Skip to content
Leeds Community Healthcare NHS Trust Logo

Sleep

Why can’t I sleep?

It’s likely that there are a number of causes of your sleep difficulties. Here are six triggers often found by people living with pain:

  • Your medication for pain or low mood makes you drowsy in the day so you sleep at irregular times.
  • You worry about how your lack of sleep will affect you the next day.
  • You are not in a regular routine so your mind and body are confused about when it is time to rest.
  • You notice your pain more as there are no other distractions at night.
  • You are experiencing mood changes that create tension in your body.
  • You are not comfortable in your bed or you are disturbed by sounds or light in your bedroom.

Medication, mood and worry have already been discussed in week 3 and 4 of the pain management group. Other sleep strategies will be discussed later in the booklet.

  • Sleep is needed for a healthy body and mind.
  • A normal amount of sleep ranges from 6 to 10 hours.
  • As we get older we need less sleep and we spend more time in lighter sleep, this may lead to periods of waking during the night.

How much sleep do you have a night?

Do you have a problem getting to sleep, staying asleep, waking too early?

Reduced sleep can:

  • make you feel tired, lack energy and motivation.
  • reduce performance and concentration.
  • affect mood.
  • increase risk of accidents.
  • make pain worse!
  • you have other medical conditions that contribute to tiredness, such as Fibromyalgia and Chronic Fatigue Syndrome.

The link between pain and sleep

  • Up to 90% of people with long term persistent pain report problems with sleep (Finan et al, 2014).
  • Poor sleep is a risk factor for developing persistent pain.
  • A study of people without persistent pain when sleep deprived became more sensitive to pain (Finan et al, 2013).

Normal sleep

Often the perception of a good night’s sleep is that we fall asleep quickly and spend 7 to 8 hours in a deep sleep.

But actually:

  • Normal sleep occurs in several cycles through the night, about 90 minutes long.
  • Cycles are often separated by wakening.
  • Sleep becomes lighter as the night progresses.
  • We spend more time in lighter sleep towards the end of the night.

Getting a better night’s sleep with chronic pain

Improve your sleep with some positive lifestyle changes and consistent sleep habits.

  1. Regular sleep schedule: Try to maintain a consistent sleep pattern 7 days a week. Getting up at the same time everyday can help.
  2. Relaxing bedtime routine: Spend time before bed relaxing: read a book, meditate, stretch, do yoga, have a shower or bath. Avoid difficult conversations, activities or work.
  3. Avoid stimulants: Don’t drink caffeine, sugary or energy drinks in the evening. Avoid nicotine before bed. Only drink alcohol in moderation at night, if at all.
  4. Good sleep environment: Keep your bedroom clean, tidy and comfortable. Use a quality mattress and bedding. Keep the bedroom aired, and a temperature between 60 to 70 degree fahrenheit (17 to 21 degrees celsius)
  5. Block out noise and light: Make sure the bedroom is dark and quiet. Use blackout curtains or a sleep mask. Use earplugs, white noise, a fan or music to mask external noise.
  6. Only sleep and intimacy: Only use the bed for sleep and intimacy with partner. Avoid watching TV or using other devices in bed. That will help associate the bed with sleep.
  7. Exercise and daylight: Try to do regular exercise, but not too intense before bedtime. Spend time outside in the daylight. Even a short walk during the day can improve sleep.
  8. Eat well: Try to eat a balanced, healthy diet. Avoid heavy, fatty, fried or spicy food late in the evening if you get indigestion. Bananas, yoghurt or healthy cereals are good bedtime snacks.

Your body clock determines when it is time to go to sleep; this is set by daylight and activity during the day:

  • Aim to spend some time outside each day.
  • Aim to do some form of movement or exercise each day.
  • Aim to avoid day time naps or resting on the bed during the day.
  • Aim to go to bed at the same time every day.
  • Aim to get up at the same time every day.

Imagery

A detailed image of a pleasant place or event, involving all senses. You need to plan this in advance and practice.

15 to 30 minute rule

  • Set a limit on time spent trying to sleep.
  • Get up and do something unstimulating.
  • Don’t eat or put bright lights on, only return to bed when you feel sleepy.
  • Repeat

Challenging negative thoughts

  • Write your negative thoughts down
  • Question the thought: Is the thought true? Yes or no
  • Is the thought helpful? Yes or no

Mindfulness is about noticing with kindness our thoughts and feelings and accepting them rather than fighting them. It is about being in the present rather than spending time thinking about what could be, what ifs and what was.

Trying to cure pain and rid ourselves of unhelpful thoughts can lead to a life of dissatisfaction.

Mindfulness focuses on how we react to thoughts.

Useful links for mindfulness:

Check if there are any medical problems that are affecting your sleep that you need to discuss with your GP, such as:

  • sleep apnoea.
  • restless legs
  • needing to go to the toilet frequently during the night.

Alcohol

Avoid excessive amounts of alcohol because this can affect the quality of your sleep.

Homework

  1. Please complete the sleep dairy below.
  2. Please add your sleep goals to your Pain Management Plan.
  3. Try some mindfulness exercises from the links above.
  4. Please look at the following sources of information
survey icon
Tell us what you think

We would love to know what you think of our website and if there is anything we can improve.

Complete our survey and share your thoughts.