I have terrible insomnia. I’ve spent hours of my life lying awake in bed late at night/early morning, praying for sleep. Patients suffering from chronic pain often find their problems are compounded by insomnia and sleeping disorders.

The term “insomnia” includes all types of sleeping problems, such as difficulty falling asleep, difficulty staying asleep, and waking up earlier than desired. Of all medical conditions, pain is the number one cause of insomnia.

A study done between 2009 and 2012 in Pittsburgh found that more than 70 percent of adults with Sickle Cell had sleep disturbance. Pain and sleep are inter-related, so much that pain disturbs sleep and disturbed sleep amplifies pain and increases risk for developing chronic pain.

Chronic pain can impact sleep in a number of ways. To understand how a pain problem can make it difficult to fall asleep, try thinking about your routine before bed.

You most likely try to eliminate all distractions or other influences in an effort to relax and fall asleep. This may include quieting the room, turning off the lights, eliminating any other noises, meditating, trying to get comfortable, and beginning to try to fall asleep.

But for chronic pain sufferers when trying to fall asleep, there are no distractions except for the pain, and the perception of pain can actually increase when you quiet one’s environment which can cause problems and the longer falling asleep is delayed, the more stressful the situation becomes.

Patients will often report that one of their primary pain management tools during the day is to distract themselves from their chronic pain by staying busy with other tasks (e.g., reading, watching television, engaging in hobbies or crafts, working, interacting with others, etc.).

Recently I have been trying to develop better “sleep hygiene” and I think I’ve got a few tips that may help someone with insomnia like me, pain or no pain.

Have a comfortable pre-bedtime routine

• A warm bath or shower.
• A warm milk drink without caffeine.
• Meditation, or quiet time.

Keep a regular sleep routine

• Go to bed at the same time, each night. Wake up at the same time. Ideally, your schedule should remain the same every night of the week.

Don’t stay in bed awake for more than 20-30 minutes

• If you find your mind racing, or worrying about not being able to sleep during the middle of the night, get out of bed and sit in a chair in the dark. Let your mind race while you are in the chair until you are sleepy, and then return to bed.

Don’t watch TV, read in bed

• No TV or internet during these periods, because they will just stimulate you more. Exposure to artificial light after dusk and before bedtime may reduce sleep quality by suppressing production of the hormone melatonin.

Do not drink caffeine after 5 pm

• Caffeine’s half-life is 5-6 hours. I try not to have any caffeine after about 5pm and if your one of those that is easily affected by caffeine try not to have any past lunchtime.

Have a quiet, comfortable bedroom

• Set your bedroom thermostat to a cool temperature. Generally, a little cooler is better than a little warmer.
• If your pets wake you, keep them outside the bedroom.
• Your bedroom should be dark. Turn off bright lights.

My brother wrote quite an interesting and even more informational blog post on sleep that explains the science behind sleep.