Core Essential number 6 – Sleep:

The Core Essentials to Physical Health and Well Being

Core Essential number 6 – Sleep:

Sleep is a dynamic form of rest that conserves energy and permits reorganization of brain activity.  The deepest stages of sleep, in particular, seem to reflect homeostatic processes for the mind and the body.  Our anabolic hormones are released mainly during sleep.  A possible boosting of the immune system also occurs at night.

Sleep disturbance is perhaps one of the most prevalent complaints of patients with chronically painful conditions.  In fact, pain is one of the leading causes of insomnia.  Up to 67% of chronic back pain sufferers experience sleep disturbance.

Other consequences of sleep deprivation/disturbance include: a decreased ability to concentrate, to handle stress, to maintain a healthy immune system, and to moderate our emotions.  This suggests that aggressive management of sleep disturbance may be an important treatment objective with possible wide-ranging benefits beyond the improvement of sleep.

The three rules:

If the position you are sleeping in is the right one for you then three things should happen:

  • When you lie down at night, your pain should never get worse.
  • You should not be woken at night because your pain has gotten worse. This is not the same thing as waking at night to go to the bathroom and still being in pain.
  • The Most Important: when you wake up in the morning you should always have less pain than when you went to bed. Note this is before you get out of bed, as it is pretty common to have “seized up” during the night.

If your sleep cycle does not match with these three rules, then working on your sleep hygiene should be a top priority for both you and your therapist!

Identify the Source of Pain

There are a number of commercial products available such as neck rolls, lumbar rolls, bolsters, etc. that can help support the injured part of the body in a neutral or comfortable position.  Speak with your clinician with regard to this.

Sleep Hygiene

The ability to sleep at night is also partially a learned habit.  There are a number of things you can do to set the stage for your mind and your body to sleep at night.

  • Establish a regular sleep schedule. Go to bed at the same time every night and get up at the same time every morning.
  • As a part of the bedtime ritual, schedule a relaxation period to separate the body and the mind from the day’s hassles. Use some relaxation techniques, play cards, or listen to soothing music, or take a warm bath.  Avoid working on the computer, watching TV, or exercise.
  • Set aside some time for “programmed worry” earlier in the day.
  • Ensure that the bedroom is a conducive environment for sleeping. The bed should be comfortable, large enough, in a quiet dark room with the right temperature.  Use the bedroom primarily for sex and sleep, not as an all-purpose activity arena.  Never do any work in bed, no paperwork, or work/job related reading.
  • Use “white noise” to mask sounds that may interfere with sleep.
  • Exercise on a regular basis but do not engage in strenuous activity late in the evening.
  • Avoid the use of alcohol2 hours before bedtime. While it may help you fall asleep, it leads to sleep disruption and deprives you of deep sleep.
  • Stop smoking, especially close to bedtime.
  • Decrease your caffeine intake.
  • Do not drink excessive amounts of liquid before going to bed.
  • Avoid heavy meals in the evening. If you are hungry, try a light snack or a glass of warm milk.  Peanut butter and dairy products are high in tryptophan, an amino acid that tends to increase sleepiness.
  • Do not try too hard. If you are still awake after 20 to 30 minutes, get up and go to another room.  Engage yourself in some quiet activity such as reading to allow you to relax.  Do not go back to bed until you feel sleepy again.


Watch for other Core Essentials in future posts, so that you can truly live a healthful and active life.

To your pain-free health,


Bob Jacobsen

Bridge Physiotherapy and Massage

Leave a Reply