Patients experiencing neuropathy symptoms, including those of diabetic peripheral neuropathy, not only have to manage pain but also sleep disturbances. Here are some techniques on how to stop the cycle of pain and sleeplessness….
When dealing with neuropathy, you might think insomnia is the least of your problems. But, the compounding effects of neuropathy symptoms and sleep disturbances require that you address both head on.
Neuropathy can affect sleep in several ways. For some people, neuropathy symptoms, such as abnormal sensations or hypersensitivity to touch, particularly in the feet and legs, may make it difficult to fall asleep or stay asleep.
Without daytime distractions such as work, friends or hobbies, many patients find themselves focusing more on the pain in the evening, reporting that their perception of pain actually increases when trying to sleep.
For others, sleep disturbances can aggravate neuropathy symptoms. For example, sleep deprivation can lower your pain threshold and make the neuropathic pain feel worse.
People who sleep poorly are susceptible to depression and other mood disorders, changes in eating, decrease in physical activity and an overall decline in health. Compounded with neuropathy, this becomes a vicious cycle.
How to Get More Rest
But you can stop the cycle. Start by tracking your neuropathy symptoms and sleep patterns, and then make healthy changes to your daytime habits and bedtime routine:
- Keep a regular sleep/wake schedule.
- Develop a bedtime ritual, such as taking a warm bath or reading light material.
- Limit or eliminate caffeine four to six hours before bed and minimize daytime use.
- Avoid smoking, especially near bedtime or if you awake in the middle of the night.
- Avoid alcohol and heavy meals before you go to bed.
- Turn off your TV, smartphone, iPad and computer a few hours before your bedtime.
You also can adopt relaxation techniques to help induce sleep. These include:
- giving yourself an extra hour before bed to relax and unwind, and time to write down worries and plans for the following day
- doing deep breathing exercises
Finally, create a comfortable sleeping environment. For example,
- Make sure your bedroom is dark, quiet and well-ventilated.
- Make sure your bed and pillows are comfortable.
- Elevate the bed sheets so that they’re not touching your legs and feet.
Seek Your Doctor’s Help to Address Sleep Disturbances
If sleep problems persist and interfere with your ability to function, it may be time to consult your doctor. Describe your sleep symptoms, the effects of sleep symptoms on your daily activities and neuropathy, and medication history. That’s because many prescription medications and some herbal remedies can affect the quality of your sleep.
After evaluating your neuropathy symptoms and sleep problems – as well as ruling out other causes of sleep disturbances – your doctor will review with you:
- Self-help techniques – These are techniques you can adopt (as described above) if you’re not already incorporating them.
- Non-pharmacological treatments – These include cognitive behavioral therapy, relaxation techniques, stress management and acupuncture. They are preferred to prescription sleep medications, which can lead to sleepiness during the day, cause dependency and have side effects.
- Pharmacological treatments – Used as a last resort, these should only be used temporarily, especially when the insomnia is chronic. Sometimes, medicines used to reduce pain or aid sleep can affect your sleep.
- Over-the-counter pain medications – For mild pain, over-the-counter pain medications , such as Tylenol and Advil, may suffice. Some over-the-counter pain medications, such as Advil PM or Tylenol PM, also have an antihistamine to help with sleep.²
- Prescription medications—For more severe or chronic pain, your doctor may recommend prescription pain medications such as codeine, and morphine. Some antidepressants and anticonvulsants can also be prescribed. To help with sleep, your doctor might recommend drugs typically prescribed for anxiety, called benzodiazepines (e.g., lorazepam, clonazepam, triazolam), and nonbenzodiazepine hypnotics that are particularly helpful for sleep and appear to be better for longer-term use than benzodiazepines (e.g., zolpidem, eszopiclone, zaleplon).³
Poor sleep, depressed mood and anxiety can complicate your (and your doctor’s) efforts to manage neuropathic pain. The key is to recognize this and partner with your doctor to find the right treatments and approaches that work best for you.