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Missing Sleep? How Helpful is Counting Sheep?

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For pain patients, sleep is precious. Sleep is a respite from a tough day and allows pain patients to tolerate discomfort. Lack of sleep not only isn’t restorative enough, it also inhibits our abilities to handle pain.

Unfortunately, many pain patients also suffer from insomnia.

What to do?

The traditional answer has always been to literally “count sheep”. This has meant envisioning sheep going by and counting them. The practice probably is a relic from an old shepherding tradition of having to count the herds before bedtime.

But not every old practice works, and apparently, counting sheep actually extends wakefulness.

So, what can help you get to sleep?

A cool room, but not too cold.
Comfortable bedding and pillows.
The optimal amount of noise (white noise if you need it; silence if that is better)
Comfortable proximity to your significant other. Many people like to sleep while in physical contact with their partner. Others like their partner nearby but not touching.
All screens off (and no screen time for several minutes before bedtime.)
Comfortable breathable nightwear (or none at all, if it’s more comfortable).

If these conditions still don’t bring on sleep, instead of counting sheep, which apparently is actually too boring, consider these exercises:

Reading a fairly mundane book–no thrillers, mysteries or bodice-ripping romances. I’m reminded of my friend who was a camp counselor and would read to his campers from his college macroeconomics textbook every night.
Don’t rehash the day or make lists of what you need to do (although these are great things to do as you’re preparing for bed, just not as you’re getting into bed.)
Visualize relaxing settings that you like (a peaceful coastline, a mountain view, a snowy walk, a path in the woods).
Breathe naturally but slowly and deliberately.
You can play some mind games, particularly if they are a little boring. Alphabet games are great because you typically won’t make it to “z”. Think of a place that begins with each letter or a celebrity (first or last name).
Spiritual or prayerful thoughts. If you’ve memorized a few psalms or Bible verses, say them to yourself silently. Think of every person you know and say a silent wish for them.

If you consistently cannot fall asleep (or stay asleep), discuss this with your health care team. You may need to be evaluated by a sleep specialist to rule out sleep apnea and evaluate if you would benefit from a mild nighttime sedative.

The Sleep-Pain Paradox

It’s a problem.

People who suffer pain need restorative sleep, more than the general population. Yet, people in pain tend not to get enough restorative sleep. The 2015 Sleep Poll conducted by the National Sleep Foundation says that 23% of chronic pain sufferers say they have been diagnosed with a sleep disorder.

It’s important for pain sufferers to take control of their sleep as if it were a high priority project. Pain sufferers need sleep in order to function in their already somewhat compromised state. So, here are some reminders:

Try to sleep for at least eight hours per night, not too much more and not too much less. If it takes you a long time to fall asleep, you need to create a sleep schedule that gets you into bed for more than eight hours to allow for that extra “sleep prep” time.
Regarding too much sleep: it is a real thing. Pain sufferers benefit greatly from daily physical activity and too much bedrest contributes to poor circulation, weight control issues, and even more pain.
Some people find naps restorative. If you must take a nap, limit the nap to 30 minutes. Make sure your nap is at least six hours prior to your scheduled bedtime.
In addition to scheduling your sleep, schedule your physical activity with a goal of 30 minutes of stretching, cardiovascular or weight-bearing exercises daily. Avoid exercising just before bedtime.
All days are equal. You need to have a sleep routine on Tuesday night and on Saturday night that allows for eight hours of sleep. Weekends are a great opportunity to catch up on sleep, but overdoing socializing or overscheduling is a missed opportunity. In addition, oversleeping is a mistake, too.
Eat dinner at least two to three hours before bedtime.
If caffeine affects your sleep, avoid it after 12:00 noon. If you can, wean yourself from caffeine altogether.
Avoid alcohol use or limit your intake to one drink in the evening.
Remove all screens from the bedroom. From the TV to your smartphone, the temptation is too great to keep watching, keep reading or keep texting. Better to read in bed or do crosswords than have a screen to stimulate your brain and visual cortex and prevent deep sleep.
See a sleep specialist if you consistently cannot obtain restorative sleep to rule out sleep apnea and other sleep disturbances.

Getting enough sleep is as important as pain treatment. It is a lifestyle decision that only you can control.

Taking advantage of the Time Change

Perhaps you didn’t feel the time changing in the middle of the night, but this one-hour shift can be a gift or an unwanted intrusion, or a bit of both.

Earlier Nights:

For insomniacs, an earlier darkness is conducive to falling asleep. If you can allow your body to dictate to your mind that it is time to prepare for bed, you can benefit from some much needed restorative sleep. All of us who suffer occasional or chronic pain are aware that sleep helps with our ability to manage pain and lack of sleep impairs our ability to adapt to pain.

The downside of this earlier darkness is an abbreviated late afternoon of daylight for those who were used to walking or exercising outside.

Good Day, Sunshine!

If you have been noticing the dark mornings at bus stops and during your morning drive to work, you will now have daylight for your commute and for an hour or two before. This is great news for early risers, especially for those who work out in the mornings with walks and other activities like classes or at home routines. Working out in the morning tends to be the most advantageous time of the day and leads to a greater adherence to a workout regimen.

For those who awaken with the sun’s rays through the windows, utilize the extra hour to prepare a healthier lunch or indulge yourself in a breakfast that takes a bit longer to create. Better yet, do some stretching or light exercise to kickstart some healthy routines.

Parenting Woes:

Children’s bodies don’t understand that the clock has turned and can take a week or two to adjust to their “new” bedtime, even if the clock says exactly the same thing. Toddlers and babies are particularly sensitive to this time change and will still wake up and become sleepy at the old time, an unfortunate occurrence for sleep-deprived parents.

That extra hour of daylight can be beneficial for our bodies, especially for us in Michigan, as we are at the far western and northern end of our Eastern time zone in the U.S.

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Missing Sleep? How Helpful is Counting Sheep?

The Sleep-Pain Paradox

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