I just want some sleep
A look at how IC can impede your sleeping habits and ways to help make nights more tolerable
You know the story well; you “wake up” more tired then when your head first hit the pillow. Thinking to yourself, forty winks – I’ll gladly settle for three or four! A night of up and down to the bathroom has left you exhausted. Most people experience the occasional night of poor (quality) or lost sleep, but with IC some patients find themselves becoming “over night insomniacs”.
Even the most diligent partier, worker, or medical resident needs sleep. It is a natural human function, like eating and breathing; forgoing it is not wise for any extended amount of time. During sleep many bodily systems continue to work (such as the production of some hormones and chemicals), certain areas of our brains even increase their activity!
Sleep is essential to a person’s well being. Anyone deprived entirely of sleep or forced to sustain on tiny amouts of sleep for extended periods of time runs the risk of doing substantial damage to their health. Laboratory research has shown total deprival of sleep for more than two weeks in rats leads to a painful death, similar in some regards to starvation.
But let’s assume that we are just talking about inadequate daily sleep, not total ongoing sleep deprivation (which has been used through out time as a very persuasive means of torture).
There is no exact amount of sleep that is perfect for everyone, on average scientists think that adults require around 7-8 hours of sleep a night. Some people function perfectly well with only 5 or so hours, and others don’t feel properly rested without 9 or more hours. The right amount of sleep is what feels right for you; however much it comfortably takes for you to feel properly refreshed in the morning and stay alert (and awake) through out the day.
All human beings (and the majority of animals) run on an internal biological clock which makes us naturally inclined to sleep at night, when it is dark. This most likely comes as a result of our genetic forbearers for whom life was more dangerous, less productive, and colder at night. Though it is not necessary to only sleep at night – take for example those who work nights or “graveyard” shifts, it is usually the preferred time to sleep. This may be due to the fact that light is largely responsible for synchronizing our internal clocks.
Many factors can cause a person to lose sleep; stress, illness, events which require you to forego sleep, addiction, etc. Some people develop real sleep problems such as insomnia or sleep apnea either due to an external reason or unknown causes. We all have nights of tossing and turning, but for many ICers sleep is greatly affected on a long-term basis by the symptoms of their Interstitial Cystitis.
Try as we may to fool our bodies otherwise, we need a proper night’s sleep. Getting less than a full night’s sleep will cause you to be sleep deprived. The analogy of a bank has become commonplace to describe sleep. If we do no get proper rest we occur sleep debt, and the longer this continues (night after night) the larger the debt becomes. Daytime sleepiness follows suit, as daily functions and activities are impaired to some degree by this lose of sleep. You may become less alert, more prone to clumsiness; less focused (unable to properly concentrate), and absent minded – your mood and temperament can even be affected. As well as being a negative action for your body, inadequate sleep can lead to potentially dangerous scenarios such as falling asleep behind the wheel or whilst you are preparing food on the stove (sadly, more than one house fire has occurred when someone put something on the burner or in the oven, sat down and proceeded to fall asleep).
Waking up refreshed is a beautiful feeling, one that most of us strive for. But when IC begins to impair your ability to sleep soundly or comfortably through the night it can become a real problem for many ICers.
The most common reasons why proper sleep is difficult for ICers are urinary frequency, the (often un-relentless) sensation of having to void (urgency), and bladder/pelvic pain. Virtually every ICer will have times – say during a flare in their symptoms – when sleep is affected. But for some these symptoms (and others) can, and do occur night after night, month or even year after another. It is not uncommon for an ICer to have very broken sleep, waking multiple times a night to void, and being unable to sleep due to pain/symptoms. Sleeping for any significant block of time without waking up may be impossible. Leading to scraps of sleep gathered through out the night, as voiding may cause you to wake as often as every few minutes (some ICers get as little s an hour or two of sleep a night). The medical term for voiding which occurs at night is nocturia. As a result of this, and coupled with the already taxing affects of IC during the day (as well as for many ICers other overlapping medical conditions) it’s no wonder that many ICers are in a state of semi-permanent exhaustion, both mentally and physically. Your body absolutely needs sleep to function as best it can during the day. Depriving a healthy body of sleep is bad enough, deprivation for someone with a chronic medical condition, such as IC is even worse. As sleep may be the only form of respite that they (ICers) are able to obtain. As well as being a very important regenerative time for the body.
If you are experiencing sleep issues due to IC (or for any reason) on any sort of an ongoing basis it is a really good idea to talk to your physician(s) about it. If you are having a hard (or impossible) time sleeping there are options and ideas, which may help you.
-For starters are you comfortable? It is important to have soft, comfortable bedding and pillows. A good mattress will make a huge difference in the way most people sleep. It is important that you are not allergic to any of your bedding (down can cause a problem for some allergy sufferers, as can dust mites in the bedding), and that it is clean and fresh. Try sleeping with various types of pillows and blankets if possible to see which ones make you more comfortable. This may not actually increase you over all sleep, but it can help to make you more comfortable during the time that you are asleep and in bed.
What you wear to bed can also play a role in how well you sleep. It is wise for ICers to skip pyjamas and undergarments that are in any way restrictive, especially on the lower adnominal (bladder) area. Look for gentle, comfy, warm fabrics that regulate body heat well, such as a light flannel or soft cotton.
-Position: for some sleeping on their sides may be less painful then sleeping directly on their stomachs (pressing right on the bladder – ouch!) or flat on their back. Sleeping with a pillow or equivalent between your legs (often at the knees) can also help to take some of the strain off your hips and pelvis.
-Temperature: not only do you want the temperature in the room to be pleasant (many people in general find that they sleep better in a room that is slightly on the cool side) but you may also want to introduce some heat or coolness directly near your bladder and pelvis. Heating pads (electric or microwaveable) and heating blankets are great ways to deliver targeted warmth. It may be a good idea to skip the hot water bottle though, as they can be quite heavy on tender areas such as the lower abdomen. Alternatively some people find a cold compress or ice pack helpful in relieving some discomfort and pain. (Just make sure that as the ice melts it won’t soak the bed!)
-Predictability: though it is not always possible, try to create a routine sleeping pattern. Attempt to fall asleep and wake up at more or less the same time every day, or at lest during the weekdays. If you do sleep-in or under-sleep try to get back on track as soon as possible.
-Get physical: Whenever possible try to exercise during the day. Many with IC are limited in which exercises they can comfortable do, but good options include walking, some forms of yoga and stretching, light jogging and swimming. It is wise to try and exercise for even just 15-30 minutes a day when you are able to. Never push yourself too much though, or you risk doing more harm than good, and potentially giving yourself a flare.
-Kick the addictions: even if you are not dependant on caffeine (such as coffee, some teas, some medications, and soda), chocolate, recreational drugs or alcohol they can all have very serious and far reaching consequences on your ability to sleep properly and on the wellbeing of your bladder! If you do consume caffeine try to do it early in the day, and in minimal amounts.
As well smoking cigarettes can impair sleep, in addition to its myriad of other problematic and potentially fatal health affects. Some ICers find that by quitting smoking their IC improves dramatically. Many programs and books are available to help you kick the habit, as well as medical options like nicotine patches. Some people are even having success with hypothesis to help them quit.
-Eating: it is always best to avoid any foods that you know have negative affects on your bladder. Try to eat your last large meal of the day at least 3 hours before going to bed. If you do snack before bed or during the night keep it light. Bladder friendly teas, warm milk, crackers and rice cakes are good options if you do need a little bite before tucking in.
-Live your day during the day: in other words, leave the briefcase, lap top, paper work, etc out of the bed. Reading in bed in one thing, but working on that big report is another. It is wise to keep the bed as sleep focused as possible, which may even mean flicking off the TV!
-Tranquillity: Strive to make sleep as calm and relaxing as possible. Before going to bed you might want to take a relaxing warm shower or bath perhaps with essential oils. Try asking a loved one for a short message or shoulder rub. Use a heating pad, or try deep breathing techniques or meditation. Turn off your cell phone; keep a glass of water near the bed, try to take care of anything that might distract you prior to crawling under the covers such as “did I let the dog out?” “Is the back door locked?” And so forth. Before calling it a night run through these sorts of things in your mind and form a mental check list.
Some people benefit from soothing sounds or soft music while they sleep. A vast array of tape, cds, and even noise or “sleep” machines that play soothing sounds or spoken words are available. Alternatively some people like to use earplugs or soft headphones to block out external noises.
As well as being cute and reminiscent of hotels and airline flights, a comfortable dark eye mask may help you to block out light.
-Avoid being scammed: many devices, potions and pills exist on the market to help people with sleeping problems. But very few of them work anywhere near as well as they promise – if at all. Before you turn over your hard earned cash, make sure you have done your research.
-When you do wake up: don’t curse yourself or your bladder, it won’t help anything and being frustrated may keep you awake even longer. It may help to keep your slippers and robe within reach at all times during the night, as well having a small nightlight in each part of the house you will venture through to reach the washroom.
When you have finished in the washroom try to return directly to bed, the shorter you are wake the better your chances of being able to fall back to sleep (if possible). If you do find yourself awake and it is too soon to start the day you may want to try taking some relaxing breathes, listening to music softly, or reading for a little while. Initially try to stay in bed.
If however you are unable to fall back to sleep entirely, get up and do something constructive, but not demanding such as knitting, reading, writing letters, or surfing the internet.
-Medical help: Everyone says from time to time that they wish they could just pop a sleeping pill, but that may not be the bet solution for you, especially if your sleeping problems are a result of a medical condition not independent sleep issues.
Many ICers are finding that taking medications such as Atarax (Hydroxyzine) an antihistamine which reduces mass cell production and therefore inflammation, and Elavil an antidepressant can help to significantly reduce they number of time they wake to void, especially if taken shortly before turning in for the night.
Other options may include antispasmodics/anticonvulsants to aid in muscle and bladder relaxation and decrease spasms, as well as overall pain. Anticholinergic medications such as Detrol and Urised which aim to prevent bladder contractions and postpone the urge to void. These medications are traditionally used for urge incontinence, frequency and overactive bladder syndromes and conditions.
Medications specifically designed to induce sleep have something of a checkered reputation (such as barbiturates), as some can be addictive or have serious side effects if taken for extended periods of time. If you do feel that you will benefit from “sleeping pills” talk with your doctor, explain what you are experiencing in terms symptoms/pain and work together to find the best option for you.
There is rarely a quick fix when it comes to improving sleep health. But taking the steps above and managing your IC as best during the day can all help to make those night time hours a little more bearable.