By Penney Cowan, Founder and CEO American Chronic Pain Association

“Sleep is the golden chain that ties health and our bodies together.” — Thomas Dekker

Sleep restores our body, allows us to function during the day, think clearly, and enjoy the moments.That sounds wonderful, but as many of us know, sleep and pain are strange bed fellows.It is just not easy getting a good night sleep when pain seems to interfere many of your nighttime hours—those hours where you lie alone hoping that sleep will come quickly, that your body will be able to finally let go of some of the pain and stress so thatyou can escape even if just for a few hours.But as hard as you may try, you just cannot seem to get a good night’s sleep.For many sleep is next to impossible.

Sleep disturbance is a common problem for many people.Why is it that after a long day, exhausted as you might be, you can still not get a good night sleep.You even struggle with just falling asleep.When sleep does come, it seems short lived, with far too many moments where you wake up and struggle to get back to sleep.

When Sleep Isn’t Sleep
Some people complain that they almost never sleep. When they are studied in sleep laboratories with all-night brain wave recordings, it is found that they actually sleep most of the night.However, their deep, slow-wave sleep is “contaminated” with brain waves characteristic of wakefulness.Thus, their sleep isn’t restful, and they are often aware of being awake during the night.

Closed for Maintenance
Sleep isn’t merely a time when your body shuts off. While you rest, your brain stays busy, overseeing biological maintenance that keeps your body running in top condition, preparing you for the day ahead. Without enough hours of restorative sleep, you won’t be able to work, learn, create, and communicate at a level even close to your true potential.[1]

While many people struggle with sleep because of stress, such as the night before a trip, an exam, family issues, or a major event at work, the problem is usually short lived. But living with chronic pain or an ongoing stress like COVID-19 can contribute to a chronic sleep problem. So how much sleep do you really need?

How Much Is Enough?
According to the National Sleep Foundation, a young adult between 18 and 25 and adults up to the age of 64 need about the same amount of sleep: seven to nine hours on the average.But they could be well rested with between six to ten hours of sleep.Older adults need about seven to nine hours a sleep each night.However, it is important to be aware that there is no amount of sleep that is correct for everyone.Some may feel good after five hours while other need as much ten hours of sleep each night.

Melinda Smith, M.A., Lawrence Robinson, and Robert Segal, M.A., Sleep Needs, https://www.helpguide.org/articles/sleep/sleep-needs-get-the-sleep-you-need.htm

If you aren’t getting the amount of sleep you need, the first thing to do is talk to your health care professional to see if there is a physical reason for poor sleep, such as sleep apnea.

What Can Help?
If everything checks out,there are some things that you can do to help improve your sleep.Below are some helpful hints to improve your sleep.

Exercise: Vigorous physical exercise in the afternoon or early evening (NOT close to bedtime) has been shown to increase the portion of time spent in the deepest stages of sleep. So, you may not sleep more, but you will probably sleep better if you exercise.

Schedule: It is important to set the same time for bed every night and stick to it rigidly. It may help to prepare yourself for bed with a bedtime ritual, such as a bath, a glass of milk, etc. at the same time each night. Then you should set a wake-up time and stick to this, no matter how little you have slept the night before. It’s very tempting to sleep in when you’ve been awake half the night before, but this only increase the chances that you won’t sleep well the following night.

Naps: Usually naps increase the problem of insomnia. They should generally be avoided by those with insomnia until their sleep has become regulated. On the other hand, a 20-minute period of napping, meditation, relaxation exercises, etc. can help to reduce the tensions of the day for many and can enable them to resume tasks with renewed energy.

Stimulants: No coffee or tea after dinner. Also, until you’re sure you are not affected by them, avoid chocolate (caffeine), decongestants, etc., in the evening.

Don’t Fight It: Many people drive themselves into a near frenzy rolling and tossing all night in a futile effort to force themselves to sleep. Make a rule for yourself that if you aren’t asleep after 15 minutes, you’ll leave the room and do something restful. Knitting is good, as are such things as jigsaw puzzles, or quiet radio shows, but they should not be done in the bedroom. Mystery shows, true crime stories, and action movies are off limits. Not only do they cause adrenal in to flow, but they’re hard to leave. Stay off your electronic devices, as well. When you begin to feel drowsy (no human is capable of staying awake forever) then return to bed. If you’re still awake in 15 minutes, leave the room again.

Bedrooms Are for Sleeping: And loving. Nothing else. Using the room for paying bills, doing homework, arguing, etc., can prevent the room from being a comfortable refuge in which you can automatically relax.

Avoid Habituation Drugs: Avoid drugs such as tranquilizers and sleeping pills. Most people who have used these drugs for a period of time and in substantial amounts find that it takes as long as six months for their sleep to fully normalize.

1. If you have back trouble, lie on your back and place a small pillow under your knees to take the pressure off your back.

2. If you sleep on your side, allow the leg touching the mattress to extend up and slightly bend the other leg up toward your chest.

3. If you have neck problems, place a small pillow roll under your neck instead of using large bed pillows. This will keep your neck well positioned in relation to the rest of your spine.

4. Try to avoid sleeping on your stomach: it puts strain on your spine.

Of course, pain and pain flairs may always interfere with your sleep no matter what you do to improve it. If that is the case, you need to discuss with your health care professional what they might do to help you obtain a better night’s sleep.

Resources:
Sleep Foundation:https://www.sleepfoundation.org/
How to Sleep Better: https://www.helpguide.org/articles/sleep/getting-better-sleep.htm
Sleep Tips: https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/sleep/art-20048379
Sleep: What you need to know: https://my.clevelandclinic.org/health/articles/13268-sleep-what-you-need-to-know

American Chronic Pain Association : From Patient To Person: First Step, pp. 166-169, © 1987-2016 , ISBN # 0-9673878-3-3

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