Sleep & Chronic Pain – Thoughts for the Day

Sleep & Chronic Pain – Thoughts for the Day

By Liza Zoellick.

We need sleep. It starts from the day we are born, this need for sleep, and continues throughout our lives. There are some times we need more sleep and other times we need less sleep. We all know babies need lots of sleep. We are all familiar with how much sleep teenagers need. It is a restorative function of our body to sleep and repair that which needs repairing. Babies grow a lot and sleep helps aids these small, growing bodies; it’s a lot of work!  Sleep also keeps our minds sharp and helps to function at our absolute best. Many things can disrupt our sleep cycle, from caffeine to jobs that interrupt our natural sleep rhythm; and pain is no exception. Pain can delay sleep, it can cause us to have interrupted sleep and chronic pain can lead to insomnia.

Liza Zoellick

Chronic pain and insomnia are a lethal combination. It is said that as many as one in five Americans struggles with this combination at least a few nights a week. Not only does it rob you of needful, body restorative sleep, but the lack of sleep makes you more fatigued and more sensitive to pain. In a study led by Børge Sivertsen, PhD, of the Norwegian Institute of Public Health, Bergen, “People with sleep problems have an increased sensitivity to pain. The effect on pain tolerance appears strongest in people who suffer from both insomnia and chronic pain.” But how do you get this, all important, body repairing sleep, when you are in pain? The first step is: Better Habits.

I know half of you are staring at your screen wanting to smack me, while the other half just rolled their eyes at me and are looking for something more interesting to read. Stay with me a moment, because I am right there with you. I have chronic pain and I’ve balked at people who have tried to give me advice. But the thing about advice is that you don’t have to take it. So, read to the end and no hard feelings if you don’t want to give it a try, but it can’t hurt, and if it does help you will get a few more hours of sleep.  I’m also not saying new habits will cure the insomnia or pain and it might not work every night, but I’m definitely the sort who feels “I’ll take what I can get.” More sleep is not a bad thing even if it’s once a week.

Get into the habit of a sleep routine. Pick a fair time to go to sleep and wake up. Before heading to bed try drinking a tea with Chamomile and Lavender. These are both great for relaxation and can help ease you into a sleepy state of mind. Stay away from Valerian if you take narcotics or any other drugs that may cause drowsiness because it can make you excessively sleepy, lethargic or unresponsive. If you can, also get into a routine of taking your pain medication an hour before scheduled bedtime. This will hopefully give you the best chance at pain-free sleep.

Sometimes falling asleep is not the problem, it’s staying asleep. A constant tossing and turning, waking up that leaves us not very rested at all. One thing you can do to help is not reaching for your phone. I know many of us turn to our device to try and distract us from pain and help us get back to sleep, but don’t do it. In fact, your new routine should also include at least one hour before bedtime that you do not have any devices. When you wake up in the middle of the night try to get back to sleep on your own, but if you must get up do not turn any lights on. Keep night lights that will help you see and perhaps a lamp you can keep on a dim setting so that you don’t switch your sleepy brain to awake mode. Try reading a book or magazine for a little while before heading back to bed.

A little meditation to distract the pain away. If you feel that it is the distraction of pain keeping you awake at night try some basic meditation to lull you into sleep. It can be as simple as some breathing exercises and some image guided meditation or even something like music guided meditation. Studies have shown that listening to music can aid in lessening pain and relaxing us enough to sleep. If the idea of learning meditation is too complicated for you there are meditation apps for the phone, I would just suggest that you keep it on a dim, night time setting so if you have to turn it on you won’t jolt yourself awake.

I have been utilizing some of this advice myself and have noticed somewhat of a improvement. I still struggle with pain-somnia, but there are nights where I get more sleep and I am grateful for it.

Liza is a chronic pain warrior from Houston who has been chronicling her journey through chronic pain and illness on her blog: http://lovekarmafood.com. She is a contributor to the National Pain Report.

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Authored by: Liza Zoellick

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Hayden

The best sleep aid I have found (in the last 3 months} is about a hal a quart of 80 proof. If you told me that I would be doing this about a year ago, I would not have believed you. Isn’t that rediculous for someone that has not drank 6 beers and 4 botlles of wine for New Years Eve in over 40 years? I guess a pickled liver is what will be next. Doesn’t help much with pain but, I can sleep occassionally. 23 years of continued working, providing for my family and remaining active until…..the policy from CDC, start of 2017 ( sooner for veterans). I AM 59 years old but since the age of 22 I worked hard. I suppose we do what we have to do. I’m still e-mailing, calling, and wrting almost everyday to my “elect” and dot/gov health agencies but, in the end, pain is intolerable once you have exceeded your personal endurable range of torture.

Lisa-
I’m so sorry to heat what you’ve endured, and while I do not disagree about quality of life being important, I’m still completely convinced that sleep is vastly important to our well being. Thank you so much for reading and for your shared thoughts.

Heather-
What great tips you’ve provided! Thank you so much for sharing.

Don-
Thanks so much for reading! I’m glad to hear that taking pain pills a few hours before bed is helping you. I’ve noticed it helps me too depending on the pain level that day.

Susan-
It’s amazing how much sipping some herbal tea can relax us. I think it’s partly the herbs and partly the calming ritual.

Terry-
Thanks for the tips and for reading. A sleep aid can help some, but with me, for instance, I’ve had no luck with any of them including the one you talk about. I have had too many side effects, including sleep walking and sleep eating and so I’ve decided they are just not an option. But it may help some and it certainly is a viable option.

Penny-
Sorry to hear this. This is not be any means a one-size-fits-all type of thing. What works for me or anyone else may not work for some. But I think it is important for us to have all the information we can at our disposal so we can make the most informative decision.

JoDawn-
Yes, sleep is so very helpful and sometimes the difference between getting things done or not.

Jilly-
Let me know how it goes! I hope something works for you!

Mist-
Something I’ve touched on in my blog is that doctors-even pain mgmt. docs, do not know how to treat chronic pain patients. That is not to say none do-but the vast majority have been trained to treat illnesses and problems that have very straight forward answers and chronic pain does not.

Terri James-
Yes, that is very true for many. Inadequate pain meds is causing many sleepless and painful nights for many. Encourage those you know in the pain community to contact their representatives. Maybe we can change things. Our voice matters.

Rachel-
Thanks so much! I will definitely check out that book!

Lisa Shuman

Please…SLEEP is no way as important as QUALITY OF LIFE..if you think like that..you have no way lost your quality of life.ive been unable to walk or do anything for 5 years due to a drunk unlicensed driver behind the wheel of a car with dollar a day insurance…i cry everyday..and scream WHY did GOD CHOOSE ME..Ive already had 2 failed spine surgeries..If I could walk..i don’t think sleep would bother me..do you know how much I’ve slept in the last 5 years…enough for a life time..

Heather

Sleep has to be a priority for me. Thanks for the article!

Here are some things that have helped me:
– Wind-down time (I know it takes me awhile to get ready for bed, so I plan on it instead of rushing so that I can settle in easier)
– A notebook and pen near the bed (because when do you think of things you have to do in the future, right?)
– Take sleep meds earlier so they have time to work.
– See what meds may be “activating” or “stimulating.” Ask a doctor or pharmacist.
– Don’t take Vitamin D at night! It does help with magnesium absorption but it also interferes with the production of Melatonin (Found out the hard way!)
– Self-talk. Tell yourself “I will wake up rested in the morning.” Or “I will sleep well.” I do think it helps. Every little bit I can do, but when I was consistent with this, I think I did sleep more soundly. (less awakenings)
– Breathing. I used to always lie in the position that I usually fall asleep, closed my eyes and breathed as if I were imitating myself sleeping. Sometimes I dropped off to sleep very quickly.
– Hot shower before bed, room temperature comfortable (a little chilly is supposed to be best), dark room (hard to convince myself to turn off the TV but I’m working on it!)
– Make sleep a priority and plan ahead. What can you do when you get home so that you’re not rushing around before bed? What can you do so that you can leave more quickly in the morning if you’ve got to go out? Are you planning to be away from home too late in the evening?
– Experiment. Try chamomile tea. Try a new pillow. Try gentle stretches before bed if you can manage it. Try listening to soft music. Try meditation. See what helps!
– Avoid stressful conversations later in the day. Journal if if helps you.
– Purposefully manage stress. Problem-solve, ask for advice, talk to a therapist, meditate/breathing exercises, seek out support, listen to music, spend time with a pet, take a hot soak in the tub, watch something funny, go for a walk, make a list of pleasurable and relaxing things that elevate your mood so you can refer back to it.

I’m happy to hear from other people about sleep and to be reminded to make it a priority.

Don Whimpey

Right you are Liza. I’ve had Cronic Pain for over 10 yrs now do to a drunk driver crushing all my bones on my left side from the pelvis to the shoulder blade and it’s caused insomnia and pain every night but I started using some of the things you’ve talked about & it’s increased my sleep from no sleep to maybe one hour to now getting a solid 6 hours. I think the best for me that has helped is taking my medication one to two hours before with a sleepy time tea that after an hour I can usually fall right to sleep with waking up at night maybe two or three times instead of 12 to 15 times a night.
Thanks for your article.

SusanSeelbinder

Some of this has worked for me. I drink 1 cup of coffee, I drink ginger ale. Gave up come 2 yrs ago. I drink herbal tea before bed. I take my meds an hour or so before turning out the lights.

Terry

I have more thoughts about getting some sleep. I used to go to bed around 9 just so I could sleep and get relief from my pain but my pain usually woke me up. Here’s my tips: 1) find a good sleep aid, I take Lunesta and it works well, there are zero side effects or groggyness the next day either. 2) take it when you go to bed, it will kick in about an hour later and last through the night. 3) Try and go to bed when you’re sleepy, not too early like I used to. You will fall asleep much quicker and the Lunesta will kick in to get you in REM sleep. 4) When you wake up to go to the bathroom at 6 a.m., use the bathroom and go right back to bed for a few more hours. 5) Do some light exercise 2 hours before you go to bed. No closer than 2 hours or it will work the opposite. 6) Force yourself to think of times in your life that you were the happiest, you will drift off and have nice relaxing, calm dreams. This is what has worked for me and I usually get a full 8 hours most nights. So good luck to all of my chronic pain brothers and sisters. Today I am doing a large 3 foot x 4 foot painting in the style of Jackson Pollock and I’m very excited. It helps to have things to look forward to. God bless you all.

Penny Rosen

After almost 25 years of suffering from CRPS (a.k.a.RSD),
I’m telling you now that what you are suggesting I tried long
before you started your journal. My journal consists of 82
books. And, guess what? I still haven’t been able to sleep.

JoDawn

So true!!! I can handle MUCH
more the next day, if I just get a decent nights’ sleep!!

Jillyn31

My painsomnia has never been as bad as its been the past 10 or so days. The lack of sleep has taken a toll on me all the way around. Glad I saw this article! Look forward to trying some of your tips & hopefully setting & sticking to a new bedtime routine. Thanks!

Mist

After my neck surgery The pain was unrelenting and severe to the point I was begging hospital staff to kill me. I got a total of 3 and 1/2 hours of sleep in 7 days when my doctor got back after vacation and finally gave me some treatment I was able to sleep an hour a night after that still will stay away for 24 hours until i am so tired I just drop off.
That is what many in pain can relate too and it has alot to do with conditions of pain there is no cure for.
I keep saying Cure me or treat my pain

Thank you for all of of your kind advice. I hurt so bad at times I do lay down to sleep. Since this new law has passed; it’s happening in the daytime as well. Every few hours I wake from the pain. I’ve tried everything. Even the medication I take to help me sleep is not working due to the pain. We need our pain medication back that helps all of us so very much…..

Rachel

Excellent post. Read Prof Matthew Walker’s book “Why We Sleep” Allen Lane/Penguin 2017. It’s in the best seller lists for a good reason: sleep is way more important to quality of life and disease prevention than we ever thought, this book is easy to read and gives lots of tips on how to improve your sleep,and therefore you health. The book is also available on Audible for those who prefer to listen.