5 Ways to Improve Sleep When You Have Chronic Pain

Sleep is important for your overall wellbeing, but if you have a condition like arthritis, it can be difficult getting comfortable. Here are some ideas that might help you get some rest.
September 30, 2020 | 4 min read

Sleep is essential for everyone, and especially for people living with chronic joint pain. 

Because here's the thing:

When you sleep, you aren't just lying there "doing nothing." During sleep, your body is actually working hard to repair and regenerate its cells, tissues, and organs. If you consistently don't get the recommended 7 to 9 hours of sleep per night, your short-term and even long-term health can be negatively affected—and your chronic pain may even feel worse.1,2 Chronic sleep deprivation even increases the risk other health conditions frequently associated with pain, including heart disease, diabetes, and certain kinds of cancer.3 

Of course, even if this all makes perfect sense to you, you may still feel frustrated. After all, falling or staying asleep with chronic pain can be challenging, and many people with conditions like arthritis or fibromyalgia struggle with insomnia.2,4 

So, here's the pickle: people with chronic pain often struggle to sleep, and are more likely to have insomnia than people without chronic pain.3 But a lack of sleep can worsen pain, whereas sufficient sleep can make it better. What can you do?

While there's no one simple fix for anyone, there are several strategies you can explore to improve your sleep and make it easier to get your much-needed rest. Check out the suggestions below. 

1. Use the right mattress, pillows, and sleeping position for your needs

Your sleep environment should meet the needs of your body and personal preferences. So aside from using your bed and bedroom only for sleep and sexual intimacy, experiment with positions and products that work best for you. Here are a few general ideas:

  • A firm mattress is often preferable over soft for people with chronic pain (especially in the lower back)
  • Some people opt for adjustable mattress frames so they can sleep with their upper body more elevated
  • Very thick, or very thin, pillows may strain the neck
  • Extra pillows/body pillows under or between the knees, or held in the arms might ease pain and improve shoulder, low back, and hip position
  • Sleeping on the back can sometimes help people with chronic back pain; people with shoulder or arm pain might want to avoid sleeping on their affected side

2. Consult with your doctor before trying or altering sleep aids and other medications

You should always check with your doctor before starting or stopping any medication, whether it's prescription or non-prescription. Pain medication or sleeping aids may be useful to you, but they do carry certain risks including side effects and dependency.

Sleeping medications may even disrupt the quality of your sleep cycle.3 This is why many leading sleep experts recommend exploring other natural ways to improve sleep before reaching for the medicine cabinet.

3. Practice good basic sleep hygiene

Sleep hygiene is a collection of lifestyle habits and behaviours shown to boost sleep quality and quantity, and optimise the systems in the brain and body that facilitate sleep.3,5-7 To help yourself fall and stay asleep even if you have pain daily, keep these habits in mind:

  • Reduce or eliminate caffeine and alcohol consumption
  • Go to bed and wake up at the same time every day
  • Sleep in a dark, cool room
  • Get healthy exposure to sunlight during the day, especially in the morning
  • Avoid excessive exposure to artificial light at night (dim lights, use blue-light blocking filters, turn off TVs and phones an hour before bed)
  • Only go to bed when you're sleepy

4. Establish a relaxing bedtime routine

Part of good sleep hygiene involves having a relaxing routine at night. This helps your body get used to your schedule, promotes sleepiness, and keeps you from being too overstimulated to fall asleep. 

The trick? Do relaxing things you enjoy! Ideas include: 

  • Journaling
  • Reading
  • Meditation (shown to relieve pain)8
  • Deep breathing exercises (shown to relieve pain, too)9
  • Crafting, drawing, playing and listening to music, or any other calming hobby
  • Self-massage, gentle yoga, and stretches

5. Exercise during the day

Exercise can improve sleep and also help you manage chronic joint pain, so daily movement is important for both.3,10 Talk to a physical therapist or doctor about ways to exercise safely and what things you can do to improve joint function and muscle strength.

Bottom line

There's no question that people who report chronic pain tend to also report lower quality and quantity of sleep compared to people without pain. But that doesn't mean your chronic pain condition has to prevent you from ever getting good night’s sleep. Implement these techniques today, and if you're still struggling, talk to your doctor.

References
  1. Finan, P., et al. (2013). The association of sleep and pain: An update and a path forward. Journal of Pain. 14(12):1539–1552. www.ncbi.nlm.nih.gov/pmc/articles/PMC4046588/
  2. How to sleep well despite chronic pain (2020). Harvard Medical School. www.health.harvard.edu/pain/how-to-sleep-well-despite-chronic-pain
  3. Colten, H. and Altevogt, B. Eds. (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Institute of Medicine (US) Committee on Sleep Medicine and Research Washington (DC): National Academies Press. www.ncbi.nlm.nih.gov/books/NBK19961/
  4. Louie, G., et al. (2011). Sleep Disturbances in Adults With Arthritis: Prevalence, Mediators, and Subgroups at Greatest Risk. 2007 National Health Interview Survey. Arthritis Care Research. 63(2):47–260.  www.ncbi.nlm.nih.gov/pmc/articles/PMC3461323/
  5. Pain and sleep (2020). Sleep Foundation.  www.sleepfoundation.org/articles/pain-and-sleep
  6. What is sleep hygiene (2020). National Sleep Foundation.  www.sleep.org/articles/sleep-hygiene/
  7. Bolash, R., and Drerup, M. (2015). How to beat insomnia when you have chronic pain. Cleveland Clinic.  https://health.clevelandclinic.org/managing-insomnia-for-those-with-chronic-pain/
  8. Steiner, B. (2014). Treating Chronic Pain with Meditation. The Atlantic. www.theatlantic.com/health/archive/2014/04/treating-chronic-pain-with-meditation/284182/
  9. How to: Relaxation, Meditation, and Deep Breathing. Australian Pain Management Association (2020). www.painmanagement.org.au/2014-09-11-13-35-53/2014-09-11-13-36-47/261-how-to-relaxation,-meditation-and-deep-breathing.html 
  10. Ambrose, K., and Golightly, Y. (2020). Physical exercise as non-pharmacological treatment of chronic pain: Why and when. Best Practice & Research: Clinical Rheumatology. 29(1): 120–130. www.ncbi.nlm.nih.gov/pmc/articles/PMC4534717/
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