Keep a regular sleep/wake schedule. Develop a bedtime ritual, such as taking a warm bath or reading light material. Limit or eliminate caffeine four to six hours before bed and minimize daytime use. Avoid smoking, especially near bedtime or if you awake in the middle of the night. Avoid alcohol and heavy meals before you go to bed. Turn off your TV, smartphone, iPad and computer a few hours before your bedtime.
You also can adopt relaxation techniques to help induce sleep. These include:
giving yourself an extra hour before bed to relax and unwind, and time to write down worries and plans for the following day meditating doing deep breathing exercises
Finally, create a comfortable sleeping environment. For example,
Make sure your bedroom is dark, quiet and well-ventilated. Make sure your bed and pillows are comfortable. Elevate the bed sheets so that they’re not touching your legs and feet.
Self-help techniques – These are techniques you can adopt (as described above) if you’re not already incorporating them. Non-pharmacological treatments – These include cognitive behavioral therapy, relaxation techniques, stress management and acupuncture. They are preferred to prescription sleep medications, which can lead to sleepiness during the day, cause dependency and have side effects. Pharmacological treatments – Used as a last resort, these should only be used temporarily, especially when the insomnia is chronic. Sometimes, medicines used to reduce pain or aid sleep can affect your sleep.Over-the-counter pain medications – For mild pain, over-the-counter pain medications , such as Tylenol and Advil, may suffice. Some over-the-counter pain medications, such as Advil PM or Tylenol PM, also have an antihistamine to help with sleep.² Prescription medications—For more severe or chronic pain, your doctor may recommend prescription pain medications such as codeine, and morphine. Some antidepressants and anticonvulsants can also be prescribed. To help with sleep, your doctor might recommend drugs typically prescribed for anxiety, called benzodiazepines (e.g., lorazepam, clonazepam, triazolam), and nonbenzodiazepine hypnotics that are particularly helpful for sleep and appear to be better for longer-term use than benzodiazepines (e.g., zolpidem, eszopiclone, zaleplon).³
Poor sleep, depressed mood and anxiety can complicate your (and your doctor’s) efforts to manage neuropathic pain. The key is to recognize this and partner with your doctor to find the right treatments and approaches that work best for you.