Ep. 23 Sleep and Pain: Anchoring, the Rice Cooker and the Nappucino
In this Pt. 2 of sleep and pain, Dan and Juz cover the conservative measures around improving your sleep, particularly if you struggle with insomnia, or painsomnia, as many pain patients refer to the challenge of falling asleep. They cover external and environmental factors including circadian rhythm, as well as internal or behavioral variables that affect our sleep quality and drive. They also delve into special topics and strategies around constructing an effective wind down routine including releases and diaphragmatic breathing, and how to nap in a way that is more helpful than harmful so you can feel tired when you want to, and have energy when you need it. Listen if you're a patient struggling with sleep, or a clinician looking for more effective resources and communication to help your patients improve this piece of pain
Introduction
In this episode of "It's Not In Your Head," hosts Dr. Dan Bates and Justine Feitelson continue their discussion on sleep, focusing on conservative management strategies for insomnia and other sleep issues. They emphasize the importance of addressing sleep quality beyond just relying on medications or supplements.
Internal Behaviors Affecting Sleep
Stress Management
High cortisol levels can disrupt sleep, especially in the early morning hours
Mood management and stress reduction techniques are crucial
Developing tools for on-demand down-regulation is important
Substance Use
Caffeine: Limit intake, ideally stopping by 2-3 PM
Alcohol: While it may help with falling asleep, it disrupts sleep quality
Cannabis: Similar to alcohol, it can affect sleep quality despite aiding in falling asleep
Exercise
Regular physical activity improves sleep quality
Avoid intense exercise close to bedtime
Gentle forms like Pilates, yoga, and Tai Chi can be beneficial, especially for those new to exercise
Screen Time
Limit exposure to blue light from electronic devices before bed
The dopamine release from scrolling can increase excitability
External Environment
Bedroom Optimization
Create a sanctuary-like atmosphere
Ensure the room is dark, quiet, and cool (60-67°F or 15-19°C)
Use comfortable bedding and pillows
Circadian Rhythm
Aim for 15-20 minutes of sunlight exposure daily
Maintain consistent sleep and wake times
Develop a routine to combat stress
Specific Strategies
Relaxation Techniques
Practice diaphragmatic breathing
Use mindfulness techniques (BAD Mindfulness framework)
Incorporate release techniques for pain management
Wind-down Routine
Aim for a 20-minute wind-down period before sleep
Engage in relaxing activities like gentle stretching or reading
Avoid stimulating activities and electronic devices
Napping
Limit naps to 30-90 minutes
Avoid napping late in the afternoon
Use naps strategically based on specific needs (recovery, preparation, energy boost)
Conclusion
Improving sleep requires a multifaceted approach. By implementing these strategies and understanding the science behind sleep, individuals can significantly enhance their sleep quality and overall well-being. Persistent sleep issues should be discussed with a healthcare professional.