Vitamin D and sleep to manage pain

Supplementing with vitamin D and getting a good night’s sleep could be the key to pain management, suggest researchers.

Pain can be an all-encompassing, daily struggle for many people with medical conditions that are currently managed by drugs, rest and in some cases, pain management therapy sessions. Some drugs, known as non-steroidal anti-inflammatory drugs (NSAIDs) can lead also onto other health problems according to research and statistics [1].

New studies are suggesting that there could be effective alternatives, and the solution is rather simple: vitamin D and plenty of sleep. The latter may appear easier said than done if you’re kept awake because of pain.

However, taking vitamin D supplementation, or getting adequate amounts of daily sun exposure (and you really don’t need that much!) could help control sleep regulation and inflammatory processes in our bodies.

Brazilian researchers reviewed the existing science literature (known as a literature review) and concluded that getting the right recipe for proper sleep combined with vitamin D supplementation may help get the most from your pain management plans [2].

This could particularly help with conditions such as:

• arthritis
• fibromyalgia
• menstrual pain
• chronic back pain

Pain is regulated by the central and peripheral nervous system, but it also involves the immune system. Many pain-causing diseases, such as arthritis, are caused by inflammation, which itself heightens sensitivity to pain.

Vitamin D could help because it may have a direct influence on inflammation markers, although the science is by no means conclusive on this and there is plenty of room for many other studies [3]. The current belief is that vitamin D has an anti-inflammatory effect, thus reduces pain and in turn improves sleep.

Vitamin D

Vitamin D is best got from the sun. Just 10-20 minutes per day, strolling out in the sun with arms and legs exposed, can adequately top up your vitamin D levels. Failing that, the following foods are good sources of vitamin D:

• Fatty fish such as mackerel, salmon and tuna
• Eggs (the yolks)
• Cheese
• Liver
• Foods fortified with vitamin D (some milk alternatives like almond or soy milk, breakfast cereal and bread in some circumstances)

If you choose to supplement, choose vitamin D3. The amount you should take depends upon your vitamin D status – which means having your blood tested. A friendly GP may do this for you next time you have your bloods taken for analysis.

Sleep hygiene

How to get the best sleep relies on what is called sleep hygiene. We associate hygiene with cleanliness, but in this instance, we mean the right environment to get to sleep and stay asleep throughout the night.

According to the National Sleep Foundation [4], the following are the best tips for getting a good 6-8 hours’ quality sleep (along with a few of my own!):

• Avoid napping during the day or, if this cannot be helped, limit naps to 30 minutes.
• Decide on a point in the day where you stop drinking caffeinated drinks such as coffee, tea and cola. My personal advice would be to limit caffeine to the mornings and switch to decaff after lunch.
• Limit alcohol. Alcohol disrupts sleep and whilst you may fall asleep very quickly after a few drinks, you won’t get good quality sleep thereafter.
• Exercise helps promote sleep. If this is difficult for you due to your condition, even gentle exercise like yoga or pilates could help. Consider searching for local groups who offer pilates and yoga classes and explain to them your medical condition.
• Watch what you eat late at night. Fatty foods, high sugar foods, fizzy drinks and spicy foods may all cause you to have disrupted sleep. Kiwifruit, on the other hand, may help promote sleep [5].
• Sleep with a window open. We sleep better if the room is cool, with circulating fresh air. If this is not possible, look at using fans, dehumidifiers or even buy a lighter duvet (low tog rating for example) and then use blankets or throws over the top during the winter (or have two duvets: a winter one and a summer one).
• Read a book before you go to sleep, not a screen-based device such as smartphone, tablet or laptop. The type of light that these devices emit can disturb our sleep [6,7].
• If you live in an area with a lot of ambient light, or you go to bed during the height of the summer when it’s still light outside, consider using blackout blinds. The amount of light in the room can affect our sleep.
• A comfortable mattress and pillows is really important for good sleep. When you lay down, pain aside, you should feel comfortable and relaxed on your bed. Turn your mattress regularly (in all directions, don’t just flip it horizontally), and think about replacing it when it starts getting lumpy or you wake up more sore than usual. There’s no real set time, but after 5-8 years, you need to be more aware of how tired your mattress is becoming. Particularly if there are two of you sleeping on it.
• Pillows should be washed regularly and replaced from six months, particularly if you have allergies. Similarly, remember your duvet won’t last a lifetime! It gathers dust, sweat and debris and will need replacing too, especially if you don’t use summer and winter duvets and therefore swapping them twice a year.