Who doesn’t like a good night’s rest? I know I do. I also know my patients do. I was discussing sleep with one of my patients today, or rather the tendency for one of his legs to “jump” when he’s asleep. We all know sleep is important, but did you know how important it is to the healing neurologic system?
The article talks about several points of note. First, it is much harder to learn new motor tasks when you’re tired. Which is a lot of physical therapy is– learning new motor tasks. So how can your patient absorb what you’re teaching if they’re not sleeping? Also, poor sleep has been associated with decreased ability to absorb those pesky beta amyloid plaques that contribute to Alzheimer’s dementia. Problems in REM sleep are also associated with developing neurodegenerative disorders like Parkinsons. See? Sleep is VERY important. So why don’t we ask our patients about it more often?
Mostly because we aren’t expected to. The article mentions a survey in which the “large majority” of physical therapists respondents said they were not educated on sleep health in school or in continuing education courses. But despite the lack of education, 57% said they assess sleep habits and quality. If we know nothing about it, how are we appropriate assessing sleep health? Answer: we probably aren’t. Until now!
The article mentioned two sleep health questionnaires to add to our repertoire: the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. And also gave a nice list of history questions to ask about sleep health to tease out folk that might really have a problem and need to be referred on to a sleep specialist.
In 2015, the APTA House of Delegates adopted population health as a priority of the profession. Sleep health falls into that realm. So for those folk that are complaining of not getting enough shut eye, but don’t necessarily fall into the needing-see-a-specialist category, a little education may go a long way. Here’s a handy patient education chart.
Those could easily be typed up into an appealing pamphlet that could hang out in a lobby or waiting room. One other educational points: positioning for comfort and pain relief when sleeping, especially for those post-surgical or with back pain. Sleep equipment education might not be a bad idea either. I can’t count the number of elderly patients I’ve seen show up to the hospital with their “favorite” pillow and it obviously has been a favorite for 20 years. Or that have one of those huge memory foam mattresses that they have to log roll out of, because it envelops them like a cocoon. It sounds nice in theory, but it’s not fun fighting your bed every time you have to go to the bathroom in the middle of the night. We also may need to address bed mobility difficulties more readily as well. If you can’t adjust yourself at night, you’re going to really uncomfortable and definitely not sleep.
I thought the last bit of the article of wearable smart devices for sleep monitoring was very enlightening. I wear one and the stats on sleep are rather fascinating. They were saying studies have shown that they’re not very accurate thought. *Womp, womp* So they may give you a general idea of how you’re doing, but not be diagnostic of anything. I will attest that mine certainly doesn’t know every time I wake up. There have been nights that I tossed and turned and it says I slept pretty good. NOT. Anyway, take those results with a grain of salt.
Speaking of sleep, I’m off to catch my Zs.