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Your immune system relies on sleep to stay healthy. It’s involved in the healing and repair of your heart and blood vessels. Sleep maintains a healthy balance of the hormones that make you feel hungry or full. It affects how your body reacts to insulin, the hormone that controls your blood glucose levels. Sleep also supports healthy growth and development
To sum this up, a lack of sleep can have dangerous consequences. Prolonged sleep deprivation can lead to increased risk of heart disease, kidney disease, high blood pressure, diabetes and stroke. Chronic sleep deficiency increases your risk of obesity and can affect how your immune system responds to common infections.
What if you are in pain and cannot sleep?
Sleep problems and chronic pain go hand in hand.
Does pain make sleep worse or does poor sleep make the pain feel worse?
The answer is both!
You need sleep to heal but pain prevents you from getting it. A good night’s sleep can improve your quality of life and ability to tolerate pain. The subjective intensity of pain decreases when you sleep well.
The opposite is true for bad sleep. Poor sleep quality is correlated with more severe pain and an increase in fatigue. Ironically, many of the common medications for severe and chronic pain can have the side effect of making sleep problems worse.
Opioid drugs prescribed to treat severe pain can suppress rapid eye movement (REM) sleep — the stage of sleep where you dream. They can also make you more sensitive to the pain they are meant to treat, a condition known as hyperalgesia.
Your body needs to calm down in order to sleep.
To fall asleep, your nervous system has to calm down. If you are experiencing chronic pain, you have a much more active nervous system. This can affect how quickly you fall asleep and how deep of a sleep you experience.
Healthy sleep comes in waves during the night. You cycle through lighter stages, then go into deeper stages of sleep, then back to lighter stages and finally into REM sleep. This cycle repeats a few times during the night.
Usually, after the REM stage, you wake up. You might roll over and stay asleep without realizing it. When you are in pain, you most likely wake up and notice your pain. This will result in increased activity in your nervous system and you need it to calm down all over again to fall back to sleep.
Sleep routines can decrease pain and help you fall asleep.
If you can initially fall asleep quickly when you have pain, many of your sleep strategies should work to help you get back to sleep when you wake up during the night. But if you have trouble falling asleep in the first place, a sleep routine can help calm your nervous system and put your body in a relaxed state that’s ready for rest.
- Go to bed around the same time every day.
- Get up at the same time every morning, even if you had a bad night’s sleep.
- Spend 30 minutes or more before bed doing the same thing, such as showering, reading a book or getting ready for the next day. This helps your body and mind learn to prepare for sleep and expect it.
- Try relaxation techniques before bed to help calm the nervous system.
- Go to bed when energy levels are lower. Be aware of the signs of sleepiness so you can get to bed at an optimal time for your body.
- Avoid heavy, sugary and fatty foods before bed. Stop drinking caffeine four hours before calling it a night.
- Do not exercise within two to three hours before bedtime. Exercise increases your heart rate and body temperature, making it more difficult to fall asleep.
- Reduce the light, noise and temperature in your bedroom. Your body sleeps better when it’s cooler and darkness increases your melatonin, the hormone that promotes sleep.
If you can’t sleep, don’t worry! Worrying about it actually increases the activity of your nervous system and makes it more difficult for you to fall asleep. Try to accept the fact that your sleep issues are a side effect of pain and do not distress over it. Practice letting go of your thoughts and refocus your attention. This will help your body relax so you can get some restorative sleep to help ease your pain.
PaulaJirak , PTA
Paula Jirak, PTA has been with The Iowa Clinic since 2004. The outpatient setting and opportunity to work with multiple specialties in one building are what appealed to her about The Iowa Clinic.
Paula's interest in physical therapy came about from seeing the impact it can make in people's lives, which is what drove her to become a physical therapist herself. She has seen patients become more independent, avoid nursing facilities, return to work with no discomfort, and athletes return to their sporting activities after injury. There is nothing more rewarding than receiving a spontaneous hug from a patient, letting her know what a positive difference she has made in their lives.
In her free time, Paula is usually watching one of her children's sporting events with her husband. She loves being outdoors, spending time with her friends and family, and having game nights with her husband and children.