Hello again, my lovely loves!
Let's jump right in with and look at the next steps of getting better sleep. Today we'll be looking at dealing with pain, and the first steps of setting up a good sleep environment.
Dealing with Pain
I have created a whole post on dealing with pain, so you may wish to go look at that in more detail if pain is a common insomnia trigger for you. There are a few that are more sleep specific, however, so I’ll discuss them here as well.
To see the separate post for dealing with pain, head here.
Keep warm (or Cold)
By far the most useful thing I’ve found to deal with pain at night is heat. My pain is usually centred in my hips, and sometimes my legs and back, so I basically cover myself in hot water bottles in those areas.
Mmm. Like a toasty snuggle pile.
Obviously this becomes difficult to manage in summer, but I do tend to have less pain in summer anyway, presumably due to the warmer temperatures.
Similarly, I try to keep my hips covered and warm throughout the day to prevent the aches setting in before I go to bed.
Hot water bottles, heat packs, and warm clothes are your best friends.
If cold works better for you then consider ice packs.
Watch for environmental changes
See if you also get more pain at certain times of the year. If, like me, you get more pain in winter or when the temperature abruptly drops (ta, Britain), then it’ll mean you’ve got more options for preventing extra pain by doubling up your clothes in your problem areas.
I wear two pairs of leggings pretty much from autumn to spring.
Medications
There are many options when it comes to pain medication, and these can sometimes be combined with sleep aids. The best thing is to have a chat with your doctor and work out what the best option is for you.
You doctor will likely ask you how often you suffer from pain, and insomnia. If both are frequent, and likely linked, they may suggest Amytripaline, which is used to help long term arthritic pain, as well as being used for sleep issues. Other options include Diazepam.
For me, my insomnia and pain is less frequent, so mine gives me Zopiclone (a straight-up sedative), which I use now and then for insomnia, and then I use paracetamol for the pain.
You may have a little bit more difficulty getting sedatives, as these are potentially addictive. However, if you really need them, stand your ground.
Find the best environment for you
Getting a comfortable environment to sleep in is imperative if you suffer from chronic pain, especially joint pain. It’s important for sufferers in general, so I’ve given it it’s own section, but definitely read it, because you’ll likely find it useful.
Dealing with Environmental Issues
This particular section is about getting rid of all those little niggling issues that make it harder for you to get comfortable. If you’re not comfortable it’s harder to sleep, and that’s why this is linked so closely to pain issues.
What follows is going to seem like an extremely unnecessary level of detail, but when you’re struggling with sleep, every little helps.
Optimising your sleep environment can often be a little expensive, but I’ll do my best to give as many options as possible in the hope that you can find the cheapest things that will actually work for you, and to prevent you shelling out for something that’s ultimately useless.
Getting a good sleep environment has been one of the most expensive parts of being ill, but given the improvement I’ve seen since I’ve actually been able to sleep, I’d say it’s been a good investment for me.
As I said before, don’t feel pressured to try all these things at once. Take the the time to really think about what bothers you when you’re trying to sleep and judge accordingly.
A good bed
If you’re going to invest in one thing for your sleep environment, choose a good mattress. Nothing will make more of a difference to your comfort, and it can really make a difference with pain.
And the most important thing to remember when buying a mattress? Orthopaedic does not necessarily mean good for pain; it just means firm. And firm does not mean better for you. It depends on your weight, build/gender, what kind of pain you experience, and what position you usually sleep in.
When my mother went shopping for a new mattress for me, that was the first thing the salesman said to her.
I can’t tell you how glad I was to hear about this. My parents had been gunning for me to have an orthopaedic mattress for a while, but I KNEW that solid surfaces just made my pain worse. I wanted something as soft as I could get away with.
I know there are studies into orthopaedic mattresses, but frankly, I’m unsure if those studies took different body shapes, or even different genders, into account.
Look at this way. I am 5’8”, and I have wide shoulders and hips, and a relatively small waist in comparison. I’ll use this basic shape to show my torso.
That weird red line is my spine in this scenario.
I usually sleep on my side. When I lie on a firm surface, even if I sink into it a little bit, my waist goes down, and my hips and shoulders are forced upwards.
Mmmm comfy.
This puts a lot of pressure on my hips and shoulders and twists my upper back. I end up with pain in NEW areas, as well as pain so intense in my hips that I can’t sleep.
This was the problem I had with the N:Rem mattress topper, during the product review I took part in.
It uses foam that is fairly solid alongside softer pieces that you arrange according to the area you have pain in.
The hip pain arrangement had the softer pieces at the hip, and more solid pieces at the top, but because of my wider hips it forced my shoulders into the solid foam and made them hurt. My shoulders having nowhere to go in turn pushed my hips into the mattress and made those hurt too.
On a softer mattress my wider points (which are also the heaviest points) sink into the mattress. My waist is a little more supported. I’m not twisted into a weird shape. My pain lessens.
I can’t tell you exactly what mattress you should be getting, but I can tell you the three general rules the wonderful salesman told us.
1 - Your weight/height
Generally speaking, the heavier you are, the more firm a mattress you’ll need. Men typically have firmer mattresses for this reason - they naturally sink into them more. I would say, however, I have a soft mattress, and I’m probably around 10.5 stone. (I think... I don’t really weigh myself to be honest.)
Taller people will tend to have their weight more evenly distributed across the mattress (unless you sleep curled in a foetal position) and so will probably be able to get away with a softer mattress than they might otherwise do.
2 - Your build/gender
Another reason why men are traditionally more comfortable with firmer mattresses is that they don’t tend to have bodies that are as curvy. This obviously is a sweeping generalisation, and I suspect is not very helpful.
Instead, look at these shapes.
Actually look at your body. Are your hips wider than you shoulders, the same, or smaller. Is your waist significantly smaller than your hips/shoulders.
Pick the shape that most resembles your body, and imagine it on its side. You can even make your own shape if you want.
Where are the pressure points? Do those match up with where your pain is? If they do then maybe you need to rethink your mattress.
If you sleep on your back or front it still makes sense. Women with larger chests who sleep on their fronts will need a softer mattress, because a firm one will provide no give in the bust area and force their backs to arch, putting more pressure on those muscles and joints.
On your back, if your spine is very arched then a firm mattress will potentially leave it unsupported and leave those muscles in your back tense. (My mum has this issue.) You may want to add support with a small pillow.
3 - Number of occupants
If there’s more than one person using the mattress this will effect the weight on the mattress, and usually mean that a mattress has to be a little firmer to accommodate for it.
It means there’s also some compromise needed on what each user finds most comfortable. I’ve got to say, us singles actually have an advantage when it comes to picking a sleep environment, because it doesn’t have to suit more than one person.
If a firmer mattress is needed for weight reasons, then you can soften it by using one or more mattress toppers. You may end up with a princess and the pea situation, but it’s worth it if you’re comfortable.
Finding a fitted sheet may pose a problem...
I would argue that the person with the worse pain should probably have the last say, however. People who aren’t in pain or chronically ill can adapt much more easily to a different sleeping situation than those that are.
This is one area where something like the N:Rem sleep system would have the advantage, because different sides of the bed can be set up with different levels of firmness, so both occupants are comfortable.
You’ll also need to think about whether to go for a sprung mattress, a foam mattress or a mix. Mine is a Highgrove Beds Vicuña natural pocket spring mattress.
I always get the impression from people with foam mattresses that it’s not particularly easy to move around on them, so for a jifflebum like me, a sprung mattress is better.
I don’t really know enough about mattresses to break down the pros and cons of these options, but a decent sales assistant at a show room should be able to help, even if you ask over the phone or via email.
It can be difficult to get to a show room to test mattresses, but a trusted friend or family member can always go for you as long as you’re clear with what you want. My mum chose my mattress and it’s great.
The very, very nice salesman also allowed us to have it delivered and let me lie on it before the plastic was taken off, on the basis we could still return it if it wasn’t suitable.
I suspect this is unusual, but if you’re housebound like me, maybe it’s worth discussing options with your local showroom.
Some mattresses and toppers also offer trial periods and money-back guarantees, so it’s worth keeping an eye out for those if you’re not able to go try things yourself.
Even though financing options are often available for larger purchases, it may not be possible for you to buy a new mattress.
If you need a softer surface, but can’t afford a new mattress you can always look into mattress toppers. These make a surprising amount of difference, and can even be layered to create even more softness.
They usually come in foam, synthetic padding and feather options and come in various thicknesses, and a variety of prices to match.
I have one on my soft mattress; partially because I had it left over from my old mattress and we didn’t want to waste it, and partially because the softer my bed is the happier I am. I essentially want to sleep in a giant cloud-nest.
Any quip I could write could never beat the text of the Image source
Pillows
Pillows are also an important factor in both comfort and pain management. It took me a long time to find something that didn’t give me neck ache, but now I use a sculpted memory foam pillow, that supports my neck. You can find it online, here.
My step-dad, David, is actually the person who got me on to this. He got one a while back and swore it was brilliant. I was reluctant as it was described as firm (as I’ve mentioned, I like soft things) but he lent his to me for a couple of nights because my super squishy ones were giving me neck ache. After using his I immediately bought one for myself.
It’s very difficult to tell you what’s going to work for you, but it’s a little easier to experiment with pillows than mattress, given that they’re generally much cheaper.
I tend to prefer synthetic fibre and foam pillows to feather because, unless you get a very high quality pillow, the feathers can poke through the fabric and you get jabbed by the pointy feather quills when you least expect it.
It’s the ultimate betrayal. There you are, minding your own business and expecting squishy goodness, and then tiny duck needles stab you in the face and neck when your guard is down. No, ta.
(Feathers can also be an allergen or asthma issue, and make my acne worse. Yaaaaay.)
In addition to my foam head pillows, I also have synthetic fibre pillows for between my knees and to hug. I wasn’t joking about cloud-nest.
Putting a pillow between your knees can help take further pressure off your hips and prevent your knees rubbing together. I don’t know if I just have extra bony knees, but it tends to hurt if I don’t use a pillow. I keep my ankles apart, or cushioned by a duvet for the same reason.
Hugging a pillow does the same thing for your shoulders, and tends to open up your chest a bit more. Sometimes my ME makes me short of breath, and being of the busty persuasion can mean the added weight exacerbates this issue.
When my upper arm is supported by a pillow I find it much easier to take deeper, slower breaths, and it stops my shoulders and back muscles being pulled around.
My knee pillows are square and from a brand called Rectella. (That’s quite the name.) I got them cheap on eBay and they are AMAZING.
My arm ones are just normal synthetic rectangle pillows.
There’s also a pillow under the foot of my mattress to bump this up ever so slightly. I didn’t know it was there for ages, Mum snuck it there, but she swears blind I’ve slept better since it was there, so… worth a try?
Sheets
Make sure you have non-scratchy sheets, if you can avoid it. ME can make your skin more sensitive, and it's going to be difficult to relax if you're laying on the equivalent of a bed of straw.
Nice quality cotton sheets are fairly easy to come by, and have become more affordable in recent years, but if that's still too scratchy try jersey.
For the winter you can even get brushed cotton, which is a bit like falling asleep wrapped in giant fuzzy pyjamas.
If you can't afford new sheets, then there are unscented, natural fabric softeners available from places like Big Green Smile or Ethical Superstore. The eco-friendly options usually cater well to people with skin and scent sensitivities.
You can also get a debobbler or pilling remover, that will take any uncomfortable pilling from your sheets and make them softer again. You can get manual combs, but for ease of use and saving your energy I'd recommend an electric one.
Part three will come tomorrow where we'll look further at getting a good sleep environment.
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