Building a Good Nighttime Routine Considering Pain Management

One of the most commonly recommended tips for getting better sleep is to build a good nighttime routine; but, where do you start and what if you have chronic pain? Chronic pain and sleep do not compliment each other: “painsomnia” is real. Although a nighttime routine cannot solve the issues surrounding sleep and pain, it can certainly improve your ability to fall asleep, especially if pain management is part of the routine.

This article will explain how to build an effective nighttime routine that can help you fall asleep, incorporating elements of pain management. At the end of this article, you will know more about the association between sleep and pain, what to avoid and what to focus on before bed to get better sleep, and the key points that make a routine effective.

The Problem with Sleep and Pain

The main issue with sleep and pain is that they are interconnected. When you do not get enough sleep, it can make pain more intense, but when you are in pain, it is more difficult to sleep. This can create a vicious cycle where sleepless nights lead to pain which lead to more sleepless nights.

Conversely, quality sleep can act as a critical pain management tool. After a good quality sleep, you may notice you are better able to cope with your pain, or that your pain is less intense. For this reason, harnessing tools to work towards better sleep is essential. The first step is to build a good nighttime routine that you can stick to.

Building a Good Nighttime Routine

Your nighttime routine should focus on three key goals: promote sleep, discourage stimulation, and manage pain. The routine should be simple, and easy to repeat every night. You do not want it to be overly complicated, with too many steps, or stressful. It should be a routine that becomes muscle memory.

Promote Sleep

To promote sleep, engage in activities that are calming. How can you get ready for bed in a way that emphasizes relaxation and comfort? For instance, if you find taking a warm shower relaxing, you could take a warm shower, do your skin care routine, and get into cozy (but cool) pajamas. 

Before bed, do an activity that makes you sleepy rather than excites you. For example, rather than scrolling through TikTok videos on your phone in bed, try reading a couple pages of a book or listening to a calming bedtime story podcast.

The activities that make you sleepy will be specific to you. While some may find stretching relaxing, others may find it too stimulating. Try different calming activities to find what works for you!

Discourage Stimulation

To allow yourself to become sleepy, you must avoid all stimulating activities or environments. This includes bright lights, loud sounds, caffeine or nicotine consumption, etc.

Take inventory of everything in your space that could be potentially stimulating. Plan to disengage from these things a couple hours before bed. Your goal is to ensure that you will not be stimulated or energized by the time you get in bed.

For example, do you have very bright overhead lights? One part of your nighttime routine could be to go around your home and turn off the overhead lights, opting for dim lamps instead.

Manage Pain

As someone with chronic pain, a key element of your nighttime routine should be to manage your pain before bed. Adding this extra care into your routine can help ensure that your pain is less likely to keep you awake or wake you up prematurely.

Take a moment to reflect on ways in which you could reduce your pain overnight. What works for you will be very specific to your needs and condition(s).

Here are some ideas:

• Gentle stretching to release tension
• Meditate to release anxiety
• Take your meds at a certain time to ensure your pain will be managed overnight
• Create a supportive pillow structure in bed
• Give yourself a foot massage
• Hydrate and eat a very light snack
• Practice progressive muscle relaxation exercises

Stay Consistent

The most important aspect of your nighttime routine is to stay consistent. Do this everyday if you can at around the same time, in the same order. Eventually, with enough repetition, you begin to train your brain to associate these activities and timing with becoming sleepy.

Overtime, as you build this association, falling asleep will become increasingly easier.

In Conclusion…

A solid nighttime can help prepare your body for sleep. With enough repetition, this routine can cue your brain to get sleepy. Adding elements of pain management into this routine ensures you are doing what you can to combat painsomnia each night.

If you found this article interesting and/or want to learn more about getting better sleep despite pain, check out our I-Engage Academy eLearning course: Sleep and Chronic Pain. It discusses the science of sleep, how pain and sleep are connected, and strategies to get better sleep. Sign up for a free I-Engage Academy membership to access this course: here.

References

Gupta, C., Sprajcer, M., Johnston-Devin, C., et al. (2023). Sleep hygiene strategies for individuals with chronic pain: a scoping review. BMJ Open. 13(2). DOI: https://doi.org/10.1136%2Fbmjopen-2021-060401 

Harvard Medical School. (2016). How to sleep well despite chronic pain. Harvard Health Publishing. Retrieved from: here.

Healthwise. (2022). Improving Sleep When You Have Chronic Pain. HealthLink BC. Retrieved from: here.

Michael G. DeGroote Pain Clinic. (2017). Chronic Pain and Sleep. Hamilton Health Science. Retrieved from: here.

Pain BC Society. (n.d.). Sleep Factsheet. Pain BC. Retrieved from: here.