Tips
for Getting a Good Night’s Sleep for CPRS/RSD & Chronic Pain Patients.
I have seen more and more posts on
Twitter about Pain Patients having problems sleeping. I know with my CRPS at its worst I had a
terrible time with sleep and that is an understatement. Finding a ‘Sleep Routine’ helped me to gain
the additional sleep that my body needed so much. I hope by sharing the information that I was
taught it can help others to gain some much needed ‘shut eye’ too.
How you feel during your waking
hours hinges greatly on how well you sleep. Your sleep schedule, bedtime
habits, and day-to-day lifestyle choices can make an enormous difference to the
quality of your nightly rest. The following tips can help you optimize your
sleep so you can feel better, emotionally balanced, and have more energy throughout
the day.
Well-planned strategies are
essential to deep, restorative sleep. By learning to avoid common enemies of
sleep and trying out a variety of healthy sleep-promoting techniques, you can
discover your personal prescription to a good night’s rest.
The key, or secret, is to
experiment. What works for some might not work as well for others. It’s
important to find the sleep strategies that work best for you.
The first step to improving the
quality of your rest is finding out how much sleep you need. How much sleep is
enough? While sleep requirements vary slightly from person to person, they say most
healthy adults need at least eight hours of sleep each night to function at
their best. While this is great
information to know, as a Chronic Pain patient we all know that the likelihood
of getting a full eight hours of sleep can be difficult. Sometimes it seems like it is impossible, but
with putting in place a bedtime routine it can help you find that nighttime slumber
you are seeking.
Getting in sync with your body’s
natural sleep-wake cycle—your circadian rhythm—is one of the most important
strategies for achieving good sleep. If you keep a regular sleep schedule,
going to bed and getting up at the same time each day, you will feel much more
refreshed and energized than if you sleep the same number of hours at different
times. This holds true even if you alter your sleep schedule by only an hour or
two. Consistency is vitally important.
Set
a regular bedtime. Go to bed at the same time every
night. Choose a time when you normally feel tired, so that you don’t toss and
turn. Try not to break this routine on weekends when it may be tempting to stay
up late. If you want to change your bedtime, help your body adjust by making
the change in small daily increments, such as 15 minutes earlier or later each
day.
Wake
up at the same time every day.
If you’re getting enough sleep, you should wake up naturally without an alarm.
If you need an alarm clock to wake up on time, you may need to set an earlier
bedtime. As with your bedtime, try to maintain your regular wake-time even on
weekends.
Nap
to make up for lost sleep. If you
need to make up for a few lost hours, opt for a daytime nap rather than
sleeping late. This strategy allows you to pay off your sleep debt without
disturbing your natural sleep-wake rhythm, which often backfires in insomnia
and throws you off for days.
Be
smart about napping. While taking a nap can be a great
way to recharge, especially for Chronic Pain patients, it can make insomnia
worse. If you must nap, do it in the
early afternoon, and limit it to thirty minutes.
Fight
after-dinner drowsiness. If you
find yourself getting sleepy way before your bedtime, get off the couch and do something
mildly stimulating to avoid falling asleep, such as washing the dishes, calling
a friend, or getting clothes ready for the next day. If you give in to the
drowsiness, you may wake up later in the night and have trouble getting back to
sleep.
How
to discover your optimal sleep schedule
Find a period of time (a week or two
should do) when you are free to experiment with different sleep and wake times.
Go to bed at the same time every night and allow yourself to sleep until you
wake up naturally. No alarm clocks! If you’re sleep deprived, it may take a few
weeks to fully recover. But as you go to bed and get up at the same time,
you’ll eventually land on the natural sleep schedule that works best for you.
Melatonin is a naturally occurring
hormone controlled by light exposure that helps regulate your sleep-wake cycle.
Melatonin production is controlled by light exposure. Your brain should secrete
more in the evening, when it’s dark, to make you sleepy, and less during the
day when it’s light and you want to stay awake and alert. However, many aspects
of modern life can disrupt your body’s natural production of melatonin and with
it your sleep-wake cycle.
The bright lights at
night—especially from hours spent in front of the TV or computer screen—can
suppress your body’s production of melatonin and make it harder to sleep.
However, there are ways for you to naturally regulate your sleep-wake cycle,
boost your body’s production of melatonin, and keep your brain on a healthy
schedule.
Increase
light exposure during the day
Remove
your sunglasses in the morning and let light onto
your face.
Spend
more time outside during daylight.
Try to eat your breakfast or lunch outside in sunlight (weather permitting), take
a leisurely stroll outside, take a few minutes each day to enjoy the sunshine or
walk your dog (if you feel up to it) during the day.
Let
as much light into your home/workspace as possible. Keep curtains and blinds open during the day.
If
necessary, use a light therapy box.
A light therapy box can simulate sunshine and can be especially useful during
short winter days when there’s limited daylight.
Boost
melatonin production at night
Turn
off your television and computer.
Many people use the television to fall asleep or relax at the end of the day,
and this is a mistake. Not only does the light suppress melatonin production,
but television can actually stimulate the mind, rather than relaxing it. Try
listening to music or audio books instead, or practicing relaxation exercises.
If your favorite TV show is on late at night, record it for viewing earlier in
the day.
Don’t
read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an
eReader that is not backlit, i.e. one that requires an additional light source
such as a bedside lamp.
Change
your bright light bulbs. Avoid
bright lights before bed, use low-wattage bulbs instead.
When
it’s time to sleep, make sure the room is dark. The darker it is, the better you’ll sleep. Cover electrical
displays, use heavy curtains or shades to block light from windows, or try a
sleep mask to cover your eyes.
Use
a flashlight to go to the bathroom at night.
If you wake up during the night to use the bathroom—as long as it’s safe to do
so—keep the light to a minimum so it will be easier to go back to sleep.
Chronic Pain patients have more
barriers than the typical person, so it is even more important to try to get
into a bedtime routine as we are dealing with prescription medications that
affect our sleep in addition to our pain.
If you make a consistent effort to relax and unwind before bed, you will
sleep easier and more deeply. A peaceful bedtime routine sends a powerful
signal to your brain that it’s time to wind down and let go of the day’s
stresses. This is the same concept as
setting a bedtime routine for babies.
This is done to calm them down, relax them and get them ready for a good
night of rest. As we become adults we
forget to pamper ourselves and continue to set a bedtime routine for ourselves
to take the stress out of our day, relax our muscles and set the tone for a
better night of rest.
Make
your bedroom more sleep friendly
Keep
noise down. If you can’t avoid or eliminate
noise from barking dogs, loud neighbors, city traffic, or other people in your
household, try masking it with a fan, recordings of soothing sounds, or white
noise. You can buy a special sound machine or generate your own white noise by
setting your radio between stations. Earplugs may also help.
Keep
your room cool. The temperature of your bedroom
also affects sleep. Most people sleep best in a slightly cool room (around 65°
F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold
can interfere with quality sleep.
Make
sure your bed is comfortable.
You should have enough room to stretch and turn comfortably. If you often wake
up with a sore back or an aching neck, you may need to invest in a new mattress
or a try a different pillow. Experiment with different levels of mattress
firmness, foam or egg crate toppers, and pillows that provide more or less
support.
Relaxing
bedtime rituals to try
Read a
book or magazine by a soft light
Take a
warm bath
Listen to
soft music
Do some
easy stretches
Wind down
with a favorite hobby
Listen to
books on tape
Make
simple preparations for the next day
Do you find yourself unable to sleep
or waking up night after night? Residual stress, worry, and anger from your day
can make it very difficult to sleep well. When you wake up or can’t get to
sleep, take note of what seems to be the recurring theme. That will help you
figure out what you need to do to get your stress, anger or anxiety under
control during the day.
If you can’t stop yourself from worrying,
especially about things outside your control, you need to learn how to manage your thoughts. For example, you can
learn to evaluate your worries to see if they’re truly realistic and replace
irrational fears with more productive thoughts. Even counting sheep is more
productive than worrying at bedtime.
If the stress of managing your pain,
doctor appointments, family, or finances is keeping you awake, you may need
help with stress management. By learning how to manage your pain effectively,
handle stress in a productive way, and maintain a calm, positive outlook,
you’ll be able to sleep better at night.
Yes, I know – easier said than done.
Relaxation
techniques for better sleep
Relaxation is beneficial for
everyone, but especially for those struggling with sleep. Practicing relaxation techniques
before bed is a great way to wind down, calm the mind, and prepare for sleep.
Some simple relaxation techniques include:
Deep
breathing. Close your eyes, and try taking
deep, slow breaths, making each breath even deeper than the last.
Progressive
muscle relaxation. Starting with your toes, concentrate
on the specific muscle group; completely relax that area until it is limp or
heavy. Work your way up from your feet to the top of your head. This is also a good way to decrease pain
levels.
Visualizing
a peaceful, restful place. Close
your eyes and imagine a place or activity that is calming and peaceful for you.
Find a place that was calming to you prior to your Chronic Pain, get that image
in your head, concentrate on it, see it clearly and set this as your place to
go when you need to relax. Concentrate
on how relaxing this place makes you feel.
Mindfulness. Close your eyes,
take a three slow deep cleansing breathes to relax your body, say to yourself “I
am calm, I am relaxed, I am sleeping…” (Do this three times prior to going to
sleep.) If you awake during the night close your eyes and repeat this process,
including saying to yourself, “I am calm, I am relaxed, I am sleeping…”
It’s
normal to wake briefly during the night. Chronic Pain patients’ have problems
with sleep disturbances due to pain, medications affecting sleep cycles or being
wrestles; the reality is it happens more
than we would like. But if you’re waking
up during the night and having trouble falling back asleep, the following tips
may help.
Stay
out of your head. The key to getting back to sleep is
continuing to cue your body for sleep, so remain in bed in a relaxed position.
Hard as it may be, try not to stress over the fact that you’re awake or your
inability to fall asleep again, because that very stress and anxiety encourages
your body to stay awake.
Make
relaxation your goal, not sleep.
If you find it hard to fall back asleep, try a relaxation technique such as
visualization, deep breathing, or meditation, which can be done without even
getting out of bed. Remind yourself that although they’re not a replacement for
sleep, rest and relaxation still help rejuvenate your body.
Postpone worrying and brainstorming. If you wake during the night feeling anxious about
something, make a brief note of it on paper and postpone worrying about it
until the next day when you are fresh and it will be easier to resolve. Similarly,
if a brainstorm or great idea is keeping you awake, make a note of it on paper
and fall back to sleep knowing you’ll be much more productive and creative
after a good night’s rest.
