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Sleep and Chronic Pain

Sleep: the ultimate reset switch. We’ve got tons of research about just how important sleep is to our long-term health and well-being. It turns out that between 67% and 88% of people who deal with long-term pain also have trouble sleeping well. Poor sleep, in this way, is both a cause and effect of pain. Without the right levels of REM Sleep and Deep/Slow-wave sleep, our bodies are simply unable to regenerate effectively. Sleep deprivation impacts many areas of the brain that have a role in pain, including: opioid processing, neurotransmitter production (like serotonin), immune function, melatonin production, the endocannabinoid systems, and the hypothalamus-pituitary-adrenal axis. If there was a medication that could impact ALL of those systems at once, it’d probably be in the water supply. Instead, we have to sleep. So, what factors impact our quality and quantity of sleep the most? 1. Regularity: getting to bed and waking up at the same time every day is essential for deep sleep 2. Light exposure: the room has to be pitch black. Our cave-dwelling ancestors wouldn’t have had it any other way. Similarly, blue light from screens is terrible for our transition into sleep, preventing production of the all-important sleep hormone melatonin. 3. Temperature: in order to fall asleep, our core body temperature has to fall 2-3 degrees. Sleeping in a cool room is essential (65-67 degrees seems to be ideal). This is the same reason people like a hot cup of herbal tea or a hot shower before bed: it brings our core body temp up to facilitate it dropping 4. Coffee and Alcohol consumption: Depending on your genetics, it may take up to 24 hours to process the amount of caffeine in just one cup of coffee. Similarly, drinking alcohol (especially before bed) can impact REM sleep for up to 4 days! 5. Stress: Avoid stressful conversations or television (turn that news off!) before bed. More importantly, don’t do anything in bed (people who work on the laptop right up until they close their eyes, i’m looking at you) other than sleep and sex. Journaling may be one exception, if it lets you process the day - so long as you leave your feelings there and don’t take them with you to sleep. What’s been most helpful for you to get effective sleep? PMID: 31207606

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