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.

Preparing for Slumber

Depending on where you are in the world and your environment, you may notice some changes taking place. A change of season. It is quite obvious where I live as the foliage, the trees and the grasses are all preparing for winter. Transitioning to a new phase. Not only the beauty you can see here but the seasons also provide a steady rhythm to life. Continuity.

When menopause struck and I was suddenly experiencing disrupted sleeps, yet another transition. A new season. I couldn’t help but recall another stage of life gone by, the early days of parenthood. Those feelings of being absolutely depleted, exhausted. I can only surmise my dreary eyes gazing upon those loving baby faces helped get me through it.

I distinctly remember every time we got in the car to go somewhere, babies safely tucked into their car seats, I immediately fell asleep. Why was that?

I was exhausted.

I knew our babies were safe. I had some time and space when I no longer had to be vigilant, listening and watching over them.

The subtle swaying motion along with the soft hum of the car as my husband drove provided some cues, a stimulus that helped me drift off to slumber.

What were some of the things you did to help get your babies to sleep? I can recall softly stroking their head, their face, “tickling” as we called it. Soothing, rhythmic music playing in the background. There were at times suggestions made to put them on top of the dryer or something similar (maybe for the same hum, swaying that the car provided me). Wrapping them tightly in my arms. Bouncing, swaying, rocking.

We used another strategy when our twins were babies. During the day, we kept them downstairs in the living room, using one of those portable beds so they could get used to sleeping amidst the goings on of our daily life. But at night we took them up to their cribs, to a quiet, darkened room. A different signal that it was now night-time, different than their brief naps during the day.

We can use strategies, we can develop habits and routines to help create conditions for sleep. These are some of the things often discussed in terms of general sleep hygiene. Learning more about our circadian system or rhythm can also be helpful.

What what else might be useful if we’re having trouble with sleep?

Well, there is evidence to show how stress can affect our physiology and our sleep. And, I can imagine many are feeling the effects of stress these days. This hyperarousal, or perhaps it is more like hypo-arousal these days.

How does stress show up in the body? What happens? What are the changes that take place? Can we change or influence our nervous system’s response to stress?

Navigating transitional moments of life is a challenge. Often, there is a letting go required and a stepping into the unknown. Uncertainty. There may be feelings of loss, grief, sadness. Maybe there is anger or resentment or … well there are likely to be many feelings. Including love, beauty and joy. Maybe freedom. All showing up, moving, shifting like a roller coaster ride. Felt and experienced in the body.

Perhaps exploring this a little, what we notice, the sensations that rise and fall throughout the day (and night) might be useful. Making sense of it. Accepting these moments with some kindness and compassion, moving through them with awareness, finding some ground when we need it most. A way to settle into slumber when night falls.

Curious?

I’m planning to offer an online program where we can explore this both through some gentle movement practices, journaling or other written work, information, breath and awareness practices. If this is of interest to you please let me know, send me a message, comment below, sign up to the site or email me at info@yogatoolsforlife.com. There’s no commitment from you required, I’m only gauging if there is interest at this point.

Take care.