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Contributor: Sleeping Better with Chronic Pain

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I’m a chronic pain sufferer from Copenhagen, Denmark who suffers from multiple pain conditions following an accident four years ago. I have a disc prolapse in my neck, nerve damage in my shoulder, and thoracic outlet syndrome, so, unfortunately, I’m no stranger to pain. I’m also a writer and editor for a Danish bedroom and wellness magazine.

Sleep and Pain Go Hand in Hand

Something that’s been with me since the accident is poor sleep. I’ve become very sensitive to my sleeping environment; noise, temperature, mattresses, and pillows have to be exactly right if I am to get a good night’s sleep.

I know this is something I share with many who suffer from chronic pain. We sleep poorly because of pain, and that, in turn, creates even more pain. Did you know that sleep is fundamental in dealing with inflammation? Poor sleep is a strong predictor of pain, creating a vicious circle. This is why we should do our very best to get the sleep we so deserve!

I’ve been experimenting for several years to find the best methods for sleeping soundly through the night. I still don’t sleep as well as I used to, but I’ve gone from waking up feeling like crap every day to feeling “okay” most of the time. I’ll settle for that. I’m here today to share what I’ve learned about managing pain, so you can hopefully sleep better as well.

That said, let’s talk a little about your bed and bedding.

Mattress

I used to be able to sleep anywhere, anytime, on anything. I spent several months sleeping on the couch of a friend when I was in my twenties. That’s not happening anymore. I need my mattress and topper, or I’m not getting any sleep at all.

Buying a mattress is not something most people think much about. Maybe you’ve replaced your mattress once or twice in your life, but generally, we tend to stick with our mattress for far too long. That might be okay if you’re young and healthy, but if you suffer from any kind of muscular or spine condition, then that’s a big mistake.

A mattress has a maximum lifespan of 10 years, but frequently they only last four to five years. If you have an old mattress, you will either sink into it or find a valley of depressions and bumps. A too-soft mattress is the number-one cause of back pain!

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If your mattress is more than a few years old, consider replacing it with a new one.

There’s been research conducted on the relationship between mattress age and back pain. A study done on 59 Americans with back pain tested the effects of replacing an older mattress (>five years) with a new one. They checked in after four weeks and eight weeks, respectively, and:

“… it was concluded that, in this population, new bedding systems increased sleep quality and reduced back discomfort…”

My personal experience definitely confirms this. I sleep much better on my new mattress than I did on the old. I also have significantly less shoulder pain. I used to sink into my old mattress, which led to a lot of pressure on shoulder and neck muscles.

What kind of mattress, then?

Box, spring, foam — I don’t think it matters too much. What does matter is quality. You want pocket springs if you buy a spring mattress, and high-quality foam if you buy a foam mattress. Personally, I prefer a pocket spring mattress, but a modern foam mattress can definitely be a good option. Give both a try in the shop with the same mattress topper. Foam can be quite a bit cheaper, so keep that in mind.

Firm or soft?

There used to be very firm mattresses called “orthopedic mattresses,” so named because they were recommended by orthopedic surgeons. That’s not the case anymore. Recent studies recommend a normal “medium firm” mattress as you would suggest to everyone else.

When choosing firmness for your mattress, choose by weight and not by feel. It’s impossible to properly judge firmness in a few minutes in the shop. Ask your salesperson about which mattress is best for your weight. Firm mattresses are generally for people above 185 lbs, while medium works for those weighing below that. If you’re above 200-220 lbs, you might benefit from an “extra firm” spring mattress.

Mattress toppers are underrated

A mattress topper is a thin independent mattress on top of your actual mattress. Mattress toppers are a relatively recent phenomenon but are a big upgrade over a “naked” mattress. They provide additional comfort and support, which is very important for those suffering from pain. They also allow you to have a firmer mattress while retaining comfort. I’ve found the combination of a firm mattress with a soft mattress topper to be the best for minimizing pain. Mattress toppers come in several different materials; foam, memory foam, and latex are the most popular.

Memory foam is a material originating in space with NASA. It was created to absorb pressure for astronauts during launch but was later adopted for use in pillows and mattresses. It’s probably the most popular material for mattress toppers today. Memory foam actually has quite a bit of scientific proof behind it. Several studies have shown the beneficial effects of memory foam on back, neck, and muscle pain. Memory foam conforms and contours to your body, giving you a gentle embrace through the night. This is the reason why it’s so popular.

Latex is another popular material, frequently produced as a combination of natural latex from the rubber tree and artificial latex produced from a foam material. It’s a springier, firmer material, which provides comfort but doesn’t let you sink into it as memory foam does.

Pillows

Depositphotos_102229946_m-2015Pillows! Now that’s something I have experience with. I have a slipped disc in my neck and thus pillows are something of a big deal for me. The wrong kind of pillow makes me wake up with a completely stiff neck and pain down the upper back. I know this is very common in those suffering from whiplash syndrome and other conditions.

When it comes to pillows, there are many types to choose from, but I’ll focus on those pillows made specifically for neck health, called “ergonomic pillows.” The alternatives are traditional pillows with down or various kinds of synthetic fillers. My experience here is that they do not give enough support for those suffering from neck pain.

Latex and memory foam are, coincidentally, also what most ergonomic pillows are made of.

Memory foam pillows for the back sleeper

Tempur-Pedic is probably the best-known brand when it comes to ergonomic pillows with “the original” memory foam pillow. Lots of copycats have since entered the scene, so it’s difficult to figure out if the extra cost of Tempur-Pedic is worth it.

Pillows made from memory foam adapt to the curvature of your spine, neck, and head. You’ll sink into it, and your neck will be gently supported. Many of the pain patients I converse with online swear by this, though I’m not a big fan. That’s because I’m 1) a side sleeper and 2) a restless sleeper. I turn over a lot, and I’ve found that I don’t like memory foam for this reason. It doesn’t support me well in the side-sleeping position.

If you are a calm back sleeper, however, then this could be the pillow for you. It’s not just hyperbole; I’ve heard testimony from so many patients with whiplash, fibromyalgia, and slipped discs.

Latex for a more “pillowy” experience and for side sleepers.

Latex is my personal choice of pillow. I actually have a hybrid pillow made with a latex inner core and another layer of goose down. It’s really great for me and was the winner in a test of ergonomic pillows that my magazine did (it’s in Danish, but you can see pictures and star ratings). The latex core gives firm, but soft, support of my neck, regardless of positions, and the down layer makes it feel like a real pillow. This particular pillow was from a Danish brand called Dunlopillo, but I’m sure there are alternatives.

I particularly enjoy that the latex material is more flexible in terms of position, yet never clumps together or flattens like a regular pillow. It’s strong and supportive, but very soft to the touch. I highly recommend it.

Sleeping position

Your sleeping position supposedly says a lot about you. Sleep on your back and you’re confident; sleep on your side, and you crave security and comfort. I’ll not get into the psychology of that, interesting as it may be. Rather, I will discuss the various sleeping positions from a pain perspective.

Spine-Health.com is an excellent online resource for back pain. They’ve written a great guide to choose a sleeping position based on your diagnosis.

I can’t comment on those specifically, as I’m not a medical doctor. I can, however, give my opinion on the sleeping position that works the best for me.

The semi-side sleeper position

This sleeping position is for those who suffer from pain and stiffness in the upper quadrant (neck, shoulders, upper back) and those with hip and lumbar issues.

It’s a variation of the side sleeper position and the stomach position.

  • By sleeping on your side, you lessen pressure on the spine and hips.
  • By leaning over and halfway onto your stomach, you lessen pressure on your shoulder.

It also works best with a side sleeper pillow, but you can make do with normal pillows or your duvet. Side sleeper pillows are also known as “pregnancy pillows,” as they give support to a big belly — but they are definitely for everyone, men and women. Below is an example of such a pillow:

This position frees up your shoulders and puts less pressure on the Brachial Plexus nerve bundle near the collarbone, which affects the arms, shoulders, and upper back. If it gets compressed during sleep, it can lead to pain in unexpected places, such as in your shoulder blades and upper back.

Likewise, by placing a pillow between your legs, you free up the hips and lumbar spine.

Give it a try! I recommend buying a side sleeper pillow, but two ordinary ones are fine to test it out.

If you’re unsure how to do it, check out this video. It’s in Danish (yeah, I know), but at 2:30 minutes into the video, the chiropractor provides a demonstration.

Bonus Tip: Earplugs

I sleep with earplugs almost every night. I’ve been very sensitive to sound since my accident and was told by a doctor at a pain clinic that this was very common for chronic pain patients. Your nervous system is on high alert, so it responds to things that it shouldn’t. Waking up because of noise is really bad for your sleep. I use soft foam earplugs, which I hardly feel at all. I usually take them out at night without remembering, but they are very effective when falling asleep.

Bonus Tip: Naps are your friend

My last tip: embrace napping. I think we all know those days when you wake up and just know that you won’t be able to do much that day. I’ve found that napping is a really good idea on those days. Don’t fight it and don’t overdose on coffee; lie down and nap for an hour or two. Set your timer at least an hour and a half later, as it usually takes longer to fall asleep during the day. You’ll wake up feeling refreshed and energized.

Summing It All Up

Let’s recap:

Tip 1. Buy a new mattress with a mattress topper

Get a new mattress if your current model is five years or older. Buy a medium-firm topper according to your weight class. Get a mattress topper in latex or memory foam. Thicker is better.

Tip 2. Get an ergonomic pillow

An ergonomic pillow provides support for your neck, shoulders, and upper back. Get one in latex or memory foam, but try them both before you buy. It’s important to get the correct size.

Tip 3. Sleep on your side with a pillow

The semi-side sleeper position is the best position for your shoulders, spine, and hips. Get a special long side sleeper pillow, place it between your knees, and hug it with your arm.biopic

That’s it! I hope you will find relief and better sleep with my humble contributions.

Eric is a chronic pain patient from Denmark. He is also an editor and writer for a Danish magazine about sleep and wellness, Sove.nu, with several years of experience in researching bedding and sleep products.

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