So I’m going to start with this tidbit: The brain literally starts eating itself when it doesn’t get enough sleep.
AHHHhhhhhh!!!!!!! My brain is EATING itself. WTAF!
Other issues with sleep deprivation can include:
- Impacts short-term and long-term memory
- Concentration becomes impaired along with problem-solving abilities and even creativity
- Mood instability- obviously lack of sleep can make a person cranky as all hell. But long term it can be comorbid with anxiety and depression and make depression more intense
- Less than 5 hours a night can cause your blood pressure to increase
- It increases your risk for Type 2 Diabetes
- It increases the risk of heart disease
- It can lead to poor balance and increase the likelihood of falls
- Affects immune system and it may take you longer to recover from illness
- Increases the chances of obesity (source: Healthline)
And if that were not enough there is also a shortened life expectancy.
AND increase in PAIN. Which is a big one for chronic pain. The cycle is, we can’t sleep due to insomnia, we are in more pain the next day, we can’t sleep due to the pain, which makes the pain worse…
Obviously, I should recommend the Basics Of Sleep Hygiene for the First-Line Treatment of insomnia. If you have had insomnia as long as I have, you have heard it 1 billion million times.
We know sleep is good for the body. No one has to tell Us that when we bloody well can’t get any actual damn sleep. I have chronic insomnia and then I have chronic pain which gives me Painsomnia. This means when pain is moderately high to high I have extreme sleep problems and often get up. I just cannot sleep because of the level of pain. If I do, it isn’t for long, the pain wakes me up.
Just for insomnia I suggest trying:
- Valerian root
- Wild Lettuce leaf
- Kava kava
- Medications from your doctor (Trazadone is a common one for fibromyalgia)
- Meditation at night
- Follow the sleep hygiene for sure. It does make a difference
- A nice relaxing, slow-down, nightly routine that works for you
And I have done a lot of that and really none of it worked. I was told since my insomnia was since I was quite young it was embedded and difficult to treat. But, you have to remember, pain became a factor me quite early as well which complicated things. So I do those things, yes, but when Pain enters the picture it can trump all of that.
I have had painsomnia severely for the last week. The barometric pressure has got nutbars and my migraines have been constant for five or more days and severe. I have done everything I can to manage them during the day, as I would normally do, but at night… what to do… what to do. That is the question.
Okay, so what do we do about painsomnia then? This is a tricky pickle that causes the most difficult and extreme sleeping issues.
- It may require different sleep medication (sleeping pill- I am on zopiclone myself but this depends on your doctor and your medications)
- It may require pain medication to manage pain levels (I am on tramadol for pain management which does help with FM… doesn’t do nothing for migraines so that still is an issue for my Painsomnia)
- It likely will involve a sleep study to eliminate any Other sleep disorders complicating the issue (this is recommended for chronic insomnia anyway, by the way)
- Still do sleep hygiene
- Meditation still helps but Also breathing exercises to help with calming the body down. I do deep breathing exercises all the time at night when I am in high pain to just try and breathe through it and calm my physical response, relax, and Hopefully fall asleep. But stay asleep? Not likely.
- Cognitive behavioural therapy may help as well and you may be doing this for pain management anyway so it can be a facet of that
- some people do self-hypnosis techniques
- Visualization techniques… sort of like meditation but not mindful meditation. More like a positive visual meditation you have worked on.
- Finally, if all else fails, get up and do something relaxing and distracting that will tire your brain… read if you can… watch a movie… that sort of thing to just help distract and tire yourself out more. Sometimes this can help and then go back to bed and try again.
- If you get up, you may want to ice or heat an area of particular concern (For a migraine I ice my head, for FM I use my heated blanket). Or a pain cream. And just redo what you would do for management during the day and see if that will give you that Slight edge you need to sleep. Sometimes this works.
One of the problems with Painsomnia is we cannot distract from pain like we would when awake (when possible) and so it is far more Present in our minds. We need to distance ourselves from it. Thus relaxing music and meditation and deep breathing… and designed to calm the system and slightly distance us from the pain.
Most psychological techniques begin with controlled deep breathing. Although there are many relaxation exercises, the following is a simple example of a deep breathing technique that can help people fall asleep:
Lie down in a comfortable position on the back with legs straight and slightly apart. Allow the toes to point comfortably outward and let the arms rest at the sides without touching the body. Place the palms up and close the eyes.
Focus on breathing. The hand can be placed on the spot that seems to rise and fall the most as one inhales and exhales. Notice the position of the hand. Is it on the chest, abdomen or somewhere in-between?
Now, gently place both hands on the abdomen and again focus on breathing. Pay attention to how the abdomen rises during inhalation and falls during exhalation. Try to make the hands rise and fall.
Breathe through the nose during this exercise. If needed, one may clear the nasal passages prior to doing breathing exercises.
If breathing into the abdomen is difficult, press the hand down on the abdomen during exhalation and allow the abdomen to push the hand back up during deep inhalation. The hand pressure will help create awareness of the action of the abdomen during breathing.
Notice if the chest is moving in harmony with the abdomen, or if it appears rigid. Take a few minutes and let the chest follow the movement of the abdomen. This is done by continuing to focus on the abdomen moving up and down as one breathes and simply allowing the chest to follow its motion naturally.
So that is what I have to help with Painsomnia and insomnia in general. Keep in mind, even all those things all at once will Not work every time. Pain can be severe and when it is it can simply be too much to distract from with any method and it trumps all medication and we simply cannot sleep. Those are the days we get a fitful exhausted few fractured hours when we are lucky. But we have to do what we can do all the time to try to get the best sleep we can because lack of sleep and pain is a vicious cycle of more pain and more lack of sleep. The better we manage it the better off we are. But it is difficult. It is a really difficult one for me. Constantly trying different things and trying to relax and do what I can to just lull myself into sleep… but then I wake up and do it all over again or get up and distract myself.
I’m just going to say, I also need naps during the day to just Function At ALL. So there is that.
We need sleep. We need it and we do not get as much as everyone else does or the quality everyone else does. So do what you can when you can to get the as must as you can when you can. It is as important as any other thing we manage, if not more, but a real tricky one. We may win one night and get a good 9 hours and lose another night and get 4 crappy hours. But it is very important to do the work and try to get the best we can get. I have had an extremely disruptive, poor sleep cycle before that I didn’t manage well, other than sleep hygiene and medication… and I was lucky to get 4 hours a night. It made pain worse. Mood worse. Cognitive problems were worse. Everything was worse. And for me it is still very difficult to manage but I do win some days.
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