John Claude Krusz, Ph.D., M.D.
ANODYNE Headache and PainCare
5446 Glen Lakes Drive
Dallas, TX 75231
214-750-6664
http://anodynepaincare.org/Clinic_Staff.htm
Transcript: Treating chronic pain by improving sleep quality
Well you know another important aspect of treating chronic pain or headaches for that matter is that people develop two things with chronic pain. One is an anxiety disorder which is co-morbid because they fear when the next bad episode’s going to take them down, take them away from their families and what they want to be doing, and put them to bed. They also develop a sleep disorder. Sleep disorders are highly co-morbid with chronic pain syndromes.
And when we track, about every three or four years, a hundred consecutive new patients, it’s consistently come up over the last four or five trackings that about 96-97% of folks who visit us for the first time don’t sleep an adequate sleep. They have problems falling asleep. They get awaken by pain, multiple awakenings and they simply don’t feel refreshed. And I think if I had asked one question it would be “Do you wake up refreshed in the morning?” And if you don’t there is something fundamentally that could be done to better your sleep quality.
And there are sleep stages where the brain rests, where muscles relax and there are some medications that will help put the brain into a nice amount of stage 3, stage 4 restful sleep. One of these medicines with a very high percentage of that kind of activity goes by the trade name of Zanaflex. It’s called Tizanidine. It’s been around for a very long time, 25+ years in Europe and Japan. We’ve had it here for a while. And I have quite a number of patients who will begin sleeping. Now officially the medicine’s on the market for spasticity of muscle spasm but off label, it does in gender high quality sleep. It blocks pain transmission, in and of itself. Sometimes more potentially than opiates: Hydrocodone, Codeine, etc. It also relaxes muscles, as I mentioned officially. It does help take down migraines, headaches, pain. And it also is a phenomenal anti-anxiety agent. So you have more off-label uses for a medicine that has one of official approved us. And I think it can be a great tool to helping people to sleep and also block another element of pain by a mechanism that is totally different from what the neuronal stabilizers do, totally different from what the opiates do, totally different from other categories of medicine.