Sleep quality and pain

I’ve been keeping a fairly comprehensive log of pain, sleep, exercise, food, weather, and general health. I’m still collecting data, and figuring out the best ways to analyze it. (How do I isolate variables when there are so many? I guess I should collect a lot of data points.)

There was one correlation that lept off the screen, and I thought I’d share it here in visual form. The two lines are “sleep quality” and “morning pain level,” both ranked on a 1-10 scale. In this case, one is the best possible scenario. Ten is really, really terrible.

See if you notice a pattern.

The part towards the right where it appears that there is only one line is actually the two lines overlapping.

I recently realized that I dread going to sleep. It’s not a nice, relaxing, mmm-this-is-going-to-be-good experience. I basically feel as though I go to bed, am unconscious (hopefully) for a number of hours, have the occasional bizarre dream, and wake up just as exhausted as when I first went to bed. I do not feel rested.

Apparently this is not normal, even though I’m so used to it at this point that I forget some people actually enjoy sleeping. Long story short, I’m going to see my doctor about sleep quality. Poor sleep is associated with fibromyalgia. I’m just hoping that something can be done about it.

Methods for organizing symptom logs

I keep searching for the perfect symptom log system. You know, that log your doctor is always encouraging you to keep – th e one that keeps track of your symptoms so that you can figure out what your triggers are. The American Chronic Pain Association describes it this way:

Many things can affect your pain. These can include stress, sleep, money worries, and even the weather. The Pain Log can help you track the everyday things that have an impact on your pain. When you understand what makes your pain worse, you can begin to work on ways to reduce or deal with your pain “triggers.” The more you know about how your body reacts, the more you can be in control. And being in better control can help you be less afraid and better able to manage your pain. We encourage you to fill out a chart out at the end of each day or several times a week. You also can take your “log book” to your doctor visits. It can help you talk more openly with your healthcare provider so that together you can find ways to improve your quality of life.

Note: The American Chronic Pain Association has a sample log about halfway down their Communication Tools page.

The real beauty of such symptom logs is that they offer an objective view of what impacts your treatment. It’s no longer, “I think I started feeling better once I stopped eating gluten/meat/processed foods.” You can also see whether or not you started exercising more during that time, or if dietary changes led to weight loss. Any number of factors could lead to changes in your symptoms – wouldn’t it be nice to know for sure that it was gluten before you gave up bread forever?

I wrote about my attemps at keeping a sleep journal/log awhile ago. It worked for awhile, and it soon became fairly obvious that poor sleep (and late bedtimes) contributed to my pain levels about two days later. There seemed to be kind of a lag. Not surprisingly, I also fared better if I went to sleep before midnight. I also found that being conscious of the fact that I would be writing the results of my sleep down to be an effective motivational tool: it was like having to tell the teacher that I didn’t do my homework. Or rather, telling the computer that I didn’t get up until 11:00 am. I gained many useful insights from my sleep log, and I wish I’d managed to make it a sustainable part of my daily routine.

The longest lasting and most successful symptom log I ever kept was a simple paper mood log that my psychiatrist gave me to keep track of mood symptoms. It was created by the Depression and Bipolar Support Alliance, and its genius was that it was paper, portable, and had a built-in graph so you could track when your symptoms went up and down. (To download a printable version, try going to their “Working Towards Wellness” section. There appears to be an online version as well. Note that these are both for mood disorders.) “Hmm, when I started taking medication A, I began feeling dizzy. I should call my doctor.” It also helped to have my doctor ask me for it – again the factor of telling the doctor I didn’t do my homework. I could also see that it was impacting my treatment, as it offerred a scientific and objective means of tracking the effects of new medications on my symptoms.

The down side to keeping logs and journals is that it is time consuming. Also, how do you organize it? On paper or on the computer? What software do I use? Did I do it in the morning or the evening? What about if I’m on vacation?

I’ve come to these general conclusions about symptom logs and myself:

• The more complicated it is, the less likely I am to keep it up.
• The more time-consuming it is, the less likely I am to keep it up.
• Seeing real results from my log (insights into sleep, information for my doctor) motivates me to continue.
• Having someone – the computer or a person – “keep track” of whether or not I’ve done my log motivates me to continue.
• Symptom logs help me be an active participant in my care (both self-care and care with health care providers).

I’m trying some new log systems out. When I’ve got more details, I’ll report back.

The longest lasting and most successful symptom log I ever kept was a simple paper mood log that my psychiatrist gave me to keep track of mood symptoms. It was created by the Depression and Bipolar Support Alliance, and its genius was that it was paper, portable, and had a built-in graph so you could track when your symptoms went up and down. (To download a printable version, try going to their “Working Towards Wellness” section. There appears to be an online version as well. Note that these are both for mood disorders.) “Hmm, when I started taking medication A, I began feeling dizzy. I should call my doctor.” It also helped to have my doctor ask me for it – again the factor of telling the doctor I didn’t do my homework. I could also see that it was impacting my treatment, as it offerred a scientific and objective means of tracking the effects of new medications on my symptoms.