How to Sleep with Hypermobility


For some, the pain associated with hypermobility can create difficulty sleeping. The five best ways to improve sleep with hypermobility are with strengthening exercises, diet and hydration, practicing good sleep hygiene, and proper pain medication management. 

What is Hypermobility?

Joint Hypermobility is a trait where joints are more flexible and have a larger range of motion than is typical. Approximately 10% of children have hypermobile joints, and women are more likely to have them than men. Having hypermobile joints is also known as being “double-jointed.” Some standard tests of hypermobility include:

  • Bending your small finger back further than 90 degrees
  • Bending your thumb forward to touch your forearm
  • Hyper-extending your elbows and knees, bending them beyond a straight line
  • Putting your palms flat on the floor without bending your knees

Joint Hypermobility Syndrome

In most cases, highly flexible individuals don’t have medical issues as a result, but in a small set of circumstances, it can cause chronic pain and discomfort. People who suffer chronic joint pain that is related to their hypermobility or the looseness of different tissues have a condition called Joint Hypermobility Syndrome (JHS). In these cases, sleep may be affected, and pain management is necessary.

Ehlers-Danlos Syndrome

A rare inherited syndrome, Ehlers-Danlos is a group of disorders that include hypermobility, very elastic skin, skin that is easily bruised, and weak tissue. In individuals with this syndrome, hypermobility can cause frequent joint dislocations and pain. These types of injuries can also lead to difficulty sleeping.

Causes of Sleep Difficulties

There are two leading causes of sleep problems in people with hypermobility:

  1. Chronic pain
  2. Too much adrenaline

Daytime Solutions for Sleep Issues

Strengthening Exercises

Individuals with hypermobility should be vigilant in keeping their muscles strong, as this will aid in keeping their joints stable and reducing the likelihood of dislocation, or pulling and strain.

The best type of exercise for them is lightweight strengthening exercises. Too much weight can cause strain on the joint, so use only enough weight so that you can complete eight repetitions without strain. Resistance exercise is vital to joint stabilization, so this should be a regular routine that is done at least three times a week. Consulting with a physical therapist or trainer may be advisable if the individual is new to this type of exercise.

Avoid contact sports and high impact exercises. Any exercise that required vigorous pushing or pulling should also be avoided. Swimming, walking, Pilates, and Tai Chi are all excellent choices.

Yoga is not necessarily advised for individuals with hypermobility. Some forms of yoga can increase mobility, which is not an important goal for folks that already have too much of it. Strengthening and stabilizing should in the end be the goal.

Diet and Hydration

Individuals with hypermobility should take should test their vitamin and mineral levels. Vitamin deficiencies can exacerbate chronic pain and sleep issues, so getting a blood test can be an essential first step in improving one’s diet.

Inflammation can be a cause of joint pain and chronic pain. Individuals who have arthritis find relief with an anti-inflammatory diet, and this could work for those with hypermobility as well. An anti-inflammatory diet includes several servings of fruits and vegetables a day and avoiding foods that increase inflammation, such as processed foods, refined sugar, dairy, alcohol, and red meat.

Foods should be added to reduce inflammation. This includes foods high in Omega-3 fatty acids, like olive oil, avocados and salmon, and foods that contain antioxidants like fresh berries and green tea.

Staying hydrated is vitally important for reducing fatigue and pain in the body. Water is necessary for lubricating joints. It is also crucial for maintaining muscular health, as the cells can more easily clear toxins out of the system with enough water. Joints are made of cartilage, and 60% of this tissue contains water. Staying hydrated helps stimulate the production of synovial fluid, which keeps the cartilage lubricated. Water will also help reduce inflammation around the joint and support the growth of new cells in the cartilage tissue.

Sleep is disturbed by chronic pain as a result of the sleep cycle being disrupted. People who are in pain are unlikely to get a full sleep cycle and may miss out on deep sleep and REM sleep. The autonomic nervous system, the system in charge of the fight or flight response, is not turning off appropriately. Having too much adrenaline in the system will cause this as well.

Nighttime Solutions for Sleep Issues

Sleep hygiene refers to a set of behaviors that add up to a good night’s sleep. Similar to oral hygiene, where brushing your teeth twice a day, flossing and avoiding soda and sweets can create healthy teeth, following these guidelines will lead to healthier sleep no matter the cause of the sleep issues.

  • Avoid caffeine — Although it’s tempting to reach for another soda or coffee when you are already tired, caffeine impairs sleep, and in some folks, that can happen even when the caffeine is consumed long before bedtime. Keep the caffeine to a minimum, or cut it out altogether, and be sure not to drink any caffeine after noon.
  • Turn off the screens — One of the number one culprits of insomnia today is the blue light emanating from our screens. Phones, tablets, TVs, and computers all create a light that blocks the production of melatonin in the brain. We need melatonin for a good night’s sleep. Turn off all screens at least an hour before bed, opting instead for a book, a podcast, or some light music.
  • Exercise — As discussed above, exercise can have healthy effects on joint pain. It can also aid in a better night’s sleep. Restlessness at night can often be caused by not moving the body enough during the day. Even a walk has been shown to help improve sleep. Just avoid any vigorous exercise right before bed.
  • Temperature — Bedrooms should be kept at a reasonably cool temperature. Approximately 65 degrees Fahrenheit is shown to be the best temperature for sleeping.

Pillows and Sleep Props

Many folks with Ehlers-Danlos syndrome report some relief with different types of pillows for support. Wedge-shaped pillows, memory foam, and even pregnancy pillow help to support joints at night and prevent dislocation. Some individuals have reported relief with weighted blankets as well.

I highly recommend using a Xtreme Comforts 7″ Wedge Pillow (link to Amazon) for the best possible comfort. I purchased one going on a year ago, and have found that its been more comfortable than any other wedge pillow I’ve tried in the past!

Similarly, I just reviewed a weighted blanket that I found worked the best, and managed to be the most comfortable one I could find. Here is a link to the review that I posted – Best Weighted Blankets.

Medication Management

Finally, a discussion of joint pain would not be complete without a mention of medication. For some, pain medication is necessary to have a good night’s sleep. But, this discussion should be had with your doctor or healthcare professional.

Chronic pain is a pressing issue, especially when it leads to sleep problems. It’s important not to simply tough it out or see it as something that you have to put up with. Medication may help you sleep, and in that case, it may also improve your mood, energy levels, and ability to concentrate. With the extra energy, you may be able to try these other helpful tips, like stabilizing exercise, but when fatigued, these things may seem impossible. Over time, you may be able to reduce the medication, but it can be an essential first step for some in maintaining a healthy lifestyle.

Conclusion

Hypermobility, while common and usually benign, can sometimes lead to joint pain and sleep problems. But the good news is that from diet to exercise, pillows and sleep aids, there are many things that can help.

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