Prescribing Better Sleep: How to Help Your Patients Heal Themselves $0.00

Prescribing Better Sleep: How to Help Your Patients Heal Themselves

By: Rebecca Moore | Feb 21, 2019
Prescribing Better Sleep: How to Help Your Patients Heal Themselves

Sleep isn’t just a basic human need; it’s a critical period of recovery that supports the health and function of the cardiovascular system, neurological system, musculoskeletal system, gastrointestinal system and more.1 When it comes to healing your patient’s injuries, improving their performance or enhancing overall-health, advocating for better sleep should be one of the foundational components of your treatment plans. But what is “better” sleep, why does it matter and how is it achieved? To answer these questions, let’s begin by taking a look at the power of a good night’s sleep.


How Sleep Improves Recovery


While you sleep, your body is hard at work repairing and recovering itself from the impact of the previous day. But how to do you get busy bodies to go to bed? Here are the two main benefits of sleep you can share with your patients to motivate them to catch more Z’s:

1. Sleep promotes healing throughout the entire body.


The best treatment to compliment the care of a physical therapist, chiropractor, massage therapist or other hands-on healthcare professional is sleep. After dozing off, the brain releases hormones that promote tissue growth and muscle restoration. During this process, everything from minor cuts and bruises to larger bone, ligament, cartilage and tendon injuries have time to mend and rebuild.2 Sleep also plays a part in maintaining healthy bone marrow and making more white blood cells to defend the body against bacteria and viruses. This means that sleep is one of the most important ways to help the body protect itself from infection.3

2. Sleep helps decrease pain perception.


It’s safe to assume that the majority of your patients come into your clinic to get rid of pain; they can even leave with more acute pain post-treatment as well. Therefore, it’s important to prescribe sleep as a part of your pain management plans. Studies show that there is a reciprocal relationship between sleep quality and pain perception:

“People with sleep disturbance report increased sensitivity to pain, but also those experiencing high pain intensity have reported significantly less total sleep time, delayed sleep onset, increased night time wakening, and decreased sleep efficiency. Pain has been associated with poor sleep quality and shorter sleep time in patients with chronic pain, including those with fibromyalgia, osteoarthritis, low back pain, and painful diabetic peripheral neuropathy.”1



Are You Emphasizing Home Exercise Programs?


A key component to patient outcomes isa successful home exercise program. Home exercise compliance is associated with better outcomes. With the number of clinic visits decreasing, it’s more important than ever for patients to have a home exercise program…and with MIPS it’s even more important that they are compliant for better outcomes. Here are a few important points to remember to improve your home exercise program prescription:

“People with sleep disturbance report increased sensitivity to pain, but also those experiencing high pain intensity have reported significantly less total sleep time, delayed sleep onset, increased night time wakening, and decreased sleep efficiency. Pain has been associated with poor sleep quality and shorter sleep time in patients with chronic pain, including those with fibromyalgia, osteoarthritis, low back pain, and painful diabetic peripheral neuropathy.”1/p>

Promoting Healthy Sleep Habits


The National Sleep Foundation recommends that people adopt these five habits to establish a healthy sleep routine:

  1. Try to go to sleep and wake up at the same time every day to establish a circadian rhythm - that means on weekends, too!
  2. Be mindful about your consumption: avoid nicotine and caffeine four to six hours before bedtime, avoid alcohol in the evening, don’t go to bed on an empty stomach and don’t drink too many liquids before bed.
  3. Create a comfortable sleeping environment free of excessive light and noise.
  4. Start an evening ritual that you perform every night to wind down (that doesn’t include the television or any other screens!).
  5. Don’t stress yourself out by staring at the clock.4

While guiding your patients through these principles is helpful, your biggest duty as a master of musculoskeletal health is to promote proper sleep positioning.



Not All Sleep is Good Sleep: Building the Proper Sleeping Position


When a patient is healing from an injury, improper sleeping positions can leave them at risk to aggravate the injury and prevent it from healing. On the other hand, even patients who have not suffered an injury can still develop problems and pain if they’re sleeping wrong.

“This is because, when scar tissue develops, it can bind up and tie down tissue that needs to move freely. This buildup is known as adhesions, trigger points or knots. As scar tissue builds up, muscles become shorter and weaker, tension on tendons can cause tendonitis, and nerves can become trapped. This can reduce range of motion and strength, and create pain. If a nerve is trapped you may also feel tingling, numbness, and weakness.”5

Specialists advise sleeping in a neutral position, but there are multiple ways to reach ‘neutral’ depending on position preference: some people are side sleepers, some are stomach sleepers and some are back sleepers. Keep in mind that clinicians should consider the patient’s diagnosis when making a sleeping position recommendation; positioning for sleep in a pain-free or pain-reduced position may limit sleep disruption for these individuals, and you want to ensure that the position is not putting too much pressure on sore muscles, joints or tendons.3

When sleeping, most patients will need to consider one or more of the following positioning aides:

  • Neck support - A pillow should not be so flat that the cervical spine is in lateral flexion, and not so thick that the cervical spine is in lateral extension.
  • Low back support - Keeping the lumbar spine in a neutral position doesn’t always mean that a support aide needs placed around the back or core. In some instances, changing the positioning of the knees can anteriorly tilt the pelvis or better align the spine, resulting in less pressure on the low back to support the body.


Prescribing the use of high-quality tools and aides will help your patients reach these optimal postures. While experts recommend people sleep in supine or side-lying positions and avoid prone positions, here are the recommended sleep aids to support all three positions:


Optimal Positioning for Side Sleepers



Optimal Positioning for Back Sleepers

Optimal Positioning for Stomach Sleepers

Sleep Tight!


For more information about the power of sleep and how to best enable your patients to sleep well, check out The National Sleep Foundation’s site. You can also learn more about the Rolyan line of sleep support products here.


Click here to download our sleep positioning PDF so you can pass it on to your patients!

Sleeping Position Guide



Resources:

  1. https://academic.oup.com/ptj/article/97/8/826/3831304
  2. https://www.webmd.com/a-to-z-guides/discomfort-15/better-sleep/healing-power-sleep?page=2
  3. https://www.chicagotribune.com/suburbs/advertising/marketplace/ct-ss-suburbs-four-crucial-ways-that-sleep-helps-the-body-to-heal-20180112dto-story.html
  4. https://www.sleep.org/articles/design-perfect-bedtime-routine/
  5. https://www.bewell.com/blog/making-the-connection-sleep-and-injuries/
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