Chronic pain and insomnia are an unhealthy combination. According to the National Sleep Foundation, chronic pain disturbs the slumber of one in five Americans at least a few nights a week. Whether it’s from a bad back, arthritis, or headaches, chronic pain puts you in double jeopardy: the pain robs you of restful sleep and makes you more fatigued, and thus more sensitive to pain.
But you can start to break this vicious cycle.
“For chronic pain conditions, what you need is good sleeping habits from the beginning — things that will last,” says Dr. Padma Gulur, a pain medicine specialist at Harvard-affiliated Massachusetts General Hospital. That means relying on the brain’s natural sleep drive as much as possible.
Try “relaxing distraction”
Dr. Gulur recommends “relaxing distraction” to her patients. Some relaxation techniques use basic rhythmic breathing meditation; others focus on guided imagery, in which you imagine being in a calm, peaceful location. Find something that appeals to you and helps you fall asleep. You might look for these exercises on CD, or consider group or individual trainings or sleep education sessions.
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For some people, chronic pain not only makes it harder to fall asleep, but can also interrupt sleep. Simply shifting position in bed can trigger pain from a back condition or arthritic knee.
One approach is to take your pain medication right before bed. Check with your doctor to be sure that fits into your treatment plan. If pain does wake you in the middle of the night, first try meditation, visualization, or whatever relaxing distraction you favor. But if it doesn’t work, getting up to read a book in a quiet room with low light can help you to get back to sleep. Avoid loud sounds and bright light (that means TVs, smartphones, tablets, and computers).
Staying on a regular sleep schedule is also important. Go to bed at the same time every night and, no matter how the night goes, rise the next day at the same time and remain awake until your planned sleep time. This helps to set your internal sleep clock and enhances the natural sleep drive.
To learn more ways to ensure that you get a good night’s sleep, buy Improving Sleep, a Special Health Report from Harvard Medical School.
Many people find that crossing several time zones makes their internal clocks go haywire. In addition to experiencing headaches, stomach upset, and difficulty concentrating, they may also suffer from fitful sleep.
But there’s no need to waste time riding out the effects of jet lag. Try these tips the next time you travel.
When you’re traveling shorter distances
If your destination is just one or two time zones away, it may be possible to wake up, eat, and sleep on your regular home schedule. At your destination, schedule appointments and activities for times when you would be alert at home.
When you’re traveling longer distances
Gradually switch before the trip. For several days before you leave, move mealtimes and bedtime incrementally closer to the schedule of your destination. Even a partial switch may help.
During the flight, drink plenty of fluids, but not caffeine or alcohol. Caffeine and alcohol promote dehydration, which worsens the symptoms of jet lag. They can also disturb sleep.
Switch your bedtime as rapidly as possible upon arrival. Don’t turn in until it’s bedtime in the new time zone.
Use the sun to help you readjust. If you need to wake up earlier in the new setting (you’ve flown west to east), get out in the early morning sun. If you need to wake up later (you’ve flown east to west), expose yourself to late afternoon sunlight.
If you’re traveling on short notice or you’re facing an especially stubborn case of jet lag, ask your doctor about a specially timed dose of melatonin or ramelteon, which can help shift your circadian rhythms. If all else fails, a short course of an over-the-counter or prescription sleep aid may do the trick.