What are the Effects of Sleep Deprivation?


Sleepless nights and bouts of insomnia can naturally take a toll on someone’s overall emotional health.

It is one of the more common conditions hospice patients experience, but there is hope that with the right interventions will help improve your loved one’s sleeping.

There are millions of people in the world that suffer from difficulty falling asleep or staying asleep and there are many ways to approach treatment of insomnia.  As a hospice nurse, it is important to address the inability to sleep because of potential physical impact as well.

It is very important that hospice patients are able to get the much needed rest that happens with  prolonged quality sleep.  It the brain is not allowed to rest, often times people will have a decreased mental clarity and can be moody.  The body needs rest to support the immune system, which a body’s way of protecting someone from getting ill or getting infections.  Hospice patients already have an unstable immune system and is not uncommon that antibiotics would be prescribed from time to time due to all the increased risks for infections.

It is very difficult to treat insomnia without first looking into the factors that maybe contributing to the inability to sleep.

 Pain can really interfere with restful sleep and quality of life, so that should always be a top priority.  Another reason hospice patients  may suffer from sleeplessness is the inability to breathe, which is often intensified while laying down.   A hospital bed can really help because the head of bed can be elevated some and which allows for easier chest expansion and more relaxed breathing.  Most hospice patients have an oxygen set up in the home, and getting that extra oxygen while sleeping can also help. Digestion problems can lead to sleeplessness and most commonly Heartburn or reflux with be the culprit.  There are other medical conditions that will cause insomnia, especially the ones that affect the brain like dementia and Parkinson’s disease.  Sleeplessness is truly a symptom of the disease.

My hope is to simplify the treatment options for insomnia and there are many worthy of consideration.

 One of the more common concerns that my patients and families express is a fear of becoming addicted.  I would like to stress that addiction and dependence are different from one another.   It is true that some these medications may cause some physical dependence, which really means that withdrawal symptoms can occur when the medications are stopped.  Addiction has an element of compulsion and it is actually classified as a disease.  

In medicine, we are always trying to find a balance weighing the benefits versus the risks of any particular treatment or medication.  The benefit of restful sleeping and improved emotional health outweighs the risks of physical dependence in this instance.

ALTERNATIVE THERAPIES

SENSE OF SMELL

It has believed that Aroma Therapy was practiced by ancient civilizations thousands of years ago, and all sorts of ills and ailments can be treated with different scents.  There is some
science to aroma therapy that is involved little receptors that are found in the nose.  The receptors interpret various smells and send pathways of communication to the part of the  brain that regulates our emotions.  Aroma therapy is delivered through the diffusion of oils that are made from plants.  

Oils of  Lavender and Chamomile plants are frequently used and are highly recommended to improve sleep and relaxation.   There are all kinds of medicinal uses for aromatics, and there are many formulas available on the market.  

*CLICK HERE FOR MORE INFORMATION ON PLANT THERAPY

SENSE OF HEARING

Another method to improve sleep is activate our brain through the sense of hearing.  Two varying tones are played into the both ears, and the sound waves are emitted at a low frequency.  When the brain interprets the two tones, and it is a strange phenomena, that brain invents a third tone called a Binaural Beat.  So when you listen to these beats,  the speed of your brainwaves will slow down relatively quickly with the desired effect of relaxation and increased ability to fall asleep.  I find this science and techonology to be very interesting and have discovered a program that uses Binaural beats meditation for the treatment of insomnia.  

The program explains……

Binaural beats meditation is special music that helps the brain move into specific states. The technology was first discovered in 1839 by a German experimenter named Henreich Dove, but it wasn’t until 1973 when a biophysicist named Doctor Gerald Oster presented a paper called “Auditory Beats in the Brain” (Scientific American, 1973) that the technology really began to develop.”

*CLICK HERE FOR MORE ABOUT BINAURAL BEATS 

SUPPLEMENTS

During the sleep process the body restores itself and there is a lot of activity that happens with hormones specifically.  There are many hormones that are found in the  blood and stimulate the our various cells and tissues throughout the body.  One of the hormones that is produced in high levels while asleep is Melatonin, and it is the hormone that regulates our sleep cycle.  When someone is deprived of sleep, there is a decreased production of Melatonin, and the body’s natural sleep rhythm starts to go bananas. There may be some benefit in taking a supplement of this hormone to attempt to restore the balance.  As a bonus, there are also other potential benefits of taking  Melatonin daily  in the treatment of conditions like dementia, lung disease,  cancers of the breast, lung, brain, and prostate.  These supplements can be safely used with other medications that your doctor may prescribe as and is worth consideration.

*CLICK HERE FOR MORE INFORMATION ON MELATONIN

An amino acid called L-Tryptophan is used by the body to regulate Serotonin in the brain and also sleep.  This amino acid  can be founds in many foods, meat products in particular.  Hospice patients tend to have compromised nutrition and could benefit of supplementing  L-Tryptophan.   One example of it’s effectiveness is…..Turkey is known to have a high amount of this amino acid, and this is the contributor to that sleepy feeling that one experiences after eating Thanksgiving dinner.  Other foods that have higher amounts of this amino acid are cheese, tofu, nuts, and seeds.  This is a natural way to treat insomnia and has been known to be effective.

*CLICK HERE FOR MORE INFORMATION ON L-TRYPTOPHAN

OVER THE COUNTER MEDICATIONS

These medications do not require a prescription from your doctor and many people use these medications regularly.   ALL of these medications contain the SAME active ingredient called Diphenhydramine HCl and is commonly referred to as an Antihistamine.  These medication are designed to block the production of Histamine that is released by the body, when something triggers the immune system to work.  One of the desired side effects of this medication can be an increased sensation of feeling relaxed and can be quite effective in promoting a some restful sleep. 

  • Tylenol PM
  • Benadryl
  • Unisom

MEDICATIONS PRESCRIBED BY A DOCTOR

ANOTHER ANTIHISTAMINE

A medication that can be prescribed that is similar to Diphenhyradamine in action, but is actually what we call a “First Generation Antihistamine” is Hydroxyzine.  Antihistamines are often tried initially because there is no risk for physical dependence. 

ANTI-DEPRESSANTS

These medication work a little different than the more well known anti-depressants like Zoloft or Paxil, and  in they are used specifically to treat insomnia.  I have personally found that these are very effective methods to treat insomnia and the people feel rested without a “hang over feeling” that is common in with tranquilizers. 

  • Trazodone
  • Remeron aka Mirtazapine

HYPNOTICS

These are medications that we DO NOT USE in Hospice typically.  There is some controversy over these types of medications and the side effects.  While they may be effective in treating insomnia, I would encourage you to use caution. 

  • Ambien
  • Lunesta
  • Quaaludes

TRANQUILIZERS

These medications should be supervised closely by your Hospice Doctor and Nurse to ensure safety.  Tranquilizers are medications prescribed to slow down brain activity, and have a sedating effect.   When these medications are use routinely, there can be some unpleasant withdrawal symptoms, and should be stopped with supervision and by lowering the dose in increments.   The milder of two families of tranquilizers are anxiolytics, also referred to as Benzodiazepines.  The PREFERRED medication in this group specifically for promoting sleep is Vistaril aka Temazepam. Please note that there are more benzodiazepines on the market, but the following are the most commonly prescribed in hospice.   

 MILD TRANQUILIZERS 

  • Vistaril aka Temazepam
  • Ativan aka Lorazepam
  • Xanax aka Alprazolam
  • Klonipin aka Clonazepam
  • Valium aka Diazepam

The more potent tranquilizers are referred to as antipsychotic medications, and are commonly used in hospice to treat insomnia with symptoms of agitation and restlessness too.  These are typically a first line of treatment in patients with dementia and mental illness.  

STRONG TRANQUILIZERS

  • Seroquel aka Quetipine
  • Risperdal aka Risperidone
  • Haldol aka Haloperidol
  • ABH aka Ativan-Benadryl-Haldol

Ultimately your loved one is depending on you to advocate for them.  The treatment of insomnia does requires some consideration of all the factors.  I encourage you to discuss this in more depth with your Hospice Nurse.  There is no reason for anyone to suffer from sleepless nights, and there is hope.

I hope you found this information useful.  Please feel free to ask a question or leave a comment. 





8 Comments

  • Paul March 27, 2017 at 1:22 am

    Hi Heather,

    Being an enthusiast for alternative health and healing, I was glad to see you included aromatherapy. Essential oils are far more powerful than many people realize.

    Have you considered chamomile tea? Many people find it to be a very useful sleep aid. Also, consuming celery on a regular basis can help someone fall asleep at night. There are quite a few things nutritionally that a person can do as either an immediate sleep aid, or a routine that benefits sleep over time.

    Reply
    • Heather Williams RN CHPN March 27, 2017 at 3:22 am

      Hi Paul,
      Thank you so much for mentioning TEA. I completely agree! As a matter of fact I have “Sleepy Time” tea in my cupboard right now, and the primary ingrediet is Chamomile. This definitely another great sleep aid! was surprised to see that Celery of all things! I will personally now find ways to eat more celery and maybe I can even get my kids to eat it too. 😉
      Take Care,
      Heather

      Reply
  • jeffrey16201 March 27, 2017 at 9:17 pm

    Hello Heather,

    I am sure your patients just love you, you sound like a very sensitive and caring nurse by your article today.

    I am not a hospice patient but I have struggled with sleep all my life, you are right it does affect your emotional health as well as your physical health.

    I am very much like your patients, no sleep meds for me if I can solve my problems in another way. I will try the aromatherapy sleep suggestion soon, like article with lots of options to try

    Reply
    • Heather Williams RN CHPN March 28, 2017 at 1:18 am

      Thank you for the lovely compliment. I often feel very blessed that my families that I work with allow me into their lives during such a sacred time for them. Also, I do hope the aroma therapy helps you out. The power of senses should not be underestimated. Take Care, Heather 🙂

      Reply
  • Rilina April 5, 2017 at 6:21 am

    Hi there, the topic of your site really brought to my attention. I for one use to suffer from insomnia and it was the worst. So, thank you for letting others know how they can treat their insomnia. Overall, I adored your website and absolutely am drawn to the look of it!:)

    Reply
  • Vitaliy April 28, 2017 at 3:27 pm

    Hi Heather
    Let me thank you right out of the gate for this valuable information. I think insomnia is very serious problem that we should pay attention to. Especially for those who are in hospice care facilities. Many people have aging parents and relatives. They should know more about this existing problem and they need more quality information on how to fight it.
    In addition to that many are suffering form insomnia as well. In our modern society with its crazy rhythm of life many people getting tired very quick and as a result have not enough sleep. And they are looking for solutions.
    Alternative therapies that you recommend could be the one. Binaural Beats meditation sounds interesting. I should try one.
    Cheers,
    Vitaliy

    Reply
    • Heather Williams RN CHPN April 29, 2017 at 2:17 am

      I am pleased that you found the article informative. I could not agree more that sleep is essential overall health and well being.
      Thank you,
      Heather

      Reply

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