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How To Improve Your Sleep & Help Heal Your Chronic Pain With Yoga and Ayurveda

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Insomnia and Watching the Clock

Sleep Hygiene and You

One of my favorite little bits of science-speak or expert lingo in the CP (chronic pain) arena is sleep hygiene .

Bwaa!

As if. As if it’s just a question of you getting clean enough. Like, “take a bath! you’ll sleep just fine.” And yes, I know that’s not what they’re really talking about when they use the word “hygiene” in this context. They mean the practices and procedures and routines you adopt around sleep.

Still. Bwaa, I say. Like it’s my fault I can’t sleep more than four hours straight. Like it’s something I did wrong when I hurt so badly that I can’t even get to sleep in the first damned place. Like it’s as easy as brushing your teeth or using the proper wiping technique after going number two. Whatever, experts.

The way I see it, we’ve got three options, basically, when the sleep has left the building . . .

Door Number One …

Suffer. Lie there and suffer. Not appealing.

Door Number Two …

Ambien. Hey, been there, swallowed that. Still do, from time to time, when it’s really bad or when I have a major event the next day and just have to get a good night’s sleep. Still, I try to keep this one as a last-ditch effort. It is a controlled substance, so people look at me funny at the pharmacy when I go pick it up on my third refill. (You know the look I’m talking about.)

(By the way, I tried that other one – Lunesta – about five years ago. It was awesome — until I realized that the horrid taste in my mouth was not something I’d accidentally gotten a lick of but the Lunesta itself and it lasted all. Damned. Day. Nothing would make it stop.)

Door Number Three …

Alternative therapies. And here’s one aspect of CP management where I’m a huge believer in the alternative stuff. (Long-time readers know I’m extremely skeptical and at times highly critical of all the hype and puffery surrounding alt-therapies for CP conditions. But that’s another post. Or four.)

But when it comes to sleep? Alternative rocks. (Hee. I made a pun.) Especially bangin’: yoga and ayurveda, the twin components of Indian health management that have been around for centuries.

Yoga Your Way to Dreamland

The kind of yoga I’d recommend for sleep improvement is not the “Steve Ross on Oxygen”/fast-paced flow routine you might associate with a lot of Western approaches to yoga. Rather, this kind of yoga is gentle, restorative and way easier on the joints.

As with any yoga, however (well, heck, really this applies to any exercise at all but especially with yoga) you’ll want to check with your doc first, if you’ve never done it before, and you really want to start any kind of yoga program under the guidance of a trained teacher. If you can’t manage a live person in the same room with you, correcting your form, and keeping you from hurting yourself — yes, it is possible — then at the very least, a competently-made DVD or video where such a person demonstrates proper form is highly recommended.

That said, a few poses that I find really helpful are “Legs Up the Wall” and a little number I like to call “Reclining Bound Angle With a Boatload of Props.”

Legs Up the Wall

Just exactly what it sounds like. Getting into position can be tricky, so scout around your house for the best location. Personally, I like to do this on one side of a doorway or open archway. You’ll need a sturdy wall and enough space in front of the wall to accommodate your upper body in a prone position.

Sit on the floor, and scoot your butt right next to the wall. Very gently, lie down on your side, and curl your legs up to your chest as you roll over on your back — nice and easy. Then as much as you can without straining (that part is important), straighten your legs up the wall. Lie there and breathe for a few minutes. To come out, reverse the roll: bring your knees to your chest, roll to your side, and gently push yourself up.

The doorway variation I like to use: I angle my butt so it’s right against the right side of the door jamb and put my right leg up the wall, and the left leg I extend straight through the doorway. That adds a nice stretch to the front of the left hip and thigh. To work the other side, shift to the left side of the doorway (or the other side of the door, if that’s easier — either one works).

Now, a few notes. This is not a contest to see how straight you can make your legs. It’s about taking the pressure off your hips and lower extremities, and gently stretching out your back, the sacroiliac area, and the hamstrings.

You can also use a bolster to support your back as shown in the photo on this page.

Reclining Bound Angle With Boatload of Props

This one you can do anywhere you’ve got a patch of floor big enough to lie down on. I recommend a soft padded surface, so if you’ve got a mat, carpet, thick rug, comforter you don’t mind throwing on the floor, whatever – use it. Spread it out. You’ll also need the following (OK, perhaps “need” is a tad strong – you don’t actually need these things, but, boy howdy do they help):

  • Lightweight sandbag for eyes
  • Bolster (or thick blanket or large towel folded in half, then rolled up into cylindrical shape)
  • Two thick pillows – preferably foam
  • Another warm, soft blanket (this one to drape over yourself)

Rather than talk you into this one myself, I figure you’d appreciate the experts’ take on it. Get step-by-step instructions here from Yoga Journal, then add the bolster (lean back against it, resting vertically along your spine), the sandbag on your eyes, and the blanket over your body.

Ayurveda for Better Sleep

Yoga Journal has a pretty decent introductory article on Ayurveda and sleep disturbance here. I wouldn’t personally go for the clarified butter massage but you can achieve a much less messy result with any kind of warmed-up massage oil.

It might seem like an odd approach — different treatments for waking up before or after 2 AM? Vata? Pitta? What? — but our philosophy here at the Diaries is “try it all, keep what works.” Honestly, this stuff? Works. It’s a keeper, in my book. As always, your mileage may vary. Obviously, check with your doctor if you have any sensitivities or food allergies before trying ingesting or rubbing any new substance on your body.

Read On!

And if you’re in the mood to read more on this subject, check out my earlier Diaries posts, “To Sleep, Perchance to Lose Weight? Awesome ” and “More on Sleep and Chronic Pain” (the latter has links to posts at other sites about the relationship between sleep and CP).

Also, check out the cool Zemanta round-up of related articles below:

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To Sleep, Perchance To … Lose Weight? Awesome.

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You’ve undoubtedly seen the headlines lately. FMS Global News (a highly recommended news site for fibro patients) shares the skinny in this post (attributed to WebMD):

Lose weight while you sleep. It sounds like something you would hear on a late night infomercial — just around the time you are reaching for that bag of cookies because, well, you cannot sleep.

But as wild as the idea sounds, substantial medical evidence suggests some fascinating links between sleep and weight. Researchers say that how much you sleep and quite possibility the quality of your sleep may silently orchestrate a symphony of hormonal activity tied to your appetite.

“One of the more interesting ideas that has been smoldering and is now gaining momentum is the appreciation of the fact that sleep and sleep disruption do remarkable things to the body — including possibly influencing our weight,” says David Rapoport, MD, associate professor and director of the Sleep Medicine Program at the New York University School of Medicine in New York City.

I highly recommend reading the entire post, because the article covers three different experts’ take on the connection between sleep and weight.

Probably the worst of the symptoms for me, personally — at least in an emotional sense — is the impact fibromyalgia has on sleep. When was the last time I slept through the night without waking up from the pain or at the very least tossing and turning? I don’t honestly remember. My new “normal” is waking up several times at night, sometimes not getting to sleep for four or more hours after I turn in, sometimes getting to sleep quickly enough but then waking up at 3 in the morning and not being able to sleep again until the next night.

The impact on my pain levels from this sleep havoc is bad enough, but emotionally it’s even worse. It just feels rotten, creepy, miserable, scary, and just plain weird to be the only one in the world awake at 3 AM (or so it seems). Well, me and the kids from Paranormal State , I guess, who are busily engaged in their own version of Dead Time.

And is it any wonder that I’ve struggled mightily with my weight the entire time I’ve been dealing with this disease? No. No, it is not.

So what exactly is the connection between sleep and weight? It’s thought to be related to two hormones — leptin and ghrelin. The first hormone, leptin, increases your feeling of satiety after you eat. Ghrelin, in turn, stimulates the appetite and makes you hungrier. So, when you lose sleep, leptin goes down and ghrelin goes up. Effect? You get hungrier, but you don’t feel full. Talk about double jeopardy.

There may also be a link between sleep apnea (breathing difficulties during sleep) and being overweight. The article goes into more detail with this potential link, as well as other possible ramifications of the no-sleep cycle that fibro causes.

It’s not just fibro either — any chronic pain condition can be the cause of insomnia. Although it’s obvious more research needs to be done, it looks like there’s enough information there to make sleep an even bigger priority for us all. Without proper, adequate rest, none of us are going to feel better, and too many of us are struggling with the excess weight which can just exacerbate the pain levels. Sleep loss isn’t some cute punchline to a late-night joke. It’s serious stuff.

How do you deal with insomnia? Personally, I give up early. I’ll lay there for maybe 30 minutes but no more. Then, I get up and get busy on something for at least 30 minutes. Usually I can get back to bed after a few hours. But it’s not enough to keep me out of a sleep deficit, so there are occasional naps each week.

What about you?