Need to change my attitude about sleep + dealing with injury
June 24, 2020 2:18 PM   Subscribe

I've never been much of a sleeper and have often suffered from insomnia. Lately it occurred to me that I don't enjoy sleeping and I'd like to change that. Sleeping has become even more annoying and difficult these last few months as I've suffered a worsening tear in my rotator cuff and no positions are comfortable.

My attitude about sleep needs to change. I currently find sleeping to be kind of pointless and a waste of my time. I do it because I should, to stay healthy, but not because I particularly enjoy it in and of itself -- it's akin to brushing my teeth in that way. I am rarely sleepy and I force myself to go to sleep every night and I naturally wake up early, ready to get out of bed and go do something more interesting. I average 6.5-7.5 hours of sleep per night and have been that way for years. Normally it's fine, but these last few months I haven't been sleeping well because of a tear in my rotator cuff, which has been getting increasingly worse. I am awaiting referral for an ultrasound and then treatment/surgery as necessary. The injury + my attitude make sleep seem extra chore-like these days.

How can I make myself sleepier and/or enjoy the act of sleeping?
How can I deal with this shoulder injury in ways that help me sleep better too?

To cover off these off: I practice good sleep hygiene, I'm not stressed or depressed (I am fortunate that my quality of life has improved during lockdown), my bedroom is cool and comfortable, with nice sheets and bedding. I use a sleep lamp to wind down and wake up (I always wake up ~20 minutes before it starts no matter the time I set) and I sleep with a comfortable sleep mask to keep any light out. I also don't drink caffeine past noon and I eat healthy etc. Also, I've stopped taking medication for the pain (ibuprofen or paracetamol with codeine) as I've hit my limits of taking those drugs.
posted by iamkimiam to Health & Fitness (15 answers total) 5 users marked this as a favorite
Best answer: Have you looked into bolsters or positional aids to (potentially) help you sleep in a way that would aggravate your injury less? There are *so* many different shapes and sizes (and sometimes different foam densities) of bolsters and pillows. I don't have experience with rotator cuff injuries but for example there's this wacky "shoulder relief system"
posted by needs more cowbell at 2:37 PM on June 24, 2020

A good cryotherapy unit would be a great investment — if you get surgery it’ll come be even more helpful. The circulation and the countoured shoulder wrap are maaaaaajor upgrades over cold pack / frozen peas and delivered me real pain relief.
posted by sixswitch at 2:51 PM on June 24, 2020

Do you dream when you sleep, that you can remember? You could start a dream journal, just writing down the details you remember. Somehow doing that got me to remember more and more about my dreams, and thinking them through sometimes gets to me to realize stuff about myself and my emotions that’s helpful. Like a form of self-therapy. It made my sleep time seem more valuable/active.
posted by sallybrown at 2:55 PM on June 24, 2020 [1 favorite]

Best answer: I wonder if your body is a bit hungry for physical activity? A walk or hike or recumbent exercise-bike ride, with your injured arm in a sling, might help your body feel happier to be lying down doing nothing.

Also... cannabis? An indica edible?

You might talk to your GP or an RN about cycling your anti-inflammatory meds (ibuprofen in this case). Mine said a few weeks on, a few weeks off greatly reduces stomach issues and side effects, and is a better balance than no pain relief at all for some people.
posted by sixswitch at 2:57 PM on June 24, 2020 [3 favorites]

Longtime insomniac here: one of the biggest philosophical shifts I kind of accidentally stumbled upon is a mindset of "rest if not sleep", which a) is a good point b) takes away the immediate-onset anxiety that I used to get when I can't sleep/get sleepy.

I take a magnesium supplement about an hour before bedtime. It can make you poop, so you don't want to do it right before you get comfortable, I usually take it in my last half hour of pre-bedtime-routine entertainment so by the time I go to wash/brush/etc it will kick in about then. A lot of doctors are of the opinion that most people are deficient, and there is some science that suggests mg is important to normal sleep function, and it can also help with restless legs and muscle cramps; it is generally calming overall as well. If you don't have health conditions that contraindicate potassium supplements, that can also help with cramps/relaxation and general mellowness.

I'm a big proponent of the Insight Timer app, which has an extensive library of free meditations including relaxation/sleep-specific tracks as well as word-free music (often quite ambient) tracks in varying lengths.

For the shoulder, is there a physical therapist you can speak to? I'm sure there are known good support methodologies (you might also check youtube) for sleeping with a torn rotator cuff. You may need to get a special pillow or two, but I'd review the methodologies before committing to anything.
posted by Lyn Never at 3:07 PM on June 24, 2020 [1 favorite]

I'm not really sure from this what is the problem. Are you sleepy and having trouble focusing during the day and feel like more sleep would help? Are you having trouble getting to sleep and no longer waking up happy? Or are you just trying to improve your attitude towards sleep so that you can feel less put-upon by it?
posted by Lady Li at 3:18 PM on June 24, 2020

Best answer: Longtime rotator cuff injured person here. Ice, pillows - get obsessive about positioning. CBD or THC help with pain and going back to sleep...
posted by leslies at 3:56 PM on June 24, 2020 [1 favorite]

I am like you! I have always hated sleeping and felt resentful of all the wonderful things being asleep was making me miss out on.

What helped me the most was totally letting myself off the hook emotionally for not enjoying sleep, and stopping trying to make myself Go To Sleep or further optimize my honestly excellent sleep hygiene.

Now I get in bed, read (no more thrillers though), and tell myself, “You’ll fall asleep when you want. Your body knows how much sleep it needs. You are at rest and your body will transition to a sleeping state when it needs to”. For me this helps me stop stressing about falling asleep and lets me relax enough to actually get there. YMMV.

(And on preview, it’s extra hard to want to sleep when doing so is painful! Seconding CBD, pillows, or other therapies so you can get some pain relief.)
posted by stellaluna at 4:01 PM on June 24, 2020 [1 favorite]

I think for a certain kind of bad sleeper, the conventional sleep hygiene advice of "don't use your bed for anything but sleeping" is actually really counterproductive, because it makes you associate the bed with anxiety and failure. This is definitely true for me. A wind-down period where you do something you enjoy in bed could help break the association and ease you into sleeping time.
posted by showbiz_liz at 4:22 PM on June 24, 2020 [1 favorite]

OH also try some topical ibuprofen ointment — in North America it’s called Voltaren. Avoids stomach issues, super good for bringing pain down to sleepable levels. I did find only extra strength was really useful.
posted by sixswitch at 4:56 PM on June 24, 2020 [2 favorites]

Best answer: I have an ongoing story I tell myself before bed, and I look forward to going to bed and thinking about it (I'm awesome in it) the same way I look forward to watching a TV show I like. I don't allow myself to daydream about it; I save it for bed.
posted by The corpse in the library at 5:21 PM on June 24, 2020 [7 favorites]

Best answer: Hello! I too have a torn rotator cuff! Before last week’s cortisone shot it was so exquisitely painful that I spent hours every night in agony, unable to sleep, UNLESS I took a 20:1 CBD/THC fruit chew, in which case I slept through the night. Can not recommend highly enough.
posted by HotToddy at 5:33 PM on June 24, 2020 [1 favorite]

Seconding The corpse's excellent advice. Sleep is where you get to be a viking! It's great if when you lay down you have a fun story or mental pamphlet that you want to expand upon and think about without any pressure. You'll be out before you know it.
posted by Balna Watya at 1:04 AM on June 25, 2020 [2 favorites]

If you have health insurance, inquire about doing a "sleep study". There are "in-home" and "in-lab" types (the latter is more expensive, and may not be available in your area because the facilities are rather rare).

I just did one last weekend (because I sleep too much).
posted by biersquirrel at 2:59 PM on June 25, 2020

What finally worked for me (a little bit), a night owl if there ever was one, was to remember what we told our kids at night. You do not have to go to sleep. You do have to go to bed. No pressure to sleep. Just stay in bed thinking about fun things. It works for me in that I get rest.

As for sleeping with an injury, I have had 4 operations on my back starting when I was 15. Sleep is painful. I try to explain this to my gf when she complains that I come to bed at 4:30am and won't lie in bed with her when I get up. I set up the bed to semi force myself to sleep in a position that is least painful. I put a wedge under my knees and calves. I am forced to stay on my back bc if I roll over, my legs are on top of the wedge and I am sort of being folded in half while on my side. Painful for anyone much more for someone with a bad back. Is there some sort of foam wedge or pillow that you can use to keep you from lying on your shoulder?

Btw, 7.5+ hours of sleep is a lot to me. As my grandfather used to say to me and I now say to my kids and friends, "I sleep fast". I get about 5.5 hours a night. Too uncomfortable for more.

I find that medication works if I am in pain. I get not wanting to rely on pain medication, but the alternative is lack of sleep. I will start with a Tylenol PM. One. IF that does not work that night, the next night I will take the recommended dose of 2. If that does not work, I go to the prescription stuff. I have also found that the right edible will put me to sleep. If medication is not your thing, I would try reading very dry stuff like a professional trade association magazine.
posted by AugustWest at 11:05 PM on June 25, 2020

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