Hospice Patients with Insomnia
Patients receiving hospice care either at home or at a hospice can find that their previous patterns of sleep are disrupted. There are many reasons why this may be the case (including possible side-effects of medication) though sometimes, the reasons are psychological. Studies have shown, for instance, that people with cancer can experience anxiety and depression, which may interfere with their ability to sleep in line with their circadian rhythms. Sleep is important, however, since sleep deprivation significantly alters one’s emotional wellbeing and ability to function during the day. When it comes to patients receiving hospice care, the key is to discover the cause of their restlessness at night time and to increase their comfort as much as possible.
What are the Causes of Sleep Disorders in Hospice Patients?
There are many reasons why a person receiving hospice care may have new patterns of wakefulness. These include but are not limited to medication (such as diuretics or stimulants, which can lead to frequent wakefulness or alertness, respectively), respiratory difficulties, symptoms such as sweating, bladder or bowel issues, and neurological conditions. At other times, however, the things keeping them awake may be the same ones as in the general population. For instance, sleeping in a room that lets too much light in, is near a noisy area, or is too hot, can lead to wakefulness. If your loved one is affected by insomnia, discuss the issue with their doctor so you can perhaps consider different medication, or suggest treatment for breathing problems and/or sleep apnea, of required.
Adapting a Bedroom to a Person’s Needs
As a family member, you can work alongside your loved one to make changes that can help them sleep. They may prefer to sit in a comfortable chair to a bed, for instance, when they are having difficulty breathing. Their room should be completely dark and cool at bedtime, and noise should be kept to zero via soundproofing or moving the bedroom to a quiet spot in the home. Bedding is also key; because your loved one may in pain, a mattress with the right firmness should be used, so that all major pressure points in the body are supported. They should also have pillows of the right height and firmness to reduce neck pain. Blankets should not be too thick and in the summer, should be made of a light, breathable material.
Trying Relaxation Techniques
If stress or anxiety is what is keeping your loved one up, guide them in progressive muscle relaxation or controlled breathing exercises, both of which have been found to significantly reduce stress hormone levels. Progressive muscle relaxation involves simply tensing then relaxing all the muscles for a few seconds - start with the toes and work your way up towards the face. Controlled breathing, meanwhile, usually involves taking various seconds to inhale and exhale air. If you are unfamiliar with these techniques, the good news is that there are a host of apps that can guide you through the process. Calm, winner of Apple’s App of the Year awards in 2017, can help teach your loved one various exercises that are specifically aimed at quelling stress.
Encouraging a Regular Sleep Routine
Try to encourage your loved one to sleep at the same time if possible, and to avoid drinking caffeine and other stimulating beverages in the afternoon. Ensure that visitors see your loved during the day, so they can feel more relaxed as night sets in. Finally, ask them it they would like a warm bath or other way to relax every evening. Ensure that gadgets and devices are not kept inside the room, since these can contribute to night-time alertness. A music system or headphones are one gadget that should definitely be kept bedside, however. A study by J Bradt et al at Drexel University found that music reduced anxiety significantly more than standard treatments. Benefits were also seen for the heart rate, breathing rate, and blood pressure.
Sleep problems are very common in persons receiving hospice care. Factors like medication can alter a person’s sleep-wake patterns, which can cause them to feel more tired during the day. If an issue like sleep apnea, breathing difficulties, or waking up to go to the bathroom frequently is the problem, see your loved one’s doctor about possible solutions. Finally, aim to turn their bedroom into a restful and comfortable space.