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Top Ten Sleep Disturbances – #7 Pain

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#7 Pain
A Serious Intruder on Restorative Sleep
Heather Johnson, RN, Resource Nurse

A recent poll of the American public, found that 21% of Americans experience chronic pain and 36% had had acute pain in the past week. Combine those totals, and it equates to 57%, leaving only 43% of Americans who report being pain free. Pain ranks as number seven in the Top Ten Sleep Disturbances.

People with pain often report feeling less control over their sleep. They report being worried about lack of sleep and its effects on their health. Worry leads to stress. Stress and poor health, often go hand-in-hand and can often be linked to fragmented sleep. Fragmented sleep translates to interrupted sleep which prevents a person from receiving 7-9 hours. Seven to nine hours of uninterrupted sleep is necessary for restorative sleep. Restorative sleep is needed for physical and emotional healing. Sleep loss is known to contribute to feelings of depression and fatigue, which in turn can increase a person’s pain perception. Research indicates that if a person experiences poor sleep due to pain one night, they are more likely to experience pain the next night, and the next night, and so on. We know that pain can be a serious intruder on restorative sleep.

Pain, depression, and fatigue are interrelated. Further, pain often is linked to insomnia, and, when both of these problems coexist, the perfect recipe for additional problems has been created. Additionally, evidence suggests that sleep loss increases reports of pain, when you don’t sleep well you have a heightened sensitivity to pain. This vicious cycle of poor sleep due to pain affects multiple areas of a person’s day to day life.

What can a person do?

  • Determine the source of the pain. Is it physical pain? Is it emotional pain? Get to the root of the problem, identify the root cause. Once you’ve identified the source, address the source with the right solution or intervention.
  • Seek direction from your medical provider.
  • Exercising or stretching of sore muscles by stimulating blood flow and easing pain
  • Evaluate your positioning in bed; your pillow, mattress, and environment.
  • Retrain you brain to think of something positive as you head to bed for the night.
  • Research non-pharmacological interventions such as, relaxation techniques (focus on your breathing), guided imagery, aroma therapy, heat/cold, and massage.
    If it’s physical pain, consider a longer acting pain reliever, one that will last throughout the night.

Don’t let pain rob you from a good night of sleep!

References:
Cosio, D., Lin, E; PPM: Practical Pain Management. Disturbed Sleep: Causes and Treatments. 2018. https://www.google.com/amp/s. Accessed November 20, 2018.
National Sleep Foundation. Recommended Sleep. 2015. https://sleepfoundation.org/how-sleep-works/how-much-sleep-dowe-really-need. Accessed November 20, 2018.
Onen, SH., Alloui, A., Gross, A., Eschallier, A., Dubray, C. 2001. The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects. J Sleep Res. 10, 35-42. doi:10.1046/j.1365-2869.2001.00240.x

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Falling From Grace

Author:  Heather Johnson, RN Clinical Educator & Program Specialist

Without a doubt, I can say almost 100% of our population has fallen at some point in their lifetime.  When I pose this as a question to participants in educational sessions I often find a handful of individuals that honestly report they have never fallen.  Unless you are some type of super-human and are as agile as a mountain goat or monkey, you have fallen at some point in your lifetime and the odds are you will fall again.

My older sister was nicknamed “Grace” in our childhood years as she mastered the uncanny ability to fall even while going UP the stairs in our home.  We often referred to this ability as her “talent” and would laugh if we were present to witness her mishap.  As we grew older and more experienced I came to understand how the consequences of her missteps could carry horrific injuries.

While a fall for any age can have serious results, the impact of a fall for an older adult can be grave.

Are you aware one in four Americans aged 65 and older falls each year?  Every 11 seconds, an older adult is seen and treated in a hospital emergency room due to injuries sustained from a fall?  Hip fractures, broken bones, hematomas and traumatic brain injuries are often the result of a fall for those over the age of 80.  One in five hip-fracture patients will die within one year of their injury.  Yes, they will die.  The trajectory is not in their favor.

I spent this past week at the 4th Annual National Falls Prevention Conference in Philadelphia and took part in a learning experience that left me feeling both extremely positive and proud about the work we are doing in falls prevention.   Simultaneously I was overcome with a desire to continue to push harder and work for better outcomes for our seniors.  While in Philadelphia, I had the opportunity to see the very steps Sylvester Stallone made internationally recognizable in the movie Rocky, the ever-famous steps of the Institute of Art Museum. In the movie, Rocky not only climbs these steps in different weather elements, but he runs.  He runs, he trains, makes himself stronger, and he becomes more agile each day.  Rocky was relentless in his training with his desire to ultimately become the Heavy Weight Boxing Champion. While you may not be training to become the next world famous boxer, we certainly can be left inspired by his grit and undying desire to improve himself.  At the age of 71, Sylvester Stallone makes it well known that he takes his physical health and exercise seriously.

What can we do?  Evidence-based best practices support assisting individuals with maintaining (or even improving) mobility, balance and core muscle strengthening through regular exercise.  These are proven ways to greatly reduce the chances of falling at all ages.  This alone is the number one way to prevent falls!  The National Council on Aging offers a wide range of exercise and for all abilities.

https://www.ncoa.org/healthy-aging/falls-prevention/   

By encouraging and promoting activity, you are not only reducing the risk of falling for an older adult, you are also encouraging their opportunities for socialization which, in turn, has been proven to decrease episodes of both depression and anxiety.

 Falling is not a normal part of aging and there are numerous ways that are proven to reduce the chances of having a fall.

I encourage you as a care provider, a son or daughter of aging parents, as a grandchild or as a friend to a senior, to not only consider the physical environment, footwear, and eye glasses when striving for preventing a fall, but to also consider what you can do to help promote movement, core strengthening and social opportunities for the aging.   By doing so, maybe we can all extend each other a bit more “Grace.”

Written by:  Heather Johnson RN, Clinical Educator and Program Specialist

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