Ways you can get hurt by sleeping

September 10, 2019


I often evaluate conditions in which someone will wake up with particular symptom, like radiating back pain, knee pain, or some kind of pain that appeared to be unrelated to the prior day’s activities.  It’s a strange phenomenon when a person wakes up after having a supposed restful night of sleep and recovery only to experience an unusual pain pattern the following day.

I started making a list to explain how you can acquire injuries while sleeping, and surprised myself at the number of ways our bodies can be subtly assaulted doing something so passive!  Here’s a non-comprehensive, but substantial list of 10 major “sleeping injuries”!

1. Strains and Sprains via Tissue Creep.
Tissue creep is the phenomenon that our connective tissues (fascia, muscle, tendon and ligaments) can stretch or compress beyond it’s structural limits slowly over time to cause an injury.  Your brain doesn’t detect these subtle changes in length or compression, but after a few hours in bed, this phenomenon becomes cumulatively significant enough to trigger pain.

2. Rotator Cuff Impingement
Lying on your shoulder can induce an impingement on the rotator cuff tendons and shoulder capsule if your shoulder is vulnerable, swollen, or having inflammation.  Time and repetition always increases the load and the cumulative intensity, so beware!

3. Brachial plexus compression
Sleeping while seated or in an upright position typically causes the head and neck to bend for long periods.  If bone spurs are present, prolonged compression can cause the sharp spurs to pierce the nerve, or irritate a disc.  Arm or hand numbness or weakness then follow.  Ouch!

4. Elbow and wrist compression syndromes
Our upper extremities are probably most vulnerable during sleep, especially following a mild to moderate injury.  Swelling and inflammation in the presence of prolonged pressure to the extremity results in further injury.  Night braces for the hand and wrist are recommended if you are nursing a new injury.

5. Spinal compression and rotation
There are so many small joints that support the spinal column, and sleeping in a rotated position or on your stomach can result in compressive forces on your spinal facet joints.  Symptoms can include radiating pain or neuritis that is painful to the regions in which the nerve affects.

6. Knees over-extended
If you sleep with your feet elevated (such as on the couch arms) without supporting the back of the knees, then you could be in trouble!  Over time, an over-extended knee that is unsupported can experience ACL injuries and meniscus irritation just by the weight of the leg.  So support the back of your knees!

7. Post-nasal drip leading to bronchitis
Bacterial or viral rhinitis (aka the common cold) is typically contained in the nasal passages.  When you sleep on your back during rhinitis, the nasal content can and will eventually travel into the throat and bronchial regions of the lungs, leading to sore throats and bronchitis.  Sleep on your side instead.

8. Going to sleep dehydrated
This can cause you to wake up very sluggish and mentally slow to respond.  This is an easy to fix problem by drinking a few glasses of water at night.  

9. Sleeping too hot or cold
Being at the right temperature helps achieve a comfortable sleep pattern, and allows your body to recover from injuries and stress, optimize the parasympathetic nervous system, and digest nutrients.  Interrupted sleep is an enemy to recovery!

10. Pillow too high
An elevated head/neck from a high pillow will compress your spine, stress the brachial plexus, and strain small neck muscles leading to tension headaches.  It takes time for your body to adjust to hotel pillows and beds, and the first few nights can leave you feeling unsettled because of it.

Don’t forget that loading and compressive forces can be subtle but cumulative over time.  Get to know your own sleeping patterns, and how well you wake up the next day.  A good night sleep is therapeutic and necessary for everyone!

Dr. Adrian Pujayana has been providing drug-free solutions for health and wellness to adults, athletes, and youth since 2000 through his private practice at Family Chiropractic Center of South Pasadena, a place for strength training and nutrition based health care.  For comments or questions, email him at southpaschiro@gmail.com


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