My wife is depressed and doesn't sleep well. She lost her job about six months ago because of back pain. Would sleeping pills help improve her sleep and her pain levels?

Disrupted sleep is a common problem for people with chronic low back pain. Depression or mood disorders are commonly observed in people with chronic pain from any cause. Some experts say it's natural to feel depressed when pain is constant and disrupts our lives.

Some studies have shown that poor sleep patterns affect mood more than mood affects sleep. So getting a good night's sleep every night may be the key to improving pain, mood, and function.

Ways to improve sleep are called sleep hygiene. Sleeping aids such as a sleeping pill may be needed, but most sleep experts suggest other measures first. Daily exercise is a key factor to improving sleep. Likewise, a healthy diet is advised. Caffeine should be avoided before bed.

Some chronic pain patients benefit from cognitive behavioral therapy (CBT). Improved mood, sleep, and function have been reported with this type of counseling and behavioral changes. Pain management should include medications, CBT, exercise, and good sleep hygiene.