Sleep

“Sleep is the best medicine”

-Dalai Lama

Poor sleep or lack of sleep has been shown to increase inflammatory cells in your body. If you are constantly living in a state of poor sleep you will be disposed to chronic inflammation and have a much higher level of inflammation in your musculoskeletal system. This means that tissue damage due to an injury or aging will be more inflamed compared to the person who has good sleep hygiene. More inflammation at the site of an injury leads to increased pain. Poor sleep also makes it more difficult to heal from an injury. Sleep is another factor we need to consider when exploring why one patient can have minimal symptoms and a quick recovery from a musculoskeletal ailment and another patient can become disabled. Making improvements in your sleep will not just help your orthopedic ailments but it will also improve other health problems such as heart disease, high blood pressure, diabetes, stroke, obesity, and mental health issues.

Some people can fall asleep easily, sleep through the night, and wake up refreshed daily. As we age, this becomes a rare occasion for many due to a variety of factors. If you feel that sleep is one of the issues contributing to your poor health I would commit to making some improvements. Unfortunately the answer is not usually in a pill, but rather in lifestyle changes. There is abundant information on the internet with articles, books, podcasts, and Youtube videos on how to improve your sleep. You could also consult with a doctor who specializes in sleep medicine if you fell that your sleep issues may be more serious. Here are some points that most experts will support.

14 Ways to Improve Your Sleep

Create a sleep schedule. Our bodies have a natural rhythm for sleep known as the Circadian rhythm. If you stay up late Saturday and sleep in late on Sunday you may have difficulty falling asleep on Sunday night and not get enough sleep heading into the week. Your body wants to go to sleep at the same time every night and wake up at the same time every morning. If you can routinely do this you will be more able to handle the occasional disrupted schedule. You do not have to be perfect; going to sleep and waking up at consistent times 70-80% of the week is what you’re aiming for.
If you have some money to spend, get a comfortable mattress and a comfortable pillow. Spending some money will be worth it in the long run. Most of us will spend 6-9 hours of the day in our bed. This is far more time than we spend in our car but most of us spend way less time researching our purchase of a bed than a car.
Make your room as dark as possible. Avoid artificial light almost completely. I say almost because you need to be able to move about your room safely if needed.
Keep your room cool. Your body temperature needs to drop 1-3 degrees to sleep comfortably. There are a number of ways you can do this ranging from having a fan, opening a window, and adjusting the air conditioning/heat to cooling blankets and temperature controlled matresses.
Avoid bright lights from screens before going to bed. These lights will disrupt your sleep rhythm and interfere with the body’s natural production of hormones that allow you to fall asleep and stay asleep. Blue light blocking glasses are available and could help your sleep if avoiding screens before bed is not possible or not your preference.
Drinking alcohol and most sleep medicines will interfere with your deep sleep. If you have a strong sleep routine, occasional moderate drinking may not be an issue but the routine evening drink could be contributing to your poor sleep. Alcohol is also a diuretic and may wake you up in the evening to go to the bathroom.
Most people need to avoid caffeine 8-10 hours before going to sleep. There are some people who are less affected by caffeine and can drink caffeine in the evening without it impacting their sleep. Another group needs to eliminate caffeine completely if they want a good night sleep. If you choose to intake caffeine, I recommend experimenting with the amount and timing to ensure it does not impact your ability to sleep.
Napping in the afternoon helps many people but you should likely limit the nap 10-30 minutes. As you get closer to 90 minutes you could go into a deep rest, wake up more tired, and interfere with your evening sleep schedule. Additionally, a good rule of thumb is to avoid napping after 5pm.
If anxiety is the cause of your sleep issues there are many sleep meditations available on the internet which could be helpful but ultimately you will need to work on both your anxiety and your poor sleep. Poor sleep increases anxiety, and anxiety causes poor sleep. It is a rough cycle and you would likely benefit from professional help.
Many people have increased energy and focus one hour before falling asleep. Go to bed at your scheduled time anyway. Do not get in the habit of binging shows, scrolling on your phone, finishing the book chapter, or completing the project because you feel awake. You will pay for it down the road.
Studies show natural sunlight aids in improving our sleep rhythms. Going outside in natural light 30-60 minutes after waking without sunglasses and then again in the afternoon or as the sun sets will improve sleep.
If you wake up frequently to go to the bathroom you may need to concentrate on hydrating the 10 hours after waking and limiting your fluid intake the few hours before bed.
Sleep medicines disrupt deep sleep similar to alcohol and are not without side effects. Some supplements can be helpful but you need to research what works for your body.

You will likely need to make the lifestyle and scheduling changes to see real benefits.

Sleep is critical to not just our musculoskeletal health but our overall health. Only recently have healthcare providers and researchers started to focus on sleep's relationship to health. Sleep is interwoven with the other baskets of health. If your nutrition is poor it could cause poor digestion and sleep disruption. On the other hand, poor sleep can interfere with your metabolism contributing to weight gain and increased inflammation. Exercise will improve your sleep not by just decreasing stress and anxiety but by making you tired at the end of the day. If you can not sleep some would argue working physically and mentally to exhaustion is the solution. However you will not see great results from exercise if you sleep poorly. Most importantly addressing sleep and anxiety go hand in hand. Both can be improved for optimum health.