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Painsomnia: How To Build A Healthy Sleep Routine Around The Pain of HS

Last updated: December 2022

You’ve probably been there: Tossing and turning, desperate for sleep but in too much pain to do so. Sleep hygiene is an important part of physical and mental health, but a good night's sleep can feel impossible when you’re dealing with the pain HS can cause. Here are a few of my favorite tips for building a sleep hygiene routine that can help you stay balanced during the worst of your flares.

Pick a bedtime and a time to wake up-and stick to it

This may seem like a no-brainer, but how many of you have a designated bedtime that you actually stick to, and genuinely get out of bed the first time your alarm goes off and not 3 snoozes later? Having a set bedtime and time that you wake up helps to keep your circadian rhythm in check. As per, “Circadian rhythms work by helping to make sure that the body’s processes are optimized at various points during a 24-hour period. When properly aligned, a circadian rhythm can promote consistent and restorative sleep. But when this circadian rhythm is thrown off, it can create significant sleeping problems, including insomnia.”

Choosing and sticking to a time to wake up and a time to go to sleep can help to set and keep your circadian rhythm functioning, allowing you to fall asleep and stay asleep a little easier in times of stress.

Set a GET ready for bed alarm, not a GO to bed alarm

Let’s say you’ve chosen 10 pm as your bedtime- a lot of people will set an alarm for 10 pm to remind them, which is great in theory but doesn’t factor in the time you need to get ready for bed and the time you need to fall asleep. Set an alarm for 45 minutes before you want to go to bed so that you’re in your jammies, washed up, and already resting in bed by the time your desired bedtime rolls around! This will lead to your brain starting to associate that time with relaxing, winding down, and falling asleep.

Get a support pillow

Also known as a pregnancy pillow, these U-shaped or C-shaped pillows can be used to prop up aching joints and stop flares and/or skin from rubbing and causing more pain. I often use mine to sandwich between my legs and cushion the flares on my thighs and groin. I also find the pressure from the pillow helps to keep bandages and wrapping in place because you move around less. I got mine from Amazon as it was cheaper than all the maternity stores- it was around $60 CAD (about $48 USD) and worth every penny!

Take your pain relief an hour before bed

Rather than waiting until right before you are going to bed, take any pain relief medications about an hour before you go to bed. This allows the pain relief to start before you try to fall asleep and will allow you to fall asleep a little bit easier. If you are not taking an oral pain medication, you can talk to your doctor about using a topical pain reliever such as an over-the-counter benzocaine cream before bed to slightly numb your flaring areas and give you a bit of a break from the pain.

Talk to your hidradenitis suppurativa doctor about a sleep aid

I don’t always take sleeping medications, but when I’m in a particularly bad flare I will use a combination of melatonin, an all-natural sleep assistant, and trazadone, a pharmaceutical medication prescribed to me by my family doctor to use when the pain is so bad I spend 3 or more nights mostly sleepless. Sleeping pills can be fairly addictive, even the natural melatonin, so always make sure you have medical professionals monitoring your usage. This is why I choose to only utilize them when I am really struggling.

Keep your room cold and your bed warm

Studies have shown that having a cooler room and a warmer bed is a good way to help your circadian rhythm as well as help you fall asleep and stay asleep, but keeping the room cool is also a good way to reduce the night sweating that HS pain can cause. Also, consider the fabrics you’re sleeping in. Try using something breathable like cotton rather than something like silk or fleece.

I hope these tips help make your sleep a little easier and a bit more comfortable. Try them out and let us know in the comments if any of them help you!

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