Can better sleep reduce your pain?

Self Care, Pain Management


Young man sleeping in a white tee-shirt, on white sheets, and white pillowcase
The short answer is yes. Rapid Eye Movement (REM), the dream state of sleep, and Non-Rapid Eye Movement (NREM), the deepest state of rest, allow your brain and nervous system to recover from the day’s activities.

In his 2017 book, Why We Sleep: Unlocking the Power of Sleep and Dreams, Matthew Walker tells readers a lack of sleep makes people vulnerable to significant health conditions, such as cancer, diabetes, stroke, heart attack, depression… and chronic pain.

According to Walker, during NREM sleep, the brain prunes memories and transfers short-term memories to long-term memory areas, gains “muscle memory,” secretes growth hormones, and activates the parasympathetic nervous system.

REM sleep forms new neural connections, assimilates complex memory knowledge, supports problem-solving, creates dreams, dulls emotional responses to painful memories, and gives people the ability to pick up on facial cues.

Many studies show an association between increased pain and less sleep. Research by Patrick Finan and his colleagues suggests that sleep disturbances impair key processes that contribute to the internal development of chronic pain, including joint pain.

People require both pain and sleep for survival.

At first glance, that statement makes us stop and think. Do we need pain for survival?

Yes. Pain is a warning system.

  • It helps us avoid danger.
  • Pain is produced by the brain based on danger messages.

Sleep helps our bodies and our nervous systems recover from painful situations.

Three areas to adjust for better sleep.

According to Matthew Walker, there are several habits you can adopt to regulate and normalize your sleep. Changing just one or two habits at a time can improve your sleep. But there’s a caveat: What works for one person may not affect another. The key is to find the best sleep routine for you.

Adjust your bedtime and morning routines. Most activities work better on a schedule. Your sleeping pattern is no different. Creating a waking and sleeping plan can help you enjoy better sleep quality.

  1. Set a sleep schedule. Try to sleep and wake up at the same time every day, even during the weekend. Adopting this habit is the single most effective way to improve sleep.

  2. Try not to use an alarm. Once your body gets into a routine, you may not need to depend on an external clock. Waking up naturally is best for your body. Alarms cause a considerable stress reaction when they wake people up.
  3. Don’t press the snooze button. Pressing snooze multiple times causes repeated stress traumas, which spike blood pressure and increase heart rates.
  4. Wake up with the sun or use very bright lights in the morning. Bright lights help set your circadian rhythm, which is your internal wake-sleep cycle.

  5. Skip the daytime or early evening nap. A nap or falling asleep on the couch after dinner can interfere with a good night’s sleep. If you’re tired, try to stay awake until bedtime and rest well.
  6. Get out of bed if you can’t sleep. If you’re having trouble falling asleep, get out of bed and do something quiet and relaxing until you get sleepy.

 The lifestyle choices we make during the day can affect how we sleep at night.

  1. Avoid caffeine after 1 or 2 p.m. If you are sensitive to caffeine, you may notice that coffee or tea in the afternoon or a chocolate milkshake with dinner robs you of sleep. It takes between 5 and 6 hours for the average adult to process just half of the caffeine that you eat or drink.

    For instance, if you have a cup of coffee, two chocolate bars, or large iced green tea at 2 p.m., you’ll consume about 100 mg of caffeine. At 7 or 8 p.m., your body will still be under the influence of 50 mg of caffeine. For some people, 50 mg of caffeine is enough to interfere with sound sleep.

  2. Exercise regularly. Try to get at least 30 minutes of exercise every day. Remember, vacuuming the house or mowing the lawn can count as exercise. Avoid strenuous exercise one to three hours before going to bed.

  3. Avoid eating large meals and drinking large amounts of liquid before bedtime. Eating a heavy meal three or four hours before bed can cause indigestion. Pair that meal with several glasses of water or lemonade, and you’ll spend the first hours of bedtime running to the bathroom.

  4. Having a nightcap to help you sleep can backfire. Alcohol makes you drowsy but does not help you stay asleep. Don’t drink alcohol unless it is completely metabolized before bedtime, including the aldehydes it produces.
  • Alcohol fragments sleep with brief undetected awakenings, so sleep is not restorative.
  • Alcohol is one of the most powerful suppressors of REM sleep.
  • Heavy alcohol intake may contribute to impairment in breathing at night.

Create a bedtime ritual and sleep-friendly atmosphere. Take time to relax and settle down before going to bed.

  1. Shut off electronics an hour before bedtime. The blue light from your cellphone, tablet, laptop, or computer suppresses melatonin. If the devices must be on, use an app or setting on the device to reduce the blue light shining from the device.

    Some electronic devices have LED lights on chargers or electrical cords. Cover these lights with electrical tape to make your bedroom as dark as possible.

  2. Dim the lights. Turn down the lights in your house an hour before bedtime to create a restful atmosphere.
  3. Take a hot bath or shower before bed. When your body temperature drops after the shower or bath, you body goes into a relaxed state.
  4. Keep the bedroom cool. A temperature of 65 degrees Fahrenheit is ideal for sleep.
  5. Designate the bedroom as a sleeping area. It’s important to set aside the bedroom for sleep. Avoid setting up a desk or entertainment center in the corner of the bedroom.

Making changes to your lifestyle or routine can help you fall asleep faster and stay asleep longer. Over time, you will start enjoying deep, restorative sleep. As you become more rested, your sensitivity to pain may decrease.

If you suffer from chronic pain or pain that keeps you awake, contact Bone & Joint’s pain management or interventional physical therapy specialist for an appointment. A pain specialist will work with you to reduce or end pain.

Sources:

Walker, Matthew. Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner. 2017

Krause AJ, Prather AA, Wager TD, Lindquist MA, Walker MP. The Pain of Sleep Loss: A Brain Characterization in Humans. Journal of Neuroscience 20 March 2019, 39, 2291-2300; DOI: 10.1523/JNEUROSCI.2408-18.2018

Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007

 

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