SERENE SLEEP: AN AVENUE TO HEALING CHRONIC MUSCULOSKELETAL PAIN


Sleep. One of the essentials of life! People with poor sleep have increased pain sensations! Sleep is one of the most important functions of the body. Without sleep, our body will never truly have the opportunity to repair itself, and that would reduce an individual's health significantly. That's why one of the keys to successfully healing chronic musculoskeletal pain is to get good sleep.

We often ask clients if they sleep well? How is your sleep? Can you fall asleep easily? Do you sleep for 7-8 hours straight at night without waking up? How about if you do wake up? Do you toss and turn or can you turn your mind off and relax your body to fall right back asleep? What is the “normal” way to sleep? Do you know? Since sleep is important, we have an immense focus on our patient's sleep hygiene.

Checking Sleep Quality

We often tell clients that sleep is one of the essential cornerstones of mental sharpness; it allows you to concentrate, offers emotional stability, and supports your ability to stay calm throughout the day.

However, as it so happens, many people may not even be aware of getting inadequate sleep. Some assume that's the way everyone sleeps. That's why we've put together a short quiz that anyone can take to determine the quality of their sleep before moving forward.

Each question below is to be answered as "True" or "False."

  • You sleep for at least 8 hours every night.

  • It's ideal to always sleep through the night.

  • I can and must make myself sleep.

  • I should stay in bed and rest if I can't sleep.

  • I'll have a terrible day if I don't sleep well.

  • Good sleepers fall asleep quickly.

  • Good sleepers don't dream.

  • It's best to get up and be productive if I can't sleep.

  • It's normal to sleep less as we age.

  • It's comforting to check the time when sleepless.


So How well did you do? How many of these are TRUE?


Actually… NONE of them are true. These are ALL MYTHS! We'll unpack these phrases a little bit. Just like everything about you, your sleep patterns and how much you sleep are unique to you.


Over the years of researching sleep and sleeping patterns, researchers have found that everyone has a very different sleep pattern. Also, the amount of sleep a person needs may vary, which has something to do with their genetic makeup. That's why our sleep needs may not be universally 8, 9, or 10 hours.


At times our bodies may be more tired, and when that happens, it is easier to fall asleep for long unless it is interrupted by external influences.





How Can Sleep Be Improved?


Well, one of the things that absolutely should be done is to sleep and wake up at the same time every day. Regardless of what day of the week it may be, you should avoid disrupting your sleep cycle. However, if we've had a rough night, being unable to sleep for long, our bodies can adapt to it; after all, evolution has allowed our bodies to adapt to just about everything. That's why you might not notice much of a difference the following day.


Awaking in the Middle of the Night


Some people wake up in the middle of the night, sometimes multiple times. The occasional awakenings are, for the most part, normal. If you go back to sleep right after because you're feeling sleepy, that will help to prevent fatigue or long-term disruption.


Dreaming at Night


We are not sure why some people assume that being in a dream state isn't necessarily good sleep. Dreaming is a part of sleeping and, in some instances, an essential one too. If you awake from a dream and cannot get back to sleep, get out of bed, occupy a spot, and remain silent until you feel sleepy again.


Being Productive When Awoken from Deep Sleep


Some people would turn on their computers and get to work if their sleep was disturbed. That is not the right approach. You shouldn't check the time all that frequently either or engage in any productive work, or browse on your cell phone. Don't be productive just because your sleep was disturbed. In fact, if anything, you will want to do some guided meditation, praying, or listening to quiet music. Also, try some progressive muscle relaxation techniques which should help you get back to sleep quickly.


Controlling When to Fall Asleep


As doctors, we hate to say that you can't control some things or have no control. But the process of going to sleep is one of those things you cannot control. Sure, you can optimize the chances of falling asleep and maybe doing it sooner, but it can't be put off. Usually, it takes around 20 minutes to fall asleep.





Improving Your Chances of Falling Asleep


We come across many people who feel that they need help falling asleep. One way to do that is to improve your sleep hygiene by:


  • Ritualizing the rhythms of activity and rest

  • Create an energizing ritual with morning light exposure and exercise.

  • Learn to rest during the day with meditation and breathing practices.

  • Maintain a regular sleep-wake schedule, even on the weekends

  • Develop a soothing evening ritual as a bridge to sleep

  • Using dusk and darkness as sleep medicine

  • Simulate dusk: dim your lights for a couple of hours before bed

  • Always use blue light reduction technology to watch TV or use computers

  • Slow down with a warm bath, journaling, rest practices, yoga and intimacy

  • Sleep in total darkness

  • Quieting your mind's whispering

  • Avoid "counterfeit energies"-caffeine, sugary foods, adrenalin.

  • Carefully check for possible sleep side effects of all medications and supplements used.

  • Check your alcohol intake—drinking less, earlier, and with food is best.

  • Creating a sleep sanctuary

  • Temperature 68 degrees or less

  • Dark

  • Quiet

  • Use organic sleepwear and bedding

  • Move electric clocks and devices away from your head

  • Ensure your sleep space is a psychologically safe space

  • Learning to surrender to sleep

  • Avoid the chemical knockout of sleeping pills and alcohol.

  • Consider natural sleep aids such as lavender and valerian if needed.

  • Practice "letting go of waking"

  • Approach getting to sleep as a personal spiritual practice


The Use of Melatonin

Melatonin is mainly a sleep aid supplement that has grown in popularity over the past couple of years. Today over 3 million Americans use it across the country, according to a survey by the Centers for Disease Control and Prevention. If you are taking melatonin or considering it to improve sleep, it is worth understanding how it works.


Our bodies produce an adequate amount of melatonin almost every day, naturally. The melatonin itself does not make you sleep, but instead, higher levels in the evening may put you in a state called "quiet wakefulness," which helps promote sleep.


The majority of people are producing enough melatonin and can sleep on their own. But there are steps that can be taken to get the most out of the body's natural melatonin production. You can supplement it for a short time if you are experiencing bouts of insomnia or if you want to overcome jet lag.


Melatonin can be helpful as an aid to falling asleep or for staying asleep (extended-release tablets). Please consult with your physician before starting any supplements or medications to make sure they will not negatively interact with any medications you are currently taking.





Your Sleep Can Be Affected by Daytime Activities Too

You will experience a better night's sleep if you make changes to how you spend your day. You don't just sleep by falling into bed. Your body has to be primed for it, based on what you did during the day.


Here are a few things you can do:


Take Care of all the To-Dos Early On in the Day


Your evenings should serve as a time to unwind, which means not doing too many chores before you go to bed If you get up early and get your tasks done sooner in the day you'll sleep more soundly at night. Our brains are primed for mental tasks in the morning because the sunlight suppresses melatonin production. That means you can achieve a lot for as long as the sun is out. So, certainly, add waking up early to your to-do list.


Have a Power Down Routine

We strongly advise that you should have an "electronic" curfew. That means no computer, TV, tablet, or smartphone for 1 hour before going lights out. The tiny lights from these devices are known to keep people awake. So, our advice is to cover them up and turn the face of the clock away. Ideally, you'll want to invest in a non-reflective analog clock.


No Caffeine Before Bed

It's a sort of a no-brainer, but many people consider it a myth. Ideally, it would help if you didn't have caffeine at least 8 hours before going to bed. So, no energy drinks, soda, or tea. Also, coffee in the afternoon is best avoided.


Focus on Getting Fit

We have found that our patients tend to sleep better when they work out during the day. Regular exercise, ideally in the morning, is one of the keys to having a good night's sleep.

Working out near bedtime is also acceptable as a last resort. At least it is better than not working out at all. However, some people who work out in the evening may experience bouts of insomnia, and if you do, then working out at night isn't for you.


What About Naps?

Napping 3-4 times/week has been found to improve cardiac health. However, if you cannot get through every day without sleeping, or you are napping more than 30 minutes in the mid-afternoon, that may be a sign that you are not getting enough quality sleep at night.


Have a Bedtime Ritual

It is just as important to have a bedtime routine as it is for your kids to have one. Your body needs at least 30 minutes to relax before it goes to sleep completely. A warm bath, light reading, and a soft light could all be part of your bedtime ritual.

A few other daytime activities you might want to engage in to improve sleep are:

· Get at least 20 minutes of daily exposure to MORNING light shortly after arising.

· Awaken slowly and explore your grogginess in the morning.

· Let the memories of your dreams come and note them.

· Set conscious intentions to guide your waking day.

· Don't eat 3 hours before bed.

· Maintain a healthy diet (see the article about Nutrition and Chronic Pain)

· Optimize your Vitamin D level. Lower levels in the 20-30 ng/dl range are associated with poor sleep.



In conclusion, adequate sleep is the cornerstone of mental sharpness, ability to concentrate, emotional stability, and calmness during your day which will all benefit your journey towards healing and away from chronic pain.






SLEEP-WAKE CYCLE AND SUMMARY OF HEALTHY SLEEP: