Sleep, Pain, & Mental Health
Sleep is an essential aspect of our overall health and well-being. It is a time when our bodies can rest and repair, and when our minds can process the events of the day and consolidate memories. However, for many people, sleep can be anything but restful. In fact, poor sleep can lead to a variety of negative consequences such as fatigue, irritability, decreased productivity, mental health issues, and even increased pain.
One of the ways in which poor sleep can increase pain sensitivity is by leading to increased inflammation in the body. Inflammation is a natural response to injury or infection, but chronic inflammation can lead to a variety of health problems, including pain. Studies have shown that poor sleep can lead to an increase in pro-inflammatory cytokines, which are molecules that promote inflammation. This can further exacerbate pain and make it harder to manage. (1)
Another way in which poor sleep can increase pain sensitivity is by disrupting the body's natural pain-relief mechanisms. During sleep, the body releases natural painkillers called endorphins, which can help to reduce pain and promote a sense of well-being. However, if sleep is disrupted, production of these natural painkillers is also disrupted, which can lead to increased pain sensitivity. (2)
Moreover, poor sleep can also affect mental health, leading to increased symptoms of depression and anxiety. Studies have found that people with poor sleep quality are more likely to experience depression and anxiety. Additionally, sleep deprivation can also affect mood, cognitive function, and emotional regulation, making it harder to cope with stress and negative emotions. (3,4) It is important to note that sleep disorders and mental disorders coexist, and can feed into each other (5).
One of the most important strategies to improve sleep is to establish a consistent sleep schedule. Going to bed and waking up at the same time each day can help regulate the body's internal clock, making it easier to fall asleep and stay asleep. Additionally, creating a comfortable sleep environment such as keeping the room dark, quiet, and cool can also help to improve sleep.
Cortisol, a hormone produced by the adrenal gland, plays a crucial role in regulating the body's sleep-wake cycle. In the morning, cortisol levels rise, helping to wake us up and make us feel alert. As the day goes on, cortisol levels gradually decrease, making us feel more tired and ready for sleep. However, when cortisol levels remain high at night, it can disrupt sleep and lead to insomnia.
On the other hand, early morning sun exposure has been found to have a positive effect on sleep. Sunlight exposure in the morning helps to regulate the body's circadian rhythm by signaling to the brain that it is time to wake up. This, in turn, helps to regulate cortisol levels and promote healthy sleep patterns. Additionally, sunlight exposure in the morning has been found to increase the production of melatonin, a hormone that helps to regulate sleep, in the evening. A study published in the Journal of Sleep Research found that morning light exposure improved sleep quality and mood in adults with insomnia. (6) A second study published in the Journal of Clinical Endocrinology and Metabolism found that morning light therapy can improve sleep and reduce cortisol levels in people with delayed sleep phase disorder. (7)
An additional strategy to improve sleep is to limit exposure to screens before bedtime. The blue light emitted by electronic devices can suppress the production of melatonin, a hormone that regulates our sleep-wake cycle. Therefore, it's recommended to avoid screens for at least an hour before bedtime or use blue light blocking glasses. An alternative is to read from a paperback book or Kindle prior to bed.
Engaging in regular exercise is another way to improve sleep. Physical activity can help to reduce stress and anxiety, which can lead to better sleep. Additionally, exercise can also help to reduce fatigue, which can further improve sleep. It is important to note that exercise earlier in the day is preferred. Increasing your heart rate significantly at night through exercise may delay your sleep.
Practicing relaxation techniques such as deep breathing, meditation, or yoga can also help to reduce stress and anxiety, promoting a better quality of sleep.
It's also important to pay attention to what we eat and drink. Consuming a heavy meal or caffeine close to bedtime can disrupt sleep. Therefore, it's recommended to have a light dinner and avoid caffeine, nicotine, and alcohol, especially in the evening. Drinking too much water late in the day can lead to delayed sleep as well due to needing to use the restroom throughout the night.
Caffeine is tricky. Many people will say that they can drink coffee at night time and sleep immediately after. While this may be true, it is unlikely one will reach deep, restful sleep. The half-life of caffeine is about six hours. Because of this, it is best to stop drinking caffeine at noon to allow time for caffeine to get out of your system and allow for a deep sleep.
One helpful technique for sleep is the 3-2-1 technique. Three hours prior to bed, stop eating to allow your body time to digest before bed. Two hours prior to bed, start limiting fluid intake and stop all work duties to allow time for your mind to wind down. One hour before bed, stop looking at screens to limit blue light exposure.
In conclusion, sleep is an essential aspect of our overall health and well-being. By establishing a consistent sleep schedule, creating a comfortable sleep environment, limiting exposure to screens, getting early morning sunlight exposure, engaging in regular exercise, practicing relaxation techniques, paying attention to what we eat and drink, and creating a bedtime routine, we can improve our sleep and reduce pain sensitivity by reducing inflammation, leading to a better quality of life and mental well-being.
References:
Opp MR. (2017). Cytokines and sleep. Sleep Medicine Reviews.
Campbell CM, Bounds SC, Kuwabara H, Edwards RR, Campbell JN, Haythornthwaite JA, Smith MT. individual variation in sleep quality and duration is related to cerebral mu opioid receptor binding potential during tonic laboratory pain in healthy subjects. Pain Med. 2013 Dec;14(12):1882-92. doi: 10.1111/pme.12231. Epub 2013 Sep 18. PMID: 24102962; PMCID: PMC4104524.
Zhang J, Paksarian D, Lamers F, Hickie IB, He J, Merikangas KR. Sleep Patterns and Mental Health Correlates in US Adolescents. J Pediatr. 2017 Mar;182:137-143. doi: 10.1016/j.jpeds.2016.11.007. Epub 2016 Dec 7. PMID: 27939122.
Byrd K, Gelaye B, Tadessea MG, Williams MA, Lemma S, Berhanec Y. Sleep Disturbances and Common Mental Disorders in College Students. Health Behav Policy Rev. 2014 May 1;1(3):229-237. doi: 10.14485/HBPR.1.3.7. PMID: 25309939; PMCID: PMC4190836.
Sutton EL. Psychiatric disorders and sleep issues. Med Clin North Am. 2014 Sep;98(5):1123-43. doi: 10.1016/j.mcna.2014.06.009. Epub 2014 Jul 22. PMID: 25134876.
Lack, L., Wright, H., Lushington, K., & Hughes, R. (2010). Journal of Sleep Research, 19(4), 603–611.
Lewy, A. J., Lefler, B. J., Emens, J. S., Bauer, L. K., & Cutler, N. L. (2006). Journal of Clinical Endocrinology and Metabolism, 91(11), 4142–4149