We all know that for optimum health, well-being, safety, and quality of life, sufficient sleep is mandatory. However, for someone faced with painful or aching joints, a good night’s sleep is easier said than done. Because of this close relationship between pain and sleep, the prioritization and management of sleep may actually prove to be a very effective strategy in managing pain as well.
Below is an explanation of how pain and sleep are related, in addition to tips for how you can overcome your pain in order to improve your sleep — and vice versa.
Pain and Sleep
Unfortunately, pain issues are prevalent — and pain (both acute and chronic) can reduce sleep time and negatively impact sleep quality. In the 2015 Sleep in America™ Poll, 57% of Americans polled had experienced chronic or acute pain in the previous week. Overall, it is estimated that 50% and 90% of people with chronic joint pain don’t sleep well.
Lack of Sleep Contributes to Pain
For people with painful joints, it’s a vicious circle: aches and pains make sleep more difficult, and a lack of sleep worsens the pain. Aches and pains in the back, hips, knees, and shoulders can lead to fragmented, restless sleep — and a lack of sleep can lead to increased joint inflammation as well as a reduced pain threshold. Joint pain, especially in the hips, knees, and shoulders, is frequently worse while trying to sleep because joints swell at night.
Compounding that problem, sleep deprivation then leads to more health problems, including obesity, diabetes, mood disorders, osteoporosis, and low energy. For example, a Norwegian study found that compared to women who are well-rested, women with sleep problems may have a higher risk of developing fibromyalgia.
Sleep to the Rescue
On the flip side, once sufficient sleep can be obtained, this “vicious circle” can actually be reversed — becoming a “virtuous circle.” Better sleep reduces pain, making it easier to achieve good sleep, thereby further reducing pain. As this positive and self-reinforcing dynamic is established, the contribution that better sleep makes to your health, positive well-being, and quality of life cannot be overstated:
- Sufficient sleep enables the body to repair itself. As you sleep, the body releases growth hormones that are essential for muscle and joint repair.
- Getting a good night’s sleep also helps restore energy levels so you can better manage pain.
- Sufficient sleep also boosts the immune system and reduces inflammation.
- Motor skills, coordination, and safety are all positively impacted.
- Stress levels are reduced, and mood and outlook are improved.
- Motivation, productivity, judgment, reasoning, decision-making, and job satisfaction are all improved.
- Relationships benefit from sufficient sleep.
How to Improve Your Sleep in the Face of Pain
So, how do you break out of the vicious circle of pain and sleep? Most people tend to focus on pain management first, but breaking out of this cycle can also start with better sleep.
Choosing a Sleep Position
Side sleeping is often the most recommended sleeping position. A pillow between the knees in a side-sleeping position helps keep the spine and pelvis in good alignment and can also be more comfortable for the knees. The majority of people are side sleepers, but consistently sleeping on one side or placing your arm underneath your head while sleeping may cause or aggravate existing joint pain. For someone with shoulder pain, immobilizing the arm in a bandage or sling while sleeping can help minimize that pain and sleep disruption.
Stiff and painful joints can also make getting in and out of bed a challenge. Adjustable bases can go a long way in making this easier; avoid beds that are high off the ground. Mattresses with extra edge support can also be helpful.
Falling and Staying Asleep
A soothing bedtime routine is essential for transitioning from wake to sleep. There are numerous things to incorporate into your routine that will help with relaxation and falling sleep, especially if you suffer from pain. A warm bath before bed can help soothe aching joints as well as cause you to fall asleep quickly. Gentle stretching, deep breathing, meditation, progressive muscle relaxation, massage, lavender or vanilla bean fragrance, a cup of tea, and soft music can also help induce sleep. Try to maintain consistent bed and wake times, and keep the lights low in the evening. Think dark, cool, and quiet for the sleeping environment. Avoid electronics at bedtime, and use earplugs, white-noise machines, and eye masks if needed.
Heeding the Need to Sleep
Both the quantity and quality of sleep are important for managing joint pain and maintaining optimal physical and psychological health. So when it comes to dealing with painful joints, obtaining sufficient sleep is key.
Prioritize sleep in your daily life. Forego the late night TV talk shows and Internet surfing — the decreased pain levels will be worth it. Most adults need eight hours of sleep per day; very few of us can get by on less. Naps are helpful if you are having problems meeting your sleep requirement. Tracking your sleep can provide valuable insight about your sleep patterns and problems. Numerous sleep diary and sleep tracking apps are available.
Invest in the right mattress for you. People confronted with painful joints are easily distracted by a less-than-comfortable sleep surface. Sleeping on an uncomfortable mattress can result in considerable sleep loss.
There is no one “best” mattress; the right mattress depends on the individual; height, weight, medical conditions, sleep positions, temperature preference, and comfort preference should be considered. Forget the “firmer is better” mindset, and opt for comfort. As you age, you tend to need a softer sleep surface. A mattress with more cushion or extra plushness (softness) at the surface can help increase comfort and reduce pain. However, the mattress must be firm enough to allow you to change positions easily.
Don’t forget pillows, toppers, and comfortable sheets. Try using extra pillows or a whole-body pillow for additional support to help maintain a comfortable position throughout the night. Self-adjusting mattresses can be helpful, as pain levels can fluctuate throughout the night.
Follow the exercise routine prescribed by your physician: Exercise can relieve stress, reduce pain, and improve sleep. Talk to your doctor about how exercise can fit into your treatment plan. Recent American College of Rheumatology (ACR) guidelines suggest that exercise should be one of the mainstays of treatment for osteoarthritis of the hip and knee. The Arthritis Foundation conducts exercise programs for people with arthritis in many parts of the United States.
Talk to your physician about sleep. Treatment modifications, such as medication dosing schedule changes, may be made by your physician to improve sleep. Keep in mind that an underlying sleep disorder may be present that is interfering with your sleep. Consult a sleep specialist for ongoing sleep problems.
Remember: It is important to prioritize sleep, have a comfortable sleep surface, practice good sleep habits, and see a sleep specialist for sleep issues. A good night’s sleep will go a long way toward easing painful joints and improving functioning while enhancing well-being and quality of life.
For More Information:
American College of Rheumatology. Exercise and Arthritis. https://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Exercise_and_Arthritis/
Arthritis Foundation. Day and Night: 24 Hours with Rheumatoid Arthritis. http://www.arthritistoday.org/tools-and-resources/slideshows/ra-in-a-day-13.php
Better Sleep Council. Sleep Smarter with Sleep Apps & Health Tools. http://bettersleep.org/better-sleep/how-to-sleep-better/sleep-apps/
National Sleep Foundation. Fibromyalgia and Sleep. http://sleepfoundation.org/sleep-disorders-problems/fibromyalgia-and-sleep
National Sleep Foundation. Pain and Sleep. http://sleepfoundation.org/sleep-disorders-problems/pain-and-sleep
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