Pain management session five

Sleep.

Week 5 started with a recap of last week which if you saw my review of week four, I didn’t attend due to a flare up which is slightly ironic.

The session in week four was about managing stress. The group talked about what they had learned. There was some physiology which included the fight, flight, freeze response of the body during stressful situations and the effects people notice such as muscle tension in the jaw, arms, chest, legs, hands and head. The effect histamine and adrenaline  has to increase responses and how breathing becomes faster and shallower. They went on to discuss changes in memory and libido. To finish there was a discussion  about the rest and digest response which switches off stress.

The quick Recap was useful for me as a reminder of some of the basic  physiology I  learned at nursing school many moons ago. But these recaps are also good for the group as a reminder of what they have learned and more importantly  remembered.  I should  imagine that it’s  also important for the leaders, so they know they are aiming the information at the right level of understanding.  

This  week was all about sleeping and pain and how sleep affects pain.

The problems the group  were experiencing  were not unusual.  The list below highlights some of their problems.

Tired in day.
Can’t get off to sleep.
Early waking.
Problems getting comfortable.
Waking at night.
Trouble getting up.
Unrefreshed sleep.
Napping in day.

The psychiatrist suggests there is a triad of symptoms which affect each other = sleep, mood and pain. Therefore if you can improve sleep hygiene, you can affect mood and pain positively. 

The little bit of physiology this week was a description  of  what  sleep is. She described it as an anabolic process to repair and recharge the body and brain. She talked a little about sleep stages but concentrated on REM (random eye movement) stage. During this period  the brain processes memories and emotions . REM acts as a Brain wash where it removes proteins and substances which may be detrimental if left.  This little  bit  of  neurophysiology was useful to understand why sleep is so important. 

We went on to discuss the best time to sleep and how much we need.  It turns  out we should  sleep when we are tired at night-time, who knew? The amount we need depends on age and on the individual, but normally about 6-8 hours. When, depends on whether you are an Owl or lark i.e. go to bed late and get up late or bed early anext rise early.  As the saying goes I am a permanently exhausted pigeon!!!

They went on to say that there are factors that influence sleep – Unsurprisingly these are stress, exercise and personal routine. So the suggestions are numerous to improve sleep hygiene and it will take 3 weeks until you see the benefits 

The top tips are as follows:-
1. Set alarm clock
2. Get 5 minutes of natural day light in the morning when having cup tea. A
3. Do some activity in the morning and structure your morning.
4. Exercise regularly. 
5. Routine i.e. bath at night 2 hours before bed and Switch off any      technology 1-2 hours before  bed.
6. Reduce stimulants like Caffeine, nicotine and sugar.
7. Alcohol changes sleep patterns during REM so Unsurprisingly-reduce.
8. Reduce food intake and any symptoms of indigestion before bed.
9. Ensure adequate fluid Intake but don’t drink too much before bed.
10. Ensure a relaxing environment.

Lastly don’t lay awake for more than 20 mins. Get up, relax, then try again. 

It is going to take a bit of effort but they are simple measures. Unfortunately having had another  flare up  since then. I’ve  been  napping in the day and not sleeping  well at night. It’s my flare  ups  which  cause me problems but I  have  to keep my eye on the goal which is to reduce flares. So we will see.