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Sleep: The Forgotten Recovery Tool

We’ve all been there – ten minutes until your “ bedtime” and you’re three episodes deep into your latest Netflix binge. “One more episode won’t hurt” – turns out it might.

The link between sleep and pain is well established in research. Pain can lead to poor sleep quality, especially if you struggle to find a comfortable position or wake up in the middle of the night after rolling onto that sore hip, shoulder, etc. Many people find it difficult to “turn off their brain” when it’s time for bed, lying awake with anxious thoughts about pain or worrying about losing sleep. This can lead to chronic sleep disorders such as insomnia and worsening depression/anxiety related to their pain.

Chicken or Egg: Which came first?

This relationship between sleep and pain is bidirectional - meaning pain leads to poor sleep but poor sleep can also lead to increased pain. Evidence shows that the brain pathways associated with sleep are similar to those of pain, with neurotransmitters such as melatonin and dopamine involved in both processes. Sleep deprivation can lead to heightened pain sensitivity throughout the day. This can become a vicious cycle of pain resulting in worse sleep the following night. As sleep deprivation worsens, fatigue increases during the day, and it becomes more difficult to stick to other healthy habits such as exercise or eating healthy foods. This further contributes to pain and limited function. More information on this connection can be found in this article by the Sleep Foundation.

Bringing awareness to your sleep patterns

The first step is awareness! You may know your sleep patterns well, and if so, that is great! If not, there are a lot of great free or inexpensive phone apps that can track sleep and provide data on quality and quantity each night. I’ve used the Sleep Cycle app for years and find it very helpful - they provide insights into sleep regularity and quality. Sleep quality is based on several factors, including time asleep and movement/waking throughout the night.

Sleep hygiene strategies

If you are someone who struggles with getting good sleep, try some of these simple sleep hygiene tools.

  • Turn off electronics 1 hour before bed - this will help your body wind down and prepare itself for sleep by releasing hormones such as melatonin

  • Turn your thermostat down - ideal temp is around 68 degrees F as your body temperature must decrease to prepare yourself for sleep

  • Avoid caffeine in the afternoon - if you are easily affected by caffeine or other stimulants, try to limit use after 1-2pm

  • Switch to warm-colored lighting before bed - blue and white light can negatively impact the

  • circadian rhythm which controls the sleep-wake cycle, so try switching to a dim red, orange, or yellow light a couple hours before bed

Shannon Foley PT, DPT, SMFA

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