Postherpetic Neuralgia Questions you Have….
Answers You Need!

 5 Steps to Managing Sleep Problems
Associated with Chronic Pain and Depression

Deep restful sleep is your best ally in coping with the problem of chronic pain and depression. Make this a major priority, and do everything you can to improve the quality of your sleep.

Sleep specialists speak of 2 kinds of sleep: REM (rapid eye movement) sleep and non-REM sleep. Dream sleep is REM sleep and occurs about every 90 minutes. It is the deep sleep we need to feel refreshed in the morning. Everything else is non-REM sleep

Sleep researchers don’t yet agree on the significance of the various stages of sleep, but I mention some of them here so you can understand and appreciate what may be actually happening to you.

If one does an electrical tracing of the brain during sleep, they will find four phases of sleep.

alpha waves – these are normally generated during waking hours.

delta waves – these are deep slow waves, and take up most of your sleep time.

In chronic pain conditions, alpha rhythms often intrude especially into delta sleep, disrupting your sleep. These alpha waves can either jolt you awake, or rouse you to a lighter level of sleep, depriving you of that feeling of being well rested.

Before considering a prescription sleep aid, here are 5 steps you can take to improve you ability to get more restful sleep.

1. Make Your Day Sleep Friendly:

Plan your day with the view of preparing for a good night’s sleep. To do this, establish a set of habits and follow them consistently.

a) Get out of bed the same time every morning, no matter how you slept the night before. You may have to use an alarm clock initially, but once normal sleep patterns are re-established, you will no longer need it.

b) Review the report “Here’s A Positive Way To Start Your Day.” This should help you set a positive tone for the day.

c) Do not nap during the day. Stay awake and keep busy.

d) Exercise regularly in the late afternoon or early evening – but not right before bedtime. Physical exertion is an excellent way to make your body tired so that sleep could come about more easily.

e) Take a hot bath (not a shower) an hour or two before bedtime.

f) Go to bed only if you are sleepy.

g) If not asleep in 20 minutes, get up and out of bed. Move to another room and read, watch television, or do something quietly. Return to bed only when you really feel sleepy. If not asleep in 20 minutes
get up and out of bed again. repeat this process as often as necessary.

2. Maintain an Attitude That is Sleep Friendly:

a) Learn to put your worries out of mind. Concentrate on pleasant memories and thoughts. Re-create a pleasurable time or event in your life, and relive it in your mind. Learning a relaxation technique
or the use of guided imagery could be extremely helpful in getting your sleep patterns back to normal.

b) In the evening or at bedtime, soft music or relaxation tapes produce a restful mind set.

c) When in bed, imagine that you are descending a stairway, going deeper and deeper into sleep. Some people use this technique successfully to put themselves to sleep. See if it works for you.

3. Make Your Bedroom Sleep Friendly:

a) Keep your bedroom comfortable, dark and quiet.

b) Use your bedroom only for sleep and sex – not for reading, working, eating, or watching television.

c) Do not sleep anywhere but in your bed.

d) Make sure that your bed is comfortable, the mattress firm and the pillows suitable.

e) Don’t let pets into your bedroom.

4. Use Foods and Medicines That Are Sleep Friendly:

a) Avoid high protein foods in the evening. They can block the production of serotonin, and interfere with your sleep

b) Do not eat ham, cheese, bacon sausage, tomatoes, potatoes, sauerkraut, eggplant or spinach close to bedtime. These foods contain tyramine which can stimulate the brain.

c) If you must eat something before bedtime, eat complex carbohydrates that are high in tryptophan, which promotes sleep. Eat foods such as whole grain crackers, nut butter, bananas, dates, figs, yogurt and milk.

d) Sugar can also make sleep elusive and unsatisfying as it acts as a stimulant. Avoid sugar in the hours after dinner.

e) Asprin and Ibuprofen (Motrin or Advil) disrupt sleep by increasing the number of awakenings, and the time spent in alpha-level sleep. Avoid taking them near bedtime.

f) Cold pills containing pseudephrine and nasal decongestants act like stimulants, making it difficult for you to sleep.

g) Caffeine is a stimulant, and can interfere with your ability to get sound sleep. Work on removing caffeine from your diet. Do it gradually, but do it. be aware the that caffeine is not just in coffee and tea, but in colas, chocolate, and many painkillers.

h) Many think of alcohol as a sedative, and a drink with dinner might relax you in the evening, only to awaken you in the wee hours of the morning.

i) Don’t drink a lot of fluids or take diuretics in the evening.

5. Use Natural Sleep Friendly Aids:

Melatonin – can sometimes help you sleep, but you have to use caution here. Synthesized melatonin is more likely to aggravate your depression, and often does not help with sleep problems. Start with 1.5 mg daily taken 2 hours or less before bedtime. If this is not effective, gradually increase the dosage until an effective level
is reached (up to 5 mg daily).

St. John’s wort – can help you get a better quality of sleep. It may take a week or so however for its effect to begin.

Inositol – 100 mg daily at bedtime, enhances REM sleep.

Vitamin B complex plus extra pantothenic acid 50 mg daily is good for relieving stress, and may help to produce a restful state.

PainBreak – use it as directed before going to bed. This may just give you the pain relief you need to fall asleep.

I realize that all this may take a lot of effort, but good sleep is worth any amount of effort to achieve.

Are you getting enough sleep? Use the following as a gauge.

Regardless of how many hours of sleep you get each night, if you wake up easily in the morning, and can make it through the day without seeming to run out of steam. If during the day you can sit quietly for a while, or read without feeling drowsy, you are probably getting enough sleep.

NEXT TIME: You will find out what causes shingles and PHN.