Sleep was previously one of the great mysteries of medical science. It has always been known that all animals need sleep to function and that we dedicate a third of our life to it (some of us are partial to even more than that), but exactly why we sleep was still a mystery. Thankfully, our understanding of sleep has significantly increased over the last decade.
People in Western societies and in particular those who live and work in major cities often report that they don’t get enough sleep. Sleep deprivation can lead to a lack of coordination, poor mental function and weight gain, while long term sleep deprivation increases the risk of heart disease, diabetes and even dementia.
Most importantly for us physiotherapists, when you are asleep your body can focus on repairing tissue damage. It’s fairly simple in that less sleep equals less time to recover and slowing rehabilitation can lead to the evolution of injuries going from minor to chronic.
There’s also increasing evidence that sleep deprivation not only slows recovery but may even be a cause of certain injuries, particularly back pain. Let’s take a deeper look.
A recent study followed people for two years and kept a record of various aspects of their wellbeing and lifestyle, including family history, blood pressure, level of activity, exercise and hours of sleep.
Of all these factors, the only one that predicted the development of lower back pain was people getting less than eight hours of sleep a night. It didn’t matter how strong they were, how flexible they were, what level of stress they had – it all came down to sleep.
Since learning about the correlation between poor sleep and lower back pain, we’ve made a point of ask patients suffering from chronic pain in their back or neck about their quality of sleep.
What we’ve often found is that – consistent with the study – people who are suffering from back or neck pain are often not getting enough sleep. There is, of course, always a chicken and egg situation when considering the role of sleep and pain.
Is the patient’s pain exacerbated by lack of sleep, or their lack of sleep caused by the pain? Then there is stress, another key component that may be impacting sleep.
Whatever the pattern of cause and effect, improving one’s quantity and quality of sleep is essential to recover from an injury. There are proven ways to improve quality of sleep beyond recommending people to reduce their stress – which is easier said than done.
One of the many stimulating effects of caffeine is that it blocks the chemical adenosine, which induces the feeling of drowsiness. This effect continues for around 4-6 hours after consumption.
If you have caffeine in the afternoon onwards, you interfere with the natural build-up of adenosine through the evening, making it more difficult to go to sleep.
While coffee and energy drinks have the highest levels of caffeine, there is also enough caffeine in black tea, green tea and sodas to interfere with sleep.
Using dimmer, warmer lights in the evening doesn’t just create a cosy ambiance, it also helps you to sleep.
One of the ways that your body recognises that it’s time to sleep is from light levels. If you surround yourself with bright lights, your body may respond as if it daytime, once again inhibiting the production of adenosine.
For calibration purposes, most screens emit light at the same colour temperature as sunlight. This helps produce a natural looking image but can also trick your brain into thinking it is daytime.
The content on these screens – whether they’re TV shows, social media or games – are usually highly stimulating as well, preventing you from “switching off” when it’s time for bed.
If you absolutely have to use a screen late at night, many devices come with a night shift mode which changes the colour temperature to be far warmer, which is believed to reduce the effect on drowsiness.
Finally, while a drink in the evening can be a good way to unwind, you shouldn’t use it as a sleep aid.
Alcohol can make it easier to fall asleep, but the actual quality of the sleep is reduced, limiting the benefits sleep provides and leaving you more tired the next day (amongst other things).
Improving your sleep is just one of the many ways that you can treat and prevent back pain.
Our whole-body approach to injury treatment examines all aspects of your health and wellbeing, along with thorough physical examination and precise exercise prescriptions.