How To Sleep Well Even if You’re Suffering from Chronic Pain!
Written by Benjamin Semmens, Registered Nutritionist (BHSc)
Did you know that chronic pain affects 1 in 5 Australians aged 45 and over? Chronic pain can be debilitating and affects many aspects of our lives, in particular getting a good night’s rest!
People with chronic pain are more likely to experience sleep disturbances and fatigue than those without chronic pain. Considering the importance of sleep on our health, we need to do everything we possibly can to minimise pain to get restful sleep.
Chronic pain can not only reduce overall sleep time, but can also cause you to frequently wake up throughout the night that is the most common sleep complaint in people with chronic pain (1).
Sleep and pain have a bidirectional relationship – meaning that if you experience pain you may struggle to get enough sleep and not getting enough sleep make symptoms of pain even worse. Interestingly, many people have reported that their pain is reduced after a better night’s sleep (2).
For those living with chronic pain, prioritizing sleep may be the missing piece of the puzzle in reducing pain. Especially if you have conditions such as rheumatoid arthritis, chronic fatigue syndrome and fibromyalgia!
There are four stages of sleep, that you cycle through 4-6 times a night. To feel well rested we need to go through all 4 stages of sleep, however pain can cause us to wake up multiple times that disrupts this cycle resulting in average and restless sleep causing you to feel even more tired and I more pain the following day.
Furthermore, sleep deprivation can cause stress, anxiety and depression and can develop into chronic conditions like fibromyalgia and migraines. The good news is that many studies have found that quality long-term sleep can improve chronic pain! (3)
In this blog we’ll be teaching you some diet and lifestyle changes you can easily make to reduce pain to ensure you get a good night’s rest to help you feel more mobile, energetic and feel less pain!
What do we experience pain?
In most cases pain is caused by inflammation that can be acute or chronic. Acute pain is short-term that is beneficial. For example, if you cut your finger, your body will have an inflammatory response and overtime your immune system will repair the damage and it will become less painful and eventually heal.
Chronic pain refers to pain that can last for days, weeks, months, and even years. Some common types of chronic pain include back pain, headaches, joint pain, muscle pain, fibromyalgia, arthritis, and cancer pain.
How your brain interprets the severity of your pain depends on a number of factors that include your physical health, mental health and the cause of your pain. If you experience pain at night, it can interfere with your sleep and result in long-term sleep deprivation that increases your risk of obesity, heart disease and diabetes.
1. Reduce inflammation to reduce the pain!
If pain is causing you a restless sleep the simplest thing you can do is to reduce inflammation. The diet is often overlooked as a major contributor of inflammation. People think you need to go keto, vegan or fast for days to reduce inflammation. What ever happened to making small changes in your diet that are sustainable and realistic?
Processed foods are a massive part of the western that diet that contribute to inflammation such as refined sugars (eg. soda, sugary snacks), refined carbohydrates (eg. white bread, white rice, white pasta) and trans fats (eg. baked goods - cakes, cookies, pies, frozen pizza, fried foods, take away) (4).
Life is too short to remove all the things you love. The truth is that you don’t need to remove these foods permanently, you can just substitute to better alternatives majority of the time to reduce inflammation, and then treat yourself every now and then for all your hard work and discipline!
For example, drink water during the week and have a couple of sodas on the weekend or use wholegrain carbohydrates during the week (eg. wholegrain bread, brown rice, wholegrain pasta) and enjoy refined carbs on the weekend. Lastly, eat lots of fresh foods such as fruits, vegetables, and quality protein and then on the weekend you can treat yourself to some Uber eats and the occasional baked good (yum!).
The concept of eating “clean” all the time is unrealistic for a lot of people and even reducing your intake of these foods will make a massive difference in not only reducing your pain but also improving your sleep too!
2. Boost anti-inflammation naturally!
You’ve already supported anti-inflammation by limiting processed food (bravo!). Next you can introduce foods that reduce inflammation by reducing inflammation in the body.
The use of anti-inflammatory drugs such as NSAIDs (eg. ibuprofen) can be effective for both acute and chronic pain. However, there are also harsh side effects with the use of these drugs including gastric ulcers, bleeding, heart problems and even death (5).
Luckily, there are natural anti-inflammatory foods that you can consume. Omega 3 foods are a great addition to diet as they contain anti-inflammatory properties that reduce inflammation in the body and can be beneficial for pain (6).
One review that assessed 17 different studies concluded that omega 3 fatty acids are an efficient treatment for pain associated with rheumatoid arthritis, inflammatory bowel disease, and menstrual pain. While another study found that omega 3 supplements are a safer alternative than NSAIDs for the treatment of neck or back pain (7, 8).
Good sources of omega 3 include hemp seeds, flaxseeds, algae, and fatty fish (eg. sardines, salmon, and mackerel). To support anti-inflammation and reduce pain take hemp seed oil, flaxseed oil or algae oil daily and if you eat fish, aim to eat fatty fish 2-3 times a week or supplement with fish oil.
3. Turmeric!
Turmeric is also a potent anti-inflammatory food that can help to reduce inflammation and pain that may help you to sleep better. Curcumin is the active compound found in turmeric. Curcumin has shown to inhibit inflammatory chemicals and also has anti-inflammatory effects in the body (10).
In 2016, a systematic review found that 1000mg a day of curcumin reduced osteoarthritis pain and inflammation as effective as common nonsteroidal anti-inflammatory drugs (NSAIDs) that included ibuprofen (11).
There is a common misconception that throwing a teaspoon of turmeric into your curry or buying a turmeric latte will significantly reduce inflammation. While it will still have a small anti-inflammatory effect, you need a much larger dose to get these impressive anti-inflammatory benefits found in the studies. A good quality turmeric supplement can be beneficial for reducing pain through its anti-inflammatory effects to help you sleep with ease!
4. Bedding and sleeping position
Finding the right sleeping position based on the type of pain you have may help to improve your quality of sleep. For example, if you suffer from joint pain in the hip, knee, or shoulder you should avoid sleeping on the side where it’s most painful to avoid waking up multiple times during the night.
If you have lower back pain, you should sleep on your side instead of your back or stomach. The reason why is that when you sleep on your stomach it can put strain on the lower back which is the last thing you want.
When you sleep on your side, it helps to put a pillow between or under your knees. If you sleep on your back, you can try putting a small pillow under your lower back to support the natural curvature of the spine. If you can only fall asleep on your stomach, then place a pillow under your stomach to take the load off the back.
There are also mattresses and pillows designed to cushion pressure points that support the natural curvature of the spine that may alleviate pain. There are all different types of mattresses based on the kind of sleeper you are, finding the one that works for you is essential to minimise pain and get quality sleep!
5. Check your medications!
While pain medications can help to reduce pain, they can also worsen sleep that could be contributing to more pain over time!
Over-the-counter (OTC) pain medications such as aspirin and ibuprofen can increase the time it takes to fall asleep. It’s believed that these drugs inhibit our natural sleep hormone melatonin (12).
Opioids that include codeine and morphine can cause insomnia. While these medications can alleviate pain, they can disrupt our deep sleep stage (REM) sleep that plays an important role in learning, memory, mood, and tissue repair. In theory, this could lead to sleep deprivation and exacerbate your pain even further! (13).
If you’re in pain it makes sense to take pain medication, however it’s important to know the side effects of your pain medications.
6. Move your body!
One of the most frustrating things about pain is the inability to exercise! The problem with not exercising is that lack of exercise is associated with poorer sleep quality.
Regular exercise also helps to improve your overall health and reduce your risk of chronic health conditions such as heart disease, type 2 diabetes, and obesity (14).
You may be thinking exercise is last thing you want to do when you’re in pain, however multiple studies have shown that exercise is not only beneficial for mild to moderate pain conditions but can also improve function and reduce pain in severe pain conditions.
In fact, the effects of exercise have been found to be comparable to OTC pain medications and NSAIDs for people who have fibromyalgia, osteoarthritis, and rheumatoid arthritis (15, 16).
If you’re worried about exercising with pain, try low impact exercise such as range of motion exercises, bike riding, swimming, yoga, and tai chi. Even stretching for three to five minutes before going to bed can help to loosen joints to make you feel more comfortable and feel less pain before you go to bed to get a more restful sleep.
Disclaimer: Speak to your doctor before commencing exercise
7. Take a hot bath!
A hot bath has many benefits for your health such as relieving stress and can also help to reduce pain too!
Autoimmune conditions such as fibromyalgia and lupus can cause muscle pain and cramping. A 2012 study concluded that “spa therapy seems to be effective and useful in fibromyalgia, reducing pain, improving function, and ameliorating quality of life” (17)
Even if you don’t have an autoimmune condition, a hot bath can still be beneficial for muscle aches and pain by increasing the blood flow and elasticity of connective tissue. If you have tight muscles, a warm bath can help you to relax and ease aches and pains.
When you take a hot bath late at night your body must work harder to cool down your core body temperature. This is beneficial as humans sleep better with a cooler core body temperature that can help to improve your sleep quality (18).
8. Mindfulness for pain reduction
If you’ve tried everything and your pain still persists, then perhaps mindfulness may be the missing link to reducing your pain! It’s easy to be sceptical of meditation. All our lives we’ve been led to think that when you’re in pain you should take some type of medication… but in many cases pain can also have a psychological element.
To help get a restful sleep your both your mind and body needs to be calm. If you experience chronic pain, your nervous system is more active and mindfulness techniques such as meditation have shown to calm the nervous system (19).
Mindfulness-based techniques such as meditation have also shown to improve pain perception and should be considered for anyone suffering from chronic pain. If you don’t have time to meditate you can just take 5 slow and long deep breaths that helps calm your nervous system that can lead to getting a more restful sleep (20).
9. Sleep Hygiene
Good sleep hygiene is essential for getting to sleep and staying asleep that can be used for anyone suffering from chronic pain. Here are some quick guidelines for sleep hygiene:
- Go to bed and wake up at the same time each night
- Get adequate sunlight
- Create a bedtime routine
- Avoid electronics at least an hour before bedtime
- Exercise regularly
- Avoid large meals too close to bedtime
- Sleep in dark and cool room
- Only use the bedroom for sleeping and sex
- Avoid caffeine in the afternoon
- Avoid alcohol
- Avoid long day time naps
To learn more about these sleep hygiene tips in more detail check out last weeks blog: The Complete Guide to Sleep like a Baby if You’re over 50, even if You Can’t Shut your Mind Off!
Take-home Message
If you suffer from chronic pain, it still possible to get a good night’s rest. By getting restful sleep you can reduce the severity of your pain and improve many aspects of your health.
Living an anti-inflammatory lifestyle by eating a healthy diet, exercising, and practicing mindfulness is one of the best ways to reduce pain to get a good night’s rest.
To ensure a restful sleep, check that your bedding is right for you and if there are any contributing factors to poor sleep such as use of certain medications.
If you have any questions or need support with your health, feel free to email our head nutritionist Ben at ben@13seeds.com.au
Disclaimer:
This article does not constitute as medical advice and does not take into consideration your personal circumstances. Please see your medical professional before implementing the above.
References:
- https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx?inline=true
- https://pubmed.ncbi.nlm.nih.gov/22547894/
- https://pubmed.ncbi.nlm.nih.gov/24793909/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986486/
- https://pubmed.ncbi.nlm.nih.gov/16531187/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257651/
- https://pubmed.ncbi.nlm.nih.gov/17335973/
- https://pubmed.ncbi.nlm.nih.gov/16531187/
- https://pubmed.ncbi.nlm.nih.gov/16531187/
- https://www.elsevier.com/books/herbs-and-natural-supplements-volume-1/braun/978-0-7295-4171-8
- https://www.arthritis.org/health-wellness/treatment/complementary-therapies/supplements-and-vitamins/supplement-and-herb-guide-for-arthritis-symptoms
- https://www.sciencedirect.com/science/article/abs/pii/003193849490388
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5657579/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241367/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534717/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461882/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296493/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427038/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368208/
- https://pubmed.ncbi.nlm.nih.gov/30761030/
