Sleep for individuals with chronic pain is often a major struggle. Unfortunately, just like the cause of pain itself, it is a difficult and multifaceted problem with different issues contributing to sleep struggles. Pain and discomfort at night are the leading complaints, but often it is more complicated and usually not a simple issue to solve.
Underlying medical problems may also be contributing to sleep disturbances, and not addressing these may prevent adequate solutions. Addressing sleep problems often requires intervention from multiple specialists.
The Importance Of Sleep Hygiene
Sleep problems can range from simple to complex problems. Starting with the simple issues is always important. First is trying to discover what are the difficulties with sleep and what habits and patterns for sleep occur with a person. Sleep hygiene is one of the leading areas of problems. One of the most common problems is the consumption of caffeine or similar stimulants during the day. Most people are sensitive to caffeine, and it is found in many drinks, especially various sodas and teas. Drinking these after the lunch hour for many can affect sleep. The use of alcoholic beverages can also interrupt sleep, initially it may make one tired, but as it wears off, the body awakens and one may be running to the bathroom.
Sleep hygiene also includes the habits one has in the bedroom. Currently, the most common problem is screen time including computers, tablets, television and phones prior to sleep. Watching a screen tends to activate the brain and wake a person up, and the color spectrum produced with lots of blue light is also awakening. Turning off the all the screens one hour before bedtime is advised. The bedroom should be reserved for sleep. Doing work in bed and spending time in bed not sleeping gives the brain the wrong signals to stay awake. Lastly, most people sleep better in a cool room, being to warm leads to restlessness.
Your Mattress and Sleep
The most common question that is asked to me is should I get a new bed and what bed should I get? Anyone who has shopped for a bed knows this is an expansive proposition. Before buying a new bed, try to get everything right in the bedroom first, from the room temperature to the sleep hygiene. If the bed is old, first try a mattress topper with 3-4 inches of quality memory foam. A good topper is far cheaper then a full mattress and may be perfect solution. A new bed is only needed if your mattress is ancient and beyond salvage.
Since beds can be extremely expensive, start with determining your budget and then look at your options from memory foam mattresses to adjustable air bladder types like the Sleep Number bed. The mail order memory foam mattresses are often extremely affordable, comfortable and are reported to be a good quality. Everyone has a different preference for a bed, but if it is rock hard, it will not provide uniform body support and probably cause more pain. A bed that is too soft will probably also be uncomfortable and not provide adequate support to the body. The first recommendation would be try a memory foam type mattress for a new bed. If your budget is less constrained, the ability to change a bed’s hardness and support with an air bladder type bed is wonderful. Adjustable bed frames that can raise the head or feet is a further luxury.
The last issue with chronic pain and sleep is once you have optimized the sleep environment, what else can be done? The first concern is to see if there another medical concern preventing sleep. A sleep specialist often best evaluates these issues, and those who are neurologists often have the broadest understanding of all the issues. They can address problems from restless legs, sleep apnea to interrupted sleep by pain. They can be extremely helpful in determining the best medication routine for improving sleep. If a safe simple solution is not working, a sleep specialist is extremely important in determining the path forward.
Thomas Cohn, MD
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