Restful Sleep: A Remedy for Chronic Pain

In the wake of the opioid epidemic, research is studying natural, effective ways to heal chronic pain so we can decrease our use of long term addictive medications. Sleep is found to be a major factor in healing as well as preventing the development of chronic pain.

Getting deep, restful sleep is crucial to overcome chronic pain and other long term medical conditions. Insomnia is the term used to describe sleep disturbances such as difficulty falling asleep or staying asleep. Insomnia can worsen pain and pain can worsen insomnia. The main reason why people in chronic pain get less sleep is that they tend to focus on negative, catastrophic thoughts just before getting to sleep.

“There may not be a single body system that can’t be improved by getting sufficient sleep,” says physical therapist, Keith Poorbaugh in PT in Motion magazine.

How does lack of sleep affect chronic pain?

Poor sleep doesn’t allow the body’s cells to fully repair and rejuvenate. During sleep, our body is actively getting rid of old cells, making new ones and shipping the new cells to their destinations. Our brain also opens channels to flush out its waste products.
Insomnia also causes pro inflammatory cells to be released in the body which increases pain.

The “Central sensitization” pain theory says the reason for ongoing pain is the brain and nervous system have become super sensitive. Both are on “high alert” mode. Stressful social situations like an argument with a family member or work colleague sounds the alarm in your nervous system. Body movements that aren’t physically harmful 6 months past an original injury, could be interpreted as a threat. In response to these threats, the brain sends pain as a form of protecting you. This heightened sensitivity lowers your threshold for pain which increases pain frequency. Worrying about pain just before sleep is found to be the main reason for insomnia.

Life stressors, such as a pressured workload, caring for family, health related anxiety, or experiencing a traumatic event can also negatively impact our sleep cycle. Research shows that one night of sleep deprivation can result in an increased state of anxiety and pain arousal the next day. Developing effective coping mechanisms for stress can improve quality of sleep.

Talk to your health professional about your sleep as it holds the key to lowering pain.

  • How many hours of sleep do you typically get per night?
  • Do you make getting regular sleep a priority?
  • Do you feel well rested when you wake up?
  • Does your current medical condition affect your sleep? If so, how?
  • How would you rate your sleep quality?
  • Do you need to take long naps (over 20 minutes) to function during the day?
  • Do you have difficulty getting to sleep or returning to sleep if you wake up during the night?
  • Do you snore loudly or frequently?
  • Has anyone observed you stop breathing while you sleep? Address any sleep apnea issues.
  • Do you have a strong urge to continually move your legs during sleep?

10 Tips to Improve Sleep to Reduce Pain

  1. Be the early bird, not the night owl. Our body has a natural rhythm, called circadian rhythm that’s in sync with sunrise and nightfall. Make sleep a priority by getting to bed just after sundown and waking up earlier with the sun.
  2. Create a relaxing bedtime routine – shut off all back lit screen devices (phones, TV, Kindle) one hour before bedtime. Blue backlit devices delays the secretion of melatonin, a hormone that promotes sleep.
  3. Listen to a free guided meditation or calming music on YouTube to relax your body/mind and prevent worry/catastrophic thoughts.
  4. Sleep in a dark, cool, quiet bedroom that lowers the level of sensory stimuli. Your bed should be for sleep and sex. No working, reading or eating in bed to allow your brain to associate bed with sleep. If you’re having difficulty finding a comfortable position, consult your physical therapist.
  5. Before bed, free your mind from your To-Do list or concerns by writing them down. Writing helps to release the worry as you have committed your feelings on paper. Focus on the positive events of the day in bed and think about what you’re grateful for. This helps your brain sense safety and calm.
  6. Avoid long day-time naps to “make up” for missed sleep. Consult with a sleep specialist who can guide you through this habit.
  7. Limit stimulants like caffeine and alcohol a few hours before bedtime.
  8. Exercise. Research shows that regular daily exercise, like walking for 30 minutes a day, improves sleep. You fall asleep faster, get deeper sleep, increase total sleep time.
  9. Sleep medications are highly addictive, so best to avoid them completely. Talk to your doctor if any medications you’re taking for a medical condition can disrupt sleep.
  10. Cognitive Behavioral Therapy is also beneficial as it addresses your underlying cause of sleep disorders.

Goodnight and sweet dreams!

References

• http://nationalpainreport.com/sleep-chronic-pain-thoughts-for-the-day-8835975.html
• https://www.spine-health.com/wellness/sleep/chronic-pain-and-insomnia-breaking-cycle

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