Sleep is not a Luxury, it is Vital By Physiotherapist Marine Pfeiffer

Sleep has been identified as one of the core components of longevity and heart health by the Framingham Heart Study. It is a biological necessity - not a luxury. By prioritising high-quality sleep, you’re investing in your healing, immune health, and long-term wellbeing.

The Relationship Between Sleep and Pain

Sleep and pain have a complex, reciprocal relationship. Poor sleep increases pain sensitivity and reduces pain tolerance, while pain disrupts sleep quality (Finan, Goodin & Smith, 2013). Moreover, insufficient sleep has been shown to worsen inflammatory responses in the body, exacerbating pain and slowing the healing process (Haack et al., 2007).

The process of healing and sleep

Sleep is also a vital, yet often overlooked, component of recovery from injury. While physiotherapy, medications, and nutrition often take centre stage in rehabilitation, quality sleep is just as essential to the healing process. During sleep, the body releases growth hormone, which stimulates tissue growth and muscle repair - crucial for recovering from muscle strains, ligament sprains, and post-surgical wounds (Van Cauter et al., 2000).

Sleep Enhances Performance and Reduces Injury Risk

Sleep is not just restorative; it’s also performance-enhancing. Research by Mah et al. (2011) demonstrated that extended sleep significantly improved athletic performance, reaction time, and mood. Adequate sleep also reduces the risk of injury (Huang & Ihm, 2021). In rehabilitation, consistent, quality sleep may accelerate recovery and improve outcomes of physiotherapy and other interventions.

How Much Sleep Do We Really Need?

According to the National Sleep Foundation, recommended sleep durations are:

• School-aged (6 - 13 years): 9 - 11 hours

• Teenagers (14 - 17 years): 8 - 10 hours

• Young adults (18 - 25 years): 7 - 9 hours

• Adults (26 - 64 years): 7 - 9 hours

• Older adults (65+ years): 7 - 8 hours

Interestingly, research also indicates that women may require slightly more sleep than men, especially during hormonal fluctuations (Baker & Driver, 2007). Sleeping less than 6 hours - or more than 10 - has been linked to increased risks of chronic diseases including heart disease, obesity, diabetes, and depression (Hirshkowitz et al., 2015).

Sleep Hygiene and Lifestyle Factors

Sleep quality is affected by many factors: stress, screen time, caffeine, and the timing of exercise. For patients recovering from injury, establishing a consistent sleep routine can be nearly as important as completing their physiotherapy exercises. Helpful strategies include:

• Creating a calming bedtime ritual

• Reducing exposure to blue light in the evening

• Sleeping in a quiet, dark, and cool room

Even small lifestyle changes can lead to big improvements in pain control, energy, and recovery speed.

Physiotherapy Techniques to Improve Sleep

1.    Pain Management

Pain is a common cause of sleep disturbances. Physiotherapists can address pain using:

• Manual therapy (joint mobilisation, soft tissue techniques)

• Dry needling

• Electrotherapy

• Postural re-education

By reducing pain, sleep quality often improves significantly.

2.    Breathing Techniques & Respiratory Physiotherapy

For issues such as sleep apnoea or post-COVID breathing pattern disorders:

• Physiotherapists assess lung function and identify problem areas

• Breathing retraining improves oxygenation and lung efficiency

• Airway clearance techniques help if congestion is present

Improved oxygenation promotes relaxation and deeper, more restorative sleep.

3.    Postural and Sleep Position Advice

Sleeping posture can affect pain levels and sleep quality. Physiotherapists provide:

• Advice on mattresses and pillows tailored to specific conditions

• Recommendations for optimal sleeping positions (e.g., side-lying for back pain, elevated for breathing issues)

4.    Movement and Exercise Prescription

Regular low-impact exercise can reduce stress and muscle tension, promoting better sleep. Physiotherapists may provide:

• Gentle bedtime stretching routines

• Pilates-based exercise programmes (including reformer-based workouts for back conditions)

• Sports-specific rehabilitation plans known as “Return to Play” programmes, based on international sports science research

At Debbie Cameron Physiotherapy, we highly recommend Pilates for its holistic approach to body conditioning, and we offer classes from beginner to advanced levels, including sessions with Pilates equipment.

5.    Education and Sleep Hygiene Coaching

Physiotherapists often help clients:

• Understand the importance of sleep hygiene

• Build healthy bedtime routines

• Limit stimulant intake and screen time

• Create an optimal bedroom environment for restful sleep

When to Consider Physiotherapy for Sleep Issues

You may benefit from physiotherapy if you:

• Experience disrupted sleep due to pain, stiffness, or injuries

• Suffer from sleep apnoea, restless legs, or TMJ dysfunction

• Feel stress, anxiety, or physical tension is interfering with your sleep

• Want non-medication strategies to support better sleep

Never underestimate the power of a good night’s rest.

To book for physiotherapy to heal or improve performance, contact Michelle on 031 765 8898 or book online via https://www.debbiecameronphysio.co.za/online-booking.

References

• Baker, F.C. & Driver, H.S., 2007. Circadian rhythms, sleep, and the menstrual cycle. Sleep Medicine, 8(6), pp.613–622. https://doi.org/10.1016/j.sleep.2006.09.011

• Finan, P.H., Goodin, B.R. & Smith, M.T., 2013. The association of sleep and pain: An update and a path forward. The Journal of Pain, 14(12), pp.1539–1552.

• Haack, M., Sanchez, E. & Mullington, J.M., 2007. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Sleep, 30(9), pp.1145–1152.

• Hirshkowitz, M. et al., 2015. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health, 1(1), pp.40–43. https://doi.org/10.1016/j.sleh.2014.12.010

• Huang, K. & Ihm, J., 2021. Sleep and injury risk. Current Sports Medicine Reports, 20(6), pp.286–290. https://doi.org/10.1249/JSR.0000000000000849

• Van Cauter, E. et al., 2000. Endocrine rhythms and sleep. In: Principles and Practice of Sleep Medicine. 3rd ed.