Getting adequate sleep is a serious problem for countless Americans. And it’s not just about feeling rested. A lack of quality sleep is a major factor in many chronic illnesses because of its importance in the healing process and in its contribution to maintaining balance within the autonomic nervous system. Because of the tendency for back-pain symptoms to worsen at the end of the day, getting adequate sleep can be a serious challenge. For those suffering from any condition, broken sleep is a difficult hurdle in a patient’s path to healing.
If your pain is causing you to lose sleep, you are not alone. Many of our patients tell us they can learn to deal with the pain and discomfort of their sciatica or back pain during the day, but the restless nights and chronic lack of sleep puts them over the edge and seriously lowers their quality of life.
How do you know if you are not getting adequate sleep?
The simplest way is to track how many hours you sleep each night. Most adults need somewhere between seven and nine hours of sleep each night in order to feel their best, but hours alone don’t give you the full picture. Your sleep quality can suffer while your total hours of sleep stay the same. This is a big problem.
Chronic lack of sleep and poor-quality sleep can be both a contributing factor and a symptom of spinal decay. It’s another vicious cycle associated with pain. The simple fact is that, without adequate sleep, healing from any condition is very difficult. Yet for many getting adequate sleep is nearly impossible without some relief in their symptoms.
If your back symptoms are keeping you up at night, know this; getting a full night’s sleep (including deep sleep) is possible. Getting a full night’s sleep is one of the biggest milestones for our patients. It’s not uncommon to have a patient confide in us that, for the first time in years, they are falling asleep more quickly and sleeping through the entire night. Getting better sleep is one of the many positive side effects of reducing the stress response and restoring the disc. But better sleep is not just a side effect; getting better sleep is also a crucial part of the program, one that helps reduce your chronic stress and gives your body a chance to heal.
Although our other strategies discussed within the DICE protocol and being “balanced” through spinal adjustments should enable you to sleep more easily, there are a number of things you can do to start improving the quality of your sleep right away.
Most people lead hectic lives, which will add to any baseline level of stress that they may already be under. High stress is tolerable during the day, but in order to get restful sleep, you need to be relaxed at night.
You should plan on having at least thirty minutes to unwind before bed, but an hour is better. Your relaxation time should not occur in the bedroom. The bedroom, and especially the bed, should be reserved for sleep and intimacy only, no exceptions.
Activities that should be avoided right before bedtime include the following.
Here are some things that will better prepare you for bed and allow your body and mind to relax.
Light—Our bodies are much more sensitive to light than most people realize, and the eyes are not the only part of the body that senses light. Many other cells in the body are sensitive to light, so covering your eyes with an eye mask or sheets won’t solve all your problems.
Sound—This one is pretty obvious. We all know what it’s like to be kept awake by an annoying sound no matter how quiet it may be. If you can control the noise, eliminate it or at least have an agreement with others in the household about a noise curfew.
If the noise is out of your control, consider getting a white-noise machine. (These machines play soothing sounds like beach noises or nature sounds.) Another option is to use earplugs or get a fan. Earplugs are the most inexpensive solution, but long-term use can cause irritation to the ear.
Temperature—Being too hot or too cold can make it difficult to sleep. Most people prefer a cooler room for sleeping (around seventy degrees). Changing the weight of your bedding to match the season can be a big help. Running the air conditioner in the summer may cost more money, but lost sleep is bad for your health and your productivity, so it may be worth the extra money.
Mental Sleep Hygiene—A racing mind is one of the most common reasons why people have difficulty falling asleep. Giving yourself time to relax and unwind before bed may be enough to help you quiet a racing mind, but for many it’s not enough.
One quick-and-easy strategy to quiet your mind is to write down all the things you are worrying about. Many times we mentally run through all the things we want to get done tomorrow while we are lying in bed. Writing your thoughts down on a bedside note pad is a great way to let go of those things. You can easily revisit them in the morning.
Once you have written down all the worries and errands you must take care of the following day, take a few minutes to write down a few things you are grateful for. There is new research showing that having positive thoughts as you fall asleep improves sleep quality and duration and reduces the time it takes to fall asleep in the first place (Wood et al. 2009, 43–48).
Comfort—Comfort is subjective, and no mattress or sleep position will work for everyone. But there are some general guidelines that apply to most people. First off, a worn or sagging mattress must be replaced. It not only ruins your sleep, but it can also cause long-term damage to the back, neck, hips, and shoulders.
Keeping the spine aligned, regardless of your sleeping position, should always be a goal.
Side sleepers should use a pillow thick enough to keep the head and neck in line with the spine, preventing the head from tilting down while also ensuring it’s not too think tilting your head up. An extra pillow between the legs will also help keep the hips aligned.
If you sleep on your back, you will want a thin pillow under your head to prevent neck problems and a pillow under the knees or calves to take pressure off your low back. (Pillows under the elbows will also make you more comfortable.)
If you are a stomach sleeper, you may want to try to break this habit. It creates too much added tension on the neck from the need to have it turned to side.
Simple as that, these all will either force you to wake in the middle of the night to use the bathroom, keep your mind active prior to bed, or prevent you from reaching deep sleep.
If you are a parent, you know that a child who misses his bedtime will be cranky. Well, we hate to break it to you, but children aren’t the only ones who do better with a predictable routine.
Set times that will allow you to sleep around eight hours each night. Stick with these times even on weekends and holidays.
Regular exercise can do wonders for your sleep pattern. Light exercise like walking or yard work will help you feel tired at night. It is best if you can exercise in the morning. Remember, you don’t have to exercise like an athlete to get sleep benefits. Thirty minutes of light exercise a day is all you need.
Just avoid this before bed.
Exposure to light helps keep our circadian rhythms in tune with the day-night cycle. Getting exposure to sunlight helps us feel awake during the day and sets our body’s internal clock so we know it’s bedtime after the sun goes down.
A large meal requires a lot of energy to digest, and for this reason it is best to eat a few hours before bed (unless it’s a small protein-based snack).
Naps are a great way to boost your energy during the day or to make up for lost sleep, but they can be a problem too. If you have trouble falling asleep at night but nap on a regular basis, you need to cut the naps out of your routine. This is especially true if you nap any later than three in the afternoon. These naps may actually be doing more harm than good.
You should also limit a nap should to thirty to forty-five minutes. Any longer and it will almost certainly disrupt your normal sleeping pattern. Fifteen- to twenty-minute naps are ideal. They give you a little boost, but they rarely disrupt your sleep pattern.