睡觉

Getting the right amount of good quality sleep has many benefits for our physical and mental health. Evidence suggests it’s just as important as having a healthy diet and doing regularexercise。

Good sleep can:

• help your concentration levels
• help youmanage pain更好的
• allow your body to repair damaged tissue
• improve your immune system – the body’s natural defence against illness and injury
• 帮助您的心理健康 - 无法获得足够的睡眠会使您感到烦躁或情绪低落，并增加焦虑和沮丧的感觉
• 帮助您保持健康的体重 - 如果您没有足够的睡眠，您的体内可能会有更多的化学物质，这些化学物质会使您想吃更多的食物，而更少的化学物质会让您感到饱满。

获得足够的优质睡眠可以在帮助您管理长期健康状况中发挥重要作用arthritis。但是，关节炎的疼痛会使质量良好的睡眠变得困难。

如果您在睡觉时遇到问题，可以采取积极的步骤。

睡眠问题可以采取几种形式：

• Some people have trouble getting to sleep but then sleep through the night.
• Others wake often during the night or wake too early in the morning.
• 有些人不记得睡过睡眠，但醒来时不会感到刷新。

It’s normal to wake up once or twice each night. This only becomes a problem if you can’t get back to sleep again or if you’re not happy with the quality of sleep you’re getting.

无法获得足够的睡眠会增加任何担心，焦虑和沮丧的感觉。如果您感到沮丧或担心，请与人们（例如家人，朋友或您的医生）交谈来解决这样的想法或感觉。

Everyone needs different amounts of sleep. Most adults need somewhere between six and nine hours sleep a night. As we get older, we need less sleep.

You should ask yourself if you’re getting enough good sleep, by thinking about the following.

• 你白天感到困倦吗？
• Do you struggle with energy levels?
• 白天醒来和白天醒来时会感到精神焕发吗？

It normally takes people less than half an hour to get to sleep.

Not getting enough good sleep can lower the point at which you feel pain, this is known as your pain threshold. This could lead to:

• increased pain from an already painful condition
• pain from a condition that hadn’t been painful before
• 只有在身体的特定部位才感到疼痛变得更加普遍。

睡眠不良和疼痛之间联系的一个例子是纤维肌痛。这可能会导致身体许多区域的疼痛和压痛。疼痛不是直接是由于对身体一部分的伤害或损害引起的。人们认为这是由中枢神经系统（CNS）的问题引起的，该问题负责处理疼痛消息传递。中枢神经系统误读了身体其他部位的信息，并且只有稍微触摸作为疼痛刺激。当没有理由时，这会使人们感到痛苦。

People withfibromyalgiavery often have poor sleep patterns. They often say they had disturbed sleep before the pain and stiffness began.

不安的腿综合征使人们的腿部不寻常，有时甚至是不愉快的感觉，可能会破坏睡眠。它会让您觉得自己想移动双腿。它可以随时发生，但通常在晚上更糟。

一种称为周期性肢体运动障碍的相关状况仅在晚上发生，并使手臂或腿部混乱或抽搐。

这些条件会影响任何人，但经常与长期条件联系在一起。它们也可能是某些药物的副作用，也可能是由于体内没有足够的铁或维生素而引起的。

您应该看医生是否会影响您的睡眠。

以下可以有所帮助：

• talking to your doctor about medications that might be causing this, and looking at what changes you might be able to make
• 服用铁或维生素补充剂
• avoiding caffeine and alcohol
• stopping smoking
• losing weight if you are overweight
• identifying any stress in your life and taking steps to deal with it
• stretching and massaging your leg muscles.

If your symptoms are severe, your doctor may suggest treatment with a group of drugs called dopamine agonists. Examples of these drugs are ropinirole and pramipexole.

打s是常见的，可能是症状或睡眠障碍的原因。大多数打sn的人在白天保持不佳，不会感到困倦，但是他们可能对酒精或镇静剂的影响更敏感。

Severe snoring may be a sign of obstructive sleep apnoea syndrome, a condition caused by brief blockages of the upper airway during sleep.

You may be more likely to get this if you:

• are overweight
• 有一个大颈围吗
• 抽烟
• have diabetes
• have a long-term blocked nose.

It can cause fatigue and can be diagnosed by measuring the level of oxygen in the blood during sleep.

Treatment for obstructive sleep apnoea syndrome includes:

• staying at a healthy weight
• 避免酒精
• 积极的气道压力，涉及夜间戴口罩
• 药物疗法
• surgery to clear a blockage in the upper airway.

For more information visit theBritish Snoring and Sleep Apnoea Association website。

Keeping a diary of how well you’re sleeping and nights when you don’t sleep so well, might allow you to spot helpful patterns.

日记可以包括：

• the time you went to bed and when you woke up
• 无论您是否要轻松入睡
• 任何干扰的原因，例如您的心情，疼痛或疲劳
• 你在午后和傍晚吃什么和喝酒
• 您的白天活动。

If your sleep is disturbed by pain, thenphysiotherapy，运动和可能的药物治疗可能会有所帮助。但是，睡眠障碍通常是由许多问题引起的，可能包括疼痛，但也包括疲劳, stress or depression.

These issues can sometimes be difficult to deal with and might require long-term treatments or solutions.

There are also things you can do in the short term. Healthcare professionals might talk about sleep hygiene, which are ways to give you the best chance of getting a good night’s sleep. Have a read through the sections below, and see if you can try some or all of these tips.

In the bedroom

• 尽量不要使用卧室刺激活动，例如看电视，工作或进食。最好使卧室成为一个宁静而宜人的环境，黑暗而安静，温度舒适。
• 放下屏幕。电话，平板电脑，笔记本电脑和其他电气设备可以使睡眠更加困难。他们散发出可以刺激大脑的光，使它认为它是白天，因此不是时间睡觉的时间。
• A tidy, clean and uncluttered bedroom with clean linen can help you feel relaxed. Fresh potpourri in the room can also make it feel relaxing.
• 厚厚的窗帘可以帮助保持光线，并可能对您的睡眠质量产生重大影响。
• 如果您的床垫老了或不舒服，则可能应该考虑更换它。如果您患有颈部或上背部疼痛，更改枕头的数量或位置或选择柔软或模制枕头可能会有所帮助。有些人发现在狭窄的柔软泡沫衣领中睡觉很有帮助。而其他人则喜欢在膝盖之间休息枕头，而躺在他们的身边。

进入良好的例行

• 即使您度过了一个不安的夜晚，也要同时起床和上床睡觉。这将有助于训练您累的大脑。
• When you wake up in the morning, get out into the natural light as soon as is practical – it’s good to do this at the same time each day if you can. This will help you reset your body clock and make you feel alert. This will still work if it’s a grey or cloudy day.
• Avoid sleeping during the day because this can make it more difficult to get to sleep at night.
• 上床睡觉前进行温暖的浴缸，因为这可能有助于缓解僵硬或疼痛的关节。

健康习惯

• 避免咖啡因 - 例如中午后茶，咖啡，巧克力，可乐和能量饮料。这是一种会导致睡眠不佳的兴奋剂。
• Eat sensibly so you don’t feel hungry during the night but avoid eating and drinking large amounts just before bedtime.
• Avoid drinking alcohol if you’re having difficulty sleeping. While at times it can make you feel sleepy, alcohol can make sleep quality worse and cause you to wake too early feeling unrefreshed.
• There is evidence that smokers are more likely to have sleeping difficulties compared to non-smokers. This is because of nicotine, which is in cigarettes and can cause insomnia and withdrawal symptoms. If you smoke, quitting could really help improve your sleep as well as your overall health. It’s particularly important to avoid smoking during the evening and at night-time.
• Doing regular aerobic exercise can really improve your sleep. This is anything that gets you at least a bit out of breath. For example, it could be brisk walking or swimming. This can help you unwind and will tire you out and lead to deep and refreshing sleep. It’s best to avoid doing any exercise close to bedtime, so that your muscles and joints don’t feel stiff.
• You could try relaxation techniques to help you sleep. Some people find that yogic breathing helps them relax. It involves breathing in slowly and deeply, holding your breath for a few seconds, before breathing out fully and slowly. For more information about how yoga might help you, you could find yoga instructors near you on the英国瑜伽之轮网站。

If you do struggle to sleep

• Don’t look at a clock during the night, as this can make you anxious.
• If you’re really struggling to sleep, it might be better to get up and do something that’s not stimulating, such as listening to soothing music or having a milky drink. Only go back to bed when you’re sleepy.
• If there’s anything on your mind, write it down on a pad next to your bed and then try to forget about it. Do this with a pen or pencil and paper, and not a phone or electronic device.
• 尽量不要担心。许多人会不时患有不眠之夜，这通常只是暂时的。
• If you are regularly waking up in pain, see a relevant healthcare professional, such as your GP,rheumatology consultant,rheumatology nurseor aphysiotherapist。There will be things you can do to improve your symptoms, such as changes to your medication, or lifestyle changes, including exercise.
• Talk to your doctor about what time you should take your medication, in case it affects your sleep. For example, taking steroid tablets later in the day can affect the body clock and may disrupt sleep.

For more information and advice about getting a good night’s sleep, visit睡眠委员会的s website。

Research has shown that people who have trouble sleeping may benefit fromcognitive behavioural therapy (CBT)。This is a talking therapy that can help you manage your problems by changing the way you think and behave. It helps you break down what feels like an overwhelming problem into smaller more manageable parts.

失眠（CBT-I）的认知行为疗法适用于难以入睡的人。它使用：

• 睡眠不足,减少在床上的时间所以that you’re only in bed when you are tired
• managing worries about sleep
• 放松训练。

Your doctor could give you more information and help you find a service.

If you’re still struggling to sleep, see a doctor. There are drugs that may be helpful if sleep hygiene methods aren’t working. You’ll need to discuss with your doctor or pharmacist the advantages and disadvantages of medication.

Painkillers

Taking paracetamol, with or without codeine, just before going to sleep can ease pain symptoms for a time to allow you to get to sleep, but it’s unlikely to last all night. Non-drowsy painkillers that include caffeine could disrupt your sleep.

非甾体类抗炎药（NSAIDS）

NSAIDSsuch asibuprofen或萘普生减轻疼痛和僵硬。尽管这些药物具有潜在的副作用，但它们可能非常有用，尤其是在短期内。在睡前的最后一天，食物或之后，可以减轻整夜的疼痛和僵硬。

镇静抗抑郁药

一些抗抑郁药，例如amitriptyline, dosulepin and trazodone, have sedative effects, which means they make you feel sleepy, and may also reduce pain. These drugs aren’t given as sleeping tablets but may improve sleep as an added benefit. It’s often best to take them a few hours before going to bed so that the effect has worn off by the morning.

镇静剂，也称为催眠药

替甘西m，唑吡坦和唑吡克是有时会用来帮助人们入睡的药物的例子。它们有时被称为催眠药。它们可以帮助您入睡，但可能不会阻止您整夜醒来。

由于依赖风险，医生通常建议长期使用镇静剂，这意味着您可能会上瘾。几天后，这种效果通常会磨损。还有副作用的风险，但它们可能有助于短期使用。在某些极少数情况下，这些药物的长期使用可能比长期睡眠损失更好。

Many people experience painful muscle cramps during the night. Your doctor will review if any medication you’re taking could be causing the cramps, for example diuretics or statins. Doing stretching exercises before you go to bed can help. If the problem continues, you may be prescribed a short course of a drug called quinine sulphate, which can be useful for reducing these pains, though it doesn’t work on other types of pain. Tonic water may also work as it contains a small amount of quinine.

In addition, there are other drugs that are usually prescribed in people who have long-term pain and these drugs may sometimes have useful effects on sleep, for example pregabalin and gabapentin.

We are currently funding research at theUniversity of Aberdeen, to help us understand how pain, sleep, and exercise are interconnected for people with chronic pain. The researchers plan to use the information gathered to design a new combined exercise and sleep programme to trial with patients. If successful, this could reduce pain and disability in patients by improving sleep and exercise habits.