Bright Lights, Dim Prospects & Daunting News

One of the basics of sleep hygiene is to sleep in a darkened room. Kind of a no-brainer.

However, what is a common reason people wake up in the night? If you’re like me, it’s often to go to the bathroom. Where are the brightest lights in your whole house? Likely the bathroom. Imagine the signal these bright lights are sending to your sleep systems?

Maybe you wake up for some other reason and next thing you know, you’re scrolling on your phone. Many are aware there’s a way to switch it from Light to Dark mode so perhaps the light won’t interfere with you getting back to sleep – too much.

Yet, what is the content you’re reading? Is it news? Social media? Is it something that might alert or arouse your nervous system or thoughts… late at night? Both, seem to have a way to wind things up for many.

These are a few of the things we will be exploring in Rest & Restore: Strategies for Sleep that begins Feb 16th. Each Tuesday night we’ll dig into some of the research around sleep. Then, explore some practices to help calm your sleep systems or change some unsupportive sleep patterns. Add in some quiet time and finally an opportunity to ask questions, connect with others should that be of interest you.

Though the sessions will be on Zoom, if you’re not a Zoom user or are experiencing Zoom fatigue, everything will be available for you to view on your own schedule, at your own convenience on the Teach:able platform.

The chicken or the egg?

This question about what comes first. The onset of chronic pain (and/or other conditions) from sleep disturbance or the relevance of sleep disturbance due to chronic pain?

Here’s some of what we know about sleep …

Sleep complaints are present in 67-88% of chronic pain disorders and at least 50% of individuals with insomnia – the most commonly diagnosed disorder of sleep impairment – suffer from chronic pain. Further, both chronic pain and sleep disturbances share an array of physical and mental health comorbidities, such as obesity, type 2 diabetes and depression.” 1

One study found that “women who endorse frequent, “sleep problems,” defined as frequently difficult falling asleep or having a sleep disorder, were significantly more likely to develop fibromyalgia 10 years later.” 2

Also, in another how “sleep disturbance temporally preceded increases in pain, … in “temporomandibular disorder (TMD).” 3

Similar research is being conducted in terms of cancer pain, for depression, PTSD and ageing (including Alzheimer’s and dementia).

I knew poor sleep to be a contributing factor for people who live with chronic pain. What I didn’t know was how it affects not only physical health but mental health.

What’s piqued my interest is in new studies where a trend has emerged suggesting that sleep disturbance may be a stronger predictor for pain than pain of sleep disturbance.” 4

…several longitudinal studies convincingly demonstrate that insomnia symptoms significantly increase the risk of developing future chronic pain disorders in previously pain-free individuals, whereas existing pain is not a strong predictor of new incident cases of insomnia.” 5

Not just a stronger predictor for pain, but also in terms of mental health conditions.

This bidirectionality or said another way, “what came first, the chicken or the egg?”

Lots of studies to examine obviously, but here’s one on the positive side “Quality sleep has also been shown to predict chronic widespread pain symptom resolution over 15 months.” 6

Researchers will continue to find out more and doctors will refer out to specialists in many areas. Pretty much the gold standard for treating insomnia now is CBTi or Cognitive Behavioral Therapy for Insomnia.

Yet, there are things you can learn to do for yourself, that will help.

Curious about this? Exploring some practices, tools and gaining resources that can support you in getting a better night’s sleep. What stress and the nervous system have to do with sleep? Or how you might find rest during the day?

I’m offering a 4-week workshop starting Feb. 16th at 7:30pm ET.

You’ll have some time and space to explore, experience what might be helpful for you all in the comfort of your own home. Online. Change into some comfy clothes, grab a warm cup of herbal tea and join in. Anyone can follow along. We’ll be rolling on the floor a little, expending energy maybe by rocking and swaying, taking some breaths together. And learning “all the things your parents/doctors/friends/colleagues never told you… about sleep.” There’s a lot more to it than just laying your head down on a pillow, each night.

References:

  1. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  2. Mork PJ, Nilsen TI. Sleep problems and risk of fibromyalgia: longitudinal data on an adult female population in Norway. Arthritis Rheum. 2012 Jan;64(1):281-4. doi: 10.1002/art.33346. PMID: 22081440.
  3. Quartana PJ, Wickwire EM, Klick B, Grace E, Smith MT. Naturalistic changes in insomnia symptoms and pain in temporomandibular joint disorder: a cross-lagged panel analysis. Pain. 2010 May;149(2):325-331. doi: 10.1016/j.pain.2010.02.029. Epub 2010 Mar 31. PMID: 20359824.
  4. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  5. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007
  6. K. A. Davies, G. J. Macfarlane, B. I. Nicholl, C. Dickens, R. Morriss, D. Ray, J. McBeth Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology (Oxford) 2008 Dec; 47(12): 1809–1813. doi: 10.1093/rheumatology/ken389

You’re not sleeping either?

woman in red long sleeve shirt sitting on chair while leaning on laptop
Photo by Andrea Piacquadio on Pexels.com

Did you know “chronic insomnia is highly prevalent and affects approximately 30% of the general population?” 1

Or, that “approximately 40% of adults with insomnia also have a diagnosable psychiatric disorder – most notably depression?” 2

That “sleep complaints are present in 67-88% of chronic pain disorders?” 3

I was aware of the third statistic, that sleep can be a contributing factor for people living with chronic pain. But why my interest in sleep, generally? I had (mostly) been a good sleeper yet started to experience disruptions to my sleep patterns over the past few years. Along came menopause and similar to many others I found myself in a cycle of wakefulness around 2, 3, 4 in the morning and went looking for solutions.

Last fall, however, something else happened. On a Facebook page I belong to, the subject of sleep was brought up. Well, the lack thereof.

I was curious if it was only menopausal women who were struggling with sleep, so I created a random poll. Within an hour or so, there were hundreds of responses.

  • 404 responses
  • 74 comments about issues with sleep.
  • 224 neither menopausal or perimenopausal
  • 95 perimenopausal
  • 51 menopausal
  • 34 ‘other reasons’

Clearly a problem for many but I was surprised to learn that it wasn’t only my age group challenged by this issue. The poll wasn’t scientific and could just reflect the ages of people in the Facebook group. Yet, wow!

Of course people will at times need specific diagnosis, treatment and care from healthcare professionals. Yet, digging into some of the research and after some of the behavioral or environmental factors are addressed with general sleep hygiene information, a lot of what affects sleep has to do with stress and the nervous system (and other systems… circadian, homeostasis, etc.). Which you can learn to influence and modulate.

Would you be interested in exploring this thing called sleep? Safely, gently, with compassion and care you’ll get to experience and learn what might be helpful for you. In your own home, cozy in your pajamas … having some time and space to do so.

A 4-week workshop Rest & Restore: Strategies for Sleep starts Feb 16th!

What are the many factors or contributors that affect sleep? What does the research tell us? What can you do during the day, that will affect your sleep at night? What can you do when waking up from sleep? How might you find some rest in the day, if your sleep wasn’t that great?

If you’d like to join in, registration is now open.

I’ve tried to make it affordable at just $20 each week. If finances are really tight, reach out to me at info@yogatoolsforlife.com. If finances are plentiful, please reach out as well and look to sponsor someone else.

I’d love for you to join in. Experience and learn what might can be helpful, for you.

References:

1. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

2. Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med. 2007;3(5 Suppl):S7-S10.

3. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007

Just, Calm Down

It was probably my first year as a yoga teacher, 10 years ago now, when I had a student in my class I so clearly recall would get up and leave as soon as it was time for Savasana. I’ve been trying to remember what I offered her in terms of advice but it escapes me now. Likely, I didn’t have much to offer. Yet I did empathize and understand why she left, unable to stay in this ‘corpse pose’ as it’s often called.

Ask the same of people when they are told to “just” sit still and meditate. Particularly if they’re experiencing anxiety, or high levels of stress and notice what happens.

Or telling a young child having a full-blown meltdown to “just” calm down.

The last thing anyone can do in these moments is calm down. There are likely to be many reasons for the state in which people find themselves and can’t calm themselves, but the ‘state’ is the important piece.

If someone is in a state of arousal, a natural nervous system response, telling them to do the opposite may not be helpful. It might add to the stress or leave them feeling ashamed about not being able to control their emotions or behavior. All this movement, powerful breathwork (sobbing), yelling, screaming, stomping of feet, tossing and turning the body in an attempt to express feelings and emotions going on inside (insert here: toddler meltdown).

There are some ways, practices or movements that enable calming down or a relaxation response. But it might be something just the opposite that’s needed to even begin this shift. Maybe what was needed, in this particular situation, is a mobilized response. We need both… to survive and engage in the wide variety of experience life is going to throw our way.

Recognizing the state is the first piece. Having some tools and options to choose from that might be helpful to you in the moment, could be a good thing to practice.

Today, I would have a few suggestions should this person turn up in my yoga class and find it a struggle being in corpse pose.

I’m kicking off a workshop in February all about SLEEP. Deep rest. How one might get to a place of settling in… for the night. Or for Savasana. Or if you’re having a hard time with routine, uncertainty, stress in these days you might find it helpful as well. I’d love for you to join in so stay tuned here, or you can sign up at yogatoolsforlife.com.

Pay attention, to what?

Let’s look at a couple more practices you might consider to use in the evening. And why.

If you’re ever in a class or a private session with me you will hear me speak about the brain and the nervous system. Which might be unusual, when thinking about pain. Normally people will talk about tissue, bones, structure. Research over the last 10-20 years tells us pain is much more complex than the state of these ‘pieces of your body’.

Your brain, which kinda runs the show in terms of keeping you alive, is all about your survival. Which is a good thing. The problem is, it tells us something is up but it doesn’t always provide specifics or what we might do about sensation or messages we receive.

Whether physical health or mental health, however, your brain is looking out for your best interests. Which is why when you can’t seem to take your attention away from your pain, suffering, concerning thoughts or stressors, it makes sense when you think about it. It is drawing your attention, purposely to these things. It wants you to act in some way. To do something.

Sometimes, you might know what to do and choose to take action. It’s obvious. If you pick up a hot pan without gloves, your brain is saying you should have put potholders on prior to doing so. If you have a broken ankle, it is telling you to seek treatment and take some time to allow for healing. If you need to have a difficult conversation with someone, your brain – and subsequently your physiology – will send some kind of signal. You might feel motivated, mobilized, prepared and confident. Or you might feel anxious, butterflies in the stomach, strain in your jaw, neck or shoulders. In each, you receive information about your state of being concerning what is about to happen or what has occurred.

The number one thing pain or any other sensation you might feel in your body is trying to do, is to get you to listen. To get you to pay attention.

Usually working in the background without any of your awareness at all, the brain is constantly monitoring your physiology and making adjustments accordingly as required. It’s releasing hormones, sending messages to move certain muscles, signals that tell you when to eat, or sleep. It adjusts your blood pressure, regulates your temperature. Creates enzymes to digest your food. Tells you when to poop. Well, it does right?

The thing about pain, however, is it’s sending a message but often you can’t figure out what’s up. What you’re supposed to do. It’s hard, it takes time to figure it out. To explore what’s needed or right for you.

But back to this paying attention. What can you do when you’re in the thick of it? Particularly when you’re trying to sleep at night (and let me just add that the correlation between sleep and pain is huge).

How might you distract your brain, how might you shift your focus onto something else? At least for the time being. Well, there is a longer explanation that involves the Homunculus Man (above picture) but I won’t delve into it too much here. Rather, offer a couple practices you might like to try.

This, using the sounds SaTaNaMa was taught to me a couple years ago and it combines the rhythmic movement of your breath with the rhythmic movements of your jaw and fingers and rhythmic sounds. You can check it out here. I’ve had clients tell me it can be quite helpful when they are really in the thick of a painful experience/episode, flare-up. Or if you wake up in the night and immediately feel pain.

You might practice something like nadi shodhana, or alternate nostril breathing, for 5-10 minutes before bed. You can practice it sitting up if preferred but you might also do so when laying in bed (or if you wake in the night), using your fingers to close the nostrils. This practice also engages the hands, breath, the face (nose).

All these areas send a lot of sensory information to the brain. Your senses are used to take in information, that helps with your survival. Think about noxious toxins you might smell, seeing danger, touching something dangerous, your sense of taste in terms of toxins or allergens particular to you, hearing a predator in the distance. The brain pays particular attention to these areas so if you can engage the brain, have it pay attention to a ‘safe’ activity it might, just might, change your pain. Allow for some calming, easier breathing. Switch from a danger, or mobilized state in your nervous system to a more safe, restful place.

Or maybe you use one of the Apps available like Calm or Insight Timer that grabs your brain’s attention. Listen to some calming, soothing music. Or perhaps use the smell of an essential oil that for you, might trigger a response that it’s time to sleep and safe to do so.

Let me know if you give any of these a try and how it goes. I hope you find them useful in some way.

Turning off, turning in

If you’re feeling stressed or wound up at the end of your day it might be helpful to notice, perhaps try to shift it, BEFORE trying to head off to sleep.

Let me preface this by saying you may not be ready for slow, restful or focusing-in practices. It may be that you feel the need to move in ways that burn off energy. Maybe rocking or swaying from side-to-side, bouncing a little, shaking things out. Perhaps some dancing in the dark… might be what’s needed in the moment.

However, if you’d like to try some ways to calm the nervous system you might practice one of these restful poses. Or maybe do them after the movement mentioned above. Something like legs up the wall, providing support and perhaps release for the back muscles, or tension elsewhere in the body. Or maybe the beginnings of turning inward, so a forward fold on a chair, or over a bolster.

This doesn’t have to take a long time. You may want to stay in one of these poses for 5 to 10 minutes. See what happens.

Notice the length and the quality of your breath. Notice if it shifts at all, while in the pose.

Notice your thoughts. Feelings.

Maybe it’s helpful for you to listen to calming music, be in a place with lowered, soft lighting.

Taking a few minutes may help to make the transition into sleep a little more easeful. Try it. I’d love to know if anything changes at all for you.

Balancing Act

In preparation for sleep at the end of your day, it might be another time to check in with how you’re feeling.

You might feel fully exhausted, in which case you may have an easier time falling asleep. Yet, even if you’re physically exhausted there is also a possibility of being in a mobilized, or upregulated state in your nervous system.

  • You may have been going full speed ahead with what feels like a million things required of you on any given day. Trying to balance what seems like never-ending demands.
  • Maybe you’ve just had an emotional or stress-filled conversation with someone.
  • You might be feeling some of the long-term stress from these strange times of Covid-19.
  • Maybe you ate a big meal late in the evening as you didn’t had time to do so, earlier.

Your body, your physiology, automatically changes and/or responds to what is going on, what is required in a given moment of time. First of all it takes some awareness to even notice what the state of being, or the state of your nervous system, is. If you’re in fight, flight or freeze (a more sympathetic nervous system response) sleep might not come so easily. However, if you can learn to shift into a more parasympathetic type response (the rest and digest response) it might make the transition to sleep more easeful.

The first step is in the noticing.

Perhaps you can do a body scan to notice what you feel. Bringing your awareness slowly to each part of your body, noticing any sensation you feel or any thoughts or feelings that arise as you do this. Or you may come to know through noticing the quality of your breath. Or perhaps noticing your thoughts and emotions.

People often have difficult going to sleep. More so these days, I find. You might want to look at it, approach it, in a way that requires some preparation. We need both types of nervous systems responses. We have stresses in our life, we need to mobilize. Yet, how might we find some balance and what practices might be helpful in the evening to downregulate our system. To allow for rest and build capacity to meet the challenges of our days. What might make the transition, more easeful? We’ll dig into a few this week.

Re-store. Re-set. Re-new.

I remember the first restorative yoga I attended. Taught by the lovely Olivia Kulla, back in my Doha days. I thought I would feel all so sleepy, y’know? After the supportive poses, soft music, candle light. Basically having so much support, someone to “tuck me in” so to say. Allow me to fully rest.

What I didn’t realize is that afterwards I didn’t feel sleepy at all. During, yes. But after I felt energized. Rested. Ready to move forward with whatever I needed to do. It was a fascinating experience.

It was a good lesson in doing less. How less might be more.

Valuable.

Though I no longer practice strength or power styles of yoga like Ashtanga or even a flow-style of yoga I do like to get my sweat on. Take me on a good hike. Some downhill skiing and I’ll be right with you. I’m not against high-powered, cardio building stuff.

Yet, there is something about resting.

Not sleeping. Not watching TV. Not scrolling on the phone. But shutting out what can be overwhelming sensory information that bombards us from every angle these days.

Why not slip into some rest, mid-day? All the suggestions below take only minutes. Like 5 minutes or less. (Though of course if you have more time, you could do them for longer.)

  • A little legs ups the wall, pose.
  • Supported child’s pose (it even sounds sweet and supportive). This, is restorative yoga.
  • A 5 minute meditation. Maybe using an App like Calm or Insight Timer.
  • Stand up and sway from side to side, gazing out the window. Maybe you bounce a little, shake out the arms, legs, fingers, feet.
  • Close your eyes. Massage around your eyes, temples. Maybe into your neck and jaw. The back of your neck.
  • Nadi shodhana or equal nostril breathing. I’ve had clients say how energized they feel after this. However, it might also be used to help fall asleep, so notice how it shifts your energy.
  • My favorite is laying down on the floor. Perhaps a blanket folded, to support the head. Maybe a pillow under my knees which often feels good for the low back. And just rest. I always suggest laying on the floor, rather than a bed, or sofa. If you can notice it, find the support of your body’s structure (bones) on a hard surface. This might allow for the muscles to release any ‘holding’ or tension… and to relax.

Why not do one of these for 5 minutes a day, either before or after lunch (one might feel better for you) and notice what you notice. What feels right and do-able for you?

Restorative yoga. It seems these days it’s often combined with yin, or slow or gentle yoga, or perhaps confused with these. Yet in the trainings I’ve done in the style it’s not about stretching. It’s not about holding. Rather, all about support.

As you can see from the suggestions, it doesn’t have to be restorative yoga but perhaps making some time and space to do something else, take a break, might be useful. What does providing some mid-day support or rest feel like, to you? Let me know how it goes.

Riding the Waves

I can imagine it is difficult these days to feel safe. Find stable ground.

Creating a sense of safety for yourself, like anything, will be unique to you based on your life, your history, experience or environment. Now more than ever, probably a challenge.

For me, getting close to the ground helps. That is, literally. close to the ground. Sitting on the floor with lots of support below helps me to feel secure. Find stability. Another way for me is to find something familiar. That might be my breath. Noticing each inhale, each exhale. Yet for someone who is asthmatic or perhaps experiences anxiety, focusing on the breath might not be ‘the thing’.

Maybe it’s sitting next to your dog, or cat. Perhaps feeling the rhythm of their breath, their purring helps calm your nervous system. Providing that felt sense of safety. We often do that with those we love and care for. Just ‘being with’ them, sitting next to, holding each other’s gaze. Hearing a soft familiar voice might be soothing.

What is helpful to you? You might want to notice that during your day. And if you feel safe, how do you know that? What do you notice or feel in your body? Maybe your breath is long and slow, your muscles soft and relaxed. Your heart rate or blood pressure isn’t noticeable.

If you’re finding it hard to notice, try the opposite. It might be a different experience and one not always welcome but what do you feel, when you’re not safe? How do you know that? Where do you feel it? Hard to breathe, muscles tense, heart beating fast, sweaty palms?

What do you notice about your pain, in either of these states? Or your emotions, thoughts? It might be something worthwhile exploring, during your days. Having an anchor, a place or practice to go to when it feels like these big waves keep crashing down one after another, relentless at times, can be useful.

Hopefully the days will become more certain in the months to come, but it the meantime, this might be a useful practice to cultivate.

#dailypractice #daytime #safety #grounding #stability #breath #waves #uncertainty

What goes unnoticed?

It surely does not look like this out my window today. I have yet to venture out into the snow that landed over night but I will at some point. You see, I find great pleasure in being outside in the fresh, crisp air but also as nature helps me with the practice of noticing the subtle, or smallest things.

Which can be really helpful if you’re someone who lives with pain.

If we understand pain to be a protective system, it makes total sense that pain wants your attention. The most important thing for your brain to focus on ALL DAY LONG long is keeping you safe and alive. Top priority. Your brain is constantly monitoring all the systems in the body, slowing things down, speeding things up, secreting hormones and enzymes, adjusting the nervous system to respond to what is required in any given moment. Telling you when to sleep, to drink, to eat, to move. Providing messages, clues.

Throughout the day you may notice when you are in pain. For some people this may be, or feel like, it’s all day long. 24/7. But I suspect for many there are times when you don’t feel pain. Moments, minutes or days perhaps.

I wonder if you might notice when you don’t experience pain.

I invite you to notice those moments. And get curious. Why, perhaps, are you not experiencing pain just now? This practice of noticing, provides clues.

What makes your day, your life, feel more easeful? Safe, perhaps. Comfortable, pleasurable. Less painful.

Spend some time, noticing that. I’d love to hear how it goes.

If this is something you’re interested in exploring, I offer private 1:1 sessions via Zoom. Click here, for more information or arrange for a free 15-min conversation.

#daytimepractice #daytime #noticing #painsystem #chronicpain #easeful #comfort #pleasure