Pain and Sleep
QUICK TIP 1
Skills such as desensitisation, distraction and meditation can improve sleep
QUICK TIP 2
Physical activity helps sleep
In this episode, you will learn that people with pain will often experience difficulties sleeping. There are things you can do to optimise your sleep, and therefore your pain management. Sleep goals should be developed and included in your pain management plan.
At the end of each video, go to the Health Plan link to record your progress and goals. Fill in the SCI Pain Questionnaire to help your Doctor or healthcare provider design a treatment program that is right for you.
You can also provide feedback by completing a short survey at: https://www.research.net/r/SCI-pain-project-website-evaluation
Transcript: Pain and Sleep
I'd say probably most days now, most probably 5 out of the 7 nights I get good sleeps, before it was maybe one night a week, maybe no nights a week then I would be up all night pacing, trying to sit on the lounge.
I’ve got a massage chair, get up in the middle of the night, sit on the massage chair.
You just do anything you can to get a good night’s sleep, I mean you can deal with it during the day but it's when you go to sleep you need to re-boot, re-charge your energy and get ready to focus on the next day.
When you've got chronic pain and you've got a sleep problem that's an extra problem that you don't need.
it's very important to try to get onto of the sleep problem ‘cause if you can do that and manage that better then you'll have much less trouble with your pain.
And we've found that if you don't sleep well your pain can be worse the next day, and when your pain is worse it makes you sleep worse and so there's a vicious cycle for many people and some end up not being able to sleep at night and ended up sleeping during the day.
And um that ends up in a pretty hopeless situation. It's not surprising that sleep becomes a problem because. Um. if you can't get comfortable, it’s very hard to sleep, um and then of course if you have worries, things on your mind um.
then that's going to interfere with your sleep and you toss and turn, you might take things for it but they don't necessarily solve the problem and problems with sleep can be related to getting depressed, ‘cause poor sleep is one of the symptoms of depression so that's something you got to consider as well.
So it becomes a bit of a battlefield and. every night when you go to bed you think “Am I going to sleep or not?” and if you start developing the expectation there's going to be a problem it just about about guarantees you will have a problem.
So one of the things that were really difficult for me was sleeping at night, and that takes away all your energy, is not being able to sleep and you thinking about things all the time and what you can't do and um and everything's so quiet, it's just so. um. debilitating going through a night and it's something you don't look forward to going though.
Well there are lots of things you can do to improve your sleep, we call it good sleep hygiene but really it's just about following some basic rules for promoting good sleep.
It doesn't mean your guaranteed to sleep well every night but it makes it more likely and there are things like not turning your bedroom into an office or an entertainment centre, so you leave all that stuff in some other part of the house and you associate your bed with sleeping so that when you go to bed you think, this is where I sleep.
Now, it's important to go to bed roughly the same time each night and try to get up at the same time each morning so you may need an alarm clock so you get some regularity there.
Don't eat big meals before you go to bed, don't drink a lot of alcohol in the evening.
Um, keep away from coffee in the evening, ‘cause they can both act as stimulants and keep you awake.
If you've got a lot of worries on your mind, which is pretty understandable with pain, then it's important to work out a strategy for dealing with those before you go to bed.
You can also look at exercise, and one of the problems with pain that's ongoing, is that people often.
stop doing a lot of things, they're not very active, and we know that regular daily exercise is important to promote sleep not exercising late at night of course but but getting some exercise during the day tires you out a bit and gives you a reason to sleep.
So it's important to think about your general exercise levels.
Also think about your bedroom itself, is it too hot, or is it too cold have you got a bit of air flowing? ‘Cause you need a bit of air in the room to help you sleep.
If it's noisy, or the person you are sleeping with is noisy, they snore, well then you've got to think of what arrangements you can make.
You may need to buy some earplugs.
But ah there are some relatively simple things you can do, like those, and if you do those then your sleep is likely to be generally much better.
One of the things I learnt was distractions, ways of distracting yourself, you know for good, to to take away from the feeling of pain and one of the things that I use, well two of the things that have been really helpful for me, have been Poppy, have been my dog.
She um… does a lot of things, she helps me at night when I can't sleep, because when I'm awake, she's awake um… and also the whole relaxation and the um… the relaxation and the breathing she slows me down and um… so… having that and getting outside myself has been a huge change for me.
The other thing that I did, because my sleeping was terrible, was listen to audio books I started to um… buy audio books and so I'd listen to all these different type of stories so that I'm still resting, I'm still in the dark, um… and my bodies resting but it rests my mind in a way that it takes it off the pain of thinking about the pain, thinking about not sleeping, 'cause the worse thing you do during the night when you can't sleep is think about not sleeping and how bad it is! Um… I find myself often now find myself having to go back to find out where I'm up to because now that I'm getting use to it in my mind I suppose, or body getting used to it, that its taking… or I'm just completely concentrating on the story and I fall to sleep.
so um, sometimes I wake up and the book's finished and um… I have to go back and find out where I'm up to.
When I get into bed of a night I invariably start off lying on my back which means my feet are sticking up and because my right ankle was fused it… it sticks up literally like a… a sore thumb but it's a sore big toe, and that's got the sheet and blanket pressing down on it.
So it hurts, it hurts just to lie on my back with that, and that's where, um… I don't take any pain killers or anything like that and that's when I play my… iPhone, I've got a whole lot of musicals recorded on my iPhone.
It's a complete distraction.
Um… if I'm distracted I don't do feel any discomfort or pain.
If I'm not distracted that's when I focus on the pain um… so I suppose it all boils down to if you have a distraction even though the pain possibly is still there, you're not aware of it, you're not aware of it so… as far as your brain is concerned it's not there.
If you find yourself struggling with these techniques or trying to implement them and it's just not working for you it may be helpful to talk to your GP about it, um… they might be able to help you work out some ideas, but you might also need to see a clinical psychologist who can um… go into things with a bit more depth and uh, and uh identify where you might be going wrong and help you develop some better ways.
For example it may be the way you deal with worries uh… you may leave them until it's, you know, all on top of you and then try to sort them out late at night.
That's going to be a problem so… maybe looking at the way you go about problem solving could be helped by seeing the psychologist.
Equally learning a strategy like relaxation or meditation, that um… that takes a bit of practice, and some guidance from a professional who can help you with that and learning what to do if you wake up in the middle of the night and you just can't get back to sleep, what do you do ? Do you stay there, or do you get up? Then talking it over with someone who is skilled in this could be helpful so I would certainly recommend, don't just accept that bad sleep goes with having pain.
That can be improved with appropriate help.
Sometimes I'll go to bed and I might be in that little bit more pain or might have had a little too much happening during the day and I can't focus, you know on going to sleep, so I do a little bit of mindfulness to try and, you know, turn my brain off and, just put any negative thoughts… just pop it on a leaf and send it down the river and just try and, try and take everything out of my brain so that I can relax.
I've always been a person that can get back to sleep alright, it's just when I first go into bed, and if I'm hyped with pain it's a little bit hard to sort of try and relax, but then I just make sure I get myself nice and comfy and start doing the mindfulness and the deep breathing and just try and take all the thoughts out of my head for the day as hard as that is to turn your brain off, you just have to do it in order to relax, you know, just to get that sanity back again.
People often ask about taking complementary or alternate medicines, for their sleep when they've got chronic pain and that's very understandable.
And some find it very helpful and others don't.
Um… I guess we could take the view that if it works for you that's great but I think as a general rule it's very important if your taking medication from your doctor that you tell your doctor you are taking these other things because if… if… if they don't know they're prescribing in ignorance and it's possible that it could be adverse inter reactions and side affects between your so-called natural treatments and the drugs your doctor's prescribing.
So it's very important to let your doctor know about that.
Giving up old habits is hard, we all find that… but um… if you stick at it then you'll notice changes, improvements actually, pretty soon but you do have to stick at it.
Now is a great time to fill out the sleep section of your health plan.
If you haven't already done so, click on the health plan button below the video and download the PDF.
Print it out.
After each video fill out the relevant sections.
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Take your completed health plan along to your GP or your health professional.
This is a great starting point to managing your pain.