Sleep: The natural disturbance post-cardiac arrest

Surviving a cardiac arrest can be a life-changing event that affects not only your physical health but also your mental and emotional well-being. One of the aspects of your life that may be disrupted by a cardiac arrest is your sleep.

Sleep is essential for your health and recovery. It helps your body heal, the brain process information, and regulate mood. However, you may face some challenges with your sleep quality and quantity after a cardiac arrest. Here are some common sleep problems you may encounter and some tips on coping with them.

Trouble falling asleep or staying asleep

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For various reasons, you may have difficulty falling asleep or staying asleep after a cardiac arrest. You may feel anxious, depressed, or stressed about your condition, treatment, or future. You may have nightmares or flashbacks of the event. You may have pain or discomfort from your injuries or medications. You may also have changes in your circadian rhythm, which is the natural cycle of sleep and wakefulness influenced by light and dark.

To improve your sleep onset and maintenance, you can try some of the following strategies:

  • Stick to a regular sleep schedule. Go to bed and wake up at the same time every day, even on weekends and holidays. This will help your body and mind establish a consistent rhythm and expectation for sleep.
  • Create a relaxing bedtime routine. Engage in calming activities before bed, such as reading, listening to soothing music, meditating, or doing gentle stretches. Avoid stimulating activities like watching TV, using your phone or computer, or having heated discussions.
  • Make your bedroom comfortable and conducive for sleep. Keep it dark, quiet, cool, and clutter-free. Use curtains, blinds, earplugs, fans, or other devices to create an optimal sleeping environment. Invest in a comfortable mattress, pillow, sheets, and blankets that suit your preferences.
  • Avoid caffeine, alcohol, nicotine, and other substances that interfere with sleep. Caffeine can keep you awake for several hours after consumption, so avoid it in the afternoon and evening. Alcohol can disrupt your sleep quality and cause you to wake up more often during the night. Nicotine can also stimulate your nervous system, making falling or sleeping harder.
  • Limit naps during the day. While napping can benefit some people, it can also interfere with your nighttime sleep if you nap too long or too late in the day. If you feel sleepy during the day, limit your naps to 20 minutes or less, and avoid napping after 3 pm.

There are several options for seeking help for flashbacks, anxiety, and mental health issues:

1. Seek help from a mental health professional: A therapist or counsellor can provide you with a safe and supportive environment to explore your issues and develop coping strategies. They may use techniques such as cognitive-behavioural therapy (CBT), exposure therapy, and mindfulness-based therapies to help you manage your symptoms.

2. Join a support group: Sometimes, talking to others who have gone through similar experiences can be a helpful way to process your feelings and find support. We have peer support groups for both survivors and co-survivors/key supporters.

3. Try self-help strategies: Many self-help strategies can help you manage anxiety and flashbacks. These include mindfulness practices, physical exercise, grounding techniques, and relaxation exercises.

4. Talk to your doctor: If you are experiencing severe symptoms, your doctor may be able to prescribe medication to help manage your anxiety or PTSD. They may also be able to refer you to a mental health professional. Remember, seeking help is a sign of strength, not weakness. Don’t be afraid to reach out for support when you need it.

Sleeping too much

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You may also find yourself sleeping too much after a cardiac arrest. This can be due to several factors, such as fatigue from your recovery process, side effects of some medications, depression, or lack of motivation. While sleeping too much can seem harmless or beneficial for your health, it can also have negative consequences. Sleeping too much can make you feel groggy, sluggish, irritable, or confused. It can also reduce your exposure to natural light, affecting your circadian rhythm and mood.

To avoid oversleeping, you can try some of the following strategies:

  • Set an alarm clock to wake you up at a reasonable time every morning. Resist the temptation to hit the snooze button or go back to bed after waking up. Get out of bed as soon as possible and expose yourself to some bright light to signal your brain that it is time to be awake.
  • Plan some activities for the day that are meaningful and enjoyable for you. This can help you stay motivated and engaged throughout the day and prevent you from feeling bored or depressed. You can also enlist the help of a friend or family member to join you in some of these activities or to check on you regularly.
  • Exercise regularly. Physical activity can boost your energy levels, mood, and overall health. It can also help you sleep better at night by reducing stress and improving blood circulation. Aim for at least 150 minutes of moderate-intensity exercise per week, but consult your doctor before starting any exercise program.
  • Seek professional help if you suspect that you have depression or another mental health condition that is affecting your sleep. Depression is not uncommon among cardiac arrest survivors and can cause excessive sleepiness and other symptoms such as low mood, loss of interest or pleasure in activities, hopelessness, guilt, or suicidal thoughts. There are effective treatments available for depression, such as medication and psychotherapy.

Sleeping during the day

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You may also experience a shift in your sleep pattern after a cardiac arrest, making you sleep more during the day and less at night. This can be due to changes in your circadian rhythm caused by factors such as reduced exposure to natural light, altered melatonin production (a hormone that regulates sleep), or disruption of the normal synchronization between your internal clock and external cues (such as social activities). Sleeping during the day can impair your daytime functioning, social relationships, and quality of life.

To restore a normal sleep pattern, you can try some of the following strategies:

  • Increase your exposure to natural light during the day.
    Light is one of the most powerful cues for regulating your circadian rhythm.
    It tells your brain when it is time to be awake or asleep. Try to get at least 30 minutes of sunlight every morning, preferably within an hour of waking up. To mimic natural light, you can also use artificial light sources, such as bright lamps, light boxes, or dawn simulators.
  • Avoid bright light at night.
    Conversely, light at night can confuse your brain and delay your sleep onset. Avoid using devices that emit blue light, such as TVs, computers, phones, or tablets, at least an hour before bed. You can also use dimmers, shades, or eye masks to block out unwanted light in your bedroom.
  • Adjust your social schedule to match your desired sleep pattern.
    Social activities can also influence your circadian rhythm by providing stimulation
    and reinforcement for staying awake or sleeping. Try to schedule your social engagements during the day or early evening and avoid them late at night or early morning. This will help you align your internal clock with external cues and maintain
    a regular routine.

Some interesting facts about sleep

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Sleep is a fascinating phenomenon that affects every aspect of our lives. Here are some interesting facts about sleep that you may not know:

  • Sleep is not a passive state of unconsciousness but an active process involving different stages and cycles with distinct functions and characteristics.
  • The average adult needs about seven to nine hours of sleep per night, which varies depending on age, lifestyle, genetics, and other factors.
  • Sleep deprivation can impair cognitive abilities, memory, attention, judgment, creativity, and emotional regulation. It can also increase your risk of developing chronic diseases like diabetes, cardiovascular disease, obesity, and Alzheimer’s.
  • Many factors, such as temperature, noise, comfort, stress, diet, exercise, and medication, influence sleep quality. You can improve your sleep quality by following good sleep hygiene practices and avoiding disturbing sleep habits.
  • Sleep has many benefits for your health and well-being. It helps your body repair itself; your brain consolidate information, your immune system fight infections, and your mood regulate.

Conclusion

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Sleep is an essential part of our lives, affecting our health and well-being in many ways. However, you may experience some challenges with your sleep quality and quantity after a cardiac arrest. By understanding the common sleep problems you may encounter and applying effective strategies to cope with them, you can improve your sleep and recovery. You can also learn more about sleep science and its impact on society from experts like Dr Matthew Walker, a British neuroscientist and psychologist specialising in sleep. He is the author of the book “Why We Sleep: The New Science of Sleep and Dreams“, which discusses the importance of sleep, the side effects of sleep deprivation, and its impact on society. He has also shared his research on the TED original series Sleeping with Science, where he gives six tips for better sleep.

Sleep well!

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