Living With Polio

Aging Well with Post-Polio Syndrome: Addressing Physical Reasons for Sleep Problems

Researchers at the University of Washington’s Aging Rehabilitation Research and Training Center (2009)

Getting a better sleep may not always happen overnight, but if your sleep problems are due to medical issues, there are ways you can manage them.

Many medical problems can disrupt sleep in people with post-polio syndrome, such as breathing problems, so treating them is a first step in addressing sleep concerns. Sleep apnea, or episodes where people stop breathing during sleep, is a very important problem to discuss with your doctor if you have this symptom. Additionally, pain, which can disrupt sleep, is a large topic. We will address pain in a future column in order to devote more space to it.

For now, here are some physical factors that can disrupt sleep and tips on eliminating them.

Caffeine often plays a role in sleep problems, because it is a stimulant that affects the central nervous system. It temporarily increases alertness and wards off drowsiness, which are also the reasons it can cause sleep problems. People who drink caffeine are less likely to sleep well than those who do not. If you have sleep difficulties, it is a good idea to avoid caffeine or limit it only to the morning. Caffeine is present not only in coffee and black tea, but also in many sodas, so check labels. Decaffeinated coffee and tea are good substitutes if you like the flavor of these drinks, but need to avoid caffeine.

Alcohol is a sedative. Although it may seem like it helps with sleep problems, it can actually cause them. For example, alcohol can help you to “fall asleep,” but it also disrupts the sleep cycle and the quality of sleep. The sleep you get after drinking alcohol is not restful, because it interferes with our ability to achieve and stay in the deep (so-called “Stage 3” and “Stage 4”) sleep cycles. It is a good idea to avoid alcohol altogether if you have sleep problems; at a minimum, you should limit drinking it to earlier in the evening rather than right before going to bed.

Sleeping pills
Even though they are often prescribed to help people fall asleep, like alcohol, sleeping pills can actually worsen sleep problems over time. Many prescription drugs used for sleep can help you fall asleep. However, like alcohol, most sleeping medications disrupt the sleeping cycle by interfering with our ability to achieve deep and restful sleep. Almost all sleeping medications, if they are sedatives, are recommended to be prescribed only for a very short time (two weeks at most) to help someone sleep during a stressful time, such as while in the hospital. Many sleep medications are addictive and your body builds a tolerance to them. This is especially true of the benzodiazapines, such as Xanax®, Librium®, Valium® and Ativan®. If you are taking a strong sedative for sleep, you should talk to your doctor about tapering it off. Getting off these drugs must be done gradually and with medical supervision. Stopping abruptly can be very dangerous.

Nicotine, whether smoked or chewed, is a stimulant like caffeine. It causes temporary alertness or “jitteriness,” and raises your metabolism. These physical changes can in turn keep you from falling asleep or disturb your sleep once you’ve fallen asleep. For these reasons and more, nicotine can contribute to sleep problems. (Just another reason to quit smoking.)

There are factors that can help you sleep better, for example:

Getting regular exercise and being aerobically fit can contribute to good sleep. Fitness helps the body naturally create healthy sleep cycles. However, people with sleep problems may want to limit exercise to the morning, since vigorous exercise late in the day may make it difficult for your body to start winding down for sleep. If you have sleeping problems and you aren’t already exercising, explore an exercise program.

Other medications
Unlike sedatives (discussed above), medications for depression can improve sleep and help you get back into a more normal sleep cycle. Talk to your doctor about this to see if a prescription would be right for you. Some anti-depressants that can also help with sleep are trazodone, amitriptyline, Paxil® and Zoloft®.

The contents of this column were developed under a grant from the Department of Education, NIDRR grant number H133B080024. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.

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