Sleeping With A Spinal Cord Injury

Quality Sleep Can Be Elusive With a Spinal Cord Injury

Waking refreshed in the morning has been a rarity for me over the years, frequently disrupted in the night for a variety of reasons. For one, like clockwork, every one and half, to two hours, my neurogenic bladder triggers, causing the urge to urinate. Second, nerve pain in my hips, heals, ankles and sometimes sacrum can torment my lucid sleep. Third, gas bloating, bowel impaction and inflammation can lead to slight (silent) autonomic episodes; headache and nausea caused by fluctuating blood pressure. Fourth, internal temperature can make it difficult to find comfort—too hot, I remove all the blankets because I’m sweating, or too cold, and I’m curled up underneath them, shivering—this happens throughout the night. Fifth, spasticity—the slightest tug on the blankets by my wife, or a deep breath, or small movement can set off a chain reaction of full-body spasms, shaking me wide awake. And finally, sleep apnea. When I do find myself in a deep sleep, I snore so intensely that I sometimes wake myself in a gasp. Needless to say, coffee is welcomed in the morning.

I know that sleep is essential for the body and brain to rest and repair itself, and getting a good night’s sleep is important to prevent serious medical issues such as; lowered immunity, obesity, heart issues, high blood pressure, anxiousness, depression, and diabetes. And although I haven’t experienced the above issues, I have felt some other less serious, yet common symptoms of lack of sleep, including slow thinking, forgetfulness, lack of concentration, loss of motivation, temper flares, drowsiness, falling asleep during the day or just feeling tired all the time.

Based on my poor sleep experience, I have been compelled to learn more about the science of sleep and discovered some solutions for better rest, some of which I share below:

The Science:

While your body is at rest during sleep, your brain is hard at work getting you ready for the next day! Each night during sleep, you go through 4 alternating stages of non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. It’s during these stages that your body repairs itself and your mind refreshes. Typically, individuals need four to six cycles of sleep stages to feel well rested.

• Stage 1 (NREM Sleep): Lasting about 7 minutes, this sleep stage occurs when you first fall asleep. Transitioning from wakefulness to sleep, your brain activity, heart rate, and eye movement all slow as your body enters light sleep.
• Stage 2 (NREM Sleep): This occurs just before deep sleep. Your body temperature drops, brain waves briefly spike— creating sleep spindles— then slows. Memory consolidation happens during this phase.
• Stage 3 (NREM Sleep): Deep, restorative sleep begins. Brain activity slows further, and your eyes and muscle movement stops. This is when your body restores its energy, and repairs cells, muscle, and tissue.
• Stage 4 (REM Sleep): This occurs about 90 minutes after you fall asleep. Your eyes begin moving quickly from side to side, your brain activity, breathing, and heart rate all increase. Dreaming happens mostly during this phase.

Sleep helps your body and your brain recover from the current day and prepare for the next. A good night’s sleep helps your body in a number of ways that you may not even realize, including:

• Repairing or regrowing the cells your body may have damaged or lost the previous day
• Strengthening your immune system
• Repairing your muscles and aiding tissue growth
• Producing and releasing your body’s vital hormones
• Maintaining brain function and emotional wellbeing
• Regulating your mood, your appetite, and even your libido

The Solutions:

7 tips that have helped me improve the quality and quantity of my sleep.

1. Your Bed Matters

Over the years, I’ve tried hospital mattresses, pillow tops, memory foam and more. Recently, I invested in a Smart Bed— The Sleep Number 360 Smart Bed with an adjustable base. The responsive air mattress automatically adjusts to my body position throughout the night and maintains temperature control. Also, the full adjustability, via my iPhone, allows me to raise and lower my head and feet for better support and circulation. I recommend investing in a mattress system that works best for you, it’s money well spent. After all, we spend about one third of our lives in bed!

2. Set A Routine

Set a routine for bedtime. Go to bed at approximately the same time every night and wake at about the same time every morning. This will provide signals to your body that it is time to sleep, triggering your natural Circadian Rhythm. Have a consistent routine for your bladder care too.

3. General Nutrition

Put simply, the foods you eat during the day can impact how well you sleep each night. A wholesome, healthy diet contributes to better, more restful sleep while a poor diet contributes to poor sleep quality and short sleep duration. The right foods can encourage better sleep efficiency, healthier sleep onset latency— the time it takes you to fall asleep— and may even contribute to more restorative deep sleep. Macronutrients like protein, carbs and fats aren’t the only nutrients that matter for your sleep. Here are a few that may surprise you and help you get better sleep.

• B Vitamins: These are probably the best vitamins when it comes to sleep regulation. B1 helps with sleep patterns, B9 improves mood and sleep, and B12 can influence your circadian rhythm. B vitamins can be found in foods like whole grains, dark leafy vegetables, meat, and dairy products.
• Magnesium: Magnesium is a mineral found in foods like leafy greens, nuts, beans, and seeds. It helps regulate your sleep schedule and melatonin production. Magnesium is also available in supplements— if you’re looking for a great Magnesium supplement to help you sleep.
• Zinc: This mineral can be found in foods like nuts and legumes. Research has found that low zinc levels in children can negatively affect sleep patterns.
• Melatonin: Commonly known as “the sleep hormone,” melatonin is vital to a good night’s sleep. Many foods are naturally high in melatonin, and can help you sleep better.
• Tryptophan: You may be most familiar with this amino acid thanks to its association with turkey and impromptu naps after Thanksgiving dinner. But tryptophan is actually present in many foods, ranging from poultry and fish to oats and even chocolate.
• Omega-3 Fatty Acid: This is found in fish, grass-fed animal proteins, nuts and seeds, vegetable oils, and leafy green vegetables. Omega-3’spromote healthy sleep quality and support a healthy circadian rhythm.

Broadly speaking, diets filled with fiber, moderate amounts of complex carbohydrates, plenty of high-quality protein, and healthy fats are associated with more deeply restful, restorative, and plentiful sleep. I recommend consulting your healthcare professional and/or a nutrition specialist for proper guidance based on your condition.

4. Nutritional Timing

I like to eat lighter meal in the evening. A heavy meal can lead to bloating, indigestion, or gastric reflux. Also, I advise avoiding caffeine, alcohol, spicy food and sugary drinks before bed. Caffeine is a stimulant and alcohol may make you sleepy for a while but then causes your brain to wake up, so it is even more difficult to go back to sleep. Sugary drinks can stimulate your body as well as require you to wake up to catheterize.

5. Set The Scene For Sleep

Make your bed a sanctuary for sleep, a “zen-zone” I like to call it. No screen time. This includes TV, phone, and anything with a screen. No planning tomorrow’s calendar. No stressful situations. You can do a lot with the physical space of your bedroom to promote better sleep too. Keep it quiet. Keep it dark. Keep it cool – ideally 60-67°

6. Exercise Is Medicine

There are many benefits to exercising regularly, one of which is sleep. Specifically, moderate-to-vigorous exercise can increase sleep quality by reducing sleep onset – or the time it takes me to fall asleep – and decrease the amount of time I lie awake in bed during the night. Additionally, physical activity can help alleviate daytime sleepiness and, for some people, reduce the need for sleep medications. Personally, I find that consistent exercise, three, or more times a week, for 1-2 a day, helps improve my circulation, which helps my nerve pain at night. It also improves my digestion and ability to assimilate nutrients, which improves my gastrointestinal distress while in bed.

7. Meditation

I like to practice meditative breathing techniques when I first lay down at night, especially if I am in pain. By doing so, I calm my mind and body, and surrender to the present moment—inducing a sleep cycle.  When I awake in the night, I return back to my breath and start again, one breath at a time. I’ll write more about this in another blog.

Medication Alert!

The over-the-counter medication is very popular for sleep issues but can be extremely dangerous for individuals with neurological issues. It has significant side effects which can be amplified for individuals with neurological issues. These include side effects of headache, dizziness, nausea, drowsiness when you do not want to be drowsy, confusion, abdominal cramps, depression, tremor, anxiety, and extremely low blood pressure, among other issues. It can affect anticoagulant medication (blood thinners), anticonvulsants, contraceptives, diabetic medication, and immunosuppressants. Always check with your healthcare professional or pharmacist to see if any over-the-counter medication will affect your health condition or current medications.

I hope this information helps you open the door to dreamland and the restorative benefits of consistent REM— it sure has helped me! And, although quality sleep can be elusive, a mindful approach can improve the quality and quantity of your zzz’s.

Sleep well,

Aaron