Catch Your ZZZ’s – Release Your Pain:


Catch Your ZZZ’s – Release Your Pain:
The Importance of Sleep in the Battle Against Chronic Pain

February 26, 2008

Welcome to our Online Chat with Brenda Murdough MSN, RN-C, Military/Veterans Initiative Coordinator, American Pain Foundation. Brenda currently serves as the American Pain Foundation Coordinator of the Military/Veterans Initiative where she advocates for the pain management needs of veterans, military and their caregivers. In this position she provides information, education, resources and support to members of the military and veterans’ community that are affected by pain, doing outreach and collaboration with other organizations, and developing and supervising staff to assist with this work.

Brenda is also a pain management nurse specialist at the Cheshire Medical Center in Keene, N.H., where her duties include all aspects of patient care in the peri-anesthesia/pain management care setting including assessment, intervention, education and support of patients and families regarding Pain management and peri-anesthesia procedures. A member of the American Society for Pain Management Nursing, Brenda earned her nursing diploma from the Albert Einstein School of Nursing in Philadelphia, Pa., a Bachelor of Science, Management, degree from Keene State College in Keene, N.H. and a Master of Science, Nursing Education degree from Rivier College in Nashua, N.H.

Ms. Murdough will be giving a short presentation followed by a question and answer period.

Bmurdough: Hi all – I want to thank you for joining our discussion this evening. I know time is limited, so I’ll be giving just a few brief comments about sleep, some helpful tips to improve your sleep, instructions for a relaxation technique that might be helpful, and a few resources for additional information. Then we can have questions and discussion. No napping during this part. 🙂

Let’s define what sleep is – it isn’t just resting. It is an unconscious but arousable state. So laying in bed watching TV or reading doesn’t count, even though that may be relaxing or comfortable. Sleep is essential for all of your body’s functions to remain healthy and working properly, particularly your immune response and your cellular regeneration and repair. A lot is going on within your body while you sleep. But one of sleep’s primary roles is its restorative function. Muscles relax and rest. Blood flow improves. Nerves are quieted. Cellular repair takes place. Your immune system works during this time to fight disease and repair cells and tissues.

There are several stages of sleep within a 1 ½ hour cycle. It is essential that complete cycles which include all of the stages occur for restful, restorative sleep. Also, we need at least 3, but more likely 4-5 of these complete cycles every night to be well rested. So, by now you’re maybe thinking – sleep for 1 ½ hours straight and do it 4-5 times a night? 8-8.4 hours of sleep a night – I wish. I’ll never be rested! But we’ll get to that.

So what happens if we don’t get enough sleep? Well, you all can tell me – you know. Sleep debt disrupts our body’s natural rhythm or circadian rhythm – our natural clock or cycle. The restorative function of sleep is disrupted and optimal health is threatened. We feel sluggish, tired, and irritable, achy and sensitive. Our judgment is off and our coordination is affected. It effects us emotionally and socially – we don’t feel like doing our regular daily activities, we feel weak and maybe depressed. We are less active and don’t feel like socializing with our family or friends – we just want to sleep.

Does this sound a little like how a bad pain day makes you feel? So now you have daily pain and no sleep and all of the effects of one are compounded by the other. This is one reason why sleep is so important in a complete plan of care. It refreshes you for the fight. And if you don’t get enough, it can make the battle against chronic pain seem that much more difficult.

So what can we do to try to improve the quality and quantity of our sleep? Avoid substances that can disrupt your sleep cycle. They include caffeine – yes that after dinner cappuccino, tea, cola and chocolate. Smoking or nicotine can affect sleep. Alcohol, although at first may help you to fall asleep, disrupts the sleep cycle and awakening occurs. Avoid these for several hours before sleep. Maintain a regular bed and wake time, when possible – this promotes your body’s natural chemistry and circadian rhythm. Establish a regular bedtime routine. Remember when you used to put your kids to bed with a bath, a story and lights out? Well, a warm bath, light reading, relaxing music or mediation is a good practice for adults, too. Try “black out” curtains, eye shades, ear plugs or ‘white noise” such as a water fall or rain CD. Be sure to have a comfortable pillow and mattress, supporting any painful extremities. Create a quite, dark, temperature appropriate room. Cool temperatures may be painful for some persons and too warm may be painful for others. Exercise is a helpful component for pain management, but avoid this before bed time. Exceptions are Yoga or other stretching or relaxation exercises that may promote sleep. Avoid stimulating activities such as violent TV, controversial discussions or doing your taxes before bedtime. Use relaxation techniques such as soft music, aromatherapy, progressive muscle relaxation, guided or visual imagery and focused breathing to help you to fall asleep. And, one tip especially for women who are approaching menopause, the number one complaint in this group is….no, not hot flashes…but insomnia. So if you feel this might be contributing to your sleep problems, be sure to discuss this with your health care provider.

Keep a diary, like a pain diary except for sleep, to take to your next appointment so you can share it with your practitioner to see if a medication for sleep might be indicated. Always consult your health care provider before adding any medications to your regime as they may interact with those you already take.

Possible resources for information are:
The National Institute of Health-National Center on Sleep Research
The National Sleep Foundation

Here’s a quick Mini Relaxation Breathing Exercise you can try tonight. Remember that you cannot breathe deeply while holding in your stomach, so relax.

  • Begin to inhale, very slowly through your nose, counting one, two, three, four as you do this.
  • Pause for a few seconds. Then exhale slowly, counting four, three, two, one. Repeat several times.
  • You may close your eyes to better visualize the air moving slowly in and slowly out. Think abut dropping your shoulders into a relaxed position as you exhale out, releasing the tension. Repeat for several times.
  • Ok – Time to wake up… I’ve given you a few ideas about sleep to consider so now let’s hear from you – we often learn best from sharing our experiences. I welcome your comments, suggestions and questions.


The remainder of this article as well as the full original post can be found by clicking here.

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