For those of us navigating the daily challenges of chronic pain, the concept of a restful night's sleep can often feel like a distant dream. Even when I sleep well, it’s still not considered a good night’s sleep by normal standards. But it’s a good night’s sleep for me. The very thing our bodies crave for healing and rejuvenation – sleep – can become a battleground where pain flares, discomfort intensifies, and anxieties about the next day creep in. When it’s late, my legs are throbbing, and the room is dead quiet, I can hear that throbbing. It’s as if my legs have pulses that beat on their own, and I can hear that rhythmic beating of my legs throbbing. Often, when I finally get to sleep, I am woken by a sharp electrical jolt in my ankle that shoots up my leg, and it startles me awake. When you are woken like that, it’s hard to go back to sleep. But amidst these struggles, there is a powerful ally we can cultivate: sleep hygiene.
It might sound like just another wellness buzzword, but for chronic pain sufferers, sleep hygiene isn't a luxury – it's a vital component of pain management. It's about creating an environment and establishing habits that optimize your chances of falling asleep, staying asleep, and waking up feeling as rested as possible, despite the persistent presence of pain. I use an app to track my sleep through my Apple Watch, and it shows that I wake often in the night and that my heart-rate is often elevated. It also shows that because the pain makes it hard to sleep, that I don’t go into that restorative sleep cycle as much as I should. I am constantly working on improving that.
Why is Sleep Hygiene So Crucial for Pain Warriors?
The relationship between pain and sleep is complex and often cyclical. Poor sleep can actually worsen pain, making you more sensitive to discomfort and hindering your body's natural healing processes. Conversely, pain can make it incredibly difficult to fall and stay asleep, leading to a vicious cycle of sleepless nights and heightened pain levels. So it’s important to try and break this cycle.
Here's why prioritizing sleep hygiene is paramount when living with chronic pain:
- Pain Amplification: Lack of sleep can disrupt your body's natural pain regulation mechanisms, making existing pain feel more intense and widespread. I definitely feel my pain more on the days I didn’t get a good sleep. These elevations in pain are important for me to manage, because if I don’t, they can quickly drain me and send me into a depressive episode, which I have a hard time working through.
- Increased Inflammation: Chronic sleep deprivation can contribute to systemic inflammation, which is often a key driver in many chronic pain conditions. I also find I get really bad headaches that come from my whiplash injury in my neck and shoot through my neck, head and face, when I don’t get enough sleep.
- Mood and Mental Health: Poor sleep significantly impacts mood, increasing the risk of anxiety, depression, and irritability – all of which can exacerbate the emotional burden of chronic pain. It is so hard to feel happy or excited about anything when you are fighting to keep your eyes open. When that happens, I get that weighed down feeling of exhaustion and sadness enveloping my whole body. Some depressive episodes only last a short period of time, but some of the harsher ones have taken me months to work through. Getting a good night’s sleep is important in maintaining your mental health.
- Reduced Coping Abilities: When you're tired and sleep-deprived, your ability to cope with pain, manage stress, and engage in self-care activities diminishes. There just isn’t enough energy for it, as sad as that sounds, and things can escalate quickly, leaving you to feel a rush of overwhelm come over your mind and body.
- Impaired Cognitive Function: Lack of sleep can affect concentration, memory, and decision-making, making it harder to manage your pain effectively and navigate daily life. I suffer with this quite severely. My brain does not think the way it used to, so I have to utilize tips and tricks I’ve learned to help me to get by. It’s so full of trauma, and pain, that it has impacted my executive functioning to the point I need help managing it.
The Positive Ripple Effects of Good Sleep Hygiene
Investing in good sleep hygiene can yield significant positive impacts on your overall well-being, even when living with chronic pain:
- Potential Pain Reduction: While it might not eliminate pain entirely, improved sleep can help to dampen pain signals and reduce overall intensity. When you feel more rested, you can engage in activities, like mild exercise, which will help improve your pain and overall sleep.
- Enhanced Mood and Emotional Resilience: Better sleep can lead to a more stable mood, increased feelings of well-being, and a greater capacity to cope with the emotional challenges of chronic pain. I know when I’m tired, I don’t handle my pain flares very well, and my mood tanks into a depressive episode.
- Improved Energy Levels: Even small improvements in sleep quality can translate to noticeable increases in energy and reduced daytime fatigue. This is especially true as most chronic pain sufferers also suffer from chronic fatigue, and getting that good night’s rest can increase your spoons for the next day. My sleep app says that by doing exercise while you are in an energy dip, actually increases energy levels and helps you sleep better.
- Better Pain Management: When you're well-rested, you're better equipped to engage in other pain management strategies, such as exercise, physical therapy, and mindfulness techniques. When your pain is managed better, you naturally feel better, and have more mental energy for your pain management strategies. Some pain management strategies take a lot of effort, and it’s not always that easy to do them.
- Enhanced Quality of Life: By reducing the burden of poor sleep, good sleep hygiene can contribute to a more fulfilling and engaged life, despite the presence of chronic pain. This is an important take away. At the end of the day, we all want to have a good quality of life, and I do believe it’s possible, despite my chronic pain.
Coping Skills and Tips for Improving Your Sleep Hygiene When Pain Keeps You Awake
It's one thing to understand the importance of sleep hygiene, but putting it into practice when pain is a constant companion can be challenging. Here are some coping skills and tips to help you improve your sleep hygiene:
- Establish a Consistent Sleep Schedule: This is where routine is super important. Try to go to bed and wake up around the same time every day, even on weekends, to regulate your body's natural sleep-wake cycle (circadian rhythm). This consistency helps your body anticipate sleep and wakefulness. I struggle with this, because often I don’t sleep well and am exhausted the next morning. To catch up on sleep it means I get out of bed later, which has a negative impact on my day. I like to be up early so that I can tackle my to do list while pacing myself.
- Create a Relaxing Bedtime Routine: Wind down for at least an hour before bed. This could include taking a warm bath or shower, reading a physical book (avoid screens), listening to calming music or a podcast, or practicing gentle stretching or meditation. I like to meditate and do something creative at my desk as part of my wind down. I journal, listen to a guided meditation or 2, and read.
- Optimize Your Sleep Environment: Make sure your bedroom is dark, quiet, and cool. Invest in comfortable bedding and pillows that support your body and minimize pressure points. Consider using blackout curtains, earplugs, or a white noise machine if needed. This is where I also struggle. Because of my back pain and severe reflux, I need to sleep in my recliner, which is in the livingroom.
- Limit Exposure to Screens Before Bed: The blue light emitted from electronic devices (phones, tablets, computers, TVs) can interfere with melatonin production, a hormone that regulates sleep. Aim to put away screens at least an hour before bedtime. I’m not always good at this because I have both blue light filtering glasses, and I turn on my blue light nighttime settings on my phone which removes the blue light.
- Watch Your Caffeine and Alcohol Intake: Avoid caffeine, nicotine, and large meals close to bedtime, as they can disrupt sleep. While alcohol might initially make you feel sleepy, it can lead to fragmented sleep later in the night. Also, you have to pee more if you are drinking this stuff too close to bedtime.
- Get Regular Exercise (But Not Too Close to Bedtime): Regular physical activity can improve sleep quality, but avoid intense workouts in the hours leading up to bedtime. Aim for exercise earlier in the day. It has taken me nearly 2 years but I’ve finally worked up to being able to do 1-2 exercise videos every day, and it’s made a huge difference. My endurance and balance are both better and my legs don’t tire as easily.
- Manage Daytime Naps Wisely: While naps can be tempting when you're fatigued, long or late-afternoon naps can interfere with nighttime sleep. If you need to nap, keep it short (20-30 minutes) and earlier in the day. Because of the meds I’m on, it’s almost impossible for me to nap, but when I was able to nap, I had to be careful not to nap too long, or I’d wake up still feeling like I’m in a coma lol.
- Learn Relaxation Techniques: Practices like deep breathing exercises, progressive muscle relaxation, and mindfulness meditation can help to calm your mind and body, making it easier to fall asleep even when experiencing pain. I like to do one of my pain meditations in my meditation app Balance.
- Address Pain Before Bed: Take any prescribed pain medication as directed and consider using other pain relief strategies like heat packs, ice packs, or topical creams before getting into bed. Position pillows strategically to support your body and alleviate pressure on painful areas. I take my meds at the same time every day, and my last ones are at 10pm right before I go to bed.
- If You Can't Sleep, Get Out of Bed: If you've been lying awake for more than 20 minutes, get out of bed and engage in a relaxing activity in dim light until you feel sleepy. Avoid activities that are stimulating, like watching TV or using your phone. This is a hard one too, as sometimes I fall asleep right away, but then wake due to pain and then I’m alert. If that happens, I get out of bed and sit at my desk to journal whatever is bothering me.
- Seek Professional Help: If your sleep problems persist despite implementing good sleep hygiene practices, talk to your doctor. They can help identify any underlying sleep disorders or recommend other treatment options, such as cognitive behavioral therapy for insomnia (CBT-I). Going to therapy was one of the best choices I made and I learned so much.
Living with chronic pain is a journey that requires constant adaptation and self-compassion. Prioritizing sleep hygiene is an act of self-care that can significantly impact your pain levels, mood, and overall quality of life. By establishing a consistent routine, creating a supportive sleep environment, and learning effective coping skills, you can reclaim your nights and find the sweetest relief that restorative sleep can offer.
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