Why sleep is important
We are all familiar with some of the symptoms of lack of sleep – fatigue, brain fog, irritability, and finding it harder to cope with pain and other stressors. However, long-term lack of sleep can affect our heart, breathing, and immune system, as well as brain function and mood, and, particularly relevant to hypermobile people, a lot of our healing processes happen during sleep.
So good sleep is important to everyone, but even more important to people with chronic health issues, including symptomatic hypermobility – which can unfortunately also make it harder to maintain good sleep due to symptoms!
It is also worth noting that the different phases of the menstrual cycle, pregnancy, perimenopause and menopause can also affect sleep.
This is why it is important to establish habits that promote a good night’s sleep (also known as ‘good sleep hygiene’) and give us the best chance of getting the sleep we need.
How much sleep do we need?
Studies on adult males have indicated 7-8 hours of sleep is needed, but the indications are that women may need a bit more, and people with chronic health conditions need a bit more still. So don’t be surprised if you need 9-10 hours. (Remember these are approximate figures, and everyone is different).
Tips for getting a good night's sleep
While good sleep hygiene can sound like a simple list and rigid process, for people with symptomatic hypermobility it will need to be flexible and adapted around our symptoms. So, these are not hard and fast rules, but things to try and see what works for you and what works may change over time.
Remember: It really is a case of “every little help’s” - there is rarely one big solution to sleep challenges. It is almost always a combination of lots of things that each help a little bit.
It is also important to note that once your body is in a good routine, you are likely to be better at sleeping, even when you cannot follow your full routine (for example due to changes in your health, work, family, or social life).
Some tips for getting a good nights sleep:
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Have regular times for going to bed, and for getting up – that is consistent both on busy days and quiet days. This helps the body learn when to start winding down and when to start waking up. In time your body can start to automatically follow this pattern, and sleep should become easier.
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If you can, get outside into sunlight within an hour or so of getting up in the morning – this will help you wake up and reset your circadian rhythm (your internal body clock).
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Exercise during the day can also help improve sleep – and therefore decrease fatigue, even though it can make you feel more tired in the short term. (See our website for tips on exercising with hypermobility.)
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Establish a nightly routine, which you stick to every evening. This creates a pattern that your brain associates with sleep and will help you wind down and fall asleep quicker. This can include things like a warm bath, relaxation exercises, doing a gentle activity like folding laundry or doing a jigsaw puzzle, reading, and having a warm drink before bed.
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Avoid all caffeine from mid-afternoon and avoid alcohol and sugary drinks and snacks from early evening.
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Avoid having a TV in the bedroom, as this can distract you from sleeping and switch your phone off or put it on silent, so it will not disturb you. Turn off screens 2 hours before you plan to sleep.
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Make sure your room is the correct temperature for you, and that it is dark.
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Have a comfortable mattress and use additional cushions or pillows to support painful or unstable joints.
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If your mind is racing with things to remember or do, jot them down so that you do not have to worry about forgetting them, and can deal with them later.
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Take time to manage your stress levels – they have a big impact on sleep.
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If you need to sleep during the day, and it suits your lifestyle, 90 minutes is a good length of time as it allows a full cycle of sleep. Set an alarm to wake you, so that you do not accidentally sleep longer.
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If you wake up during the night: Do not stress! Make any comfort-adjustments that you need (changing position or adjusting the temperature) and try doing some relaxation exercises like breathing. If you are still awake after 15 minutes or so, get up and do something gentle until you feel sleepy – then go back to bed.
Establishing new sleep habits can take several weeks. So, keep trying!
Adapting sleep routines for neurodivergent needs
For neurodivergent people, especially those with autism or ADHD, a good sleep routine will need to focus on things that are sensory calming for the individual and so it may look slightly different.
For example:
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Backgound ‘white noise’ or a familiar audiobook instead of silence. Or wearing ear plugs to increase the quiet.
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Soft lighting may be more effective than darkness. Or blackout blinds to increase the darkness.
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Using an essential oil or perfume that you find calming.
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Having a soft toy or other sensory comforter while in bed.
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Ensuring all bedding and night clothes are comfortable – no scratchy labels or annoying seams.
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Do gentle stretches or proprioceptive exercises to help calm the nervous system before bed.
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Having a longer period of ‘wind down’ time as part of the bedtime routine (especially for anyone who struggles with transitions). For example, a time where you read a book, do some colouring, use a calming stim toy, or other activity that helps to regulate or calm the nervous system before starting the process of actually going to bed.
For some people, playing a calming game on a device can be an effective part of a sleep routine, but if this is the case it is a good idea to use a filter or app that reduces the glare from the screen, as bright light from screens can interrupt the sleep process.
Engaging deeply in a special interest is not recommended as part of the bedtime routine as it will stimulate the brain rather than calm it.
What if all this doesn’t help?
If you are doing all of this as well as you can but still struggling with sleep after a couple of months, you should speak to your GP about it. Sometimes sleep aid medications can be prescribed for the short term, and sometimes other conditions such as sleep apnea might be present and need diagnosing and treating in order to improve your sleep.
There are also cognitive behavioural techniques especially designed to help address insomnia (CBT-I), which your GP may be able to refer you too and which is also available privately.
Useful links
HMSA members can find more detailed information on sleep – both the neuroscience and practical tips for sleep when hypermobile on the recording of the Sleep session of our Living well with hypermobility course by Jo Southall (Occupational therapist) and Kim Clayden (Solution-focused Psychotherapist): Members Video resources | The HMSA
There is also an insomnia guide on NHS Scotland’s website here: that some people may find useful – but please note that you may need to adapt some aspects around your hypermobility and/or other conditions.
https://www.nhsinform.scot/illnesses-and-conditions/mental-health/mental-health-self-help-guides/sleep-problems-and-insomnia-self-help-guide/
Tips from the community
Struggling to sleep is a really common issue in our community. One of our support groups came up with a list of things they find help them sleep - and here it is.
Please note, not everything will help each individual. Different things will help different people.
Always discuss any medications or supplements with a health care professional before starting them in case they interact with any of your existing medications or aren’t recommended for your particular health issues.
Curved neck support pillows for side and back sleepers with cooling cotton pillow cases.
Hot water bottles (traditional/rechargeable), bean bag, heat pads, or electric blankets
Night resting splints for painful and unstable wrists (keeping them in place while relaxed and asleep)
My routine involves doing a small jigsaw as part of winding down - it gets me away from screens, and doing something I enjoy and find relaxing and gentle seems to help me get to sleep more quickly
Use a long flat pillow for between legs (knees and ankles) to hold hips in place.
Space to move around in bed, and aids such as silky low friction PJ’s and sheets to make moving easier
Pillow under the upper arm when side sleeping (stabilising the shoulder).
To help with ankle and foot pain and keep ankles in a good position, try a blanket cradle (a frame that keeps the weight of the duvet/blankets off the feet), or if front sleeping, try sleeping with feet off the end of the bed to maintain good ankle position.
Lavender and Mandarin aromatherapy.
Leg elevation (hip & pelvis support) wedge for back sleepers.
Wedge shaped cushion to raise upper body to help manage reflux, hiatus hernia and PoTs. These can sometimes be placed under mattress to prevent them sliding off. An alternative is to put bricks under the frame at the head end of bed so the whole bed is tilted - raising the head.
References
1. Insomnia and Risk of Cardiovascular Disease https://pmc.ncbi.nlm.nih.gov/articles/PMC5577359/
2. Clarifying the Effect of Sleep Deprivation on the Respiratory Muscles https://www.atsjournals.org/doi/10.1164/rccm.201912-2493ED
3. Exploring Sex and Gender Differences in Sleep Health: A Society for Women's Health Research Report https://pmc.ncbi.nlm.nih.gov/articles/PMC4089020/
4. Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society https://pmc.ncbi.nlm.nih.gov/articles/PMC4442216/
Article by the HMSA, reviewed by Jo Southall, OT and Kim Clayden, Psychotherapist
Last Updated April 2026