MEDICAL ADVICE ON PAIN

by Dr Stephen Jackson, Consultant Geriatrician at King's College Hospital, London

It is a human failing to believe that the grass is always greener elsewhere. This is particularly true of our satisfaction with our sleeping habits. Those of us, such as myself, who would like to manage with less sleep, envy those who need only a few hours sleep per night. Similarly those who have a nightly struggle to get off to sleep, or wake very early (or both), long to be one of those who can fall asleep as soon as their head hits the pillow. Many patients find that they need less sleep as they get older. Just like appetite, sleep requirement varies from person to person and, like appetite, is affected by many other factors. Pain is a common cause of sleep difficulties and should prompt sufferers, particularly those with back pain, to think about whether their bed/mattress is right for them.

New beds are expensive, and no one can decide whether a new bed will help until they have slept on it. If you are lucky enough to he able to sleep elsewhere for a few nights, this may help you to decide whether a firmer mattress would help. Another consideration is whether your pain killers will continue to work throughout the night. Drugs such as paracetamol and co-proxamal, for example, do not tend to provide pain relief throughout the night in some patients.

Daytime sleeping may aggravate sleep problems. Thus whilst an afternoon nap may suit some it should be avoided in people who have difficulty sleeping. In addition, many patients find certain activities just before retiring help them to sleep. Examples include walking the dog (also an activity some associate with being unable to sleep), a night-cap, or having a hot drink. In general, if sleeping is a problem it is a good idea to avoid drinks containing caffeine such as coffee, coca cola, and tea, for the whole evening and not just before you go to bed. These drinks are available in caffeine-free form. These can help with relaxation, which is an important part of a successful sleep pattern.

Sleeping tablets must not be seen as miracle cures for all sleeping problems, particularly as some of them are difficult to stop once started. However, there are many different types of sleeping tablet, the most appropriate of which are ones that are short-acting, helping to induce sleep but not causing hangover effects the next morning.

Alternatives to sleeping tablets should always be tried first, and your doctor should always be consulted.