Have you ever considered that your pain may be originating from your sleep? Pain is a complex phenomenon that is influenced by many factors, including your emotional state, past experiences and surrounding environment.
You may have had the unpleasant experience of straining your neck or back at the end of a long day at work when you were exhausted, and your whole world came crashing down: you were fed up with your injury, you didn’t have the energy for it anymore, enough was enough, you burst into tears. Sound familiar?
Perhaps you can recall another instance where you were well-slept and feeling upbeat and energised, but then your neck “went” on you? Whilst it hurt like hell and probably put you in a shitty mood, you were able to get through a day at work, make a joke about your dodgy neck with a colleague and still go out to dinner with your friends that night.
Same neck strain, but very different experience. Here’s why your sleep quality may be the missing link:
Scientific studies have shown that poor quality or reduced duration of sleep results in a huge increase in pain sensitivity. The parts of your brain that are responsible for processing pain are 40% more sensitive after sleep deprivation. To put this into context, your 5/10 pain after a good night’s sleep just became a 7/10 pain after sleeping poorly.
When sleep quality improves, these brain regions become less sensitised. Painkillers like Endone act on the same part of the brain, so you can think of sleep as a natural painkiller (and pain booster when you don’t get enough).
Sleep and the immune system
There is also a lot of scientific evidence showing that sleep improves the immune system, which is the main system in your body that heals injured body tissues (such as muscle, bone and nerves). A large factor in pain is inflammation, which can become excessive and persistent in chronic conditions. Getting sufficient sleep has been proven to reduce inflammation and promote a healthier immune system response, therefore creating faster tissue recovery times and stimulating the repair of cells in the body. Studies have even shown that long-term sleep loss is a predictor of increased injury rates.
Sleep and movement quality
When pain has been around for a while, it is usually accompanied by poor movement patterns in the body. Sometimes these poor movement patterns play a role in creating the injury, other times they are developed as a result of the pain, but in both cases, they are involved in maintaining the pain.
With this in mind, it should come as no surprise that improving the quality of how you move is critical to overcoming your pain (refer back to step 1 on structure for a refresher). It turns out that learning new movements patterns and exercises is heavily impacted by the quality of your sleep. Studies have shown that skill learning (e.g., improving the quality of how you rotate your neck) is improved by 25% after high quality sleep.
Sleep and physical performance
There are some seriously negative effects on your body’s ability to function at a high level when you sleep less than 8 hours per night. Even if you’re not an athlete, each of these effects will also impact your everyday life and your pain:
- Time to physical exhaustion during exercise drops by 30%
- A 30% drop in muscle power
- Decreases in both maximal strength and endurance
- Increased lactic acid build up
- Reduced oxygen uptake
Whether the above effects are experienced during exercise or just during activities of daily living, they all result in bad movement patterns and pain. To put a positive spin on it, if you can achieve 8 hours of quality sleep per night then you will experience increased muscle strength, power and endurance, less physical exhaustion and improvements in how your body uses energy. Each of these will have dramatic benefits on your neck pain.
Sleep and emotions
Pain is heavily dependent on your emotional state. One of the biggest determinants of your emotional stability is the amount of REM sleep you get each night. During REM sleep, emotions are processed through dreams and your brain is able to detach from emotionally challenging experiences. If you do not get sufficient REM sleep, you will experience emotional volatility which will dramatically increase your pain levels.
What are the key factors that determine sleep quality?
There are multiple factors, but one of the most important is your sleep equipment, aka, your pillow and mattress!
You spend ⅓ of your life in your bed, so the position you sleep in has an enormous impact on your posture and the position of your neck and spine.
It’s very challenging to consciously sleep in a new position, because as soon as you fall asleep, you will unconsciously get back into their favourite position – even if it’s terrible for your neck or back.
So how do you offset this? First, you need a good quality pillow. The thickness of your pillow should ensure that your head is neutral when sleeping on your side. If you draw a line down your forehead and through your nose, the line should then continue perfectly straight along your sternum.
If your pillow is too thick or too thin then your neck will be flexed or side-bent all night, which is not ok.
My favourite pillow is the Ecosa pillow. It’s comfortable, supportive and ticks all the boxes. We are now stocking them at the Advanz clinics, or you can purchase online.
Next, you need a good mattress. More specifically, you need the right density for your body. If your mattress is too soft, your spine will be in excessive flexion (forward bent). Too firm and it won’t allow for the natural curvature of your spine. Similar to your pillow test, if you draw a line along your spine when lying down on your side, the line should be dead-straight.
Again, for mattresses I recommend Ecosa. The mattress is firm and supportive but very comfortable. They offer the best mattress on the market at an affordable price (under a grand), and you can even test it for 100 nights to make sure it’s right for you (which I’m sure it will be). I’ve personally been using an Ecosa pillow and mattress for a while now and it was a total game-changer, so I’m a big fan.