What kind of sleep pattern do you have at present?

Write down in your notebook what your sleep pattern is like now. Take last week as an example. (We will look at this in more detail later in this chapter.)

1   How many hours’ sleep did you get, on average, at night?

2   How many hours’ sleep did you get, on average, during the day?

3   Do you feel you are getting enough sleep?

4   What things affect how well you sleep? Use the problem list on the previous page for ideas, and add your own experiences.

5   What thoughts and worries do you have about your sleeping pattern?

Note: Discuss with your doctor any concerns you may have about your drugs and how they affect your sleep.

How much sleep do you need?

Adults never usually need more than 9 hours’ sleep. Some people report feeling refreshed and alert after 5 hours. Generally, having one longer sleep is more satisfying than napping and waking often. People vary in how many hours’ sleep they need. Your sleep requirements can also depend on your age, and on how active you are.

Our need for sleep decreases as we get older. For example:

•   A teenager may need 10 hours’ sleep.

•   At age 40–60, we usually need 6–7 hours’ sleep.

•   At age 60 and older, we need only 5–6 hours’ sleep.

If you are not active, you will need less sleep, but may feel more fatigue due to inactivity (see Chapter 9).

You may have a clear idea of how much sleep you should get. However, this may be based on what your sleep pattern used to be, rather than on what is happening now. A disrupted sleep pattern can usually be improved, despite ongoing pain. It is common for people who have trouble sleeping to feel edgy and irritable. Lack of sleep can affect your concentration. However, it is easy to let thoughts about poor sleep (for example, worrying that lack of sleep is causing you long-term harm) get out of proportion. (Take, for instance, Jim’s worrying over Ann’s health and all the things that he needs to do every day even when his pain is severe.) Sleeplessness is quite common, even for people who do not have ongoing pain problems. It does not usually cause harm.

You can do positive things to improve your sleeping pattern. Here are some ideas that have helped others with chronic pain to have better-quality sleep. They may help you improve your sleeping pattern too.

How to use a sleep diary

If you feel that you do not have a good sleep pattern, you could start keeping a Sleep Diary. For a whole week, write down all the times you were asleep, whether you meant to be or not. There is a Sleep Diary below, with an example.

It is important to write down even a five-minute snooze, because it can affect your sleep later. Keeping a Sleep Diary will give you a ‘baseline’ for your sleeping pattern, so that you can see if any changes that you make are working. Fill in the hours when you were asleep. You can then see what your sleep pattern is like. You can put in a note about where you were when you fell asleep (for example, if you dropped off in front of the TV).

Note down:

•   When you took tablets which affect your sleep

•   If you were worrying

•   If you had a nightmare

•   If you woke because of pain or discomfort

All this information will help to focus your efforts to get better-quality sleep.

Here is an example of Jim’s sleep diary. The shaded areas are times spent sleeping.

How many hours of sleep is Jim getting each day, on average?

How does this number of hours compare with adequate sleep for you, given your age and activity level?

There is a blank Sleep Diary overleaf for you to use. What did your Sleep Diary tell you about your sleep pattern?