Are there sleep tips for those with limb loss?

Guillermo J. Bernal, MD
Physical Medicine & Rehabilitation
There are sleep tips for those dealing with limb loss.
After losing a limb, there are several reasons why a patient might have problems sleeping. The first one is pain. Some patients develop pain not only at the stump, but also phantom pain, or phantom sensations, where the limb used to be. This can interfere with sleep. The second thing that needs to be controlled is edema. Edema in the stump could cause increased pain and phantom sensations. The third would be depression, as depression contributes to insomnia and lack of sleep. Fourth would be activity. Some patients have not been very active before or after amputation. And if you’re not active during the day, you may have more difficulty sleeping at night. All of these things need to be addressed and controlled for improved sleep.
After an amputation, it’s also important to avoid putting any pillows below or under your amputated limb to avoid contractures in the hip or knee. Contractures make it very difficult to fit someone with prosthesis.
Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
Physical and emotional distress are key reasons for insomnia. While some people find limb loss makes it hard to get into a comfortable position and fall asleep, others wake up during the night and are unable to get back to sleep again.

When you live with physical and emotional distress, getting sound sleep may cause even more stress for you. However, disrupted sleep not only affects how you feel physically, but it can create a weakened emotional state. Some new findings indicate that disordered sleep leads to the lower levels of serotonin in the brain, which can result in an increase in pain sensitivity. Serotonin is a naturally occurring neurotransmitter in the body. Neurotransmitters are brain chemicals that send specific messages from one brain cell to another. What this means to those with limb loss is getting plenty of healing sleep may be an effective tool in controlling both physical and emotional distress. Consider the following sleep suggestions:

Use a relaxation therapy when you lie down in the bed. Then when you close your eyes for sleep, your attempt to fall asleep will not be as difficult. If you awaken during the night, use the relaxation response again to calm down and put your body back into a calm, peaceful mode.

Sleep only as much as you need to feel refreshed, but no more. Some people lose sleep all week, and then try to make up for this on the weekend. This only disrupts your body's circadian rhythm. Circadian rhythms are separate, individually synchronized internal rhythms that affect our daily sleep cycles, performance and alertness, moods, and even gastrointestinal function.

Wake up at the same time every day, weekday or weekend. This strengthens your circadian cycle -- our daily rhythmicity -- and will help to establish regular sleep patterns.

Use earplugs, if you are bothered by noises while sleeping. Some people find that "white noise" -- a machine that produces a humming sound or turning the radio to a station that has gone off-air -- helps.

Hunger may disrupt your sleep. Eat a snack high in serotonin-boosting carbohydrates to lull you to dreamland. Try crackers, a bagel, cereal, or frozen yogurt to relax.

Caffeine disturbs sound sleep. Avoid caffeine after noon each day.

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