Psychologists have a significant role to play in managing sleep and pain
- 00:00 – 01:01 Approach to managing sleep in persistent pain
- 01:01 – 02:39 Modifying CBTi for people with pain
Dr Giselle Withers is a Clinical Psychologist with over 15 years experience working across private and public health services in Australia and in the UK. Giselle runs mindfulness groups online and at the Melbourne Sleep Disorders Centre. For information on mindfulness classes, check out Giselle’s site, A Mindful Way.
You can also download a brochure on mindfulness classes at the Melbourne Sleep Disorders Centre here.
- Pain and sleep: thinking and behaviour around sleep
- Pain and sleep: lifestyle & medications
- Pain and sleep: A sleep physician’s approach
David Cunnington: Giselle, in your role as a psychologist managing people who have problems with pain as well as in your role of managing problems with people having trouble sleeping, how would you approach helping someone sleep better if they’ve got persistent pain?
Giselle Withers: Well, it is a common problem. As I said, 70 percent of people with chronic pain also have a sleep disturbance. So we routinely assess the sleep problems and offer sleep management treatment as part of their pain management treatment and that – we use this cognitive behavioural therapy for insomnia approach, but tailored towards pain.
So for example, when we’re using some cognitive restructuring techniques, all of the things and the thoughts that we’re restructuring tend to be related to pain whereas someone within traditional CBTI might be sleep-related thoughts.
David Cunnington: And you still use sleep consolidation and stimulus control?
Giselle Withers: Absolutely. It’s really important that people have a realistic understanding of sleep stages and sleep states. So there’s a lot of education that we provide on sleep and stimulus control is important for someone needing to nap and rest throughout the day and we still recommend that they don’t lie in bed but they rest on the couch and also that they look at matching their time in bed more closely with the time that they’re actually sleeping. They’re not spending long periods of time awake in bed at night time.
David Cunnington: That’s a good point about bed and people who are sleeping with pain often using the bed both for rest and sleep a bit sort of interchangeably. So yeah, that’s a good message. What about the relaxation component? Do you modify that at all for people with pain?
Giselle Withers: One of the – I think a great aspect of our sleep management program with pain clients is that we spend a lot of time helping them get comfortable.
So that might be using padded mats on the floor and using pillows to help them get into position that would help them to relax. It’s not about finding the one and ideal position but just learning how to experience pain but still relax the body in that position.
So, we might – we teach them some relaxation strategies or draw around mindfulness-based approaches as well to help people I guess relate differently to their pain.
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