Common issues with sleep:
- Trouble getting to sleep
- Waking in the night
- Waking un-refreshed
- Morning stiffness and mobility issues
What should normal sleep look like?
Most people need around 7-9 hours of sleep, with a reducing amount as we get older. Children will need to sleep more than adults.
It is normal to wake up 1-2 times per night, and this in only an issue if you cannot get back to sleep.
Impact of poor sleep on health:
When poor sleep becomes a recurring issue then you find you experience the following;
Fatigue, stomach problems, difficulty concentrating, headaches, difficulty driving.
Sleep can have a big impact on our mood. Those with poor sleep can often lead to anxiety or depression, but also depression and anxiety can impact on sleep too.
Cycle of pain and sleep disturbance:
When there is disturbed sleep due to pain, illness, stress or anxiety (or a combination of many of these) this can lead to insufficient periods of deep sleep that results in day time fatigue and struggles with daily activities. This then results in a vicious cycle of more sleep disturbance.
Importance of good sleep:
Good sleep can help with:
- Improving pain levels
- Your immune system and fighting infection
- Allowing adequate healing of tissue and muscle damage that needs repaired
- Keeping your weight in a healthy range
- Help with your mental wellbeing and concentration levels
Sleep and Arthritis:
Your sleep may be impacted from pain- getting to sleep or waking up due to pain or not being comfortable.
Pain may be from an already painful condition, or from one that hasn’t been painful before (for example a new flare or new presentation) or from widespread pain such as fibromyalgia.
Not only is it important to get a good duration of sleep but good quality also. This will help with the disrupted sleep cycle as shown above to help with pain as well as tiredness.
- A dark and quiet room
- A comfortable temperature
- Reduce screen time 1hr before bed (TV, phone, computer)
- Routine of trying to get to sleep and waking up a similar time every day if possible
- Reduce caffeine consumption after 2pm
- Avoid alcohol late at night
- Try to avoid day time sleeping
- Try a warm bath or shower before bed
- Regular daily exercise but not too close to bed time
- Make sure your mattress and pillow and comfortable and supportive
You may wish to keep a diary of your sleep patterns to help work out which factors help or hinder your sleep
Fibromyalgia patients may find benefit in a low dose medication of amitriptyline. This is usually taken 2-3hrs prior to going to bed to help with pain and sleep.
Medications and treatments:
Taking paracetamol with or without codeine just before bed can help with your pain levels overnight
If you take NSAIDs these can be taken with or after food in the evening
Antidepressants such as amitriptyline and trazodone that also function as an analgesia for certain types of pain may help you to fall asleep more easily in the evening as they can have a sedative effect
Sedative/hypnotics such as zopiclone may help you get to sleep, but will not stop you waking up at night- these should only be used on a short term and not long term basis if prescribed by your doctor.