Did You Know Sleep Is Therapy? – Part 1Jo Clacher
Article by Hans Giebeler
Did You Know Sleep Is Therapy?
Essential to good quality of life is adequate and undisturbed sleep. Sleep is well known to be restorative and forms an essential component of daily life.
Not all of us sleep consistently well, in fact many of us experience disturbed sleep for a great variety of reasons. When sleep is regularly or consistently disturbed the consequences can be very significant and unfortunately compounding.
What Is Sleep?
Sleep is a naturally recurring state of mind and body, characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity and inhibition of nearly all voluntary muscles during rapid eye movement sleep, and reduced interactions with surroundings. Different people need different amounts of sleep. Eight and a quarter hours is the average for adults. Some people can cope very well with much less and some need much more every night. Normally, the first three hours of sleep have the deepest stages of sleep (Slow Wave Sleep). Later on in the night we experience a stage of sleep characterized by vivid dreams (Rapid Eye Movement Sleep or REM sleep). Sleep changes across the night in cycles of about 90 minutes. REM sleep is present in every cycle, even if only for a short time.
Some people cope with a lack of sleep much better than others. But everyone who is very sleepy loses concentration easily and experiences mood changes. The usual mood changes are feeling more depressed and irritable.
A frequent cause of sleep disturbance is pain. It is well known that the relationship between pain and sleep is bidirectional and is complex. Pain reduces the amount of deep sleep and increases the number of times you may wake up. It often prevents you from returning to sleep once awoken. Chronic back pain, for example, is known to be often associated with decreased sleep duration and quality. Over half of people with chronic back pain have clinically significant insomnia. Most pain clinic patients have at least one sleep complaint.
If your amount of sleep is less than your normal sleep needs, your pain may increase. This is because inadequate sleep makes us more sensitive to unpleasant stimuli. Poor, fragmented sleep reduces the brain’s capacity to deal with the effects of unpleasant stimuli, such as pain. In conditions like fibromyalgia, nerve pathways within the brain are more sensitised. Thus, there is a heightened reaction to touch and pain, which can lead to unstable sleep which, in turn, worsens pain.
In summary, persistent pain has been associated with sleep disturbances in a bidirectional manner, with pain disrupting sleep, and sleep deprivation or disturbance increasing pain.
Here are some tips on how to improve your sleep and pain experience…
- Establish a routine in preparation for a better night’s sleep. Plan to go to bed at the same time each night.
- Stop using devices at least one hour, preferably two hours before going to bed. ‘Blue light’ emitted by television sets, computers and mobile phones inhibits our body’s natural release of melatonin. Melatonin is what makes us drowsy and sleepy.
- Shower/bath with water at a comfortable temperature as part of preparing for sleep. Showering 60 – 90 minutes before bed in water temperatures 40-42° C has been shown to facilitate the release of melatonin.
- Avoid consuming stimulant substances such as caffeine, alcohol, cigarettes 1 -2 hours before bed. Allow 1 – 2 hours after a meal before lying down to sleep.
- Try to practice ‘active relaxation’. Mindfulness, Yoga, slow and deep diaphragmatic breathing, ‘body scan’ relaxation and progressive muscle relaxation are all examples of techniques that help us achieve a more relaxed state in preparation for better quality sleep.
- Keep your bedroom comfortably cool and dark.
If you or someone you know experiences persistent musculoskeletal pain and sleep disturbance encourage them to speak with one of our Physiotherapists. We understand pain and its relationship with sleep and the consequences for you when sleep is not restful and comfortable.