• How Sleep Affects Your Pain Level & What to do About it

    Woman sleeping in bed

    Do you ever wake up in the morning feeling worse than when you went to bed? Maybe you feel stiff first thing in the morning, but as you start moving through your day, the stiffness dissipates. Maybe you notice that it takes less stress to make you crabby, which then gives you a headache. Or that a metaphorical pain in the neck turns into a physical one at the drop of a hat. Maybe you notice that when you get crappy sleep (or not enough sleep) it takes much less physical exertion to bring on a pain flare.

    You know that when you get a good night’s sleep, you not only feel better the next day, you’re more clear-headed as well. But what does a “good night’s sleep” entail? How many nights can you forgo an acceptable quality and quantity of sleep before you suffer repercussions? Hint: it’s much less if you have existing pain issues than if you don’t. What can you do to improve your sleep?

    A Good Night’s Sleep

    In order to keep pain at bay, or at least pain caused by bad sleep, here are a few things to consider:

    • Get enough sleep – According to the National Sleep Foundation, most healthy adults need 7-9 hours of sleep per night. Most Teenagers need 8-10 hours a night. Remember, these are averages so that means there are some people who can thrive on 6 hours of sleep and some who must get 10, but the majority of us need a good 7-9 hours per night.
    • Get uninterrupted sleep – Interrupted sleep not only decreases the overall amount of sleep you get, it can interrupt your sleep cycle. This is important because restoration and repair takes place during deep and REM (Rapid Eye Movement, or dream) sleep. REM sleep happens every 90 minutes or so and deep sleep immediately precedes it.
    • Get deep sleep – Sleep is when your body rests and repairs itself. So, it will work on repairing damage in your body that might be causing you pain. It will also repair damage done by prolonged exposure to the stress hormone cortisol. A full sleep cycle takes about 90 minutes to complete and consists of moving from light sleep to deep sleep, and finally REM sleep.

      Here’s a full breakdown of what happens when we sleep.

    How Do I Get Enough Sleep?

    Everyone’s different, so there is no one-size-fits-all sleep plan, but here are a few suggestions to get you started:

    • If you have trouble falling asleep, avoid caffeine and nicotine in the late afternoon and evening. Both can delay your ability to fall asleep.
    • Plan your to-do list so that you’re finished 1- 2 hours before you have to go to bed
    • Go to bed 7-9 hrs before you have to get up.
    • Avoid napping. If you have trouble falling asleep, naps often interfere with your ability to be tired enough for sleep at bedtime.
    • Finish your workout at least 3 hours before bedtime. If your body hasn’t had enough time to properly cool down, you will likely have difficulty falling asleep.
    • Develop a peaceful, relaxing routine before bedtime. This will help signal the body and mind that sleep is coming which can help them slowly switch gears so they can be ready for sleep when you go to bed.
    • 1 hr before bed, turn off all electronic devices. The blue light is stimulating and will make it difficult to both fall and stay asleep.
    • 1 hr before bed, put on music that’s designed to take you and your brain from multitasking mode to a light meditative state. Example: Stephen Halpern’s Deep Alpha
    • If you have trouble falling asleep: When you go to bed, put on music that’s designed to take your brain into a deep meditative or light sleep state. Example: Stephen Halpern’s Deep Theta. Warning: Do not put this CD on repeat or you’ll stay in a state of deep meditation/ light sleep all night and will not be rested in the morning. *I may, or may not, have learned this lesson the hard way. Just sayin.

    But I Keep Waking Up. What Now?

    • Make sure you’re sleeping with a pillow that’s the correct height and firmness for you. It should be fairly high if you’re a side sleeper and fairly flat if you’re a back sleeper. If you alternate between back and side, you’ll want a pillow height somewhere between the two. If you need more guidance on pillows, try this post I wrote about the link between neck pain and pillows or this one from the National Sleep Foundation.
    • Make sure your mattress is the correct firmness for you. Just because Aunt Martha loves her memory foam mattress, doesn’t mean you will. One family member of mine used to get debilitating low back pain if he slept on a firm mattress. I, on the other hand, wake up with stiffness and pain if I sleep on anything other than a firm mattress. Unfortunately the only way to figure out what you need is by trial and error. One night’s sleep on it will not usually be enough. You’ll want to test each firmness for several days to see how your body acclimates to it. Many mattresses come with a 30 day guarantee so make sure you do all the things to ensure they honor the guarantee in case you find yourself in a world of hurt after giving your new mattress a good week’s trial.
    • Limit alcohol consumption in the evening. While it will help you fall asleep, it may cause interruptions to your sleep during the night. Quick example – I just spent 2 nights caring for an elderly relative and getting up approximately every hour. When I got home, I was exhausted but had to get up early the next day. I got about 5 hours sleep. The next night I had a couple hours to actually relax and had 2 hard sodas in a 2 1/2 hour span of time. I barely felt their effects, yet I spent the entire night in fitful, interrupted sleep despite being exhausted. I knew I was taking a chance by drinking alcohol, and this morning I’m paying the price.
    • Empty your bladder before going to bed.
    • If your bladder repeatedly wakes you up at night, consult with your physician. If they can’t help, you may need to see a pelvic floor physical therapist (if you meet the criteria for pelvic floor dysfunction).

    How Do I Get Deep Sleep?

    • If worrying thoughts or your to do list keep waking you up, do a brain dump before bed – write down every thought, no matter how trivial, just to get them out of your head. This way, any important things you need to remember are written down so you can’t forget them.
    • Control your pain. It’s no secret that pain can keep you from sleeping so follow your doctor’s advice and take any prescription pain meds on time.
    • Use music that’s designed to activate the brain waves needed for deep sleep such as Stephen Halpern’s Sleepscape Delta.
    • Control your sleep environment as much as you can. It should be quiet, dark, and comfortable. All of these factors have the potential to either keep you from falling or staying asleep.

    General Suggestions for Getting Better Sleep

    • Don’t use your bed for anything other than sleep and sex. If you regularly use your bed for other activities, you body and mind will not automatically associate it with sleep which can keep you from falling asleep.
    • Make sure to replace your mattress every 8-10 years.* For more information about mattresses and sleep, check out this article from The Sleep Foundation. **Yes I know how expensive mattresses are, so here’s a short term, stop-gap measure if you need but can’t afford a new mattress – buy a camping mat (they’re kind of stiff and will be either folded or rolled up in their package) for $30-50 and put it beneath your mattress pad. It’ll get you by for 3-6 months depending on the firmness/stiffness of the pad you buy.

    I can’t possibly cover every aspect of sleep and pain in a blog post. Each of those subjects is complicated and have had a multitude of books written about them. I’ll give you a list of good ones in the near future. In the meantime, try a few of the suggestions above.