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TUCK Advancing Better Sleep has some very interesting guides on how people with chronic pain and fibromyalgia can deal with fatigue, sensory and mobility issues in the bedroom, and pain-related insomnia. One of the first ones I am going to feature here is How Does Pain Effect Sleep.
Arthritis, fibromyalgia, and gout keep people awake. Back pain, headaches, menstrual cramps –all sorts of painful maladies leave sufferers less able to fall asleep or stay asleep. Sleep is often a respite from pain but if the discomfort is so strong that the person cannot sleep, the juxtaposition is a special irony.

It’s estimated that 50-80% of chronic pain patients report sleep disturbances. The worst is when pain and sleep loss get into a downward spiral of awfulness, leading to a low quality of life. Pain makes it hard to sleep, poor sleep makes the pain subjectively worse, and both lead to depression, which also affects sleep disorders and pain experience. Cognitive behavioural therapy is a possible solution for both living with pain and alleviating problem sleep.

Pain medication has a profound influence on sleep, even aside from its analgesic effects. Opioids fragment the sleep cycle, even though it may subjectively seem to the patient that the sleep is better, at least in the short run. Over-the-counter pain meds like ibuprofen and aspirin also affect the sleep cycle, although not to the same extent. The effect is not uniformly bad, of course, if the pain medication lets the person get to sleep. They put me on Nortriptyline to help me sleep but I must admit I do also take a couple of herbal relaxants as well. It was mentioned at my last pain meeting that maybe I should try and come off the Nortriptyline as it does have some nasty side effects. I had more important drugs to cut down on (Tramadol) so I left this for a later date. By accident, I completely forgot to take them one-night last week and I had the worst pain and slept very little so I am in no rush to change my routine on what I take to help me sleep. 

They say people with insomnia are more likely to have chronic pain than those without. Experts estimate 25-40% of patients with chronic pain have insomnia, many times the rate among those without. Does pain make the sleep worse or does poor quality sleep degrade make the pain feel worse? Both. Don’t discount the effect that a good night’s sleep can have on a person’s quality of life and ability to tolerate pain. The subjective intensity of pain decreases when a person is well-rested. Hyperalgesia – increased sensitivity to pain – is a result of loss of sleep, especially the loss of REM sleep. Which is ironic, because the opioid drugs used to treat severe pain suppress REM sleep and may make patients more sensitive to the pain they feel. Antidepressant drugs also suppress REM sleep and make us complain about pain more (maybe this is partly the cause of the stereotype of the diva). Poor sleep quality is correlated with more severe pain and increased fatigue.

Rheumatoid arthritis patients complain about sleep problems often and the sleep difficulty and the pain support each other in a vicious cycle. It’s well known there is a connection between pain and mood. And between depression and sleep disorders. Researchers studied arthritis patients using the HAQ-pain scale, the Beck Depression Inventory-II, the Medical Outcomes Study Short Form – 36 vitality scale for fatigue, and the Pittsburgh Sleep Quality Index for sleep quality and disturbances. They found that poor sleep quality was correlated with disability in arthritis patients.

Scientific article: Sleep Quality and Functional Disability in Patients with Rheumatoid Arthritis

Lower back pain as I know only too well is known to affect sleepboth the quality and sleep latency. The Mayo Clinic website has interesting pictures of sleeping positions that may help reduce back pain. Recognizing that pain and sleep disorders often go hand-in-hand, the pharmaceutical companies have introduced combination drugs– over-the-counter pills that include both an aid (an antihistamine) and an analgesic.

The topic of pain and sleep is tied closely to that of ageing and sleep. A much higher percentage of seniors experience chronic pain than young and middle-aged adults. A much higher percentage of seniors experience sleep disorders, too.


People have reported pain during their dreams that isn’t real pain – it’s dream pain – and vanishes when they awake. More common is real bodily pain that could be felt if the person was awake but which was incorporated into the narrative of the dream. Vivid narrative dreams happen when the brain is in REM sleep and during REM the skeletal muscles are paralyzed. This paralysis may contribute to bodily pain and make it worse than in NREM sleep when the body can more easily move around.

Psychologists did a test where they induced a mild pain in sleepers in the REM stage of sleep. Upon awakening, the subjects often reported dreams (about 30%) that included pain in the same part of the body that the researchers applied pressure to. The subjective level of pain during the dream tended to be higher than the pain when the person was awake. Curiously, burn patients report about the same percentage of pain dreams even though the level of pain they experience is much higher than the subjects in the psychologists’ tests.


Loud or unpredictable noises fracture sleepers’ rest, sometimes causing awakening, and sometimes triggering a shift to a different stage of sleep. The noise that disrupts slow-wave sleep leaves people waking to feel unrefreshed and often with diffuse pain and tenderness, even in healthy people. I can honestly say that I am quite sure I can even hear a pin drop.

Individuals have different responses to noise, of course. Researchers have even figured out how to predict who will wake up from noises, based on electroencephalography (EEG) readings.  People who have more sleep spindles on the EEG readings during a normal night of sleep have more tolerance for noise.  In other words, people who have more active brains when asleep tend to sleep better when it is noisy.

White noise – a constant hum in the background at low volumes – can help some people sleep. Presumably, this is because the noise drowns out softer unpredictable sounds.  There are commercial products that generate white noise that some find helpful and others use humidifiers partly because of their constant hum. White noise can induce sleep in infants.

Rain helps improve the subjective quality of sleep for many. You have probably heard people tell you they slept great because of the rain. This may be due to a combination of the white noise generated during the rain (but not in a thunderstorm), a sudden reduction in outdoor temperature, changes in the electrostatic characteristics of the air. Further, the “fresh” air following rain – perception of coolness, sweet smelling air, low particulate account – is conducive to sleep.

Aircraft noise disturbs sleep and when bad enough can result in sleep-deprived behaviour during the day. The WHO claims 1 in 3 Europeans suffers health harm from excessive traffic noise (cars, planes, etc.).  20% of Europeans are said to be at risk for significant health damage from nighttime noise. A Korean study found railway traffic was more bothersome and problematic for sleepers than automobile traffic.

What about birdsong and the natural sounds of the morning?  Many find these sounds pleasant when they are relaxed and report they enhance the sleep experiences around dawn when the sleeper is often in REM sleep.

A related issue is the effect of rocking on sleep.  Parents rock babies to sleep and some baby cribs are set to rock.  People enjoy sleeping in hammocks that can rock.  Is there the scientific explanation of that?  A Swiss study found the rocking at 0.25 Hz facilitates and transition from stage 1 to stage 2 sleep.  The density shown on EEG reports increases when the sleeper is rocking.


What does it mean to say someone is a sound sleeper? Or that you slept soundly? One thing it means is that the sleeper does not wake readily from noises. “Resistance to acoustic disturbance” is a measure of the depth of sleep, and it varies over the course of the night. How likely we are to wake up from sleep in response to noise varies throughout the night and even within any given stage of sleep. In deep sleep, we are less apt to be awakened from external noise. Spindle activity in light sleep seems to be a measure of how sound (less sensitive to sounds) we are.


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I’ve read many articles in the past on how light is important to health and can effect mental health in a positive way.

In an article in Forbes they said that ‘Bad lighting is associated with a range of ill-health effects, both physical and mental, such as eye strain, headaches, fatigue and also stress and anxiety in more high-pressured work environments. … A third (32%) said better lighting would make them happier at work.’

However, lighting can come in through lots of different ways but daylight is the key to the best lighting. Healthline wrote that ‘Decreased sun exposure has been associated with a drop in your serotonin levels, which can lead to major depression with seasonal pattern. The light-induced effects of serotonin are triggered by sunlight that goes in through the eye.’

So how can we get a good light into our homes now the days are getting shorter? There are special ‘Sad Lightswhich have been around to help people suffering from the condition Sad (Seasonal Affective Disorder). But direct light from outside is the perfect pick up.

The colour palette inside your home and the right discounted windows is what has made the biggest difference for me personally. As most of my readers know we moved three months ago from the East Midlands to West Sussex. We down sized big time and bought a small new build.

Our old home had the biggest windows at the back of the house and my husband was quite anxious about whether our new home would be much darker but it couldn’t be further from the truth if you have the right windows and colour scheme in your home.

The right discounted windows like our small ones work perfectly with white walls which I am sure help light reflect throughout. Every friend that has been to see us has commented on how light our house is even on a dark day.

My bedroom is my sanctuary and has two windows which I have had fitted with Venetian blinds mainly for privacy but I decided on white for most of the windows and it’s still lovely and light. We’ve bought curtains for our bedrooms but haven’t rushed to get some for downstairs and have now decided we won’t bother as we just love the light streaming in and it’s still cosy when it goes dark.

Artificial light can change your sleeping pattern from the natural rhythm of two four-hour phases broken by an hour of wakefulness to a single eight-hour phase each night and disrupts your circadian rhythm. That’s why it is important that you use as much natural light as possible. Opening up your windows and curtains and light darker areas of your home with lamps that emit natural light. My regular Sunday post Sleep Sunday, Let’s Talk About Sleep explains lots of ways to help you sleep which is so important to any chronic pain sufferer.

They say that bright colours are happy colours for your home and can boost communication so are especially welcome in the dining area and kitchen but you can get your happy colours in accessories instead of painting all your walls.

I decided I would give each room its own accent colour and it certainly works for me. My lounge has royal blue as it’s accessory colour which I introduced by adding cushions, plant pots and pictures that have some blue in them. My kitchen’s access colour is grey and green. Upstairs my guest bedroom’s accent colour is also green which is really popular this year and our bedrooms accent colour is grey and pink which is peaceful and cosy.

The brightness in my new home has certainly lifted me over the last three months. I hope you enjoy some of my images of our cosy new home. Do comment and tell me what your favourite colours for the inside of your home are.