Chronic illness and poor sleep go hand in hand. Many people with chronic illness suffer from debilitating fatigue. To make matters worse, they often sleep poorly and do not get the restorative sleep their bodies require.
Also, poor sleep has been linked to the development of a number of chronic diseases and conditions (including diabetes, cardiovascular disease, obesity, and depression) and should be addressed no matter your health status. 1 2 3 4 5 6 7
Common Causes of Poor Sleep
1A Disruptive Sleep Environment
A deep, restorative sleep is best achieved in a cool, dark, and quiet environment. You can create this setting by doing the following:
- Most people sleep best in a cool room with temperatures set between 60 and 72 degrees Fahrenheit. (According to the National Sleep Foundation, the ideal bedroom temperature is around 65 degrees.) If your significant other prefers a warmer sleep environment, there are specialized pillow cases, bedding, and fans that can keep you cool while not disrupting his/her sleep.
- Some people experience extreme swings in body temperature at night and do best if they have multiple blankets nearby which can be easily added or removed throughout the night.
- If you experience night sweats, consider using bedding and clothing that wick away moisture from your skin.
- It is best to sleep in a dark room. This is particularly important for those with chronic illness who require naps during the day. A dark room can be achieved with block-out shades and/or curtains. If these are not available, an eye mask can be helpful.
- It is important your sleep environment is free from disruptive sounds. A white noise sound machine or a fan can help reduce disruptive sounds. I use a Marpac Dohm DS Sound Machine which is the Official Sound Conditioner of the National Sleep Foundation. It is customizable and allows you to change the intensity and tone of the sound.
2Poor Bedroom Ventilation
Fresh air with adequate oxygen is needed for restorative sleep. You can improve the quality of the air you breathe while sleeping by doing the following:
- Try every day to open a bedroom window for a few minutes and/or use a fan to circulate fresh air.
- Don’t sleep with bedding covering your mouth/nose which can create a collection of exhaled air which is not healthy to rebreathe.
3An Overstimulated Brain
Your brain produces hormones to help regulate your sleep-wake cycle (circadian rhythm). These hormones tell your brain to stay awake and are triggered by anxiety, stimulants, physical and emotional stress, and exposure to sunlight and artificial light.
You can prepare your brain for sleep by:
- Creating a relaxing bedtime ritual
- Read inspirational stories
- Listen to calming music
- Do breathing exercises 12
- Try this restorative body scan technique
- Consider running a diffuser with calming essential oils (e.g. lavender) 30-60 minutes before going to bed. 13 14
- Drink warm milk or herbal tea about an hour before going to bed
- Take a warm bath before going to bed
- Retraining your sleep-wake cycle
- Install the app f.lux on your electronic devices. It automatically reduces blue light emissions during regular sleep hours. Or better yet, turn off your electronics at least an hour before going to bed.
- Use low-watt light bulbs in your bedroom.
- Stick to a regular sleep schedule as much as possible. This can train your brain into a regular sleep rhythm.
- Most of us with chronic illness get very little sunlight. Try to expose yourself to sunlight 15-20 minutes every day. This is most helpful if done in the morning because it tells your brain it is daytime and time to wake up.
- If you have difficulty waking up in the morning, consider trying a sunrise alarm clock. 15
- Avoiding foods, drinks, and chemicals that stimulate the brain
- Avoid caffeine, alcohol, nicotine, and other chemicals that interfere with sleep. Many people with chronic illness are ultrasensitive to caffeine and even drinking a small amount in the morning can affect sleep at night.
- Limit sugar intake, especially in the few hours before bedtime.
- Avoid eating large meals before going to bed. However, a small bedtime snack consisting of a healthy fat and a carbohydrate can help prevent a blood sugar drop and early morning awakening. (Tip from my favorite nutritionists at Nutritional Weight and Wellness.)
- Talking it out
Pain can make it difficult to fall asleep and stay asleep. Also, poor sleep can make the body more sensitive to pain, creating a vicious cycle. One of the best ways to reduce pain at night is to make sure your body is properly supported by your mattress and pillow(s). You can properly support your spine and joints by doing the following:
- Using a supportive mattress
- Mattresses with obvious dips and defects are usually not supportive enough for your body and likely indicate it’s time for a new mattress. Most experts say a mattress’s lifespan is 7-10 years.
- In general, most people prefer a medium-firm mattress. Lying on your back with a pillow under the knees is usually the most comfortable position. If you have severe low back pain, consider placing another small pillow under your low back.
- If you do a lot of side-lying and have hip, knee, shoulder, or elbow pain, consider adding padding on top of your mattress and use a body pillow between your legs and arms to keep your spine from rotating. You may also benefit from a small pillow under your waist.
- Some people, especially those with disc-related low back pain, feel most comfortable sleeping on the stomach, on a firmer mattress with a low-profile pillow under the abdomen. (Otherwise, I don’t recommend sleeping on your stomach because it flattens the natural curve of the spine and puts additional strain on your back and neck muscles.)
- When purchasing a new mattress, make sure you try out various mattresses at the store, and confirm the return policy allows for at least a 30-day trial period.
- Making sure your pillow supports your neck
- Even if you don’t have neck pain, a supportive pillow is a must. The pillow should keep your head in alignment with your spine (see illustration). You don’t want a pillow that is too big or too flat.
- If you sleep on your side, your pillow should fill the gap between your mattress, head, neck, and shoulders. Check out this helpful guide: pillows for side-sleepers.
- If you sleep on your back, you should sleep on a thinner pillow with extra padding on the lower third of the pillow to fill the gap between your neck and the mattress.
- If you have neck pain, check out this helpful article: pillows for those with neck pain.
- Those with neck pain should avoid stomach sleeping.
- When purchasing a new pillow, make sure you are able to return it if it does not work for you.
Important Note: Some people with chronic illness are sensitive to the chemicals released by new products (off-gassing). If this is a concern for you, make sure to ask about this issue before purchasing a new mattress or pillow.
5An Undiagnosed Medical Issue Causing Poor Sleep
If the above tips aren’t helpful, you should schedule an appointment with your doctor to discuss your sleep. Some medications can disrupt your sleep and the dosing schedule may need to be modified by your doctor. Also, there are medical conditions (i.g. Obstructive Sleep Apnea, Restless Legs Syndrome, REM sleep disorder, thyroid disease, allergies with post-nasal drip, lung disease, heartburn, indigestion, hormonal changes) that can interfere with sleep. Your doctor may refer you to a sleep specialist who can perform a sleep study to identify the cause of your poor sleep.
These practical tips can help improve the quality of your sleep so your body has more time to repair itself and restore depleted energy levels.
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