Body positioning during sleep is an important consideration for polio survivors with severe weakness and postural or joint deformities. If the individual sleeps on his or her side, the arm should be kept in front and not under the chest wall to prevent numbness in the arm. A two-inch soft foam pad between the sheet and mattress may be more comfortable for survivors who have lesser muscle mass. Consultation with experienced rehabilitation nurses or physical and occupational therapists can often solve unique positioning problems.
Difficulty falling asleep, or insomnia, has many causes. Depression is a common one and can be treated (see Depression). Sleeping pills should be used with great caution by any polio survivor with a history of respiratory compromise, because they may further depress the respiratory drive and lead to respiratory failure. Insomnia, restlessness, and morning headaches may be warning signs of obstructive sleep apnea and/or hypoventilation warranting an evaluation and treatment (see Sleep Apnea and Underventilation).