Those of us who have chronic illnesses like PD often experience chronic pain as well. This in turn leads to increased problems with sleep- falling asleep, staying asleep as I am experiencing radicular pain at this moment keeping me up! (fortunately, I have taken my medication and waiting for it to kick in so I can have a good night’s rest)
The lack of sleep causes those of us most in need of pain relief to have more pain by depriving our bodies of the healing effects produced by a good night’s rest. If we don’t allow ourselves to rest and have deep sleep, this can then lead to a vicious cycle of pain and sleep deprivation.
According to the director of Behavioral Sleep Medicine at John Hopkins, Buenaver says that “people often make their situation worst by dwelling on the problem, and worrying about their pain.” So, I often recommend taking a strong pain medication even if it is an occasional narcotic to break the cycle and prevent the brain from becoming sensitized to pain. Because once pain becomes chronic it is much more difficult to treat because our brains have accustomed themselves to thinking there is nothing to be done to make the symptoms better. You are defeated even before you have begun. This thinking is akin to an elephant who falsely believes it can be held captive or in place by a small chain not realizing its own potential because since they are small elephants in captivity are tied to trees which can hold them while young but not as they get stronger. The negative feelings that surge with dealing with chronic pain, the behavioral sleep director states, make those of us with chronic pain more sensitive to its effect.
His suggestion is to replace the negative thoughts, once they are identified, with a more balance positive train of thought which in turn is more likely to elicit greater sleep; since positive emotions not only cause relaxation but can actually ease pain by releasing chemicals like serotonin.
Next time you are bombarded with a negative thought or feeling, you have the power to STOP IT and replace it with a positive one…try it! We begin by adjusting our mind sets, resetting our nocturnal habits- turn off all electronics, lights and commence meditation (prayer) adding positive thoughts to your daily life; otherwise we are not just sleep deprived but we are also hurting ourselves in more ways than one by potentially exacerbating all of our other non-motor PD symptoms.
Sleep impacts our entire being from our brains to how our body performs. Michael Smith, director of John Hopkins Center for Behavioral Health states that” during sleep the space between the cells in our brains expand and allow fluid to flow through the entire brain and wipe away all the toxins of the day -that our brains put out.” We essentially clean house at night making for a more efficient and effective brain free of pollution. We all know what happens if we stopped cleaning our house? Soon it will be filled with garbage and uninhabitable.
Well, the same is true for our brain! We all know that when we are sleep deprived our minds operate less effectively and less efficiently. This is because it has to work extra hard to get over the trashed produced during the day’s activities. At night is when we sift through the waste and store what’s important. If not allowed to do this properly we become slower to recall and our reaction times increase…in a disease where we are already limited and experience slow recall and reaction time we do not need to increase this deficit by depriving our selves of sleep. Furthermore, sleep deprivation affects our prefrontal area – which is our decision making centers, also the area known for dealing with complex emotions and impulse control.
If we are hurting and sleepy we are at a total disadvantage to deal with primitive emotions like base needs and desires thus much more likely to succumb to impulse control effects of the PD medications. Lack of sleep can cause us to be anxious and emotionally become a train wreck which can even lead to severe depression if we allow ourselves to become chronically sleep deprived.
Remember, as I mentioned before, sleep helps with pain and healing. Sleep deprivation causes increase in inflammation which puts the neurons that fire up the pain signals on high alert ready to shoot at a moment’s notice. The neurons responsible for pain become extremely active -no wonder we are more pain sensitive when tired! From personal experience, I know that when I hurt the best remedy for me is to rest and sleep. Even my husband has become attuned to this- if I get enough sleep, I don’t hurt. The worst part is that researchers have discovered that disrupted sleep is even worse than sleeping for shorts amount of time…continuous arousals or interruptions in our nightly sleep cause greater inflammation and greater pain sensitivity…perhaps this is a reason why women and people with PD who have significant bladder issues or are wearing off at night tend to have greater pain? Even those of us who have REM behavior or severe RLS can be more likely to develop chronic pain if sleep continues to become disrupted.
As if being fuzzy minded, emotionally a wreck and sensitive to pain was not enough, sleep deprivation also increases our waistlines by making us eat more caloric foods, and increasing our food urges. Of course with all this topsy- turvy our bodies experiences when we don’t get enough sleep, we naturally become more fatigued. Perhaps, all of our Parkinson’s non motor symptoms would be much better off if we all took a concerted effort in making sure we not only got enough sleep (at least 6 hours a night) but, also a deep restful uninterrupted sleep.
Since, lack of sleep can lead to poor thinking, mood disorders, inhibit our abilities to deal with pain and actually increase our pain sensitivity while making it harder for us to metabolize food increasing our waistline- which by itself can put us at risk for other health issues. Therefore, it is imperative that if you are experiencing problems in any one of these areas, you speak with your doctor ASAP about adjusting medications for bladder, for “off “symptoms at night, RLS, and ReM behavior, pain and yes, perhaps asking them for a sleep medication to ensure a good night sleep.
However, things we can do to improve our lives and sleep are as follow:
1) Exercise in day time not night-preferably early in the morning @ least 3 times a week for at least 30minutes.
2) Limit caffeine intake- especially in the evening. No night caps-wine actually leads to rebound insomnia.
3) Control lights- turn off all electronics- do not read or watch TV in bed. Bed is only for sleep and sexual intimacy. Maintain your sleeping area cool and dark.
4) Relax. – have a ritual and a set time to go to bed and get up. Begin winding down and shutting off electronics at least an hour before bedtime.
I guarantee we will all be feeling much less pain, fatigue, forgetfulness, depression, and less likely to succumb to ICD’s (impulse control disorders).
Richards, Sarah. (Fall 2014): “Cheating Sleep.” Johns Hopkins Health Review. Vol. 1(1):70-77.
“Hurt less, Sleep more.” (Psychology): (Fall 2014): Johns Hopkins Health Review. Vol. 1(1): 19.
Dr. M. De Leon is a movement disorder specialist on sabbatical, PPAC member and research advocate for PDF (Parkinson’s Disease Foundation); Texas State Assistant Director for PAN (Parkinson’s Action Network). You can learn more about her work at http://www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at www.pdf.org or at www.wemove.org; http://www.aan.org, http://www.defeatparkinsons.blogspot.com All materials here forth are property of Defeatparkinsons. without express written consent, these materials only may be used for viewers personal & non-commercial uses which do not harm the reputation of Defeatparkinsons organization or Dr. M. De Leon provided you do not remove any copyrights. To request permission to reproduce release of any part or whole of content, please contact me at deleonenterprises3@@yahoo.com contributor http://www.assisted-living-directory.com Contributor http://www.lavozbrazoriacounty.com