Sleep… It can wreak havoc when a person with a lung condition doesn’t get enough or doesn’t get good quality sleep at night. I often find out when talking to my patients that this is a big issue for many of them. Honestly, after having three kids and going through countless nights of sleep deprivation, I can tell you that good sleep is essential.
When you have a lung condition, sleep plays a huge role in how you feel mentally, physically and emotionally. On a physical aspect, you need good sleep in order to manage your normal level of breathlessness. What I mean when it comes to “managing your normal level of breathlessness” is that when you are overtired you will feel as though your breathing is struggling more and going to do any physical activity will be so much harder than it usually feels. Many lung patients use accessory muscles to breathe and getting good quality sleep allows them to rest so they can assist you when you need them. You need quality sleep in order to maintain a strong immune system and to fight off infections as well. When a person is battling a chronic lung condition, staying “even keeled” from an emotional level takes plenty of rest. If a lung patient isn’t well rested they are more likely to be short tempered, weepy, and/or unable to keep a strong hold on their emotions when it comes to the daily grind of not breathing comfortably. On a mental level, panic and anxiety can easily set in when a person with a lung condition is not getting enough quality sleep and that can affect whether or not they are able to get out and about or even do things around the house that need to be done on a daily basis.
So, knowing all of this… Why is this happening to people with lung conditions? Well, it can mean that possibly one or more of the following are happening…
1. The person has developed poor pre-sleep habits and it hasn’t really caught up to them until their breathing condition was harder to manage (possibly before now they could manage with less or worse quality sleep)
2. The person’s oxygen level is dropping in their sleep causing them to awaken and never get into a deep sleeping state.
3. The person with a lung condition has a chronic cough or wheezing that keeps them awake at night
4. The person with a lung condition has depression and anxiety
5. The medications they are taking cause insomnia or difficulty sleeping
6. The person with the lung condition snores at night and sometimes has pauses in their breathing rhythm which wakes them up.
Now that we might have narrowed down a culprit (or two) that is effecting our sleep, let me give you Tips to Help You Sleep Better When You Have a Lung Condition.
1. Let Old Habits Die Hard – Many people have developed poor pre-sleep and sleep habits that they don’t realize are effecting them until they have been given a chronic illness like a lung condition. When talking to my patients about sleep I tend to hear…
“Well I have always done ___ and it hasn’t been a problem.”
Or
“I tried that once and it didn’t work for me.”
Bad pre-sleep and sleep habits may not have been an issue prior to having a lung condition but now that you are trying to manage daily breathlessness it is crucial that you eliminate these bad habits and focus on quality sleep.
For instance:
· Don’t use your bed for anything other than sleep and sex. It’s really easy to flip on the TV late at night or stream you favorite shows to your tablet from the comfort of your bed, but what you are doing is telling your brain that the bed is a place where you are awake not a place where you sleep. You need to establish a mental connection between sleep and being in your bed. There have been studies that the blue light emitted from some electronic devices also doesn’t allow your yes and brain to relax so cut those suckers off before bedtime and allow your eyes to rest.
· Darken and cool the room down. My patients say they typically breathe a little better in a cool (not cold) room. We keep it 68 degrees all year long in our rehab and it is a great conditioned temp to breathe when you have a lung condition. Not to mention there have been studies that a cool, dark room is better for quality sleep.
· Watch what you eat… Limit caffeine, alcohol, excess fluids and big heavy meals. If you are doing all of this right before bedtime, you probably causing yourself to get up for frequent bathroom visits. Also, caffeine has a stimulating effect and can either prevent you from falling asleep or achieving a deep restful sleep. Large meals and high acidity drinks can cause acid reflux which can interrupt sleep throughout the night.
· Rest or meditate – Many sleep specialists will tell you that working out late at night does not help you get a quality night’s sleep. Try reading a book or listening to soft music to help you to relax. Try a soothing bath and unwind from the stress and anxiety of the day. I personally love my sound machine (pictured below and available on Amazon) at night. It drowns out the random noises of the house at night and puts out a wonderful white noise that has me out like a light. We have these sound machines in each of the kids’ bedrooms and I tell you… they are awesome!
· Stay on a routine sleep schedule. Keeping your wake and sleep times fairly routine will make it easier for you to fall asleep. People with lung conditions typically benefit from a short nap to help them with their energy level for the day. Limit your naps to a length of time that gives you more energy but don’t allow yourself to sleep all day. You want to make sure your “power nap” didn’t make it difficult for you to fall asleep later that night.
2. Prop Yourself Up a Bit. Many lung patients breathe better while sleeping if they elevate their head a bit. If you sleep on your back, add 1-2 EXTRA pillows in a mild incline to elevate your head…. Be careful not to pile them up one on top of the other (more of a wedge or ramp appearance). This elevation not only may help keep your airway open a bit better but may alleviate any acid reflux or post nasal drip symptoms causing you to cough or be uncomfortable that could be occurring. If you sleep on your side, add just one extra pillow to make sure your spine and neck are aligned. Seldom do lung patients ever sleep completely flat or without any pillows at all. I commonly hear that many of my patients sleep in a large recliner just to have that incline for comfortable breathing… although that is not my “go to recommendation”, I can see why many of them choose that option because of the elevation.
3. Could oxygen be the culprit? If you are waking up with low oxygen saturations, you definitely need to address this with your physician. Unfortunately, the link between lung conditions and low oxygenation at night is pretty prevalent. When we sleep, the body takes smaller breaths and we don’t get full use out of our lungs. Very simply put, low oxygen tells the brain to wake you up and have you take deeper breaths. This roller coaster ride that entails you to be in and out of deep sleep is not good for you. Your oxygen levels can be monitored with an overnight pulse oximetry test and your physician can let you know if you need it with sleep or not. Many places will allow you to take this overnight oximetry machine home with you and you can do this test in the comfort of your own bed. If you already have a prescription to wear your oxygen 24/7 then make sure you are wearing it to bed. I recommend SuperSoft, Ultrasoft or Soft-touch nasal cannulas. They are so much more comfortable to wear for many of my patients. Also, if you are having problems with the oxygen falling off at night you can cinch those nasal cannulas up and it is more comfortable than a standard cannula. Some other suggestions for keeping the oxygen cannula on at night is running the tubing up through a night shirt and giving yourself plenty of slack to roll from one side to another.
4. Take your “sleep depriving meds” in the evening, not before bed. There’s no secret that many medications that lung patients take (like prednisone) cause sleep deprivation. It’s a catch 22… you need the medications to feel or get better but they often cause insomnia. If you can, try and take those medications (if ordered once a day) in the morning. If those medications are ordered more frequently throughout the day, try to take the last dose with dinner.
5. Make sure you are taking all breathing medications as prescribed. You really want to make sure that if you tend to wheeze at rest that you remember to take your bronchodilator to relieve as much of it as possible. There is nothing worse than trying to fall asleep and constantly hearing the squeaks of your breathing as you are trying to drift off. Identify and remove any triggers from your bedroom that can cause you to wheeze. This may mean having Fido (your dog) or Fluffy (your cat) not sleep on your bed. (I know… I’m sorry… but had to mention it.) Staying on top of your regularly prescribed breathing meds will help you to breathe more comfortably while you sleep.
6. Have a sleep study. When doing some research for this blog, obstructive sleep apnea popped up routinely on Google searches. I had a patient joke with me once that everyone probably had some sort of sleep disorder, but I have to say… many of my lung patients have had a sleep study and find out that they have “pauses” in their breathing several times an hour (and for many of them… that’s an understatement.) They are usually clued into this fact by their spouse or partner complaining of relentless snoring throughout the night. They also may be showing signs by frequently waking up throughout the night and sometimes waking up short of breath. If this sounds like you, then I would recommend talking to your doctor about a sleep study. This is done differently than an overnight oximetry study. Often time when you have a sleep study done, they require you to come in to a sleep center in the evening. The sleep technician or respiratory therapist will hook you up to a monitoring device and they will observe you through the night as you sleep. Figuring out if you have a sleep disorder can be lifesaving and when treated you will surprise yourself with how much more energy that you have and how much better you feel.
Some other notes to mention:
- Be careful taking any prescription or over-the-counter sleep aids. Make sure you check with your doctor. Some of these medications can suppress your respiratory drive and can be inappropriate for people with lung conditions. Check with your pulmonary doctor first before taking any of these to make sure they won’t affect your breathing.
- There are many different herbal sleep aides and teas that claim to help you get a better night’s sleep as well. I always think that it is good practice to check with your doctor on those just to make sure they are find to take.
Thanks for Reading! Remember: We are in this TOGETHER!
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