How to Fix Your Sleep: A Physician’s Guide, From Free Tonight to Clinical Care

By Nikhil Verma, MD, fellowship-trained interventional spine and sports medicine physician, Essential Sports and Spine Solutions, Columbus, OH

A patient told me recently that she had tried everything for her back. Injections, therapy, three different anti-inflammatories, a chiropractor, a mattress that cost more than my first car. Somewhere near the end of the visit I asked how she was sleeping. She laughed. Five hours, broken, most nights, for about four years.

Nobody had asked her that.

So here is the honest version. If you are in chronic pain and sleeping badly, fixing the sleep is probably the highest-yield, lowest-cost thing available to you, and almost nobody in the standard system is going to walk you through it. Poor sleep lowers pain thresholds, amplifies how loud pain feels, and makes every other treatment work less well. That relationship runs both directions, which is why it becomes a loop that is hard to break from either end.

I am an interventional spine and sports medicine physician in Central Ohio. I do not run a sleep lab. But sleep shows up in almost every chronic pain conversation I have, and I have spent real time building an approach for it, because the terrain a treatment lands in matters as much as the treatment.

What follows is organized by cost and effort. Start at the top. Most people never need to get past the first two sections.

One disclosure up front: I have no affiliation with any product, brand, or company named in this article. Nothing to disclose. These are things I use or recommend, nothing more.

Start Here: Free, Tonight

None of this costs anything. It is also, by a wide margin, where the biggest gains are.

• Pick a wake time and hold it. Same time, seven days a week, including weekends. Wake time anchors your circadian rhythm far more reliably than bedtime does. If you fix one thing, fix this.
• Get outside light in the first 30 to 60 minutes after waking. Ten to thirty minutes on a clear morning, longer if it is overcast. Outdoor light, even on a gray Ohio day, is dramatically brighter than anything indoors. Through a window does not count for much.
• Remove screens and electronics from the bedroom, including phones, tablets, laptops, and TVs. Charge your phone in another room and use a traditional alarm clock.
• Dim lights after sunset. Turn off overhead lighting and use warm, low-level lamps instead.
• Use candlelight or a fireplace during the last hour before bed to reduce bright light exposure.
• Practice slow breathing with longer exhales than inhales for two to three minutes before sleep.
• Keep the bedroom cool when falling asleep and allow it to gradually warm during the last few hours of the night if desired.
• Stop caffeine eight to ten hours before bedtime.
• Recognize that alcohol and marijuana may help you fall asleep but often reduce sleep quality by suppressing REM sleep and fragmenting rest.

Under $50

• Amber or red-tinted blue light blocking glasses for evening use.
• Socks, an eye mask, and earplugs.
• Bilateral audio or binaural beats if personally helpful.
• Magnesium glycinate.
• Glycine, approximately three grams one hour before bed.
• L-theanine, 200 to 400 mg.

$50 to $200

• Myo-inositol.
• Taurine.
• Ashwagandha, with physician guidance if appropriate.
• Replace bright, cool-toned light bulbs with warmer lighting.
• Self-guided cognitive behavioral therapy for insomnia (CBT-I).

$200 to $1,000

• Circadian lighting systems.
• Morning red or near-infrared light therapy panels.
• CBT-I with a trained therapist.
• A sleep tracker, if data motivates rather than creates anxiety.

Get Screened for Sleep Apnea

If you snore, wake up gasping, experience morning headaches, fall asleep during the day, have a large neck, or struggle with high blood pressure, consider being evaluated for obstructive sleep apnea before investing in additional sleep products or supplements. Home sleep testing has made diagnosis easier than ever.

One Warning Nobody Gives You

Some people become more anxious when relaxation techniques activate the parasympathetic nervous system. If breathing exercises or quiet environments make you feel uncomfortable, body-based therapies such as manual therapy, somatic therapy, trauma-informed counseling, or EMDR may be more appropriate starting points. Begin slowly and reduce the duration if symptoms worsen.

Where This Connects to What I Actually Do

I treat knees, shoulders, hips, and spines with orthobiologic treatments, including PRP, bone marrow aspirate concentrate, micronized fat, and laser therapy. The patients who experience the best outcomes are rarely those who simply receive the best injection. They are the patients whose bodies are prepared to heal.

Sleep plays a major role in that preparation. Deep sleep supports growth hormone release, tissue repair, and healthy inflammatory regulation. Sleep is not an optional wellness recommendation in my practice. It is part of the treatment protocol alongside nutrition, stress management, targeted supplementation, and appropriate activity.

Sleep and Chronic Pain in Columbus and Central Ohio

If you live in Columbus, Dublin, Westerville, Upper Arlington, Gahanna, or elsewhere in Central Ohio and have been searching for answers to chronic pain, sleep may be one of the missing pieces. My approach focuses on evaluating the whole person, not just imaging or a single painful joint.

If you would like to learn more about the protocols I use, including how I prepare patients before regenerative procedures, I discuss them in my paid newsletter, Essentials of Healing, available at nikhilvermamd.substack.com.

Frequently Asked Questions

What Is the Single Most Effective Thing I Can Do for My Sleep?

Fix your wake time and get outside within an hour of waking for natural sunlight exposure. These two habits consistently produce the greatest improvements for most people.

Does Bad Sleep Actually Make Pain Worse?

Yes. Poor sleep lowers pain thresholds, increases pain sensitivity, and contributes to central sensitization, while pain itself also makes quality sleep more difficult.

What About Melatonin?

Melatonin is primarily a timing hormone rather than a sedative. Smaller doses taken a few hours before bedtime are generally more physiologic than large bedtime doses. It is particularly helpful for jet lag and shift work.

Are Blue Light Blocking Glasses Worth It?

For many people with significant evening screen exposure, yes. They are inexpensive and may provide modest improvements, although removing screens from the bedroom typically has a greater impact.

Can I Take More Than the Recommended Dose of These Supplements?

Always discuss supplement dosing with your physician, especially if you have kidney disease, take prescription medications, or have chronic health conditions.

Do I Need a Sleep Study?

If you snore, gasp during sleep, wake feeling unrefreshed, or have difficult-to-control high blood pressure, a sleep study is recommended to evaluate for obstructive sleep apnea.

Is a Glass of Wine Before Bed Helping Me Sleep?

Although alcohol may help you fall asleep more quickly, it often disrupts sleep later in the night, suppresses REM sleep, and can worsen sleep apnea.

Does Sleep Affect How Well PRP or BMAC Works?

While definitive studies are still lacking, adequate sleep supports tissue repair and recovery, making it reasonable to optimize sleep before regenerative procedures.

How Long Until My Sleep Improves?

Morning light exposure and consistent wake times often improve sleep within several days to two weeks. CBT-I typically requires four to eight weeks, while supplements generally show effects within one to two weeks if they are effective.

Ready to Learn More?

If you are ready to discuss your pain, your sleep, and whether regenerative medicine may be appropriate for your situation, request an appointment at https://www.essentialsportsspine.com/request-appointment/.

Disclaimer: This article is for educational purposes only and does not constitute medical advice.

If you want to go deeper on these protocols, including system selection and post-procedure recommendations, visit the Essentials of Healing newsletter at nikhilvermamd.substack.com.