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  • How To Sleep Better When You Have Chronic Pain

    You know how hard it is to sleep when you’re in pain. Imagine how little sleep you’d get if you had chronic or daily pain. I’m yawning just thinking about it.

    Chronic pain and fatigue

    There are a lot of reasons that chronic pain affects your sleep, including the obvious one: it hurts. But even if you don’t have chronic pain, only occasional bouts of insomnia (or know someone who does) keep reading. Much of the info may still be relevant to you. It’s a bit lengthier than I intended but it really is a fairly quick read nonetheless. I promise.

    The 5 biggest reasons and what to do:

    1. It hurts – At the risk of stating the obvious, pain makes it hard to sleep. Consult with your physician to determine a pain management strategy. This will most likely involve pain-killing or pain-relieving drugs. In addition, you can: a) Add meditation to your daily routine before bed and upon waking. Meditation has been proven to decrease pain perception, so it’s a great option to not only help you sleep, but to function throughout the day. b) Get regular massage; it has been shown to decrease muscle pain. You and your massage therapist will need to work together to determine your optimal frequency. c) Use essential oils (EOs). There are many essential oils out there that are indicated for pain and sleep and you’ll find the best combination of oils for your unique set of symptoms by consulting a certified aromatherapist (note: this is NOT the same as someone who took an EO class from the company they distribute EOs for – besides, you want someone who is going to give  you unbiased advice as to which specific oils and brand you should use). That said, 3 top oils for both pain AND sleep are: Roman chamomile (pain killing, relieves muscle spasm, relieves rheumatism, sedative, anti-inflammatory), Lavender (pain relieving, anti-inflammatory, sedative, relieves rheumatism, relieves muscle spasm), and Clary sage (relieves muscle spasm and sedative). Lavender  and chamomile can be applied directly to the area that hurts, but make sure you dilute the clary sage with some unscented lotion or semi-absorbant oil like grapeseed or apricot kernel. But do NOT use Roman chamomile if you have ragweed allergies because the plants are in the same family.
    2. Changes in the brain – Chronic pain causes changes to take place in the brain. One of these changes causes pain sensitization. This means that a pain you would have rated a 4 when you didn’t have chronic pain, you might easily now rate a 7 or 8. And, as I mentioned above, pain makes it difficult to sleep. But now, you are even more sensitive to pain so you wake more easily. To deal with these changes, you need to treat the pain itself. Massage therapy and physical therapy are great for most kinds of soft tissue pain. If you have muscle pain, tendinitis, bursitis, etc.  you’ll be doing yourself a huge favor by working with a physical therapist, massage therapist, or bodyworker (they work with the connective tissue as well as the muscles). Pain from other sources is best dealt with by your physician. Luckily these brain changes can be reversed after you are pain free for a while.
    3. Sleep apnea –  Many people with chronic pain have sleep apnea. We don’t know why this is, or if it’s an effect of chronic pain, a cause, or just a simultaneous condition. In any case, when you have sleep apnea, you stop breathing several times a night. This creates an oxygen deficiency, which triggers an emergency gasp for air which disrupts your sleep. So not only are you spending part of every night not breathing, you’re waking up to gasp for air. If you have or suspect you have sleep apnea, you really, really need to be under a doctor’s care. This is a serious condition and should not be treated lightly.
    4. Upper Airway Resistance Syndrome (UARS) – Many people with chronic pain have UARS. With UARS, you thankfully don’t stop breathing, but you do have reduced airflow due to resistance in the upper part of your airway. UARS can only be diagnosed by a special sleep study test that only about a quarter of sleep labs are equipped to perform. While it’s not as dangerous as sleep apnea, it does cause multiple awakenings when your oxygen levels drop below a certain level. People who have UARS are chronically tired and have decreased tolerance to pain. Many people with UARS are also diagnosed with fibromyalgia and there is some debate as to whether some may be misdiagnosed with fibromyalgia when what they really have is UARS. If you wake up unrested, are tired throughout the day, and have decreased tolerance to pain, please do your research (here‘s a good place to start. And here.) and see your physician for a sleep study referral; but only if you want to feel more refreshed and have less pain.
    5. A Reset sleep schedule – The body resets it’s sleep clock when you’re regularly shorted on sleep. If, for instance, you’ve only been getting about 5 hours of sleep per night for several nights due to pain (or simply working too much), it won’t be long before you will start waking up after 5 hours whether you went to bed on time or were pain-free, simply because the body got used to getting only 5 hours of sleep, even if it didn’t like it. The absolutely best thing you can do to combat this is to go to bed and get up at or near the same time each day. I know you’ve heard this before, and I know this isn’t easy, but it works. If your pain medication wears off after 4 hours and you wake up in the middle of the night needing to take more, work this into your sleep strategy. Go to bed an hour earlier than you normally would to accommodate the time it will take for your middle-of-the-night dose to kick in and get your sleep in two 4 hour stretches. Yes, it really is OK to sleep 4 hours, wake, take more meds, sleep 4 more hours, then get up for the day. Back before the industrial age, it was the norm to wake in the middle of the night and engage in a quiet activity for 1-2 hours before going back to bed. If you read through REALLY OLD books you will see references to first and second sleep. Even Shakespeare mentions first and second sleeps, and lots of his stuff is still available.

    I hope you found this info useful. Please share it with family and friends who may need it.

    If you have a sleep strategy for dealing with chronic pain please tell me about it by leaving a comment below or on my Facebook wall or Twitter stream. And don’t forget the all important like, comment, share, & retweet.

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