Footstep 7

Sleep

If you’re living with pain and struggling with sleep then you’re not alone. It’s very common for people with persistent pain to have difficulties getting to sleep or staying asleep.

Recent research shows that by adjusting what you do during the day, as well as night, it is possible to achieve a healthier sleep pattern...

Why can't I sleep?

It’s likely that there are a number of causes of your sleep difficulties. Here are six triggers often found by people living with pain:

A vicious cycle

You have probably discovered that poor sleep can have some unhelpful effects on your day-to-day life.

After a broken night’s sleep you may find:

  • it’s harder to concentrate
  • you are short tempered with other people
  • your mood is low

It’s very common for people to find that poor sleep makes their pain seem worse. They can find themselves in a vicious cycle where pain makes sleeping difficult, and poor sleep worsens pain.

The really good news is that there are lots of ways to improve your sleep.

Five changes for better sleep

There are lots of changes you can make to help you to sleep well. Over a period of five to six weeks these can make a huge difference.

Here are the five areas that people living with pain have found to be most helpful:

1. Your daily routines

Get into a regular routine

Make sure that each day you go to bed, get up, eat meals and do activities around the same times. Try to stick to your routine no matter whether it is a weekday or a weekend and what kind of sleep you had the previous night.

Avoid napping

If possible, avoid taking naps during the day. This can be difficult – you may feel very drowsy because of your medication or be tired because you’ve had a restless night. If you feel like you absolutely ‘must’ sleep, then keep your nap short – around 15 minutes at most.

Avoid using your bedroom to rest in the daytime

If you need to take some time out because of your pain, then try to find another place in the house to rest or do a relaxation activity.

2. Your activity levels

Like many people with persistent pain, you may be avoiding physical activity because you are worried it will make your pain worse. These fears are normal and understandable – when you live with pain, the last thing that you want to do is aggravate it further! It may be encouraging for you to know that getting fit and staying active is actually good for your pain and for your sleep.

Learn the skill of pacing

Pacing is a really useful skill as it guides you to do the level of activity that is right for your body. Find out how to pace in footstep 3.

Do physical activities you enjoy

Quite simply, if you enjoy what you’re doing then you’ll be more motivated to keep it up. This could be anything from taking a morning walk through to swimming, playing badminton or gentle Tai Chi or Yoga.

Try to do some activities outside

Being in the daylight during the day helps your body clock to be in balance with day and night time patterns. It can help with stressful feelings too.

Avoid energetic activities shortly before sleep

Exercising late in the day ‘wakes up’ your body and so it can lead to problems falling asleep or staying asleep. To help with sleep, the best time to exercise is late in the afternoon or early evening.

3. Your food and drink choices

Avoid caffeine in the evening

Caffeinated drinks can have a stimulating effect on your body. Usually this lasts for around 4-5 hours. So it’s best to stop caffeine from late afternoon onwards to help you sleep well.

Try not to drink too much just before you go to bed

It may help to limit yourself to sips of water if you are thirsty before bed or in the night. Remember, too much fluid could cause you to wake up and head for the bathroom.

Avoid drinking alcohol late in the evening

Alcohol can get in the way of a good night’s sleep. It has a dehydrating effect which can cause you to wake up feeling thirsty. It can also interrupt the pattern of your sleep.

Eat your main meal earlier in the evening and have a small snack just before you go to bed

If you have an empty stomach when you go to bed you might wake up hungry in the night. On the other hand, if you eat a big meal late at night then your body may be too busy digesting your food or coping with heartburn to rest easily.

If you are awake in the night, avoid snacking

This could be training your body to wake up because it expects food. You could have a soothing drink instead – try herbal teas such as chamomile or peppermint, or warm milk.

4. Your night-time routines

Follow a wind-down routine every evening

Start by setting a wind-down time around 1 to 1 1⁄2 hours before bed. After this time, do things that help you to relax. This might be taking a bath, watching TV, listening to music or reading a book or magazine.

Only go to your room when it is time to sleep

Don’t go up earlier to watch TV in bed, go on the internet or mobile phone. If you do non-sleep activities in bed then your brain is learning that it is okay to be awake and alert in bed.

Get the temperature right

Being too hot can cause restlessness and being too cold can make it difficult to sleep. Make changes to your bedding to find the best mix of layers to sleep well. Try a fan or heater on a timer if your bedroom temperature seems to be a problem.

Make sure your room is dark

When it’s dark, our bodies release melatonin which helps us to relax and fall asleep. Block out light from outside by using blackout curtains or blinds. Cover up any light sources such as alarm clocks. Some people find it helps to wear an eye mask.

5. Helping mind and body to rest

Make sure you have a good bed

To find out more about beds and matresses visit www.sleepcouncil.org.uk

Find a comfortable position

To find a comfortable position, you may need more pillows or cushions so your body feels relaxed.

Use relaxation techniques

It can be very common to lie in bed worrying about how much sleep you are going to get. Using relaxation techniques to help you feel calm and quieten your mind can really help with this.

Avoid checking the time during the night

Some people keep checking the time if they can’t get to sleep or if they wake up in the night. This can increase worrying and make it harder to sleep. Try covering your clock or putting your phone away from your bed so you can’t check it.

If you wake up in the night – don’t struggle

It’s very common to feel frustrated or worried if you wake up in the night. Different techniques can help with this. Some people use relaxation techniques, other people find it helps to get out of bed after 15–20 minutes and do something calming in a different room. It can also help to simply lie in bed and accept that ‘sleep will come when it’s ready.’

Resources for you to use

How to Sleep Well with Pain

This great little leaflet from Live Well with Pain is based on the same ideas we've explored here, but goes into more detail. Download and print it it here:

The Sleep Council

The Sleep Council is a national body for sleep health. Its website is full of resources to help you get a good night's sleep – what to do, what not to do, and where to get more help.

National Sleep Foundation

Another really useful website with dozens of articles on all aspects of sleep disorders and solutions to help you sleep

Getting a good night’s sleep

A leaflet from Pain Concern explaining all aspects of sleep and what we can do to improve it.

Meditation for sleep

The Headspace website has hundreds of articles for any mind, any mood, any goal, including lots on sleep. Try this audio 'meditation for sleep' and read more about the benefits of sleep meditation.

Sleep: key ideas

  • Lots of people with pain have difficulties sleeping, but recent research has shown that sleeping well with pain is possible
  • Making some changes to what you do during the day will help you sleep better
  • Regular physical activity will help improve your sleep
  • Your food and drink choices will have an impact too
  • Getting into a regular night-time routine is important
  • Making sure that your bedroom is ‘fit for sleep’ can make a big difference