Alex B. Symptoms while sleeping

[Melissa E]

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Question

Hello,

Over the past year I've noticed I've developed pain when sleeping on my stomach, and it began as soon as I moved to another city to start grad school. At first I thought I just needed to adjust my sleeping position or get a new bed, but now, a year later, I have back pain and severe stiffness that wakes me up in the middle of the night no matter what I sleep on or what position. All of a sudden I'll be sleeping and turn off and get woken up be severe stiffness and pain. I never have back pain in the day when I'm up and moving around, so it goes away as soon as I get up and move around after about 10-15 minutes.

I went to a rheumatologist and she ruled out lupus; she thought it might be an inflammatory condition, and so far has done one blood test testing for an inflammatory gene that's present in about 80% of cases with my symptoms and I was normal for that. She wants me to do an X-ray and possibly MRI to see what's going on with my spine.

I've read a lot about TMS and back pain and know that even abnormal scans can still be TMS, but I'm puzzled as to why I only have this pain and stiffness when I'm asleep, as I would imagine that's when you're most relaxed? I've read a number of things that say pain during sleep points to an autoimmune/inflammatory condition. I also don't think it's any coincidence this pain started literally the week I started grad school, and grad school does cause me a significant amount of stress and conflict, but having awareness of that doesn't seem to make the pain go away so now I'm not so sure if it really is stress or something more serious. I'm just curious if there's any way this could be TMS?

Thanks!

 

[Alex Bloom LCSW]

Answer

Hi Melissa, thanks for the question.

This could definitely be TMS. You are absolutely right in assuming that it is no coincidence that your symptoms started the week that you started something as stressful as grad school. While sometimes simply being aware of this connection is enough to alleviate the symptoms, this is by no means always the case. A large majority of my clients are aware the connection between their symptoms and the stressors in their life, but as long as the pain still has the capacity to preoccupy and scare them, it is still serving a "purpose" and thus will continue to dog them.

So what you need to do is really begin to work to convince yourself that your symptoms are indeed TMS so that they begin to lose their capacity to scare you. The good news it that it sounds as though you are already doing this by speaking to physicians and ruling things out. Go ahead and get the MRI. The more evidence you can accumulate to rule out structural issues, the better you will be able to stand up to the symptoms and confront the anxiety they cause. Again, a big piece of evidence here is that the pain started in conjunction with a big stressor.

As for how your symptoms get triggered during sleep, this is actually a fairly common occurrence. While it may seem that you at your most relaxed at this time, in fact sleep is when the unconscious mind, where the stressors are really being felt, can run wild. For example, think of all those stress dreams people have, or mouth guards that protect against grinding teeth. Just because you're asleep doesn't mean you can't be feeling stress!

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Questions may be edited for brevity and/or readability.

 

[William]

This question was submitted via our Ask a TMS Therapist program. To submit your question, click here.

Question

Hello,

Over the past year I've noticed I've developed pain when sleeping on my stomach, and it began as soon as I moved to another city to start grad school. At first I thought I just needed to adjust my sleeping position or get a new bed, but now, a year later, I have back pain and severe stiffness that wakes me up in the middle of the night no matter what I sleep on or what position. All of a sudden I'll be sleeping and turn off and get woken up be severe stiffness and pain. I never have back pain in the day when I'm up and moving around, so it goes away as soon as I get up and move around after about 10-15 minutes.

I went to a rheumatologist and she ruled out lupus; she thought it might be an inflammatory condition, and so far has done one blood test testing for an inflammatory gene that's present in about 80% of cases with my symptoms and I was normal for that. She wants me to do an X-ray and possibly MRI to see what's going on with my spine.

I've read a lot about TMS and back pain and know that even abnormal scans can still be TMS, but I'm puzzled as to why I only have this pain and stiffness when I'm asleep, as I would imagine that's when you're most relaxed? I've read a number of things that say pain during sleep points to an autoimmune/inflammatory condition. I also don't think it's any coincidence this pain started literally the week I started grad school, and grad school does cause me a significant amount of stress and conflict, but having awareness of that doesn't seem to make the pain go away so now I'm not so sure if it really is stress or something more serious. I'm just curious if there's any way this could be TMS?

Thanks!

Hi Melissa, I have TMS and I have been able to get rid of 90% of my pain in the day, but night is a major problem. I have nights that I sleep well but other nights that I only sleep 3 hours. My mind runs wild at night with stressful thoughts. I am disappointed with some of the suggestions that I've received from others, I journal my thoughts and feelings but this has not helped, and I am in the process of making changes to my diet. I am going to reduce caffeine and sugar because these might act as a form of agitation. I am also doing cognitive therapy and EFT to try to get my mind to calm myself. I will let you know who it goes. I think many people on this web site don't understand how disruptive TMS can be to your sleep and I wish more people would help us in this area and that there would be a separate discussion group for sleep issues. I switched beds 3 times before I realized that it was TMS. Keep in touch. Bill K

 

[blackdog]

Hi Alex,

I wanted to ask you a question in a previous thread, but I see it is brought up here as well. I think that for those of us who are new to TMS and are trying to get ourselves to accept the possibility that the tremendous difficulties we are having could be caused by it, ambiguity is our biggest obstacle. I have seen you bring up a couple of times the difference between having a structural issue and having TMS, but without any reference to what a structural issue is. Could you explain this a bit from your perspective? People with herniated disks would seem to have a structural issue, but get better through TMS work. Is that a structural issue? I have been told by a PT that my pelvis is rotated incorrectly on two planes, is that a structural issue? It would seem that it could be or that the muscles could be tensed causing this. Just a bit more clarity on this topic would help. Thanks,

Andrew

 

[jeanbee]

Hi Melissa, I have TMS and I have been able to get rid of 90% of my pain in the day, but night is a major problem. I have nights that I sleep well but other nights that I only sleep 3 hours. My mind runs wild at night with stressful thoughts. I am disappointed with some of the suggestions that I've received from others, I journal my thoughts and feelings but this has not helped, and I am in the process of making changes to my diet. I am going to reduce caffeine and sugar because these might act as a form of agitation. I am also doing cognitive therapy and EFT to try to get my mind to calm myself. I will let you know who it goes. I think many people on this web site don't understand how disruptive TMS can be to your sleep and I wish more people would help us in this area and that there would be a separate discussion group for sleep issues. I switched beds 3 times before I realized that it was TMS. Keep in touch. Bill K

I certainly empathise with you Bill - I well know how TMS disrupts sleep - I never sleep more than 2 hours at a time - sometimes 1 hour. Friends say they don't know how I survive - I survive because there's no choice! Since reading John Sarnoe's books I have begun psychotherapy and also joined Stephen Levine's online counselling web site. All of these are helping. Its early days yet but I am very happy to say I've been able to sit more comfortably over the last couple of days and actually had quite a good sleep last night with relatively little pain - all of this for the first time in 30 years! So don't give up Bill!