tips to improve your sleep Do you dream of a good nights sleep? Read on for the best tips to help you drift off WORDS: GEORGINA WINTERSGILL Manage your pain See your doctor to try to resolve any issues affecting your sleep. If pain keeps you awake, taking your medication at a different time may help. Angela Jacklin, a specialist rheumatologist occupational therapist at Stepping Hill Hospital, Stockport, says: Your GP may be able to prescribe a slowerrelease painkiller, giving relief over a longer period. Also check that none of your medication could cause sleeplessness. Jacklin adds: Stretches before bed can help relieve muscle tension. A warm bath or shower can ease joints. Heat packs, a hot water bottle or electric blanket can help, too. DEALING WITH NIGHT-TIME AWAKENINGS Improve your room Keep your bedroom cool, dark and quiet, advises Dr Guy Meadows, clinical director of The Sleep School (www.thesleepschool.org). The temperature should be around 16-17C. Consider blackout blinds or an eye mask. Limit noise, and use ear plugs ifnecessary. Buy a mattress that fits your orthopaedic needs. If you share your bed, ensure its big enough or consider two singles that can be joined. You can also get duvets of different togs that fit together. Jacklin adds: A memory-foam mattress-topper can ease painful joints. If the weight of a duvet causes pain, an occupational therapist may provide a bed cradle to keep covers off your legs. PILATES AND SWIMMING BOTH WORK FOR ME Stick to a routine Go to bed and get up at the same time every day. Its crucial for keeping your body clock on time, says Dr Meadows. When you dont sleep well, its tempting to lie in, but that weakens the drive to sleep at night. Naps are important, but stick to less than 30 minutes, ideally between midday and 3pm. Get moving Dr Meadows says: Exercise is helpful because it tires us out. It also releases happy hormones endorphins whichcan help us sleep. If we exercise outside, were exposed to natural light, which tells our body clock were awakeand sleep will come tonight. A brisk walk in the morning is ideal. Specialist pain physiotherapist Richmond Stace says: Your body needs regular movement to be healthy. But dont exercise late in the evening. Exercise can trigger reactions by the immune system such as a bit more pain, which could disrupt sleep. Drink sensibly You dont have to give up alcohol and caffeine altogether just be smart about when you drink. Dr Meadows says: Avoid coffee after midday or 2pm. Alcohol has a sedative effect so it can help you fall asleep, but its metabolised incredibly quickly, which makes you wake up. It takes one hour to metabolise one unit, so a standard glass of wine at 7pm, containing about two units, should be out of your system by 9pm. Learn to switch o Lying in bed with a smartphone or tablet isnt unusual but nor is it conducive to sleep. Its too much mental activity, says Dr Meadows. Also, digital devices emit a blue light its like a mini-sun telling your body its not time to sleep. Ideally, you need 30 minutes where you switch off everything, slow down and read for a bit preferably an ordinary book, or an original Kindle that doesnt emit light before turning out the light. Dr Guy Meadows on how to sleep well Getting to sleep is one problem; getting back to sleep after waking up can be even harder. Dr Meadows says: Chronic pain sufferers may need to get up to stretch, but should then get back in bed resting is very beneficial. Try mindfulness meditation. Regular practice is proven to reduce the time taken to fall asleep, increase sleep quality, and be an effective way of managing chronic pain. Ask yourself what you can feel: the duvet on your toes, the mattress on your back. When other thoughts come, let them go. Notice the rise and fall of your chest and your breath going in and out. Liz Lindsay, 36, from Dorking, Surrey, was diagnosed with rheumatoid arthritis seven years ago My aching joints and muscles make it hard to get comfortable at night, especially during flareups. I can only really sleep flat on my back. There are various things I do to improve my sleep. In terms of medication, Ive been prescribed amitriptyline [a tricyclic antidepressant that helps relieve pain, relax muscles and improve sleep], which helps. During flare-ups, I take the painkiller co-codamol before bed, which makes me drowsy. Investing in a good bed and mattress has helped. I dont drink much alcohol and I dont drink caffeine after lunchtime or I cant sleep. Gentle exercise and stretches help Pilates and swimming are best. A good book helps me wind down and takes my mind off things. If Im woken by pain, I try to get back into a good position and relax a relaxation CD sometimes helps. My main tip is not to think about sleep too much. If youre thinking, Will I be able to sleep? as soon as you go to bed, that wont help."
