Finding the Sleep You Need

Empty, unmade bed

By Dr. Peter Abaci

Sleep disturbance seems to be one of the most common and problematic side effects of experiencing pain. In fact, problems sleeping are among the biggest complaints that I hear from patients each day. There are often many reasons for this. Arousal mechanisms, such as what can come from episodes of breakthrough pain in the middle of the night, can cause untimely and unwanted wake-ups. Arousal can also come about as a result of emotional processes as well, such as feeling angry about something at bedtime, as an example. Lying in a fixed position for too long can cause painful joints or muscles to stiffen up and create acute discomfort leading to sleep interference. Pain and sleeplessness can also become a vicious cycle, where the more impaired the sleeps get, the more intense the pain becomes, which in turns makes it even harder to sleep the next night.

Adequate sleep is important for good health and well-being, making this a critical topic. Sleep disorders and insomnia are linked to increased risk for a number of diseases including:

  • Hypertension
  • Coronary artery disease
  • Strokes
  • Diabetes
  • Congestive heart failure
  • Mood disorders like depression and anxiety
  • Alcohol abuse

Studies on chronic sleep disruption have shown that insomniacs have higher levels of the stress hormone cortisol and increased rates of glucose metabolism in the brain. The onset of insomnia has also been shown to precede the onset of depression later in both young adults as well as in the elderly.

Because sleep disorders are now so pervasive, with a quarter of the population affected, we now see a large percentage of the population turning to sleeping pills for help. In fact, it is estimated that up to 10% of Americans will get a prescription for sleeping pills. Unfortunately, outcome research suggests that we rethink this approach as sleeping pills pose their own potential health risks. Studies have found that those who use sleeping pills are four times more likely to die early and their risk of getting cancer goes up by 35%. In fact, one report labeled sleeping pills as “more dangerous than smoking.” What is even more alarming is that these risks are seen even for those who take sleeping pills on only an occasional basis and not daily. While this does not necessarily mean that sleeping pills directly cause serious health problems, the association should raise serious safety and public health questions.

So, what is the answer? Research shows that cognitive behavioral approaches to sleep disorders are what work the best. Cognitive behavioral therapy helps identify and replace thoughts and behaviors that interfere with sleep with habits that promote good sleep. Consider looking for a behavioral sleep medicine therapist that you can work with for the right sleep hygiene training. Here are some simple tips to help you get started:

  • Create a calming environment in your bedroom and, as much as possible, throughout your home.
  • Get regular exercise, but not right before bedtime.
  • Eliminate all caffeine after noon.
  • Don’t eat heavy meals late at night.
  • Make sure to go outdoors in the middle of the day to set your biological clock.
  • Using alcohol to sleep better doesn’t work, so don’t do it.
  • Wind down, dim the lights, and unplug at least an hour before bedtime.
  • Stick with a regular sleep schedule

Nighty night!


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