Sleep problems and increased pain sensitivity go hand in hand. When we are in pain, it may make it difficult to fall asleep or to get in a comfortable position. It is common to find yourself waking up at night after you try to move and provoke your pain problem. Further, if your amount of sleep or quality sleep decreases, your pain may increase. Pain and sleep have a two-way relationship – sleep affects pain and pain can affect sleep.

It’s fairly obvious why having pain may affect sleep. If you like to sleep on your right side and you injure your right shoulder, it becomes pretty uncomfortable to lay on that side at night. On the flip side – interrupted sleep reduces the brain’s capacity to deal with the effects of unpleasant stimuli, such as pain.¹ Sounds like a vicious cycle, right?

To break this cycle, here are 4 Tips to Improve Your Sleep and Get Out of Pain:

1. Create a bedtime routine.
Go to sleep and wake up at the same time every day. Follow the same steps before going to sleep – shower, read a book, brush your teeth, change into pajamas, etc. Do all of these things in the same order each night.


2. Strengthen the association between bed and sleep.
Use your bed only for sleep and sexual activity to help train your brain that when you are in bed, it is time to sleep.


3. Get into a state of relaxation before bed.
Your nervous system has to calm down to be in a state ready for sleep. Find a short, simple relaxation routine to downregulate your nervous system before bed. This may look like mindfulness, meditation or simple stretches and breathing exercises.


4. Improve overall sleep hygiene.
Diet: avoid caffeinated foods and beverages, alcohol and smoking for 4 hours before bedtime.
Exercise: avoid moderate to vigorous exercise 2-3 hours before bedtime.*
Light: transition from “daytime” to “nighttime” light to help with melatonin production. Avoid bright lights before bed.
Noise: ensure a quiet environment.
Temperature: find a comfortable temperature to sleep without feeling overheated.

*Exercise caveat: exercising immediately before bedtime stimulates your body and brain, which can make it hard to fall asleep. However, regular exercise improves your sleep and some people have no issues exercising closer to bedtime. Talk to your physical therapist about an appropriate exercise program individualized for your needs.

Our bodies need adequate sleep to recover and heal from injury. Sleep is often overlooked as a contributor to pain, but plays such a crucial role in healing. Implement the above four steps to improve the quality of your sleep and encourage positive progress in your injury rehabilitation. In addition, work with your physical therapist to identify the root cause of your pain and determine comfortable positions for sleeping from a musculoskeletal standpoint. The key to getting out of pain and back to the activities you love is likely intertwined with both sleep and exercise.

References

1. Pain and Sleep: Sleep Health Foundation.