Normal Sleep

A good night's sleep makes everything better. Good sleep helps normal growth, assists healing, restores energy, increases alertness, enhances memory, and improves your ability to take an interest in life. While you're sleeping, your brain is forming new pathways to help remember information. Good sleep also helps you to pay attention, be creative, control your emotions, make decisions, and boosts your learning and problem-solving skills.

Sleep deficiency is associated with mood swings, depression, suicide, and risk-taking behaviors.

It can be hard to get a good night’s sleep if you’re in pain.

When we sleep, our brains don’t switch off. They cycle through different phases of brain activity that repeat over and over during the night. The phases are called non-REM and REM sleep (REM = Rapid Eye Movement). Everyone’s sleep follows this same basic pattern. You start in non-REM sleep, then move to REM sleep, then into non-REM sleep and so on.

Non-REM sleep

In non-REM sleep, our brains are relatively inactive, but our bodies move around. Non-REM sleep has 4 stages that are associated with different patterns of brain activity. It takes from 60-90 minutes to complete a full non-REM cycle.

Stage 1: Lightest sleep
During this stage, it’s common to have a “partial awakening”. This is where people stir from sleep: They might roll over, adjust their covers, etc. These “partial awakenings” are totally normal. They usually don’t last long and people don’t usually remember them in the morning. It’s normal to have from 15-20 “partial awakenings” each night!

Stage 2: Light sleep
Your body relaxes and your temperature drops. You’re getting ready for deep sleep.

Stages 3 & 4: Deep sleep
It’s really hard to wake someone up in these stages of sleep.

REM sleep

REM sleep is also called dream sleep. It starts after stage 4 of non-REM sleep. In this stage, your eyes move and your brain is very active. Your body does not move. The amount of time we spend in REM sleep increases in the second half of the night.

How much sleep do I need?

The amount of sleep you need varies from person to person and changes depending on your age.

The National Sleep Foundation suggests that 9-11 hours for kids 6-12 yrs and 8-10 hours per night for teens is a “normal” and recommended amount. Just as some people are naturally early risers and others are night owls, some people will need a little bit less sleep, while others will need a little bit more.

Sleep Problems

You may need more sleep when you’re ill or in pain, but it can be trickier to get good sleep at these times. Pain, depression, anxiety, behaviour issues, lifestyle, and poor sleep habits may be factors that can all disturb your ability to fall asleep and stay asleep.

Chronic pain may make it tough to fall asleep and it can also wake you up in the middle of the night. So what can you do to get enough or more sleep?

Practice Healthy Sleep Habits (Sleep Hygiene)

Sleep hygiene refers to all the things you can do to help fall asleep reasonably quickly and at the right time of night. Sleep hygiene helps your mind and body build strong connections between being in bed and actually sleeping.

Falling asleep
If you get in bed and don’t fall asleep within 20-30 minutes, get out of bed and repeat your nighttime routine (e.g. have a light snack, read a chapter in your book, etc.). It might take you 25-40 minutes to feel sleepy. That’s OK. Do NOT go lie on the couch, check your phone or watch the clock; just ‘guesstimate’ how long these time periods are.

Remember, you’re trying to get your body and brain to associate your bed with sleep, so if sleep isn’t happening, you’ve got to get out of bed. It’s easier to leave a comfy bed if you have your slippers and robe ready and your bedtime routine activities handy, but not next to you. Don’t keep looking at the clock as it will only make you more worried or frustrated. Go back to bed when you’re feeling sleepy again.

Waking up
No matter how much sleep you got the night before, it is really important to get up at the same time every morning (within an hour) on both weekdays and weekends. As soon as you wake up in the morning, turn on the lights or get into daylight.

During the day
Do not nap during the day. If you absolutely have to nap, make it short: Ideally no more than 60 minutes at the most, making sure you wake up before early afternoon. Many people report feeling better able to stay awake and alert in the late afternoon and evening when they have had a daytime nap. This increased alertness typically causes people to go to bed later and to require much less sleep at night. If you want to try to stay awake instead of napping, try getting out of the house or doing some other activity that requires that you need to be standing up.

Nighttime Waking
If you can’t go back to sleep after waking up in the middle of the night, follow the same steps you did for falling asleep.

  • Get out of bed
  • Repeat your bedtime routine
  • Return to bed when you feel sleepy, in 25-40 minutes.
  • Don’t watch the clock, look at a screen, or turn on bright lights.

Do's and Don'ts


Spend time outside and be physically active during the day.

Only use your bed for sleeping.
Don’t use it for doing homework, sitting, lounging, eating, playing video games or watching TV! You might have to stop doing some things that you’re really used to or like doing on your bed. Find another cozy spot in another room where you can do these things (e.g., a bean bag pillow on the floor).

Create a fixed bedtime routine.

  • Do the same thing in the same order at the same time every night. This will help your body know that it is night and get it ready to sleep.
  • Have a set bedtime that doesn’t vary by more than an hour throughout the week.

Try these activities before bed:

  • A warm bath
  • Laying out clothes or packing your bag for the morning
  • Have some warm milk or a bedtime snack
  • Read a relaxing book or magazine
  • Listening to a relaxation CD or soft music
  • Any other relaxing activity that can be done in 20-25 minutes.

Make sure you’re in dim light in the hour before bed.

  • Dim the lights in the bathroom, bedroom, and other areas of the house.
  • Avoid the light from screens if you can. If you have to be around screens, make sure that the screen is really dim. Wear sunglasses if you have to.
  • Use blackout blinds in your bedroom.
  • Use a small night-light if you need it in your room, the hallway and the bathroom so that you don’t have to turn on the bright lights if you wake up in the middle of the night.
  • A white noise machine can help if you have a noisy house or neighbourhood.

Have a set wake-up time

  • Ideally your wake up time from day to day (including school days weekends and holidays!) should not vary by more than 1 hour. That means if you have to wake-up for school at 7:00am, you should not let yourself sleep in later than 8:00am on the weekend.


  • Do NOT Nap. If you have to have a nap for health or pain reasons, make sure it’s short and that you wake up by early afternoon.
  • Do NOT Spend time in bed for activities other than sleeping.
  • Do NOT Spend time in bed during the day for resting. Use the hour before bed for quiet time. Avoid strenuous exercise and bright artificial light, such as from a TV or computer screen. The light may signal the brain that it's time to be awake.
  • Do NOT eat large meals within a couple hours of bedtime. (a light snack is okay.)
  • Do not consume caffeine in the afternoon and evening. Caffeine can be present in caffeinated soft drinks, coffee, tea, chocolate and some over the counter medications. The effects of caffeine can last up to 8 hours.

Helpful Resources

Understanding Pain: Brainman Chooses

By: Brainman

Brainman explains a whole-person approach to managing chronic pain.

Dancing with Pain

By: Dr. Leora Kuttner

Coming to grips with chronic pain is a very trying process for teenagers and their families. "Dancing with Pain" takes us into four teen's experiences dealing with pain from, a facial injury, Sickle Cell Disease, CRPS (complex regional pain syndrome) and neck and shoulder trauma.

Worry Taming for Teens

By: S. L. Clark, J. E. Garland, Children’s & Women’s Health Centre of BC 2nd Edition.

Written specifically for youth, this manual explains the nature and basis for anxiety, the different types of anxiety, and includes information on medication. It also includes specific coping strategies for youth.