Sundowning, or sundown syndrome, is a neurological phenomenon associated with increased confusion and restlessness in patients with delirium or some form of dementia. I have always been convinced that there was some connection here also with peripheral neuropathy. Regardless, many people that suffer with neuropathy will describe increased pain in their hands and feet at nighttime, with some only describing issues with their neuropathy at nighttime. You are not alone!! While there has been no research that confirmed the reasons for increased pain in nephropathy at night, a recent study confirmed that people on medication for neuropathy reported their pain was worse around 11 p.m.
Reasons Why Nerve Pain is Worse at Night
There has only been scientific guesses as to why this is, but some do make sense. Some pain-relieving medications have been shown to disturb or disrupt sleep. Having trouble getting to sleep can often make one focus more on the pain and in turn this makes it even harder to get to sleep. If you think you may have been in this pattern, talk with your doctor about your medications to see if you can determine the root cause.
Often times, sufferers from peripheral neuropathy have abnormal sensations or sensitivity to touch. This can even be caused by a draped sheet or blankets which could make it difficult to fall or stay asleep. Check into lightweight blankets and such that may not bother your feet when you are moving them during the night. I posted this blanket throw in a earlier post which I have now purchased for my bed at a bigger size because it does not bother my feet. 9 colors and 4 sizes to choose from, I give it two feet up!!
One of my biggest problems, is at night when you are trying to sleep, often times you have to clear your mind to make it possible for you to sleep. Resting your mind from the distractions of the day gives your mind no distraction from the neuropathic pain. When I am lying there in the dark, this is when I have a chance to focus in on how annoying or bad my pain is. I find the best fix to this is to give yourself some relaxing thoughts to get your mind focused on something else than pain, but not enough to keep your mind running, in turn keeping you awake. I think about the process of fishing, putting the lure on, casting, reeling, casting, etc. This is a simple enough action that does not cause me to think about how to do it, but it is enough to get my mind off of my throbbing feet.
Lack of sleep itself can also add to your neuropathy pain. Before cancer and neuropathy, I could stay up for a few days working or sleep but a couple hours a night during a big project. Now, I am worthless if I get less than six hours a night and working more than 24 hours straight is one of those stories I tell the children about the "my younger days." There have been studies that do tell us that at least 7-9 hours a night can lower your tolerance to pain which in turn can make a nasty cycle of pain and lack of sleep.
Cooler temperatures can cause increased pain. Everyone likes sleeping in a cool room, but when the temperature drops and our peripheral nerves signal that is is colder, these nerves can also fire off pain signals. Our brain may translate these signals in temperature to feelings of tingling, sharp, or burning pain. Cooler temperatures tend to also make your heart beat slower, causing blood flow to move slower. So see blankets above...
How to Help Peripheral Neuropathy At Night
The first and foremost suggestion from relative journals state to keep track of your sleep and develop a sleeping routine. Try to go to sleep and wake at the same time each day. I find here the easiest way to track my sleep is by one of the fitness trackers. I have included some below that all track sleeping.
A comfortable sleeping environment is an absolute must to encourage good sleep. Make sure your bed, pillows, blankets, are all comfortable. One trick if you find your feet are very sensitive at night is to elevate the covers around your feet with pillows or even put your sheets over the foot board if you have one. This will still keep your feet toasty, but avoid contact with anything.
Some have said that a foot massage before bedtime increases the circulation and improves their neuropathy pain. Personally when my feet are hurting I would rather have someone stab me in the eye than rub my feet, okay perhaps a overexertion, but my fellow sufferers understand me!
If your pain is just too great and you are not getting those 7-9 hours of sleep a night, it may also be time to talk with your doctor. Your pharma regimen may need to be altered. I take my Cymbalta (Duloxetine) in the morning, but I have heard people splitting the doses to twice a day. I also find that when my sleep has been off for a few nights that an Ativan (Lorazepam) will calm my nerves enough and ease the pain, but again this is my answer; talk to your doctor and see what he suggests. Lorazepam belongs to a class of drugs known as benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect.
Take one night at a time! It’s easier said than done to not think about the pain. The goal is to try. You have the ability to rethink how you perceive pain. It will take some time and effort, but it’s worth it. My football couch used to say "If it don't mind, It don't matter!" I often think of this quote when the pain is at its worst. In closing, I would suggest to find a friend or loved one that is up late or early. Mine is my brother who has spent his life getting up at like 3 something in the morning. Yes he may need a whole different website to fix his issues (just kidding Jon), but several times when my pain was uncontrolled, he has given me a conversation to get my mind off the pain and help me ease into sleep.
Have a great week!
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