Winter 2008 Article:
Sleep Habits: Can sleep posture cause aches and pain? YES!
As Physical and Occupational Therapists, we are often treating clients with cumulative pain and nerve compression syndromes. Our primary focus is on what can be done to the work environment and what the client can do to improve their work practices to reduce the stress to these conditions. However, an often overlooked concern is the stress that a client places on their injured body part while they are sleeping. We think of sleep as rest, and rest is good for an injury. Rest is meant to heal and repair. This healing and repair is done by the body as the blood supply brings in the fuel, oxygen, and healing properties, while carrying away waste. Blood supply is key to the concept of rest to promote healing. If the blood supply is poor, then the healing and repair will be negatively impacted.
For this reason, we must consider, how does an injured body part receive good blood supply? When the body is at rest, joint position is the primary factor in allowing or diminishing good blood flow. Most of us have experienced the numbness and tingling in our foot after sitting with our legs crossed for too long. This is an example of decrease blood flow. When we sleep, our joints rest in various positions. If the position of the joint allows for good joint space, the blood flow will be good. Conversely, when the position of the joint decreases the joint space, the blood flow will be poor.
We consider joints that are in their neutral position to have the most joint space. Neutral is unique to each joint. Typically speaking, neutral is going to be a midrange position. For the upper limb: the neck is neither twisted, flexed nor extended, the natural curve is maintained; the shoulder is relaxed or slightly flexed and abducted; the elbow is slightly bent, but not more than 90 degrees, the wrist is straight and fingers are relaxed. For the lower limb: the lower spine is not twisted, flexed nor extended, the natural lordosis curve is maintained; the knees are supported and slightly flexed, and the ankle is relaxed mid-range.
Good joint positions can be achieved both lying supine and side-lying. The use of pillows to provide support in the optimal position is the key to retraining better sleep postures. Changing sleep habits is a very difficult process. Humans are creatures of habit, and poor sleep habits are formed over the years of our life. When we are young, forming these bad habits, we do not experience discomfort. As we age, the effects of these bad habits begin to take the toll. Most of us do not feel the same getting out of bed in the morning now, as we felt in our youth. Though this process is difficult, it is important for our health to retrain good sleep posture, and to educate our workers of this importance. There are nerve compression syndromes whose underlying cause may have more to do with sleep posture than daily tasks. For this reason, we must not neglect to address this aspect of our workers’ health.
Contact us for more information on this and/or other musculoskeletal disorders and the workplace.