Sleeping after shoulder surgery can be very difficult. Post-operative pain and uncomfortable slings can contribute to a poor night's sleep. Sleep disturbance after surgery is a complex topic with many contributing factors. Rampes et al. present the following contributing factors for sleep disruption after surgery: - Surgical inflammatory response
- Severity of surgical trauma - Pain
- Anesthesia used during surgery
- Post-operative opiod/narcotic pain killers
- Anxiety/fear
- Environmental factors
The Impact of Poor Sleep Following Surgery
Poor sleep has been shown to delay recovery times and to prolong the negative effects of patients' health and overall quality of life
Poor sleep quality following sugery can impair cognitive function, especially in elderly patients. Sleep disturbances also has a reciprocal effect on pain. One study suggests that "one hour of sleep loss is sufficient to cause altered pain perception." This means that poor sleep can actually increase your pain sensitivity, making your perception of the pain worse.
According to a study by Marin et al., poor sleep can also have cardiovascular effects, especially in those with co-morbidities such as cerebrovascular and cardiovascular disease.
Keys for More Comfortable Sleep Following Shoulder Surgery
1. Positioning
2. Support
3. Medication planning
4. Environment
Sleep Positioning
Typically, sleeping flat on your back is uncomfortable for the first few weeks after surgery. The use of a recliner chair or wedge pillow can help decrease throbbing pain associated with laying flat on your back. Sleeping in a recliner, however, is often uncomfortable and may not be feasible for all patients. Most people do not have a recliner in their bedroom, so this technique may require the patient to move the recliner into the bedroom or sleep in a different room. Not ideal!
Patients also typically have difficulty with side-sleeping in the sling, The traditional sling does not provide enough support to stabilize the arm in a side-lying position. The addition of extra pillows to bolster the arm can help, but the pillows do not stay in place if you make subtle changes in position.
Shoulder Support
It is important to support your shoulder properly while you sleep. Proper support not only restricts motions of the shoulder that could impact the surgical repair but can also improve comfort. Typically, patient's complain that their sling does not provide enough support to be comfortable.
Dr. Paul Marquis explains one way to enhance your positioning with pillow for more comfortable sleep in a sling:
Prior to our product, The Shoulder Sleeper Pillow, that was the best option you had for a comfortable night's sleep following shoulder surgery. We set out to solve the problem of poor sleep following surgery. We designed an alternative to stacking pillows to help improve sleep comfort.
The Shoulder Sleeper Pillow is a patent-pending supportive device designed by a physical therapist and trusted by orthopedic surgeons. Click below to learn more about how the Shoulder Sleeper Pillow can help you!
Medication Planning
Surgeons will typically prescribe medication to help reduce inflammation and pain following shoulder surgery. These medications could be non-steroidal anti-inflammatories (NSAIDs) and/or opiod pain medications. These medications can be very effective and can help improve sleep comfort when used appropriately. However, there is research that shows opiod pain medication can actually decrease sleep quality.
For the first few weeks after surgery, it is important to time these medications properly to maximize effectiveness. The Cleveland Clinic has a helpful article discussing pain control after surgery.
Environment
Sleep environment plays a huge role in getting quality sleep for everyone. Sleep environment includes the following factors: - Electronic use before bed - Temperature of the bedroom - Lightness/darkness of the bedroom
- Comfort of mattress and pillows - Pre-bedtime routine
- Avoiding stimulants (caffeine) for 4-6 hours prior to sleep
- Avoid alcohol use for 4-6 hours prior to sleep
- Activate the parasympathetic nervous system before bedtime
- Maintain a consistent bedtime and pre-bedtime routine
Getting quality sleep following shoulder surgery should be a priority. Follow these tips to improve your sleep quality and pain management! *The above blog is not intended as medical advice. Please consult a licensed physician for personalized advice for your medical condition*