Is it normal to have trouble sleeping?

It is very common for people with pain and functional symptoms to have difficulty sleeping. When people do not sleep well, they become more sensitive to discomfort and are more likely to have pain and symptoms that do not go away.

Because of this, it is very important to work on making sure you have good sleep health. Most sleep problems can be fixed with changes in sleep schedules and behaviors if they are practiced the same way every day and night.

Below are some recommendations to help you get a healthy night's sleep. Keep in mind that these changes may need to be in place for 2-3 weeks before you notice improvements.

Check the chart below to see how many hours of sleep a healthy person your age should be getting each night. If you are not getting enough sleep, keep reading to find out what you can do to improve your sleep. 

Age  Hours of Sleep Needed
School Age (6 - 12 years) 9-11
Teenagers (13 - 18 years) 8-10

Why am I not getting enough sleep?

There are many reasons why you may not be getting enough sleep. Some things that can make it hard to get a full night of healthy sleep are:

  • Pain and discomfort
  • Busy school schedules
  • Nighttime fears or worries
  • Not following a consistent sleep routine

Also, some teenagers may experience a natural delay in nighttime sleepiness, resulting in later bedtimes.

What is sleep quality?

If you are getting enough hours of sleep, but still feel tired, you may have poor sleep quality. This means that you may be waking frequently or have other disruptions to your sleep. Your sleep quality may be a problem if you sleep enough hours, but:

    • You cannot make it through the day without a nap
    • You talk about feeling tired a lot
    • You often feel moody, cranky, or upset
    • You feel less in control of your actions
    • You have trouble concentrating or remembering things

Am I sleeping too much?

You may be sleeping too much if you are sleeping more than 12 hours at night or taking naps during the day. People may sleep too much because it is a way to try to deal with chronic symptoms, they are not getting enough physical activity or exercise during the day, or because they feel depressed.

Why should I turn off electronics before bedtime?

Electronic devices (phones, TVs, computers, video games, etc.) keep the mind active. Many electronics also produce a blue light that delays the release of a hormone called melatonin. Melatonin is naturally released when our eyes are exposed to the dark. When this process is interrupted due to the bright light of screens, it is harder to sleep. It is important to turn off all electronic devices at least 30 minutes before bedtime.

Why do I feel worse after a nap?

Napping for more than 30 minutes during the day takes away from the sleep you will get that night. It does not make up for sleep that was lost the night before. Taking daytime naps can make it harder to fall asleep and stay asleep.

Also, the body falls into deep sleep within 1 hour, which means that waking up after a nap can be hard. Most people feel groggy and tired after napping for more than 30 minutes, instead of feeling refreshed and well rested.

Why should I wake up at the same time every morning?

If you are having trouble falling asleep, are not getting enough hours of sleep, or have poor sleep quality, you should set a planned wake-up time each morning. If your schedule changes a lot (waking up early some mornings and sleeping late other mornings), your body has a hard time knowing when to go to sleep and when to stay awake. This can make falling and staying asleep at night very hard.

Why should I only use my bed for sleeping?

Doing other things in bed, like homework, watching TV or playing on your phone, "fools" the brain into thinking that the bed is a place for activity and not a place for quiet sleep. You should choose another spot in the house for doing homework or activities.

Recommendations to improve sleep:

If you are not getting enough sleep, have poor quality of sleep, or if you do not have good energy to make it through your day, following these recommendations will help. Keep in mind that it can take time to see results after you make these changes-often 2-3 weeks.

If you are still having trouble sleeping after several weeks of consistently practicing these changes, let your doctor know.

Daytime behaviors

  • Do not rest or stay in bed during the day. D After you wake up, plan to spend at least 10 minutes of time outside to start the day. D Plan a fun activity in the morning (walk, special TV time), so that you look forward to starting the day.
  • Try to exercise every day (as recommended by your doctor).
  • Make sure to eat healthy meals at regular times.
  • Eliminate caffeine (in soda, coffee, tea, energy drinks, etc.) after lunchtime.
  • Do not nap during the day. Bedroom environment
  • Make your bedroom a comfortable place (cozy bedding and cooler temperatures, quiet and dark).
  • Take TVs and any other screens (computer, laptop, tablet, phone) out of your bedroom.
  • Use your bed only for sleeping {NOT for homework, watching movies, or other activities).

Bedtime routine

  • Create a pleasant bedtime routine that includes calm and relaxing activities to help your body and mind slow down before bed (like reading a book, listening to music, doing relaxation exercises).
  • Eat a light, non-sugary snack 30 minutes before bed. This can be a piece of fruit or a few crackers and cheese. Avoid heavy meals within 1 hour of bedtime.
  • Turn off all screens (TV, phone, tablet, computer) at least 30 minutes before bedtime.
  • Do not take a hot bath or shower within 30 minutes of bedtime. The body needs to cool down to get into a deep sleep.
  • If you often wake up at night to use the bathroom, do not drink within 1 hour before bedtime.

Difficulty Falling or Staying Asleep

  • Make a written plan for what to do at night when you cannot fall or stay asleep. You should not lie awake in bed if you cannot sleep after 45 minutes. Get out of bed and try a calming activity (reading with a small book light, coloring, relaxation exercise). Then try to go back to sleep again after about 20 minutes.
  • Turn your clock around so it cannot be seen from the bed. Looking at a clock during the night can cause stress and worry about sleep.

  • Never use screens and devices (like phones, computers, TVs) in the middle of the night. It will make your brain think that it's morning.

  • Put a notepad and pen next to your bed so you can write down thoughts that may keep you awake at night.

Sleep schedule

  • Set a regular time to wake up, no matter how well you slept. If you have problems with sleeping, it is more important to have a set wake-up time then a set bedtime. Wake-up times should not change by more than 1 hour, even on weekends.
  • Eliminate daytime naps completely.
  • Plan to get into bed 30 minutes before you typically have been falling asleep. For example, if you are falling asleep very late {1am), you should get into bed at 12:30am. Bedtimes can be moved earlier, once a set wake-up time is in place for one week.

Use of relaxation or mindfulness

To get really sleepy, your body and mind need to be relaxed and comfortable. Learning skills like deep breathing, muscle relaxation and mindfulness can help you get ready for a good night sleep. These same skills can be used in the middle of the night if you wake up a lot from pain or for other reasons.

  • Give it a try: To try deep breathing, mindfulness or guided imagery, go to our Guided Exercises page. You can listen to the exercise, or print a pdf of the exercise to read.
  • Caregiver Support: Getting started with a new skill like relaxation or mindfulness may be easier with some parent support. Parents can see how to help with relaxation by using our Parent Resources and How to Videos.
  • There are also many helpful apps you can use to help faII asleep. You can ask your doctor for a list of suggested apps.

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