The Crucial Role of Sleep in Recovery and Pain Management

We, as physical therapists at Steady State, often notice how the critical role of sleep in our health and wellness is underestimated. If you're working with us, chances are, we've inquired about your sleep patterns. Sleep isn’t just rest, it’s foundational to our physiology, recovery/healing, physical performance, mental performance and mental health. 

As sleep expert Dr. Matthew Walker says in his podcast, sleep is often thought of as a cost in our lives, but we should flip this switch and think of it as more of an investment. The only cost involved with sleep comes from not getting enough of it. 

Understanding How Sleep Affects Recovery 

Both Growth Hormone (GH) and Testosterone reach their peak levels while we are sleeping. The release of these hormones is affected significantly if we have fragmented sleep or sleep less than 6 hours per night. One study has shown up to a 10-15% drop in testosterone in young healthy male participants after just one week of sleeping less than 5 hours per night. One of the jobs of these hormones is to help with building and tissue repair of muscle, bone, and cartilage. One way to think about this is that our muscles aren’t built in the gym, they’re built while we're sleeping!

Not only is it important to get sufficient sleep to improve the release of these hormones, but it’s also about getting quality sleep. The REM (rapid eye movement) phase of sleep is thought to be when the greatest magnitude of GH is released. Along with reductions in GH and Testosterone, our Cortisol levels increase with poor sleep. This further slows the repairs of muscles, bones, ligaments etc. Sleep should be our number one priority protocol both to regulate and promote recovery, but also as a defense against injuries to begin with. 

Sleep and Pain

Another link has been found between sleep and pain sensitivity. This is relevant when we are chronically sleep deprived, which means our sleep is hindered for 3 months or greater. Not only does sleep disturbance delay healing and recovery, but it also increases our pain sensitivity and decreases our pain tolerance! Therefore, addressing sleep disturbances is essential for regulating the body’s normal response to pain and optimizing recovery and tissue healing. 

Optimizing Sleep

Here are some strategies that are shown to help optimize sleep:

• Stick with consistent wake times. Prioritize waking at the same time each day. This should generally make it so that you are going to bed at about the same time each night. However it is important to make sure you are feeling tired when you go to bed - consider going to bed when the first wave of sleepiness hits you. 
• Avoid Caffeine 8-10+ hours before you plan on going to sleep. Caffeine can reduce the amount of deep sleep time that you get during the night as well as make it harder to fall sleep. 
• Get outside to view sunlight within 60 mins of waking up as well as before the sun sets in the evening. This helps to prepare the body for sleep later on that night by increasing the release of cortisol in the early morning, which is when it should be at its peak. This helps to regulate our body’s sleep-wake cycle, which will enhance sleep quality. 
• Improve your sleep environment. Our body temp ideally needs to drop by 1-3 degrees to improve sleep initiation and quality. Having your bedroom temperature between 60-68°F is optimal. Avoid viewing artificial lights or screens 1-2 hours before sleep, as well as looking at your phone if you wake up in the middle of night.  

The profound impact of sleep on recovery and pain management cannot be overstated. As we've explored, sleep serves as a critical foundation for our overall health, significantly influencing hormone regulation, tissue repair, and pain sensitivity. 

We must reevaluate our perception of sleep from a mere nightly routine to a vital investment in our physical and mental well-being. By adopting practical strategies to optimize sleep, such as maintaining consistent wake times, minimizing caffeine intake, soaking in natural sunlight, and creating a conducive sleep environment, we can enhance our body's natural healing processes, improve pain tolerance, and elevate our quality of life. 

Let us prioritize sleep not just as a passive activity, but as an active, deliberate practice towards achieving optimal health and resilience!