THE QUALITY OF REST AND THE RELATIONSHIP OF PAIN IN OSTEOARTHRITIS

Article courtesy of Carla Estivill, Management and Research in Clínica Sueño Estivill

THE QUALITY OF REST

Sleep is one of the essential pillars for the prevention of disease, for the maintenance of a healthy lifestyle, as well as for the cultivation of healthy ageing. Its wide-ranging benefits are due to the multiple functions attributed to it. While we sleep, we recover, memorise and consolidate what we do during the day. It is a multifunctional time for physiological processes such as the restoration of energy consumed during the day, cleansing of substances accumulated in the brain, recovery of the metabolic system or physical restoration.

The benefits of rest are already evident in our daily lives, as sleeping well allows us to maintain our physical, mental and emotional well-being: we maintain an active and more positive attitude towards life, our social and family relationships are also more positive, as well as performing better at work, being more attentive and having a greater capacity for memorisation.

When we sleep well we also recover better physically. Recent scientific studies show that the sleep period is the peak time for the repair and regeneration of tissues such as skin, muscles and cartilage, mainly due to the synthesis of growth hormone (GH) during the hours of deep sleep. Other hormones such as prolactin, luteinising hormone and testosterone, together with the anti-inflammatory effect of melatonin, complement this function.

These substances are mainly secreted during sleep, i.e. they have a chronobiological cycle. In the case of growth hormone, for example, 70% is produced in deep sleep. Melatonin is the hormone that induces sleep, and is triggered by darkness. The highest peak appears around 2 a.m. and decreases throughout the night. With age, this substance decreases.

BENEFITS OF SLEEP IN OSTEOARTHRITIS

Sleeping well allows us to maintain good health and well-being, but without a doubt, the quality and quantity of sleep is a fundamental necessity for the care of diseases like OA, to:

• control inflammation
• promote tissue regeneration by slowing down degeneration
• control the pain threshold, which ultimately provides an adequate quality of life for good day-to-day functioning, with good mental and emotional health.

Unfortunately, the pathological process itself triggers a vicious circle, as the inflammation, which causes pain, will affect sleep itself. At this juncture, insomnia appears, resulting in difficulty in falling asleep and resting, superficial sleep, and awakenings during the night. This insufficient and inefficient rest causes a deregulation of the secretion of regenerative hormones, and feeds back inflammation and pain, causing, in short, a drastic decrease in the quality of life.

HOW WE CAN SLEEP BETTER

Taking care of sleep, rest and preventing the onset of insomnia must be part of a cross-cutting treatment of diseases such as osteoarthritis. We must ensure the correct secretion of the hormones that protect our tissues, which is why we need to cover 3 basic pillars of sleep: sleeping for the necessary amount of time, getting an efficient and quality sleep and taking care of the biological sleep/wakefulness rhythm.

The hours we need to sleep depend mainly on our age: adults should sleep between 7-8 hours. As we get older, night-time sleep tends to be reduced, although this varies greatly from person to person. But in general, it is highly recommended to supplement it with a short nap of approximately 20-40 minutes each day.

As mentioned above, the quality of sleep can be diminished due to pain, discomfort and lack of movement. However, the following sleep habits will be basic and fundamental to try to avoid or alleviate insomnia:

Although it may not seem obvious, the quality of sleep is also built during the day: an active day will stimulate our hormones, which will be manufactured chronobiologically, at night. And the regularity of our habits will ensure the regularity of this functioning. It is therefore highly recommended to be active during the day, to be exposed to natural light and to maintain a regular schedule for eating and sleeping.

Sleep must be prepared, it does not come all at once. During the 3 hours prior to sleep, the body starts up the substances that will open the door to sleep, such as melatonin. To stimulate this process, we should have dinner early, around 20:30, and then dedicate some time to an activity that disconnects us from what we have done during the day; it is also a good time to do a meditation or relaxation session; we should avoid the use of devices.

Finally, always go to bed at the same time. It is important that the bedroom is a pleasant environment in terms of light and temperature, that it is quiet and that it is a space exclusively for sleeping.

Article courtesy of Carla Estivill, Management and Research in Clínica Sueño Estivill

Article Image from Kinga Howard in Unsplash