Sleep and persistent pain: Do quality and quantity matter?

Our lifestyles have been greatly changed by technology and by societal values and expectations we have accepted as a ‘new normal’. We have experienced a general extension in our daily activities including occupation, family responsibilities, chores and leisure. Most of this has occurred at the expense of sleep.

Sleep is defined as a natural, recurrent state of behavioural inactivity defined by reduced consciousness and muscle activity, a stereotypical body posture and reduced sensory responsiveness. We typically function with a ‘consolidated block’ of sleep per 24 hour cycle.  Persistent disturbed sleep affects many biological systems including cognitive function, immune system, metabolism and pain.

Both sleep and pain are essential elements in normal, healthy human function. Sleep is protective as well as restorative and allows the body and mind to take a break and recover, change biological priorities, heal, grow and rest. Pain is a protective sensory phenomenon that allows our bodies and consciousness to respond appropriately when exposed to threat of harm, tissue damage and potential dangers. Pain is very complex and processed by parts of the brain responsible for emotion, learning and memory.

When sleep is reduced or compromised (even in healthy and otherwise pain-free humans), there are consequences that are varied and complex, not least of which, our relationship with pain. A deficit of sleep increases our chance of experiencing musculoskeletal pain and for no other reason than the effect of compounding sleep loss or disturbance. Science demonstrates that sensitivity to mechanical pain is increased in the short and long term, inflammatory processes are increased, natural pain inhibiting processes in the nervous system are reduced and our conscious processing of pain inputs is compromised.

Whilst this all sounds very technical, the messages we need to take away from the science is that if we are experiencing persistent or chronic pain, it is vital to seek help from health professionals to develop strategies to achieve consistent, higher quality, longer sleep. These strategies are made up of a variety of actions that are complimentary.

  1. Hydrate well throughout the day and don’t drink too much in the hour or so before going to bed.
  2. Eat through the day so that your evening meal is not too large.
  3. Allow some time (at least 1 hour) before going to bed after your evening meal.
  4. Avoid at all cost exposing yourself to ‘blue light’ from media devices.
  5. If you are prescribed pain medication, take it as directed before you go to bed.
  6. Prepare yourself by getting comfortable – shower before bed, wear comfortable clothing/pyjamas
  7. Practice ‘active relaxation’ or meditation to relax and prepare for sleep.

If you are experiencing persistent pain and also don’t sleep very well as a result, you owe it to yourself to take steps in the right direction and speak with the Physiotherapy Team at Embrace Life by calling 3491 6533.