Those of us who suffer from chronic pain know how precious and elusive sleep can be. Awakening repeatedly or having trouble getting to or staying asleep is a constant issue. In order to function at our best we need to experience all stages of sleep since each one is vital to awakening refreshed and ready for a new day.
Here are some ways we can help to facilitate this incredibly important process which can then lead to less pain.
Stay away from alcohol
Alcohol is a central nervous system depressant that caused brain activity to slow. Most of us think of it as a sedative, inducing relaxation and sleepiness. But research has shown it actually does the opposite. It makes falling asleep more difficult and suppresses the all-important REM cycle. This decreases overall sleep quality by causing shorter periods of sleep and more sleep disruption. Less than one drink was shown to decrease sleep quality by 9.3%, one drink nightly by 24% and more than one drink at night by a whopping 39.2%!
It’s best to stop all caffeine consumption by late afternoon. Everyone is different but for most, caffeine can stay in the system for up to ten hours. In one study 400 mg of caffeine within six hours of bedtime significantly impaired sleep. Since most commercially brewed coffee contains 500mg in a 16 ounce serving, it’s recommended all coffee consumption end by mid afternoon. This allows the body to clear the stimulant effects it produces. But caffeine also impacts the secretion of our natural production of melatonin and adenosine– sleep inducing hormones. Stopping intake as early as possible allows these important naturally occurring sleep agents to be produced unobstructed when the time is right.
Nicotine is a stimulant. In any form, whether chewing, smoking, or vaping. They all interfere with our sleep cycles by making it harder to fall or stay asleep and impairing deep, restorative sleep. In heavy nicotine users the brain can even go through periods of withdrawal during the night, causing anxiety and a feeling of restlessness in the morning,
Stop late night eating
Eating within 4 hours of sleep forces the gastrointestinal muscles and digestive fluids to work when they should be resting, impairs insulin and glucose metabolism, and prevents the body from warming up. All can delay onset of sleep or impair its quality. It can also lead to indigestion which can disturb sleep due to abdominal bloating, distention, gas and pain. Recent studies have shown both the volume and the type of food such as fat and sugar content also impaired “deep sleep” -that time when the body repairs and detoxifies tissues, releases growth hormone (especially important for children) and readies us for the next day. Sugar also activates the fat storage system which, once started, works through the night. Can’t live without that pre- bed snack? Pair one serving of protein with one serving of carbs e.g. an apple with almond butter milk. It will help keep blood glucose levels stable so you’ll awaken less often.
Don’t eat natural diuretics before bedtime
Diuretics help rid our bodies of excess salt and water by making us urinate. Water based fruits and vegetables e.g. lemons, celery, watermelon, grapes, pineapple, and some herbs like parsley are natural diuretics. Eating them before bedtime can interfere with sleep by keeping us away from the bed and in the bathroom. Make sure you’re not taking any supplements that can create this effect. Talk to your provider if you believe your medications might be the culprit as discussed below.
Check out your medications
Some medications can interfere with sleep. Diuretics are obvious ones not to take at night but many others can impair sleep. SSRI’s such as Prozac block the re-uptake of serotonin, which can impede REM sleep, as do alpha blockers used for high blood pressure and prostate issues. Steroids target the adrenal glands which then keeps the body on high alert. Beta-blockers used for hypertension and arrhythmias slowdown the body’s fight or flight system but also interfere with melatonin production- a hormone that keeps our sleep and biological clock working smoothly.
Use pillows, sheets, blankets and a mattress conducive to sleep
The type of pillow, sheets and mattress can make or break a good night’s sleep by giving proper support to your head and spine and allowing air to flow so heat doesn’t build up. Add a weighted blanket to wrap yourself in a cocoon of warmth and comfort.
Wear socks to bed
Fluffy, cozy socks can add a wonderful dimension to your sleep habits. They not only warm your feet but relax and dilate blood vessels. This improves overall circulation, helps release more heat through the skin, which then drops your core temperature. All are factors required for a good night’s sleep.
Exercising any time throughout the day improves sleep. Moderate aerobic exercise has been shown to increase the amount of slow wave sleep when the body repairs itself. Its also a great way to decompress and let go of the stresses that build throughout the day causing us to stay in a fight or flight mode. Exercise also elevates the body’s core temperature telling us to stay awake. But within an hour and a half the core temperature drops which helps us to fall asleep. That’s why some studies suggest the optimal time to exercise is an hour and a half before bedtime.
Don’t work in bed
We are creatures of habit. The body’s circadian rhythm functions by understanding patterns. Using digital devices keeps us bathed in light, especially blue light, which stops the production of melatonin as well as promoting stress and focus on the activities of the day. Keep the bed for sleeping. That way when you crawl into it at the end of a long day the body will know it’s time to shut down.
Take a warm bath
I’m already a big advocate of baths. Now research shows a warm bath an hour or two before bedtime may help us to fall asleep faster and stay asleep longer. Our circadian rhythm works in a pattern that keeps us functioning at peak levels throughout the day and night. Initially a higher body temperature, especially in our hands and feet, kicks the sleep cycle into gear. Two hours into sleep the body’s core temperature drops to keep us asleep and our natural sleep hormone, melatonin, circulates at its highest concentration. This fine-tuned dance of temperature regulation is an imperative part of the natural, repairative, rejuvenating sleep we all require.
Switch off digital devices
Our biological clocks work off of light. Humans didn’t have digital devices, indoor lights, electricity for most of our existence. In order to survive we follow a 24-hour sleep cycle that’s based on sunlight. At sunrise, cortisol is secreted so we feel awake and energized. When sunlight fades, melatonin is released to quiet the body and encourage sleep. Electronic devices emit a blue light which has been shown to reduce or delay the production and release of melatonin. It also shortens time spent in slow-wave and REM sleep, both stages are vital to cognitive function.
Get natural sunlight
Sunlight is a natural high. A healthy amount every day with proper sunscreen protection stimulates the release of our own feel good hormones- endorphins ( see post). But it also enhances sleep time, quality and duration. Sunlight ruled our bodies natural 24 hour clock. A few minutes in the morning and late afternoon can be a powerful aid in making sure our internal mechanism is ready for a good nights sleep.
Encourage only positive thoughts.
It’s easy to get bogged down with all the day’s struggles and stressors when there’s nothing to distract us. Lying in the dark, waiting for sleep, it’s easy to focus on only the negative. Take long deep easy breaths in and out. Think of all the good you have in your life. The people you love, who love you. Let the worries drain away.
Establish a healthy sleep hygiene program
Setting up parameters you can stick to is an important way to let the body know it’s time to sleep. Sleeping the same times every night not only helps weight loss, but also strengthens our sleep routine and improves the quality. Studies show every two hour shift can decrease mental and physical acuity.
Turn off every light in the room
Any type of light exposure at night can affect weight gain, causes hormonal imbalances, depression, and a fracturing of our sleep cycles because of the impact on our natural circadian rhythm. Light is the strongest signal to the body it’s time to sleep or stay awake. Intensity matters. To prevent accidents when getting up at night don’t turn on the lights, instead use the lowest intensity nightlight possible. Consider switching to one that emits a red or green light since studies show they appear to be the least impactful color and may even aid sleep.
Turn off. Period.
It’s easy to get wrapped up in that great book or want to watch just one more episode of your favorite series. It’s been a long day and relaxing, shutting down is important. But studies show the extra time added to a good nights sleep will make a much bigger difference in the long run.
Regardless of our individual sleep practices, getting at least 7 to 9 hours every night is imperative to functioning at our best the next day. Without it we get foggy, irritable, sluggish and experience worsening pain. The effects are cumulative. Although most of us like to think we are the exception, no one can function without it. Try one small change every week. Even a few extra minutes of sleep can provide powerful, long lasting results.