Top 10 Tips for Sleep Management

Chronic Pain Team

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Top 10 Tips for Sleep Management (334kB pdf)

Why is sleep important when you have chronic pain?

Chronic pain can impact a person’s ability to get a good night’s sleep. Sometimes, pain can stop you from getting to sleep, or it might wake you up in the middle of the night. It can also make the quality of the sleep you do have quite poor.

When we don’t get enough quality sleep, it can have an impact on our mood the following day. We might feel a bit grumpy, tearful or fed up. It can make us not want to move off the couch all day and we might miss out on activities we usually enjoy. Feeling tired can also make it difficult to concentrate on things such as your schoolwork and increases feelings of frustration. These difficult feelings can make pain tougher to cope with.

Sometimes you might fall into the trap of napping in the day or waking up later in the morning, which makes it even harder to fall asleep when it’s bedtime. It’s easy to get stuck in a cycle of not being able to sleep at night, due to having slept in the day. It is important humans do not sleep in the daytime, as it confuses the way our body clock works and puts us out of sync.

Just like food and exercise, our brain and bodies like things to be balanced and this is the same for sleep. When living with chronic pain, getting the right amount of sleep can help improve the intensity of our pain and the way we cope with it.

Sleep can….

Can help our brains manage pain more effectively

Be just as important a healthy diet and exercise

Make it easier to concentrate on tasks and activities throughout the day

What can I try and to help have a more restful sleep?

There are many different things you can do to help to improve your sleep.

Here are our top 10 tips to help you sleep at night:

1. Stick to a regular sleep and wake routine

Sticking to a regular sleep pattern can be difficult at times but as we are creatures of habit, our bodies thank us for going to bed and waking up at the same time every day. Waking up late on the weekends as a reward for getting up early during the week, makes it harder to get up on Monday morning and it doesn’t make up for any lost sleep during the week either.

Set an alarm for bedtime, most people wake up by using an alarm so why not use an alarm to remind you it is time to go asleep? Doing this will make sticking to a regular sleeping pattern a piece of cake!

If you feel there is no option other than to have a nap – try to do this before 3pm and for no longer than 1 hour, as having a nap later in the day can make it harder to fall asleep at night.

Expose yourself to daylight

Daylight is key for helping to keep our daily sleeping patterns. Our bodies have an internal clock, this is a clock located deep within our brains and it tells us whether we should be alert or sleepy throughout the day and night. Our internal clock uses light to help our bodies feel awake (daylight) and the lack of light to make us feel tired (darkness) as this is the most reliable source – the sun is up every morning like the Earth’s personal alarm clock. We call this our ‘circadian rhythm’.

We recommend getting outside in the natural light for at least 30 minutes a day and if you have trouble sleeping, wake up with the sunlight/in a light room and dim the lights when it is close to your bedtime.

Interestingly, our internal clock also uses our body temperature, food cues and times that we exercise as ways of perfecting our circadian rhythms (this takes us back to tip number 1 and the importance of keeping in a routine!)

Environment

Your bedroom should be a restful environment for sleep. Therefore, try to keep your bedroom as a place for sleeping only and try to avoid being on your bed to use your phone, tablet, to watch TV or to complete schoolwork during the day.

Consider what you can see, hear, smell and feel in your bedroom.

See –Think about the lighting, if your bedroom does not get dark enough; consider some thick black out curtains or an eye mask. If you struggle to sleep in the dark, consider a dim night light away from your bed. Sometimes people can struggle to sleep when they can see lots of things around them. If your bedroom is feeling a bit messy, consider giving it a good tidy.

Hear – Is your bedroom too noisy? Look around your room or house for things which might be creating noise and keeping you awake. Shut your window if traffic outside keeps you awake. If you cannot stop these noises, consider using some ear plugs if you struggle to sleep with background noise.

Smell – Calming smells such as lavender can help to create a relaxing environment. Oils and nice smelling sprays for your pillow are widely available on the high street.

Feel – Ensure you have a comfortable temperature in your bedroom, so you do not feel too hot or too cold. If your skin is sensitive to certain textures, consider changing your bed sheets and duvet to something which does not irritate you in the night.

If pain can stop you from getting off to sleep, try having a microwavable hot water bottle for that part of your body, or headache patches if you tend to experience headaches. Pain can make it more difficult to get comfy in bed – try things such a ‘V’ shaped pillow which might help. Ask an adult to turn your mattress regularly for you also.

Do you have a pet which sleeps in your bed? Whilst it is nice having a furry critter cuddled up in bed with you, if they wriggle, stretch, hog the bed and wake you up, it’s probably not helping you to get a good night’s sleep. If you like having something to cuddle at night, try this with a teddy bear or pillow instead.

Exercise

Exercise and sleep go hand in hand. Not exercising can lead to poor-quality sleep and poor-quality sleep can lead to not exercising. It is recommended to have at least 30 minutes of exercise per day, but when living with chronic pain, this can be really challenging at times. Exercise can be anything as little as going for a walk, moving around or doing some stretches. It is important to listen to your own body and find a time that exercise works for you – some people have reported that exercising 2-3 hours before bed actually keeps them awake, so it is important that you do this in the day, rather than in the evening.

Exercise can also improve our mental wellbeing and reduce stress by stimulating the production of endorphins, (chemicals in the brain that are the body’s natural painkillers and mood elevators). Feeling relaxed and relieved of stress helps us naturally transition to a deep sleep.

Wind down time before bed

Often, taking time to unwind after a busy day is cast aside to make room for other activities that we need to cram in before we go asleep (homework that needs to be in for tomorrow is the number one example!) Relaxing before bed is like doing a warm up exercise, it prepares the mind and body for what is coming next. People have different ways of feeling relaxed, find what works for you and go with that. Some examples include reading a book, listening to music or having a hot bath.

Fun fact: when getting out of a hot bath your body temperature decreases which may make you feel sleepy and ready for bed – baths also force us to keep still and slow down!

Breathing and mindfulness exercises may also help you relax and declutter your mind of any worrying thoughts. There are lots of breathing mindfulness exercises on YouTube or on apps such as ‘Headspace’ and ‘Calm.’ A simple breathing exercise, as shown, can be done in bed before going to sleep without the use of any technology.

Reduce screen time

When it is night-time or when we are in darkness, our brain starts to produce a hormone called melatonin. This helps with our internal clock and lets our body know it is time to go to sleep. Having phones, iPads and laptops directly in our face before bed can really disrupt the release of melatonin. One study found that compared to reading a printed book, reading off an iPad suppressed the release of melatonin by over 50% before going asleep!

The blue light that comes off our devices tricks our brain into thinking it is still daytime; therefore, there is a delay on when our brain thinks it is time to sleep. We recommend having a 30 – 45 minute break from screens before bed.

Pay attention to what goes into your body

What we eat and drink at certain times of the day can influence how well we sleep at night. Try to avoid large meals and drinks before going to bed as this can cause indigestion, which interrupts our sleep routine. Also, drinking too much close to our bedtime can cause us to wake up frequently during the night to go to the toilet.

However, it is also important not to go to bed hungry or thirsty as this can make it harder for us to fall asleep and cause us to wake up earlier than usual.

As well as our internal clock, we also have ‘sleep pressure’ explained in Matthew Walker’s book “Why We Sleep” as another factor that determines the wake and sleep cycle. Sleep pressure is when a chemical in our brains called adenosine builds up throughout the day and causes us to be sleepy the longer we are awake. Caffeine can make adenosine pause and block the signal to be sleepy. Caffeine is not only in coffee; it is in some teas, energy/fizzy drinks, chocolate, ice-cream and some pain relievers. Everyone has a different tolerance to caffeine, but we recommend avoiding caffeine 6-8 hours before bed.

Guided imagery

Guided imagery is like having a focused daydream; you use your five senses (taste, smell, touch, hearing and sight) to build images in your mind that your body feels as a real event. During guided imagery, you intentionally think of a peaceful place or scenario – this can be different for each person, but some examples include: a sunny beach or a meadow full of your favourite flowers. This connection of the mind and body can be used to relieve stress and pain, leaving us feeling relaxed and ready for a good night sleep.

Guided imagery can be accessed via the sleep sections on apps such as ‘Headspace’ or ‘Calm,’ which provide audio recordings that you can listen to.

Managing bedtime worries

It’s common for people to start worrying when they go to bed, or to begin having thoughts about the range of things they need to do. This can often feel unhelpful, as there is little we can do about these thoughts when trying to go to sleep. If this happens to you, keep a pen and paper handy by your bedside and write these thoughts down. If it is a list of things you need to do, getting them out of your mind and written down onto paper, means you have a list which you can work through the next day when you are awake.

If you find that the things on your mind are worries, rather than things you need to do. You might find it helpful to write these worries down and share them with someone you feel close to the following day, such as a family member or teacher.

Get up if you are unable to sleep after 30 minutes

If you can’t sleep after 30 minutes, try not to lie in bed worrying about being awake or spending time watching the clock. Instead, get out of bed and do something which you find calming and relaxing, until you start to feel sleepy again and then go back to bed.

That’s our top ten tips for a restful night’s sleep – we hope you have found them helpful and that you have some new ideas which you can try!

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.