Sleep disruption is one of those symptoms that often gets pushed aside in stroke recovery. It’s understandable. You’re likely dealing with a lot of changes and getting better sleep is the last thing on your mind. But getting better quality sleep can help you recover.
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Our bodies and brains need sleep to repair. That’s one of the main purposes of sleep. However, there are 6 common myths that surround sleep that may cause you to stress out if you’re also recovering from a stroke. Let’s break those down.
Myth #1: I need 8 hours
The amount of sleep someone gets is relative. Just like stroke recovery in general, the amount of sleep someone needs is very individualized. Eight hours of sleep may be best for some but not for others. Some may feel that 8 hours is too much, while for others it’s not enough.
When you’re recovering from a stroke, you likely need more sleep on average. This may accumulate through naps and nighttime sleep. Your brain is trying to heal. It takes a LOT of energy for the body to repair itself, and a brain injury is not insignificant.
You can become stressed if you strive for the “magic” 8-hours.
Myth #2: I should feel refreshed
I don’t know anyone who jumps out of bed feeling completely refreshed in the morning. It’s normal to spend 30 minutes or so feeling groggy before fully waking up. For stroke survivors, this can be compounded by neurofatigue. Starting the day with brain fog plus the grogginess of waking up in the morning means that it may take you a little longer to fully wake up.
Another compounding factor is that feeling refreshed after sleep is especially difficult for night owls. It’s harder for night owls to feel refreshed when they’re expected to get up earlier and before their optimal sleep window has been completed.
Myth #3: I shouldn’t wake up at night
If you don’t sleep like a rock at night, you’re not alone. Waking up during the night is completely normal. However, I want to be upfront and note that sleep-disordered breathing is more common in stroke survivors. The American Heart Association Journal published an article that found between 43% and 70% of survivors experience obstructive sleep apnea compared with 4 to 24% of the general population.
If you find that you’re waking often and coughing/choking, please reach out to your doctor. Explain your symptoms and see what route of treatment is best for you.
Outside of sleep-disordered breathing, it’s normal to be awake for up to 30 minutes during the night. It often takes someone that long to fall asleep again if woken up.
It’s also normal to wake up to 12 times a night. I don’t mean waking up 12 times to go to the bathroom. We experience microarousals, where we may turn over in our sleep, adjust our pillows, etc. You likely don’t even notice these awakenings.
Myth #4: In bed = more sleep
Some people buy into the myth that the more time you spend in bed, the more sleep you get. This is simply not true. We can actually condition our brain to be awake in bed which significantly impacts our sleep and quality of life.
Sleep and sex should be the primary activities allotted to the bedroom. Think about the things you do in bed. Do you find yourself endlessly scrolling on your phone while waiting for sleep to come to you? Do you watch television in your bedroom? By doing these things where you should be sleeping, you train your brain to expect to be awake.
It’s also important to note here that sleep quality is actually more important than quantity. So if you can get 7 hours of good quality sleep, you’ll feel better than having 9 hours of disrupted sleep.
Myth #5: Insomnia is a normal part of aging
Insomnia is when you have difficulty falling or staying asleep. While it’s true that we typically need less sleep as we age, insomnia is not a normal part of the aging process. So while you may be going to bed later and getting up earlier as you age, it’s not normal to have trouble falling or staying asleep.
Insomnia can also creep in when recovering from a stroke. As I mentioned in Myth #3, it is normal to wake from sleep. However, if you find yourself awake for hours at a time between periods of sleep, this is not normal.
There are some different strategies you can try to help with insomnia. Look at your sleep behaviors. Do you try to go to bed and wake up around the same time every day? Do you reduce caffeine and alcohol intake at least 2 hours before bed? Do you finish exercising at least 2 hours before bed?
If sleep behavior change doesn’t work, you can always talk to your doctor about over-the-counter or prescription medications that can help you sleep.
Myth #6: Chemical imbalance = insomnia
While sleep disruptions, like insomnia, are somewhat common after having a stroke, there is no evidence that a chemical imbalance causes insomnia. Medications prescribed by a doctor for insomnia work to sedate you, not repair a chemical imbalance.
Anti-depressants can help to correct acute insomnia. Acute insomnia is defined as less than 6 months and may include the after-effects of surviving a stroke, grief, a high-stress period at work, etc.
When trying to correct insomnia, sleep habits and behaviors are important to address. Medications can help but changing underlying habits will help correct the problem.
While sleep may be on the backburner of your recovery journey now, focusing on improving sleep can actually help you recover. Talk with your doctor to see if you may be dealing with obstructive sleep apnea or if certain medications could help. Then look at your current sleep habits/behaviors to see if you’re engaging in something that’s keeping you from quality sleep.