By Joe Ascher, PT, DPT

Do you struggle to get to sleep, stay asleep, or just get enough sleep? If you are like most American’s then your answer is “yes.” Sleep insufficiency and disorders are so common that it is considered by the Centers for Disease and Control to be a public health problem.

What is the big problem with missing out on good sleep? Nothing a good ol’ cup of coffee won’t fix, right? Wrong.  Sleep allows your body to recover and facilitates immune function, tissue healing, pain modulation, cardiovascular function, cognitive function, leaning, and memory. More and more research links a lack of good sleep health with many chronic health conditions such as hypertension, cardiovascular disease, obesity, depression, and diabetes, along with increased risk of accidents, injuries, falls, dementia, and increased mortality.

Sleeping well also plays a huge role in something that I see every day as a physical therapist — Chronic and persistent pain. Chronic pain is described as pain that is persistent for 3 months or longer and can be intermittent or constant. A link between increased pain sensitivity and a shortage of deep, slow wave sleep has been identified, and in general, people with sleep disturbances report increased sensitivity to pain.

Now that you understand the importance of good quality sleep, let’s talk about some strategies for getting more Z’s at night. First off, practice good hygiene when it comes to sleep, just like brushing your teeth and washing your face. Sleep hygiene education has been shown to reduce pain and fatigue in patients with fibromyalgia, which is a condition characterized by chronic pain. Here are some helpful sleep hygiene tips:

• Go to sleep and wake up at similar times each day.
• Only use your bed for sleep and you should get out of bed if you can’t fall asleep after about 20 minutes.  Return when you are sleepier.
• Develop a relaxing bedtime routine, free of overstimulating activities.
• Avoid caffeinated beverages or food at least 4 hours prior to bedtime.
• Refrain from drinking alcohol or smoking 3-4 hours prior to bedtime.
• Maintain a comfortable environment with a proper temperature.
• Avoid light emitting devices at least 30 minutes prior to going to sleep.  That includes your phone!
• Avoid eating a large or spicy meal 2-3 hours before bedtime.

In addition to practicing good sleep hygiene, be sure to implement one other low cost, easily accessible, and side effect-free way to improve your sleep: Exercise!  Exercise has been shown to improve your ability to improve hours of deep sleep, increase your total sleeping time, and decrease the time it takes to fall asleep. The American College of Sports Medicine recommends that you participate in at least 30 minutes of moderate intensity exercise, which is at 40-60% of your heart rate maximum, on 5 or more days a week with a proper warm up and cool down.

The therapists at Physiopartners are experts in chronic pain management and can assist you in your journey to obtain better sleep and manage painful conditions. We can help you initiate a safe exercise routine, provide hands-on treatment to help alleviate chronic pain, provide information on how to best position your body for restful night, and give you guidance in how to accomplish your daily tasks without aggravating your condition or with the least amount of pain.

Joe Ascher, PT, DPT, is a physical therapist at PhysioPartners.  Schedule an appointment with Dr. Ascher at

Reference:  Stevens, Suzanne, et al. “Sleep Health Promotion: Practical Information for Physical Therapists.” Physical Therapy, vol. 97, no. 8, Aug. 2017, pp. 826–836.