Does back pain keep you up at night?
When back pain affects your sleeping habits, to the point each night you get less and less sleep, it becomes a situation where your whole life is altered and we end up feeling lost and anxious at the same time.

At that point we try several options to get a full night’s sleep (tea, warm milk, reading, watching tv, medication, work out, etc) but most of the time we don’t resolve the main problem: the sleeping cycle is unbalanced.

If you do any research in this area you will come across the phrase Circadian Rhythm.  This is a complex topic to understand, however, we need to realize how this cycle affects our body, mind and behavior in our everyday life and relationships (family, work, friends, ect).

What is the Circadian Rhythm?

According to the National Institute of General Medical Sciences, “Circadian rhythms are 24-hour cycles of physical, mental, and behavioral changes that are part of the body’s internal clock, running in the background to carry out essential functions and processes. These natural processes respond primarily to light and dark and affect most living things, including animals, plants, and microbes.”

For example, they help flowers open and close at the right time and keep nocturnal animals from leaving their shelter during the daytime when they would be exposed to more predators.

For humans, some of the most important genes in this process are the Period and Cryptochrome genes. In 2017, researchers Jeffrey C. Hall, Michael Rosbash, and Michael W. Young won the Nobel Prize for their circadian rhythms research. By studying fruit flies, which have a very similar genetic makeup to humans, they showed that these specific genes produce a protein that builds up in cells overnight, then breaks down during the day. This process helps activate feelings of wakefulness, alertness, and sleepiness. 

How Does it Work?

Circadian rhythms work by helping to make sure that the body’s processes are optimized at various points during a 24-hour period. The term circadian comes from the Latin phrase “circa diem,” which means “around a day.”

The circadian rhythms are connected to a master clock located in the suprachiasmatic nucleus (SCN), which is in a part of the brain called the hypothalamus. At different times of the day, clock genes in the SCN send signals to regulate activity throughout the body. While other cues, like exercise, social activity, and temperature, can affect the master clock, light is the most powerful influence on circadian rhythms.

Circadian rhythms coordinate mental and physical systems such as:

• Hormone release: the endocrine system regulates hormones to suit normal energy expenditure. 
• Eating habits and digestion: the digestive system produces proteins to match the typical timing of meals
• Body temperature: the core body temperature (Tcore), which also cycles along with the sleep-wake rhythm, decreases during the nocturnal sleep phase and increases during the wake phase repeatedly in a 24-hour circadian rhythm. 

However, most people notice the effect of circadian rhythms on their sleep patterns. The SCN controls the production of melatonin, a hormone that makes you sleepy. It receives information about incoming light from the optic nerves, which relay information from the eyes to the brain. When there is less light—for example, at night—the SCN tells the brain to make more melatonin so you get drowsy. 

This is most noticeable when you travel and are jet lagged.  The circadian rhythm is off and you feel sleepy or awake at the wrong times for the destination you are in.

When the Circadian rhythm is thrown off, it means that the body’s systems don’t function optimally. A distrubed sleep-wake circadian rhythm can give rise to serious sleeping problems. Without the proper signaling from the body’s internal clock, a person can struggle to fall asleep, wake up during the night, or be unable to sleep as long as they want into the morning. Their total sleep can be reduced, and a disrupted circadian rhythm can also mean shallower, fragmented, and lower-quality sleep.

In addition, studies (available in the National Center for Biotechnology Information) have identified circadian rhythm disruptions as potential contributors to obstructive sleep apnea (OSA), a sleep disorder marked by repeated lapses in breathing. OSA reduces the body’s oxygen levels and causes numerous sleep interruptions through the night.

As a whole, a misaligned circadian rhythm can negatively affect sleep in many ways, increasing a person’s risk of insomnia and excessive daytime sleepiness. Given the essential role of sleep for productivity and overall health, there are often significant consequences when a person’s circadian rhythm is off.

Disruptions to circadian rhythm can occur over the short- or long-term. Experts have identified a number of types of circadian rhythm sleep-wake disorders (CRSWD) based on their characteristics and causes.

• Jet Lag Disorder: This occurs when a person crosses multiple time zones in a short period of time and gets its name from the fact that it is often experienced by people who take intercontinental flights. 
• Shift Work Disorder: Work obligations can cause major disruptions in a person’s circadian rhythm. Shift work, which requires having to work through the night and sleep during the day, puts a person’s sleep schedule directly at odds with the local daylight hours.
• Advanced Sleep Phase Disorder: People with this type of disruption find that they get tired early in the evening and wake up very early in the morning. Even if they want to be up later at night or sleep later in the morning usually cannot do so. This disorder is relatively rare, affecting around 1% of people in middle and older age 16, and occurs more frequently in older adults.
• Delayed Sleep Phase Disorder: This type of circadian rhythm disruption is associated with “night owls” who stay up late at night and sleep in late in the morning. The exact cause is unknown but may be related to genetics, underlying physical conditions, and a person’s behavior.
• Non-24 Hour Sleep Wake Disorder: This condition occurs primarily in people who are blind and are not able to receive light-based cues for their circadian rhythm. Their body still follows a 24-hour cycle, but their sleeping hours constantly shift backward by minutes or hours at a time.
• Irregular Sleep-Wake Rhythm Disorder: People with this rare disorder have no consistent pattern to their sleep and may have many naps or short sleeping periods throughout a 24-hour day. It is frequently connected to conditions that affect the brain, such as dementia or traumatic brain injury, that limit the proper functioning of the master clock in the hypothalamus.

As this list demonstrates, there are diverse causes of circadian rhythm disorders. Some circadian disruptions are related to individual behavior, such as for travel or work, that puts sleep schedules out of whack with normal daylight exposure. Other disorders stem from an underlying issue that causes an inability to receive or process environmental cues that regulate the body’s master clock. In certain situations, genetic causes may be involved, or the cause may remain unknown.

How to help get your rhythm back on track

1. Seek out sun: Exposure to natural light, especially early in the day, helps reinforce the strongest circadian cue.
2. Follow a consistent sleep schedule: Varying your bedtime or morning wake-up time can hinder your body’s ability to adjust to a stable circadian rhythm.
3. Get daily exercise: Activity during the day can support your internal clock and help make it easier to fall asleep at night.
4. Avoid caffeine: Stimulants like caffeine can keep you awake and throw off the natural balance between sleep and wakefulness. Everyone is different, but if you’re having trouble sleeping, you should avoid caffeine after noon.
5. Limit light before bed: Artificial light exposure at night can interfere with circadian rhythm. Experts advise dimming the lights and putting down electronic devices in the lead-up to bedtime and keeping electronics out of the bedroom and away from your mattress.
6. Keep naps short and early in the afternoon: Late and long naps can push back your bedtime and throw your sleep schedule off-kilter.

Personally I use ear plugs and an eye mask at night. I also use blue light blocking glasses about 2 hours before I go to bed. 

These steps to improve sleep hygiene can be an important part of supporting a healthy circadian rhythm, but other steps may be necessary depending on the situation. If you have persistent or severe sleeping problems, daytime drowsiness, and/or a problematic sleep schedule, it’s important to talk with a doctor who can best diagnose the cause and offer the most appropriate treatment.

Source:

https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx

https://www.sleepfoundation.org/circadian-rhythm

• Share this post: