Sleep disruption is a pretty epidemic complaint and a topic of many questions at the office. It is a broad topic but I thought it would at least be worth highlighting some of the issues between common presenting complaint and sleep.

When patients experience pain related sleep disruption, I first have to try to understand if the problem lies with the sleep set up (bed, pillow, sleeping position), or if it is related to their intrinsic presenting neuromusculoskeletal issues. You can normally distinguish between the two by asking a few questions:

- Have you always had issues with disrupted sleep or did this recently or suddenly start? Did you have a new injury or problem before you started experiencing sleep disruption?

- Have you had any changes in bedding, mattress, pillows in the last three months? How old is your mattress?

- Do you sleep better or worse when you are not sleeping in your normal bed, such as when traveling? This question is often one that will be a big clue. If patients have the same symptoms regardless of the place where they sleep, you lean toward and intrinsic issue with their body, but if they sleep better when away from home, you start to wonder about the adequacy of their current sleep set up.

Distinguishing between a problem with the sleep set up versus the patient’s intrinsic issues and loss of tolerance to a normal bed/pillow combination is important so that you do not waste resources chasing the wrong solution.