-- Question: I'm Ellen, and I've suffered in chronic pain for over 25 years. And restorative sleep is my biggest problem. Do you have any suggestions?
Answer: Hi, Ellen. Thank you for your question. This is a very common problem for patients with chronic pain. Getting to sleep at night, staying asleep, and feeling as if you had a restorative sleep, is very difficult to achieve. There are several things that get in the way of reaching this goal.
The first thing to think about is what medicines are you taking? Many of the medicines given for insomnia, for chronic pain, muscle spasms, other symptoms that patients with chronic pain experience, actually cause your sleep to be worse rather than better -- particularly if you take them over time and develop tolerance to them. So, look for medicines that you can actually get rid of. Look for the medicines that aren't helping you anymore and that might be creating a problem.
The next thing to think about is your sleep hygiene. In other words, what happens at night when you're trying to go to bed? You should try to go to bed at a consistent time every night. You should use the bed only for sleeping so that if you're unable to fall asleep, don't sit up and watch TV, read, go on the computer -- take yourself out of the bedroom, go do a limited activity, prepare yourself again for going to sleep, and then come back to the bed and make it a comfortable place where you can sleep restfully.
Now, you should also get up at a particular consistent time as well. And that sets us up for the third issue, which is structure you day in away that will promote sleep at night. Think about when you will have your meals; think about when you will engage in certain activities. Make sure that you're not napping throughout the day. And if at all possible do some limited amount of aerobic exercise, because all of these things will then come together so that when your bedtime occurs, you're ready to go to sleep, and you're more likely to set yourself up for a good night's sleep.