There are a few key principles, supported by the evidence, to improve the amount you sleep and its quality.
This approach has been designed for people with sleep problems. It’s based on the connection between the way we think, the things we do, and how we sleep.
Living with pain makes our relationship with sleep even more complicated. Therefore, aspects of this approach to sleep won’t necessarily work for you and your life.
Sleep retraining doesn’t necessarily take into account how your pain condition affects your daily routine and activities.
As always, we will be guiding you through some changes you may want to make and offering suggestions on how to adapt them to suit you.
In this section we are going to explore:
- Habits during the day
- Avoiding stimulants
- Winding down before bed
- Your bedroom
- In bed
- Managing the difficult “passengers”
- Myth busting about medication for sleep
Much of this approach is about preparing yourself and your environment for sleeping. Small changes can make a big difference to how ready you are to fall asleep.
There are a few questions to ask yourself before making changes:
- Is improving your sleep important to you right now?
- Is this change something that is needed?
- Is this change better than an alternative?
- Are you confident that you can put this change into practice?
Start by picking the changes you’re most confident about trying.
Sleep is important, but if you can rest in bed at night, that is still valuable and can help restore your body. Sometimes, this might be the first step towards rebuilding your relationship with sleep.
Habits during the day
This section is all about building habits into your daily routine that can support your sleep. We know everyone is different, so tailor the advice to what will be workable for you.
Online Clinic Research shows that getting up at the same time every day can help to maintain a steady sleep-wake rhythm.
This may be difficult at first, but people with sleep problems can benefit from resisting a lie-in.
If this is a struggle for you, and you find yourself waking later in the morning or afternoon and staying up late at night, go slowly.
You may want to move your wake time earlier by 10 minutes every few days until you reach the time you want to wake up.
Everyone’s circadian rhythm is slightly different. You may be a “night owl” or an “early bird”. There isn’t a specific time that you should wake up, so pick a time that works for your life.
Using an alarm clock to wake up at the same time every day (even on the weekend) can help your sleep in the long-term.
Getting dressed every day can help separate day and night, and act as a prompt for sleep.
Your day clothes may just be different comfy clothes (or even just a different pajama top). It doesn’t matter what you wear, as long as you don’t wear the same thing to sleep in.
Once you’re dressed, getting daylight in the morning, ideally outdoors, can help our internal body clocks.
If you’re not able to do this, you may want to look at getting SAD (Seasonal Affective Disorder) lighting, which mimics daylight. Make sure to sit in front of the lamp as early in the day as possible to get the most benefits.
Moving your body and eating more of your food in the morning or the afternoon can aid your sleep by increasing the drive to sleep. Movement can also ease symptoms of other conditions, which may affect sleep.
If you’re hungry before bed, having a light snack can be helpful. Avoid eating large meals or sugary snacks before bed, as this lowers blood glucose and you may wake up hungry.
If you encounter a stressful situation, recognise it and take a few minutes to step back. This can break the stress cycle and stop it from building up.
If this isn’t possible for you, and your bed is a comfortable place for you, lying on top of the bed or turning the duvet so you have a “day side” and a “night side” may separate the times of day.
It might be hard at first to keep to a new routine but try it for at least 6 weeks and you’ll start to see the difference.
It’s important to give yourself enough time in the evening to wind down as well. If you’re still doing activities later in the evening, the time you have available to sleep will be less.
As you can see, setting yourself up for sleep begins when you wake in the morning. Changing your daily routine can change how you feel about sleep and going to bed.
What Is Fibromyalgia?
It goes without saying that stimulants will affect your sleep, but many people underestimate the impact of caffeine, alcohol, and nicotine on their sleep.
Caffeine can disrupt sleep and can also be a bladder irritant. Some people find cutting caffeine out from 3pm onwards helpful. Others who are more sensitive to the effects of caffeine may want to consider cutting it out altogether.
Be aware that lots of things might contain caffeine – tea and coffee, soft drinks, and chocolate.
Alcohol (a depressant) may initially help you to sleep but will often cause poor sleep quality. If you’re regularly drinking more than one or two units per night, or six units in one evening, this could be impacting your sleep.
Nicotine is a stimulant, so try not to smoke in the hour before bed or if you wake in the night.
Are any of these stimulants affecting your sleep?
Winding down before bed
At the end of the day, we don’t just get into our beds and instantly fall asleep – especially if we have trouble sleeping.
Transitioning from our day-to-day activities into sleep is difficult, so it can be helpful to have a wind-down period of relaxation and preparation to get you ready to sleep.
It’s suggested that this should be around an hour or more before going to bed. This may involve doing less stimulating tasks and not starting a task you cannot finish.
It might be getting into a routine of stopping what you’re doing or turning off the TV, locking the doors, getting into your pajamas, and brushing your teeth.
It can be helpful to include some of the following to help you relax:
- A relaxing bath at the start of the wind down period, not too close to your actual bedtime.
- Make a hot drink (caffeine free) and think about your day.
- Read a book.
- Noting 3 things from your day you are thankful for. Gratitude has been linked to better sleep.
- A mindfulness practice – there are a range of practices designed to support your sleep with this module.
- A relaxation exercise – find a technique that works for you:
- Visual imagery.
- A breath-based relaxation technique such as the 2-minute breathing practice
Please note: relaxation is a skill that requires practice to gain the benefits.
You may already have some great strategies to enable you to wind down – so keep doing them.
If you find relaxing before bed difficult, you may benefit from practicing a relaxation exercise for a few minutes at different points during the day.
It’s important that your wind down routine is relaxing. Sometimes people put so much pressure on themselves that it becomes stressful.
We have given you some suggestions about relaxing before going to bed, but remember, rest is whatever you find relaxing.
Having a nighttime routine, even if it’s only one or two tiny things, can become a signal that it’s time for bed and help make the transition to sleep easier.