Chronic pain and insomnia are an unhealthy combination. According to the National Sleep Foundation, chronic pain disturbs the slumber of one in five Americans at least a few nights a week. But you can start to break the vicious cycle of pain and insomnia by maintaining sleep-friendly behaviors, known as sleep hygiene.
Whether from a bad back, arthritis, or headaches, chronic pain puts you in double jeopardy. “When you lose the restorative sleep, it enhances your subjective perception of pain,” says Dr. Padma Gulur, a pain medicine specialist at Harvard-affiliated Massachusetts General Hospital.
During the day, people can manage their chronic pain with activities that take the mind’s focus off the pain. But when they lay down to go to sleep, the lack of distraction can make the underlying pain more noticeable.
Dr. Gulur tells her patients to use “relaxing distraction” to get to sleep. One way to do this is with widely available audio recordings. Some teach basic rhythmic breathing meditation; others focus on guided imagery, in which you imagine being in a calm, relaxing location. Find something that appeals to you and helps you fall asleep. Group or individual training and sleep education is also available. Ask your doctor for a recommendation.
For people who experience interruptions in sleep due to pain, taking medications right before bed can help. Make sure you discuss this with your doctor to ensure that you stay within safe daily limits for pain relievers.
Getting back to sleep
Pain conditions can flare up at night and wake you. Simply shifting position in bed can trigger pain from a back condition or arthritic knee. What you do next is important, Dr. Gulur says.
First try meditation, visualization, or whatever relaxing distraction you favor. But if it doesn’t work, getting up to read a book in a quiet room with low light can help you to get back to sleep. Avoid loud sounds and bright light, such as you might encounter from watching TV or a video. “Do things that are mind-numbing to you, like organizing the sock drawer,” Dr. Gulur says. “The next thing you know, you will go back to bed and want to sleep.”
Staying on a regular sleep schedule is also highly recommended. Go to bed at the same time every night and, no matter how the night goes, rise the next day at the same time and remain awake until your planned sleep time. This helps to set your internal sleep clock and enhances the natural sleep drive.
Courtesy Harvard Medical School Publication