What is painsomnia?

Pain can give anyone the bad occasional night, but for people with ankylosing spondylitis, the inability to fall asleep because of pain – alias “painsomnia” – is an overly familiar phenomenon. A study published in December 2019 in the journal Frontiers in Medicine revealed that people with ankylosing spondylitis presented almost 3 times more risk of developing obstructive sleep apnea, a condition in which the air flow is blocked during sleep, causing a nightmare and diurnal sleepiness. And a study published in the International Journal of Rheumatic Diseases revealed that almost 60% of subjects with ankylosing spondylitis suffered from altered sleep. Chronic pain can increase the time necessary to fall asleep (known as sleep latency), reduce the total time you spend sleeping (sleep duration) and trigger frequent excitations during the night (sleep quality), according to Nathaniel Watson, MD, co -director of the sleep center of the University of Washington Medicine in Seattle. “People with ankylosing spondylitis are often struggling with not only one but the three sleep problems,” he said. A bad sleep leaves you not only tired and unhappy, but can also worsen your pain with ankylosing spondylitis. “We know that an untreated sleep disorder that causes sleep fragmentation and sleep disturbances affect how the brain interprets pain, causing reduced tolerance and worsen pain,” said Dr. Watson. Sleep loss is also associated with increased inflammation. The good news: it is possible for people with ankylosing spondylitis to break the cycle of bad sleep and worsen the pain and get the Z they need. These relatively simple adjustments to your daily and night routines can help you sleep longer and more deeply at night, and feel less pain and fatigue during the day. Do the exercise regularly. “Physical activity, and stretching in particular, is one of the most useful tools for combating ankylosing spondylitis pain,” explains Robert Bolash, MD, assistant professor in the Cleveland Clinic pain management department in Ohio. This can also contribute to a feeling of fatigue in the evening and promote better sleep. Some people find that training too close to bedtime can actually interfere with sleep. If this is the case for you, try to exercise shortly after your awakening to help relieve the pain and morning stiffness associated with ankylosing spondylitis. It’s about discovering what suits you best. Look at the clock. Healthy sleep works in cycles; Painsomnia makes this cycle fall and makes sleep more erratic and increasingly elusive, notes Watson. To resume a healthy sleep schedule, go to bed and get up at the same time every day, even on weekends. A coherent routine to end – like brushing your teeth, washing your face and reading or listening to relaxing music – can also help you stay on time by signaling the body that is time to sleep. Then turn the clock. Checking time in the middle of the night is never productive. “It makes you think about the reason it is so early when you thought you slept more or worry about the fact that you have to get up in two hours and have barely slept,” Watson explains. “It is activated the brain and perpetuates insomnia.” Facilitate PM pain with heat. The heat can help reduce musculoskeletal pain of the inflammatory type, which tends to worsen at night, explains Dr. Bolash. Try to take a hot bath or a shower or apply a heating cushion, a bottle of hot water or a bag of wheat (which you can heat in the microwave) on the affected joints before bed. Check your mattress. A mattress that is too hard or too soft can cause poor sleep and worsen pain and stiffness, notes Bolash. A semi-visual mattress is ideal for people with ankylosing spondylitis because it helps maintain the natural curvature of the spine. “You want sufficient support for when you lie on the side, your spine is straight and give yourself enough that when you are on your back, your spine can maintain its natural curve,” he explains. If a new mattress is not in the budget, consider a higher mattress that will help you provide additional support. Keep the room below 68 degrees F. Some sleep researchers identify the ideal sleep temperature as between 66 and 70 degrees F, but many experts recommend keeping your bedroom for optimal sleep conditions, according to the National Sleep Foundation. “Your body temperature drops when you fall asleep, so get closer to the same temperature drop in the room can help shorten the time to fall asleep,” said Watson. Relax with an application. Tech takes the heat to stand up to us up to every hour, but your smartphone or tablet can also be used as an invaluable sleeping pill. Many free and low cost applications can guide you through progressive muscle relaxation, a series of respiratory exercises or soothing meditation. “Incorporating one of them into your evening routine can help you relax, relieve your pain in ankylosing spondylitis and sleep better,” says Bolash. Do not force the problem. If you find yourself ruminating and you cannot sleep for more than 10 to 15 minutes, get up and do something not stimulating in another room, such as reading, a crossword puzzle or soft stretching (especially if you suffer), until you feel drowning. “Remember that sleep is not something you do,” notes Watson. “This is something that happens given the right circumstances.” Consider CBT-I. Cognitivo-behavioral therapy for insomnia (CBT-I) focuses on helping people to change the negative thoughts and behaviors that interfere with sleep. “This type of therapy has proven to be, if not more, effective than long -term sleep drugs,” explains Watson. Ask your doctor to refer to a sleep specialist who is trained at CBT-I or plan to register for an online CBT-I program.