Sleep Well. Acknowledgement

Transcription

1 Sleep Well Acknowledgement We acknowledge and pay respect to the traditional custodians past and present on whose lands we meet today. We acknowledge the deep feelings of attachment and the relationship of Aboriginal people to country and respect the cultural authority of the elders in each community 1

2 Sponsorship This program is supported by a grant from Innate Immunotherapeutics Ltd How was your sleep last night??? 2

3 Symptoms Fatigue in MS 3

4 Why is sleep important? Improving sleep quality will improve quality of life for people with MS as it provides improvement in physical and mental well being (Attarian, 2009). Lack of Sleep Increases fatigue Lessens your ability to participate in activities Can impact mood Amplifies problems with memory and concentration Decreases alertness and capacity to problem solve 4

5 Sleep cycles Sleep Disturbances I need to go to the toilet. I feel too hot. I am worried or stressed about I have muscle spasms. I don t know. I experience pain (other than Other, please specify Children or other family members Loud noises. 0% 20% 40% 60% 80% 5

6 Common Sleep Issues Environment Night Time toileting Household members (Pets, Snorers, Kids) Neighbourhood Worry Medication Stage of Life Social life Pregnancy Small children Menopause MS sleep issues Location of lesions Pain Muscle spasms Frequent visits to the toilet Depression and anxiety Medication Sleep Disorders 6

7 Sleep disorders Insomnia Sleep apnoea Periodic Leg Movement Disorder (PLMD) Restless Leg Syndrome (RLS) Narcolepsy REM sleep Behaviour Disorder (RBD) There is evidence to support the prevalence of sleep problems in MS is significant higher than the general population (Bamer et al., 2008). 7

8 Breath Counting Exercise Breath Counting (between 4-21 breaths) Close your eyes and shift focus to your breath Focus your attention at the tip of your nose Count each breath on exhalation Observe the flow of air as you breathe in and out through your nose. Count in your mind each exhalation (One, two, three etc.) Don t let your mind wander from the tip of your nose If your mind does wander bring it back and place your focus on your breath. Sleep Diary Date Time of going to bed last night How long it took to fall asleep Number of times waking at night Time of getting up Feeling on waking (refreshed, partly refreshed, fatigued) Total hours of sleep Exercise (morning, afternoon, evening) Nap (how long, am or pm) Caffeinated drinks (morning, afternoon, evening) Within 3 hours of going to sleep (alcohol, heavy meal) An hour before sleep (watched TV, worked, read, other) 8

9 Managing MS sleep issues Issue Management Pain Pain management clinic Muscle spasms Physiotherapist Toilet frequency Continence clinic Anxiety and depression Clinical Psychologist Psychiatrist Medication Pharmacy review Sleep Disorders Sleep Clinic Managing Sleep Disorders Issue Management Insomnia Treatment of cause Sleep well strategies Sleep Apnoea Sleep clinic Continuous Positive Airway Pressure (CPAP) Periodic Leg Movement Disorder Medication Restless Leg Syndrome Medication Tonic water Magnesium Narcolepsy Medication REM Sleep Behaviour Disorder Medication 9

10 Getting a Good Nights Sleep Getting a Good Night s Sleep What you do during the day What you do during the evening Getting to bed Bedroom environment During the night 10

11 During the day Don t stay in bed Exercise daily Limit / avoid caffeine - herbal tea and alternatives Rest breaks - timing and duration Daytime sleep Medication timing During the evening Timing & type of meals/drinks Timing of exercise Activities to unwind Create a bedtime ritual A word about smoking 11

12 Getting into Bed Establish a regular bed time Create a tranquil environment Use of the bedroom Physical comfort Relaxation Journalling During the night Relaxation exercises, deep breathing, visualisation Don t watch the clock Don t stay in bed - stay warm - muted lighting - nothing stimulating A reminder about smoking 12

13 What else can assist sleep? Complementary and Alternative Medicine Complimentary approaches - along side traditional medicines. Alternative approaches - instead of traditional approaches. TELL YOUR GP AND OTHER HEALTH CARE PROVIDERS ABOUT ALL THE CAM THERAPIES YOU ARE USING. 13

14 Symptom Management with CAM SLEEP FATIGUE PAIN ANXIETY RELAXATION Acupuncture Acupuncture Magnetic Reiki Therapy Bi-Feedback Meditation Relaxation Massage Aromatherapy Yoga Tai Chi Acupuncture Melatonin Valerian Massage Aromatherapy Acupuncture Reiki Yoga Bio-Feedback Aromatherapy Massage Reiki Bio-Feedback DEPRESSION Aromatherapy Massage Acupuncture Reiki BLADDER/ BOWEL Acupuncture Magnetic Therapy Reflexology Bio-Feedback STRESS INSOMNIA SPASTICITY Meditation Reiki Meditation Acupuncture Bio-Feedback Acupuncture Magnetic Therapy Reflexology Relaxation Is a skill that take practice Is a shift in thinking Is a conscious desire to make best use of planned rest breaks 14

15 Meditation Mind Body Medicine Beneficial for sleep and reducing stress. Provides a positive mind/body connection. During meditation the breath, heart rate, and blood pressure become slower. Repetition may be needed to gain the benefits of meditation. Massage Massage therapy can: Lower anxiety Helps to reduce levels of depression Provide benefits in sleep Aromatherapy and massage are often used in combination 15

16 Aromatherapy Sleep - chamomile, clary sage, lavender, marjoram, neroli, and sweet orange Relaxation - bergamot, clary sage, cypress, frankincense, geranium, lavender, neroli, and ylang ylang Anxiety - basil, bergamot, frankincense, jasmine, juniper, lavender, sandalwood, and ylang ylang Synthetic oils reproduce aroma but do not contain therapeutic properties. Aromatherapy Safety first Check allergies: to oils or their carriers Candles burn: never leave a burning candle unattended Correct storage and handling: oils are volatile Avoid using essential oils if pregnant 16

17 Yoga Yoga involves a specific sequence of Yoga postures and practices that are designed to help the body, emotions and mind to return to their natural state of good health and balance Yoga can improve sleep quality and reduce anxiety. Tai Chi Tai Chi is a slow, smooth series of gentle, rhythmic physical exercises and stretches that are coordinated with breathing Studies show Tai Chi improves sleep duration.. 17

18 Acupuncture Reported improvements in symptoms including sleep disorders for 2/3 of people with MS 1/3 report pain and soreness from needle sites, worsening of some symptoms including fatigue Acupuncture site can be more sensitive in people with MS People using blood thinners can bruise easily Reflexology Reflexology is a therapeutic methodology which uses pressure points on the feet and hands to alleviate pain. Improvements in MS symptoms reported; Muscle strength Spasticity Urinary Symptoms 18

19 Melatonin Melatonin is a hormone which assists in the body s sleep-wake cycles and is activated by darkness. Supplements have been shown to aid in sleep for people with sleep disorders Melatonin levels can be decreased with the use of non-steroidal anti-inflammatory drugs (these include aspirin and ibuprofen) Valerian Valerian is a herbal product said to have sedating and calming properties. Smells like dirty socks Usually well tolerated Conflicting evidence as to its effectiveness as a sleep aid Reputable suppliers 19

20 Medical Management Consider lifestyle changes you can make first Seek advice from GP Medications which assist with sleep (tranquilizers) have side effects and can be addictive and offer only a temporary solution. Referral to a sleep clinic might be required Take home messages Sleep issues can be managed Seek advice 20

21 Follow Up In managing your sleep or if sleeping issues persist contact your: GP Neurologist Sleep Clinic MS Connect ( ) Questions MS Connect

22 Library & Publications In the Library & Publications section of our website you can find information about: MS Library services How to borrow both ebooks and print books on topics such as wellness, and managing multiple sclerosis and its symptoms Accessing our online library catalogue MS publications, including Intouch magazine, newsletters, booklets and information sheets Visit our website for more information Library & Publications 22

23 Resources Related to Fatigue & Sleep Title: Fighting fatigue in multiple sclerosis: Practical ways to create new habits and increase your energy Author: Nancy Lowenstein Published: 2009 Availability: Print and ebook The information in this book will help you learn techniques to assist you in having more energy to do the activities you enjoy. Many people give up doing the 'fun' activities in their lives in order to get through the 'must dos.' This book will give you the tools to manage your time and activities in order to do both. Title: Sink into sleep: A step-by-step workbook for insomnia Author: Judith Davidson Published: 2013 Availability: Print and ebook Although this book is anchored in the science of sleep, the tone of the writing is reassuring and encouraging, filled with first person accounts and easy to use worksheets. Sink into sleep features chapters focused on men (often ignored by insomnia books), women and their special sleep needs, sleep and medical conditions, sleep and anxiety or depression, and the pros and cons of sleep medication. NDIS Support The NDIS is the Biggest social reform changing the way supports and services are purchased and delivered for people with a disability The NDIS has commenced rolling out across NSW/ACT/Vic and Tasmania it will occur in different ways across the regions MS is here to help you understand what the NDIS means, and assist you to prepare for a planning meeting We have resources available on our website click on the large NDIS button MS is registered with NDIA to deliver Support Coordination, Residential Respite, Social Support Day Program (Vic) Exercise physiology and personal training (NSW) Specialist Continence Assessment (NSW), Physiotherapy and Occupational Therapy (NSW and Vic). Want to learn more? Please call MS Connect on