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Andrew Terry
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Osteopathy & Pain Whilst Sleeping
Bad habits can impact sleep
Having pain whilst sleeping can have serious impacts on your health. It’s one of the reasons why when we’re not in pain we should make sure we’re doing it well. How often have you sacrificed a couple hours of sleep to squeeze in a few extra episodes of your favourite Netflix programme? Or gone into the early hours of the morning texting friends? Doing this occasionally is one thing, but if it becomes a habit it can start to have a negative impact on your mind and body. So what can we do to make sure we’re getting a good nights sleep? Is there an optimal sleeping position? Can we do things throughout the day to help get us to sleep at night? And what happens to us if we keep neglecting a good nights sleep?

What begins to happen if we don’t get enough sleep?
Well at first, not too much. Our bodies are incredible and they are capable of adapting to a multitude of stresses. Missing a few hours for one night means that we’re just likely to feel a little sluggish throughout the day, and so long as you make sure you get a good nights sleep the following evening, the majority of us will feel absolutely fine. However as soon as this becomes a habit, these are some of the things you may start to notice.
You may start to become irritable
Sleeping is literally one of the main times are brain gets to clean itself. Scientists recently discovered a new system in our body called the glymphatic system. The role of the glymphatic system is to remove waste from the brain and central nervous system, and it may also have a part to play in the transmission of compounds such as glucose, amino acids and neurotransmitters to our brain. It almost solely activates during sleep and remains mostly disengaged whilst we are awake. Poor sleep can also disrupt our bodies release of certain hormones, such as melatonin and cortisol which tend to be regulated in line with our circadian rhythm (or 24 hour body cycle), which in turn impact on our ability to handle stress, and is why we may become more irritable throughout the day. Depression and other mental health issues are also linked with sleeping disorders. Estimates suggest that up to 90% of people who suffer from depression complain about their sleep quality.
Poor sleepers have a greater risk of heart disease and stroke:
A review of 15 studies found that those who do not get somewhere between 7-8 hours sleep a night are more likely to have a stroke or suffer from heart disease. It’s important to remember that whilst we may feel fine and are able to function well during the day, your body is still missing vital time to repair itself.
Repair:
Soon after falling asleep, our body dumps a huge amount of human growth hormone (HGH) into our system. Whilst HGH spurs growth in children and adolescents, it also helps regulate body composition, body fluids, muscle and bone growth, sugar and fat metabolism and may even play a part in cardiovascular health. If you’re someone who loves to exercise, then making sure you get enough sleep is vital to ensure your body can repair itself, and you can continue to exercise without causing damage.
You may start to gain weight:
You’ll be glad to know that the conclusions to most studies that delve into the relationship between sleep and weight gain are not definitive. There does seem to be a correlation between being over weight and lack of sleep, but this tends to mostly be with children and adolescents. However most studies seem to suggest that due to feeling more tired during the day, people tend to be less motivated to exercise, and therefore the less active lifestyle can lead to gaining weight, as well as negatively impacting our hormone regulation.
Sleep impacts immune function and is linked to increased inflammation:
When was the last time you had a cold? What was your schedule like before you picked it up? Had you been busy with work, or perhaps partying? Studies were carried out with healthy men and women who were given the cold, with some being sleep deprived and others who were allowed 7-8 hours of sleep. Those who were sleep deprived were far more likely to get ill than those who got a good nights sleep. It’s also linked with increased inflammation in the gut, to such an extent that those who suffer with conditions such as Chron’s disease and other inflammatory bowel disorders are recommended to have a look at their sleep hygiene in order to improve gut function.
So now that we know a little more about what can happen when we don’t get enough sleep, here are a few tips on the best sleeping positions and how to have good sleep hygiene.
Sleeping positions
How are we meant to sleep? Are some better than others? What are the best ways to stop snoring? We develop sleeping patterns over our lifetime, so breaking them can be difficult. Here is a little bit about the the good and bad of each of the sleeping positions, and some ideas on how you break some of your bad habits.
Back
In general, this is the one I recommend to most of my patients if they can. It’s great at keeping your head, neck, and spine aligned which is what we want to promote. Whether or not you need a pillow or not depends mostly on your body shape, and the pillow should be a thickness that keeps your skull inline with your body. If you’re someone who suffers from acid reflux (heartburn), then a slightly larger pillow can help alleviate this. However, if you’re a snorer, then sleeping on your back is not recommended as it can promote snoring and sleep apnoea which can be detrimental in the long run.
Side
This is the second best position… so long as you use your pillows wisely. I recommend that those who sleep on their side get a slightly larger pillow, one that is roughly the size of their shoulder so that it supports your head whilst keeping your neck in line with your spine. Sleeping on your side is great if you have back or neck pain, and it’s also good at reducing your chances of snoring. Whether or not it reduces acid reflux or not is up for debate, as some scientists believe that sleeping on your right side can loosen your lower oesophageal sphincter, which are involuntary muscles that prevent acid from using out of your stomach and into your throat. This may also be a bad position for you if you have an issue with your shoulders or hips, as you are going to compress the area. If this sleep position works for you though, then there is no need to think about changing unless you start experiencing pain.
Fetal
This one is not recommended at all, unless you’re pregnant. It can lead to ligament and muscle adaptations over time and may lead to headaches, neck, back and hip pain.
Stomach
Despite the fact that so many of us sleep on our front, it is another position that isn’t great for us, with the only real benefit being that it also helps to stop us snoring. The bad side of sleeping on your stomach is that it alters the alignment of your neck, spine and often your shoulders depending on whether or not you raise your arm. You may also get muscle or joint pain as you turn your head whilst sleeping to allow yourself to breathe. If you are a stomach sleeper, then I recommend using as flat a pillow as possible to reduce the strain put on your neck. You may also want to put a thin one under your stomach to help keep your back straight.

For those that want to try and learn how to sleep on your back, one way is to use pillows to keep you in place. By placing a couple by your side, and another under your knees, this can prevent you from turning in your sleep. This may take some time getting used to, but in the long run will grateful reduce the chances of muscle and joint strains, as well as aiding in recovery from injuries you may have got from day to day activities.
Last but by no means least…. Sleep hygiene
It’s not just your sleeping position that helps give you a good nights sleep, but also your activities (or lack of) throughout the day. If you find that you’re not waking up feeling rested, here are some tips to improve your sleep hygiene:
· Reduce or eliminate daytime naps
· Stick to a regular bedtime and wake-up time
· Avoid alcohol and caffeine before bed (for as much as 4 to 6 hours, depending on your body’s response to them)
· Establish a pre bedtime ritual
· Block out all loud noises and lights from your bedroom (especially device and TV screens)
· Set a comfortable bedroom temperature
If you haven’t fallen asleep yet from reading this, how about reading my other blog that delves deeper into good sleep hygiene, and what we can do to make sure we get that really good nights sleep.
ZZZzzzzzzzzzzz
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Andrew Terry Registered Osteopath