain of some kind. Few said they were told about other strategies for pain management or about the long-term risks of use, including addiction.

Finding other ways to treat pain “is really a matter of life or death for people,” she said.