With chronic pain, achieving quality sleep is especially vital but additionally challenging. The relationship between sleep and well-being operates in a cyclical nature: Restorative sleep reduces your vulnerability to pain, which allows for better sleep, while poor sleep increases pain, further disrupting sleep.

Inadequate sleep also increases people’s vulnerability to emotional logic, diminishing their capacity to cope with pain and the difficulties that often arise with it. Yet, people with chronic pain are less likely to achieve a solid eight hours, and with pain conditions like rheumatoid arthritis or fibromyalgia, they may awaken feeling unrefreshed even when they do.


Parenting literature brims with suggestions about creating quieting rhythms and routines to lull youngsters to sleep. For nurtured children, the time preceding bed may involve a relaxing routine such as a warm bath, book reading and cuddling before an affectionate tuck into bed. Adults, however, may pay less attention to their own winding-down process, and simply collapse into bed, hoping for sleep to overtake them. Unfortunately, adults’ stress and worry can interfere with a peaceful transition to sleep — and physical pains, even minor ones, can interfere with com-fort and sleep.

Soothe Yourself

Think about easing into sleep as a process, and experiment with what helps. It’s easier to sleep when you are physically comfortable. Experiment with ways to develop a sleep-conducive feeling in the hours preceding bed. It may help to avoid stimulating activities, such as provocative conversations or exercise, and instead indulge in pleasant, relaxing activity, like a hot bath, gentle stretching, meditation or reading. A hot water bottle or rice bag on your pillow, calming music and sensual touch can turn bedtime into a retreat.



Promote a restful mind. When you suffer from an active mind, explore strategies, rituals or rules to prevent thoughts from thwarting slumber. For example, refrain from talk about work or worrisome topics after a designated evening hour. Writing out a “to do” or “worry” list before bedtime can also decrease anxiety. The act of recording your thoughts may allow you to release them so they do not free float in your mind, where they can disturb sleep. You may relax more easily, knowing that the list will be there in the morning when you are more ready to tackle it. Other helpful strategies include med-itation, slow deep breaths, self-hypnosis, guided imagery and progressive muscle relaxation.

The Tired Moment

Attend to your body’s signals. As you engage in your nightly rituals, note when you feel a “tired moment,”or urge to sleep. It is more restful to fall asleep quickly than to lie in bed waiting, watching the clock. For those taking nighttime medication, this may occur at a predictable interval after you take your pills. Test the timing of medication and entrance into bed to find what works best for a good night’s sleep. Plan your evening so that you are ready to lie down at the first sign of sleep readiness, rather than squandering this feeling on brushing teeth, changing into sleep clothes and so on. Experiment and find your optimal bedtime.

Create a Restful Environment

Think of your bedroom as a sacred environment. Is it your perfect sleep space? How could you improve it?


Light. If you crave darkness, hang darkening blinds or wear eyeshades or a sleep mask so that you perceive the room as dark. Or, you may want to “set your clock” each morning by allowing a flood of natural light to enter your window. Sound. The variation in noise level can be more disruptive to sleep than the sounds themselves. Because in most cases you cannot alter the noise around you — city sounds, a snoring partner or a wooded area that comes alive early in the morning — consider strategies to reduce its disturbing effects, such as wearing ear plugs, using a white noise or other sound ma-chine or running a fan. When possible, test the noise level of appliances while in the store.

Temperature. If you can control your thermostat, maintain the room at a comfortable temperature range. If not, improvise. You might adapt to a cold room with a plush duvet or comforter, or to a warm room with crisp cotton linens. Experiment with layering covers that feel right as you fall asleep but may feel too warm as the night goes on.

Humidity. Air that is too dry can interfere with sleep. Saline sprays or Vaseline can soothe nasal passages. Humidifiers and indoor tabletop fountains also work double duty: they alleviate dryness and provide a steady sound to block out random noises.


Your Dream Bed. Whether it’s a waterbed, memory foam or more traditional bed, conduct sufficient research to find the mattress that feels best to you. If you cannot afford a new bed right now, experiment with low-budget ways to upgrade your current system, such as by adding a sheet of egg-crate foam on top and a bed board underneath.

Your Dream Pillow. Having a pillow that is comfort able and supportive is as important as a good mattress. Pillows range in their filling, shape, intended position and the way they contour around specific areas. Some are advertised as ergonomic. Some are specifically designed for side-sleepers to place between their knees, or under their lower back, or supporting their upper arm, as well as full-length pillows — often recommended for pregnant women — that cradle the body. Some are marketed for jaw pain, low back pain, cervical pain, arthritis and a variety of other pain conditions. This specificity, however, is no guarantee; experiment to find your ideal arrangement. You may find that you prefer a makeshift placement of several flat pillows positioned just so, or rolled-up towel sup-porting your neck. Let your experience, and not the hype, determine what belongs on your bed.

Sleep Position and Location. The position in which you fall asleep can determine how you feel the next day. Experiment to see what position works best. Falling asleep on the couch, or while reading in bed, rather than in your ideal spot, can increase discomfort. It may take extra effort to position yourself, particularly when you are tired. Organize your schedule to increase the odds of a comfortable night’s sleep.


Finally, consider whether a sleep disorder may be aggravating your symptoms. When you suffer from a chronic condition, it is easy to attribute everything to that condition, even when a symptom may reflect something else. Talk with your doctor about any other experiences that may interfere with your sleep, such as frequent urination. Two common sleep problems are obstructive sleep apnea and periodic limb movements (or restless leg syndrome). Often, sufferers maybe unaware of any problem until their partner complains. If you have a bedmate, ask about any loud sudden snores or frequent kicks. If so, talk with your doctor. Treating sleep disorders will improve symptoms of pain, fatigue and fogginess; moreover, if untreated, sleep apnea can be dangerous. {PP}