What does SLEEP have to do with pain perception?
The answer is…EVERYTHING!
We often ask one another “how did you sleep?” But have you ever wondered WHY we ask this question? Or more specifically, WHY do we need sleep? Other than the obvious feelings of being rested and re-energized, sleep plays a vital role in brain health and therefore, central nervous system function.
Our bodies regulate sleep in the same way they regulate eating, drinking and breathing! We cannot survive if our body is without any one of these. Therefore, sleep serves a similar critical role in our health and well being as these other life-sustaining activities. When our bodies have regular and sufficient sleep, we feel better, have increased energy, are more alert and have better concentration. We are happier and better able to function in general. Anyone who has ever been sleep-deprived can attest to this.
When my daughter started kindergarten, I took a job working 12-hour night shifts at a hospital so I could have more time with her instead of being gone for 12 long hours during the day. I was a newly single mom at the time and coordinated my sleep/work schedule with her father. I often joke with other nurses and say; “I basically have no memory of that year of my life!” It seemed like a blur or as if I was moving in slow motion at times. I often had trouble concentrating and remembering things, regulating my body temperature, and was ALWAYS craving carbohydrates! I lived in a state of sleep deprivation and was often awakened by my daughter saying “Mommy, Mommy, Mommy” when we would try to watch a movie or go to the local pool together!
Theories of Sleep
The Inactivity Theory shows that animals that are still and quiet at night have an advantage over animals that remain active. They also have less accidents and injuries.
The Energy Conservation Theory states that sleep aids in reducing energy needs for times when food is scarce or when hunting is not ideal or difficult. Research shows that during sleep, energy metabolism is significantly reduced (as much as 10%), allowing us to conserve energy as well as resources if necessary.
The Restorative Theory shows that with sleep, we “restore” what is lost in the body while we are awake. This provides the opportunity for the body to repair and rejuvenate itself. Animals who have been deprived of sleep entirely lose all immune function and die in a matter of weeks. Some of our body’s major restorative functions that happen during our sleep cycle include muscle growth, tissue repair, protein synthesis and release of growth hormone.
The Brain Plasticity Theory shows the correlation to changes in the structure and organization of the brain, which is called plasticity. A great example of the importance of sleep here is the critical role in brain development in infants and young children. Infants sleep 13-14 hours per day and about half of that time is spent in REM (rapid eye movement) sleep.
How Sleep Affects Pain
Sleep research has shown that sleep is a largely “brain-focused phenomenon.” Going without sleep will literally make you psychotic and eventually, kill you. Clearly, sufficient sleep is crucial to the body’s ability to function physiologically, but also critical to function physically, mentally and emotionally. People who are sleep deprived struggle with choosing what to pay attention to and with regulating their emotions. Sleep deprivation adversely affects the immune system and alters hormone levels in the body; however, the most consistent impact shown in animal studies is in the brain. The central nervous system is ALWAYS impacted by sleep.
Sleep restores the brain’s energy and enables it to clear out toxic products produced when we are awake. The brain is a huge consumer of energy, which means it also produces a lot of waste. While we are awake, neurons in the brain produce adenosine, a by-product of the cells’ activities. This build up of adenosine may be one factor that leads to our perception of being tired. Kind of a warning system that tells our body “time to power down and clean up” driving us to sleep! During sleep, the body has a chance to clear adenosine from the system, and as a result, we feel more alert and awake.
Sleep affects synapses between neurons in the brain by strengthening them and allows the brain to use sleep to adjust to changing inputs. We have special sensory neurons called nociceptors whose job it is to tell the body “this feels bad,” otherwise known as “pain.” The spinal cord is a large bundle of nerve fibers located in the back of the brain and extends from the base of the brain to our lower back or “tailbone” area. The spinal cord’s main job is to carry messages from the brain to the body.
In the middle of our brain is the parietal lobe; this lobe is involved in interpreting pain and touch in the body. The “path of pain” registering in our body goes like this: pain felt via cut, burn, trauma etc. >>> message to spinal cord >>> neurons activated >>> input to brain and parietal lobe >>> message to brain stem >>> activation of thalamus and hypothalamus, which produce hormones that provide alertness which allows us to respond or “take action” on the pain perception.
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As you can see, our processing of pain occurs almost entirely in the brain. A body that has poor quality of sleep or is sleep deprived will clearly have difficulty perceiving pain effectively. Interruption of this process will occur either by neurons failing to communicate or “synapse” due to toxic build up of waste in the brain and/or by interruption of the entire cycle leading to failure in activating the thalamus and hypothalamus, which allow our body to properly respond and take action on pain. This may be one of the most important factors contributing to Fibromyalgia and chronic pain syndrome, as well as related symptoms such as chronic low back pain, migraine headaches and depression.
The exact amount of sleep needed in a 24-hour period varies slightly from person to person, but most healthy adults need between 7-9 hours to function at their best.
Tips for getting your BEST SLEEP
Sleep hygiene refers to a variety of different practices and habits that are necessary to have regular, good night’s sleep and quality daytime alertness.
One of the most important practices is to spend an appropriate amount of time asleep in your bed. Here are some things that will help you achieve this.
- Use your bedroom ONLY FOR SLEEP or intimacy. Not for working or any other projects or activities.
- Go to bed at the same time every night and wake at the same time every morning. It is so important to get in this habit to set your body’s internal clock so you will begin to naturally “want” to go to sleep and “want” to wake up. There is no benefit to “sleeping in” for more than an hour, or “catching up” on sleep unless you are sick or injured.
- Establish a bedtime routine or ritual such as a warm bath 1-2 hours before bed, light stretching, yoga, reading or meditation. Stick to your routine! Your body and brain will begin to expect this and automatically start to power down.
- Make sure you are exposed to at least 20-30 minutes of sunlight each day and darkness at night. Before we lived in a world with constant lights on from electronics such as computers, cell phones, televisions and iPads, our brain would get the signal from our eyes to naturally “power down” as the sun started to go down.
- Do not keep electronics such as televisions, computers and cell phones in your bedroom. If you do use these electronics, be sure to turn them all off at least 1 hour before you go to bed.
- Keep your bedroom dark and cool with black out curtains. Try to maintain a temperature between 62-69 degrees when you sleep.
- Use white noise machines or an oscillating fan to help block out external noise.
- Limit daytime naps to 30 minutes or less.
- Avoid stimulants such as caffeine or nicotine at bedtime and avoid excessive use during the day.
- Exercise during the day (even 10 minutes a day) such as walking, cycling or yoga to help promote good sleep.
- Stay away from foods that can be disruptive right before sleep such as heavy or rich food, spicy dishes, citrus fruits and carbonated drinks that can trigger indigestion.
- Avoid eating 2 hours before bedtime and especially avoid going to bed with an over-full stomach.
- Your mattress, pillows and bedding should be clean and comfortable
- Avoid emotionally upsetting conversations and activity before bed.
Frequent sleep disturbances and daytime sleepiness are the most telling signs of poor sleep hygiene. If you experience difficulty sleeping, review your routine and rituals (or lack thereof) and adjust as needed. Most importantly, be patient and kind with yourself when creating these habits or routines. It takes time, patience and persistence to change habits we have had for a long time or to introduce change. Finally, trust the natural process that is innate to your body and commit to creating quality sleep and sleep hygiene for yourself.
Sleep Hygiene 
Lisa Adams is a Certified Flowtrition Practitioner, nurse and health and wellness educator who has combined over 24 years of experience as a registered nurse with training in Flowtrition as well as therapeutic massage and bodywork to provide her clients with the most comprehensive and holistic approach to preventive healthcare. Lisa believes that wellness starts from within and that if we have trust in our body’s ability to heal as it is designed, amazing things happen. She also believes that optimal health is achieved in a multi-system approach that includes body, mind and spirit. Lisa’s passion to increase awareness in individuals about the way their body functions.
“The body cannot begin to heal while in a constant state of tension.”
~ Lisa Adams ~