April 8, 2022 - Written By: Maria Arini Lopez, PT, DPT
It is a vicious cycle—experiencing complete and utter exhaustion every waking hour of the day, yet when you crawl into bed at night, unrelenting pain keeps you awake, preventing you from getting the much-needed respite you so desperately need through sleep.
Perhaps your mind is racing at 100 miles per hour and no matter how hard you try, you simply can't find the off switch!
Perhaps you are a parent or caregiver who loses sleep yourself due to your constant worry and anxiety for your child. You would do anything to take away their pain and fatigue. You spend countless hours researching online for possible sources of pain relief for your child and any ideas to make sleep easier and more restful for them.
This Living Rare editorial is written in hope of offering your suggestions and ideas, that may work for you or your loved one.
WHY IS SLEEP IMPORTANT?
Getting sufficient sleep is ranked up there along with routine exercise and a healthy diet in the top 5 health behaviors. Quality sleep is considered essential for the body and mind to recover from the events of the current day. A good night's sleep also allows both the body and brain to sufficiently recharge to function optimally again the next day. Learning, memory, concentration, and productivity are all affected by the quality of sleep you are getting. Chronic sleep deprivation may result in brain fog and disruption of clear thoughts, making school or work very difficult.
Sufficient sleep bolsters the immune system, reduces the risk of getting sick, and may prevent development of diabetes, obesity, and heart disease. Sleep also helps to regulate emotions. I know I am a cranky pants if I don't get at least a solid 7 hours of sleep each night. If I get anything less than 5 hours of sleep, I feel inhuman.
WHAT ARE COMMON SLEEP DISTURBANCES? WHAT CAUSES THEM?
The four most common sleep disturbances are sleep apnea, narcolepsy, restless leg syndrome, and insomnia.
Sleep apnea occurs when you literally stop breathing temporarily while you are sleeping. If you are told that you snore loudly and you are fatigued despite getting the recommended hours of sleep, this might be something a doctor can evaluate.
Narcolepsy is a chronic sleep disorder where you are extremely drowsy and have sudden uncontrollable bouts of sleep during the day. This can be quite serious, especially if you need to drive to and from work.
Restless leg syndrome is a sleep disorder characterized by the uncontrollable urge to move your legs, usually due to discomfort or pain. Symptoms usually worsen at night when you are not as active. Moving or stretching relieves these symptoms. Restless leg syndrome requires a doctor's evaluation to help medically manage this sleep disorder. Some people suggest using a weighted blanket which reduces stress which triggers restless leg symptoms.
Insomnia is the most familiar sleep disturbance in which you have difficulty falling asleep or staying asleep.
Many things contribute to poor sleep quality, including late night use of electronic devices, occupational factors such as shift work or long work schedules, certain medications that cause sleep disturbance as a side effect, and chronic pain (painsomnia).
WHAT ARE SOME RECOMMENDED TIPS TO IMPROVE SLEEP QUALITY?
Establish a set bedtime routine. This might include a personal hygiene routine (Epsom salt baths), reading, meditation, aromatherapy, listening to calming music, or journaling.
Meditation, aromatherapy, calming music, and planning the next day in advance may help you to manage stress and anxiety.
Journaling might be particularly helpful. You can write down everything that happened that day or make a list of tasks for the next day, just to get them out of your head and physically put them on paper. It might help your brain to relax better, knowing everything is down in physical form. You might call bedtime journaling a brain dump.
Create a consistent sleep schedule to ensure that you get the recommended 7 or 8 hours each night. Go to sleep around the same time every night and wake up around the same time every morning.
Do not drink caffeine, alcohol, or truthfully any liquids after a certain hour. Most sources suggest no caffeine after 2 pm and no liquids for at least 1-2 hours before bed so you don't have to get up to use the restroom repeatedly when you are trying to fall asleep.
Alcohol might help you to fall asleep initially, but it negatively affects the quality and duration of your sleep. Incidentally, alcohol is a diuretic which means it makes you have to pee more. Try to avoid alcohol at least 3 hours before bedtime.
Do not eat 2-3 hours before sleep. This reduces likelihood of reflux during the night. It also prevents your digestive system from working too hard while you are trying to go to sleep. If you do suffer from reflux, elevating the head of the bed might be helpful.
Remove all electronics from the bedroom. Yes, this includes the cell phone. It might also help to use blue light blockers after 7 pm. Your brain will associate the bedroom as a place for relaxation and rest - not stimulation and work.
Daily exercise and a healthy diet improve sleep quality.
Create a restful environment. This might include black out curtains, hypoallergenic sheets, cozy blankets, a supportive mattress, earplugs, eye masks, and super comfy sleepwear! Don't wear clothing that is too tight or restricting. Nasal dilators may make it easier to breathe.
Figure out the optimal temperature for the room for you, so that you are not too hot or cold. No one likes to wake up in a puddle of sweat in the middle of the night. Typically, your body temperature lowers automatically while you sleep, so you might need to slightly lower your thermostat and/or use a fan at night.
This may be difficult when your body has trouble regulating its core temperature, creating a vicious cycle as well. Being overly hot or cold makes sleep difficult. Sleep deprivation, in turn, influences your body's ability to effectively regulate your temperature, disrupting the natural circadian rhythm cycle.
If you tend to overheat at night, skip wearing socks to bed as this may prevent release of heat from the skin's surface. Following this thought process, one might even suggest to sleep naked! Just be certain that you have adequate blankets and coverings since cold has the potential to negatively impact the quality of your sleep.
If the reverse is true, and you shiver and shake under a mountain of blankets, try heated blankets, thermal pajamas, and make sure the ceiling fan is turned off! You might also want to consult your doctor to see if there are medical explanations (thyroid problems, anemia, circulatory issues) as to why you feel like you are living in the Arctic.
Limit daytime naps to less than 20 minutes (as if anyone has time for siestas these days). Any longer might interrupt your sleep cycle.
Keep a sleep diary. Track down what you do before going to bed and how long and how well you slept to see if specific things potentially disrupted your sleep.
If nothing improves the quantity or quality of your sleep after a couple of months, pay a visit to a sleep doctor for a thorough evaluation, including a sleep study and prescriptions for any medications that might help you to achieve a better night's sleep consistently.
A sleep doctor can determine if you have sleep apnea, narcolepsy, or restless leg syndrome, all of which might disrupt your sleep. These conditions require medical intervention.
A sleep doctor can also review your current medication list to see if anything you are taking causes sleep disturbances as a side effect and find ways to manage these side effects.
If pain continues to interfere with sleep, seeking out professional help to find methods that work for you to better manage your pain whether through medication, exercise, body work, meditation, or even changing your diet might be beneficial. Just as the experience of pain differs for everyone, so do the ways in which one finds relief.
Sleep is very important for your overall health and well-being. Make getting quality sleep a priority and seek help if needed.
RESOURCES
Maria Arini Lopez, PT, DPT
Maria Arini Lopez, PT, DPT, CSCS, CIMT, CMTPT is a freelance medical writer and Doctor of Physical Therapy from Maryland. She has expertise in the therapeutic areas of orthopedics, neurology, chronic pain, gastrointestinal dysfunctions, and rare diseases, especially Ehlers Danlos Syndrome.