Sleep is so important when we are injured or in pain to help the healing and repair process; not only that, it can also aid body recovery at the end of the day to help prevent injury. So, as a physiotherapist, I am interested in your sleep pattern and want you to get a good night’s sleep! Here are some top tips for just that.

Good Sleep Hygiene (yes, that’s a thing!)

Let’s start with the Circadian Rhythm. You may be familiar with this term. In adults it is a 90 minute cycle with an alert period every 90 minutes and 45 minutes later, you hit a dip period. You can sometimes see this in sport, in a tennis match for example. Played a terrible set and lost heavily followed by “he’s got his mojo back!” and wins the next set with some amazing tennis! He’s hit his dip and then is back to his alert phase.

So we need to be ready to drift off to sleep, in bed, as we hit our dip. But we get it wrong. Imagine you have been sitting watching TV and start to feel yourself nodding off. Right, bed time. Then you get up, let the dog out for a wee, pack the dishwasher, put your clothes out for the morning, check on the kids, let the dog back in (mustn’t forget him!), brush your teeth and then go to bed, perhaps 25 minutes after falling asleep on the sofa. You might read for a bit in bed and then decide it’s getting late, turn the light off. And now you can’t get to sleep. You were asleep on the sofa half an hour ago! Why can’t you sleep now?! Because you’re approaching your alert period. Your dip isn’t for another 45 minutes.

So you toss and turn. Your mind starts to become active and you may start to worry about things. You become increasingly frustrated and manic. Then you miss your dip. Your brain is so wired it can’t switch off. It’s another 90 minutes until that dip comes round again…..

Breaking the Cycle With Good Habits

Sleep advice

  1. Recognise when you are approaching your dip. This will be the same time every night; so what time do you fall asleep on the sofa? That’s your dip time. Leading up to your dip, you may feel a bit cold as your core body temperature drops slightly, you start to yawn and rub your eyes. Once you know your Dip-Time you can start all your night time routines several minutes beforehand so when you hbit your dip, you’re in bed ready for sleep.
  2. If you are tossing and turning in bed worrying about things, try to reassure yourself that these things are not vital. Our analytical part of our brain doesn’t work so well at night which is why we often wonder what on earth we were worrying about come the morning. If this is a habit, keep a pen and paper by your bed and write it down (NOT a phone! No phones by your bed! I’ll come to this later). If your brain is still manic, get up. Dim lights and go into another room or downstairs, do a crossword or read (again NO phones or tablets and NO caffeinated drink either) and  40 minutes or so later, as your dip arrives, go back to bed.
  3. Keep a regular bedtime routine  – same time and same habits. Notice when your “dip” is and aim to go to bed 10-15 minutes before this.
  4. Avoid caffeine, alcohol, fatty drinks (including hot milk), eating, exercise in the last couple of hours before bed. All of this stimulates the body and nervous system so reducing the chances of the body falling into sleep mode.
  5. NO PHONES/TABLETS before bed or by your bed. Natural sunlight starts on the blue light spectrum and changes to red light through the day. The body builds up the hormone melatonin during the day and as the light wave changes to red this stimulates the release of melatonin which is soporific to the body and leads to sleep. Stimulating the brain again with blue light, emitted from TVs, mobile phones, laptops and tablets, inhibits the release of melatonin and reduces the chance of sleep. So avoid these devices in your bedroom. If you use your phone as an alarm clock then buy an alarm clock! It’s also much better for our mental health to avoid starting the day checking emails etc, before we have even woken up properly.

More on Melotonin

The production of melotonin is stimulated by light. So the more natural sunlight you can get, the more production of melatonin and the greater soporific effect at night. So get outside more! It’s not fresh air that makes us tired when we’ve been out all day, it’s the sunlight. Even cloudy days generate a lot more light and melatonin production than the artificial lights of offices, homes and buildings. So have a walk at lunchtime or eat your sandwiches/have a cup of tea outside.

Need For Sleep

Throughout the day, whilst also building up supplies of melatonin, we are also building up a need for sleep. Towards the end of the day that need for sleep is greater and we are more likely to fall asleep at night time. So try to avoid that “pick me up” snooze in the day or when you get home from work – that’s the time to have some caffeine! That snooze will reduce your need for sleep come bedtime.

Pillows and Mattresses

I am often asked about this. My response is that it is entirely subjective. The main suggestion I have is to try to lie with your spine in a supported position, pillows tucked into the neck and the mattress not too soft for the body to mould into it and not too hard so the body doesn’t get any comfort. Spend time trying out lots of mattresses in shops.

Finally, if you aren’t having a good night’s sleep, don’t panic about how you’ll cope the following day. We can function on a few hours sleep and you will catch up. Eventually, you will have a decent night’s sleep, even if it doesn’t feel like it at the time.

How Much Sleep Should I Be Getting?

Should adults be getting 8 hours sleep a night? Well, some of us should, some can manage quite happily on 5 hours (think Maggie Thatcher) and others can’t cope without a regular 9 hours. That’s the beauty of the human being – we’re all different! Some of us are long sleepers, and others of us are short sleepers.

Pain At Night

Image showing a person in pain

If you’re in pain at night, then please, please take pain killers before you do to bed or use heat or ice – see our upcoming blog article on dealing with early onset back pain and take a look at this advice sheet on good positions for sleeping with back pain.

If you do all these unrecommended things but are sleeping well then lucky you! You sleep well and don’t need to change anything – for now!

As ever, please do contact us if you are suffering with pain at any time of the day or night and we will do our best to help. For more indepth advice for an ongoing severe sleep problem then I recommend the Sleep Unlimited website.