Wondering if there’s anything you can do about spinal cord injury sleep problems?
Well, you’re not alone. Sleep problems are more common in people with spinal cord injuries than in the general population.
This article will explain different types of sleep problems experienced by spinal cord injury patients, various factors that can cause them, and how to effectively manage them.
Consequences of Spinal Cord Injury Sleep Problems
Getting enough sleep is crucial for ensuring that you’re functioning optimally throughout the day.
The average adult needs 7-9 hours of sleep a night.
Not enough or poor-quality sleep can result in:
- Decreased attention span
- Decreased alertness
- Poor memory
- Increased pain
- Weight gain
- Low energy
- Cardiovascular disease
- Impaired judgment and decision-making skills
Types of Spinal Cord Injury Sleep Problems
Major types of sleep disturbances relevant to SCI include circadian rhythm sleep disruptions, insomnia, and breathing disorders like sleep apnea.
1) Disrupted Circadian Rhythm
Your circadian rhythm is your body’s internal clock that is responsible for your energy levels throughout the day.
Poor sleep quality will mess with the alignment of your circadian rhythm and cause you to feel more extreme spikes of tiredness throughout the day.
Insomnia is a sleep disorder characterized by difficulties falling asleep or staying asleep throughout the night.
It becomes more prevalent as people age, and even more so after spinal cord injury.
Many complications of spinal cord injury like bladder problems, impaired movement, pressure sores, poor body temperature regulation, and anxiety can cause insomnia.
3) Sleep Apnea and Other Respiratory Disorders
If you have a cervical SCI or a higher-level thoracic SCI, it is very likely that you will experience some sort of respiratory complication that can negatively affect your sleep.
This is because the diaphragm is innervated by the C3-C5 neurological segments of the spinal cord.
Similarly, the thoracic region of the spinal cord innervates the muscles above your ribcage that allow your lungs to expand and breathe in enough air.
Sleep apnea is a sleep disorder characterized by unstable breathing that stops multiple times throughout the night.
People with sleep apnea generally experience severe snoring and feel tired during the day from constantly being woken up.
People with sleep apnea may need to use a continuous positive airway pressure (CPAP) device to pump pressurized air into your airways while you’re asleep.
Factors That Affect Sleep After Spinal Cord Injury
Every spinal cord injury is different, and a bunch of various factors can contribute to sleep difficulties after spinal cord injury.
1) Body Temperature Regulation
After spinal cord injury, areas below your level of injury may be unable to regulate body temperature on their own.
Usually, when you’re cold, your brain will make your body shiver, and when you’re too hot, your brain will make your body sweat to cool down.
Due to the spinal lesion, the body won’t be able to receive signals from the brain to regulate body temperature.
Inability to thermoregulate can disrupt sleep and cause spinal cord injury patients to wake up multiple times a night.
To cool off quickly, keep a spray bottle or wet towel near your bed.
To warm up, keep extra layers near your bed or even try using an electric blanket.
2) Impaired Mobility
All spinal cord injury patients will experience some sort of impaired movement.
More severe motor impairments can make it difficult to be active and exercise.
Additionally, not moving around enough can contribute to weight gain. Overweight and obese people are more likely to develop sleep-disordered breathing.
Try to be more active throughout the day. Move the parts of your body that you do have motor control over regularly.
For areas of your body that you don’t have motor control over, try passive range of motion exercises to stimulate the neural pathways.
We also suggest that you avoid taking naps throughout the day so that you’re actually tired at night.
The majority of spinal cord injury patients experience some chronic pain.
The more pain you have, the harder it is to sleep.
Similarly, the less you sleep, the more your brain perceives pain.
SCI patients that don’t move around every once in a while can develop painful pressure sores, which can also make it difficult to sleep.
Depending on the severity of your pain, various medications may be prescribed.
Antidepressants can help balance neurotransmitter levels in the brain, anticonvulsants can help calm the nerves, and opioids block pain signals throughout the central and peripheral nervous system.
Keep in mind that stronger medications generally come with more severe risk of side effects.
Some more natural forms of treatment include massage therapy and acupuncture.
Many people develop anxiety after spinal cord injury because of how it affects their day-to-day lives.
Anxiety is more common among SCI patients who have recently had their injury, but generally reduces as people learn to accept their circumstances and cope.
Exercise can help balance neurotransmitter levels in the brain and relieve pent up stress.
Also, consider putting aside some time to meditate and really get in tune with your feelings, thoughts, and breathing.
Medication can help train your brain to better manage feelings of anxiety when they arise.
Alcohol and caffeine can often trigger anxiety, so try cutting back a little.
Going to psychotherapy can also be very beneficial and help guide your thought process. It will help identify the causes of your anxiety and teach you how to cope effectively.
Insomnia becomes increasingly more prevalent as people age, and even more so after spinal cord injury.
This is likely due to increased experiences of chronic pain, stress, and physical inactivity.
As we get older, our bodies release less growth hormone and melatonin. These two important sleep hormones are essential for determining how deep we sleep and when we feel sleepy.
While we can’t stop ourselves from aging, we can make an effort to be as healthy as possible.
Exercise, a nutrient-dense diet, and a positive mentality can work wonders on your wellbeing.
Taking melatonin supplements may also help promote a regular sleep-wake cycle.
What you eat and how much you eat matters!
Stimulants like alcohol, caffeine, and sugar can affect your energy levels and disrupt your sleep cycle.
Eating a large meal before bed causes your stomach to expand and forces your digestive system to work harder to break down the food.
While overeating can make you sleepy, it can also cause you to wake up feeling unpleasant and still tired because the body has to expend more energy to digest the food.
Avoid eating foods that are overly fatty, sugary, or spicy. They can be difficult for your body to digest and disrupt your sleep cycle.
Also, try to avoid drinking lots of fluids before bed to prevent waking up in the middle of the night to use the bathroom.
Eating foods rich in tryptophan like milk, nuts, eggs, cheese, and fish are ideal for promoting sleep. Tryptophan helps increase serotonin levels in the brain, and serotonin can convert into melatonin (the sleep hormone that regulates your sleep-wake cycle).
It’s not all in your head. Outside factors like noise, lighting, and comfort can all drastically affect the quality of your sleep.
Creating the right environment for sleep is essential for those with sleeping problems.
Make sure that the room isn’t too hot or cold and avoid harsh lighting and disruptive sounds.
If you have pressure sores, make sure that you have ample cushioning around them.
Spinal Cord Injury Sleep Problems: Summary
Many SCI patients experience sleep problems due to changes in their functional abilities and mental health.
The 3 main types of sleeping problems are circadian rhythm disturbances, insomnia, and respiratory complications.
Generally, spinal cord injury sleep problems can be managed through medications, regular physical activity, and a healthy diet.
Sleep problems that result from respiratory complications may need the assistance of a CPAP device to ensure stable breathing overnight.
Hopefully, this article helped you better understand what’s causing your spinal cord injury sleep problems and how to manage it. Good luck!