ELLEN MILLER, MD: Chronic pain, on the other hand, is not necessarily as sharp as the acute pain. It's more like a dull, constant pain and it just doesn't ever seem to go away. And we see this more with rheumatoid arthritis or osteoarthritis.
ANNOUNCER: Both types of pain can be the culprit, robbing you of a restful night in lots of different ways.
JAMES O'BRIEN, MD: It can make it more difficult for us to initiate sleep, making it longer for us to fall asleep and beginning to train us that falling asleep is not necessarily an easy thing for us to do, even though for years it's always been taken for granted.
The other problem that sleep is affected by in terms of pain is the interruption of sleep while we are asleep. So we may be waking up at night unaware that pain is the cause, but we just happen to roll on our wrist or elbow or shoulder before we rolled back and awakened, unaware of why we are awake. And that kind of habit literally affects and habituates an individual to expect that sleep will be disrupted.
ANNOUNCER: Adding to the problem of disturbed sleep may be the very medications that people take to relieve certain types of pain, such as codeine, demerol, morphine and steroids. Others may even contain caffeine.
ELLEN MILLER, MD: Sometimes medications for migraine headaches may contain caffeine, or sometimes some other pain medications are combination medications that have several things in it and one of the ingredients is caffeine, the caffeine can keep us awake.
