Give It a Rest: Tips for Sleep-Deprived Caregivers

The National Sleep Foundation recently confirmed what Mom probably told you a long time ago: The average adult requires at least eight hours of sound sleep a night.

But to caregivers who are up and down all night helping their loved ones with serious conditions like ALS, that may sound like a laughable ideal.

Unfortunately, chronically sleep-deprived people don't laugh all that much. A recent University of Texas study of 51 caregivers of terminally ill family members found a clear correlation between lack of sleep and severe depression.

"A caregiver's sleep levels were the best predictor of caregiver depression levels," says the study's lead author, Patricia Carter of the UT School of Nursing in Austin.

Besides depression, sleep-deficit symptoms can range from misplacing the car keys to crashing the car. Researchers say an ongoing lack of sleep can cause: forgetfulness, lowered alertness, reduced creativity, inability to speak and write clearly, lowered resistance to disease, unwanted weight gain, and increased risk of stroke, heart attack and adult-onset diabetes. Sleep-deprived people also are more likely to verbally and physically abuse their children, and are more prone to falling asleep at the wheel.

Great — something else to worry about while staring at the ceiling at 3 a.m., right? Wrong. It's possible to get more rest while still getting up to care for your loved one with ALS.

Actually, getting up several times a night isn't as big a problem as not being able to fall back to sleep quickly afterward, says James Maas, a Cornell University (Ithaca, N.Y.) sleep expert and author of Power Sleep: The Revolutionary Program That Prepares Your Mind for Peak Performance, published by Harper-Collins.

Maas and other sleep experts offer these suggestions for improving the quality and quantity of sleep:

• Make it quick and quiet. When getting up, don't turn on the lights (use a low-level nightlight if necessary), don't have a conversation or do anything mentally stimulating, and stay up the minimum amount of time necessary.

• Don't try too hard. If you can't fall back to sleep within 10 or 15 minutes, get up. Do something relaxing such as reading (nothing work-related, however), light housework or listening to music, then return to bed as you feel yourself getting sleepy.

• Decrease caffeine, alcohol and nicotine. Improve your chances of falling back to sleep quickly by avoiding caffeine, especially in the afternoon.

  Ditto for nicotine and alcohol. In cases of severe sleep deficit, cut them out entirely, advises Maas. Although some people find that a drink before bed helps them fall asleep, alcohol actually increases the likelihood that you'll wake up during the night.

• Power nap. Make up some of your sleep deficit by taking a daily power nap — a short (15- to 30-minute) nap sometime during the "midday trough" between 1 and 3 p.m., when your body naturally wants to rest. A longer nap may leave you groggy and unable to sleep at night, Maas warns.

  If you're worried about sleeping too long, set a timer. If you can't fall asleep, just rest quietly. But above all, don't try to rev yourself up during the trough by having a coffee or cola, Maas says, because it may cause sleep problems later that night. Instead, force yourself to take a short afternoon rest break.

• Don't sleep in. Go to bed and get up about the same time every day, instead of trying to catch up on sleep once a week or so. A simple way to get more sleep is to go to bed a little earlier. It sounds obvious, but tired people will often perversely hang out with the late show rather than turn in earlier.

• Check out your sleep space. Is your bedroom actually a restful place? An uncomfortable mattress, snoring spouse, too much light, being too hot or too cold, pets who jump on and off the bed, and outside noises all are subtle distractions that make it hard to settle back down.
  

  Don't live with it — take steps to change it! A fan that creates white noise, eyeshades, putting the pets elsewhere or investing in a great mattress all can improve your sleep — and by extension, your life.

• Three on, three off. If it's possible, share the nighttime caregiving duties. For optimum sleep benefits, Maas recommends a three-nights-on, three-nights-off schedule, rather than switching with someone every other night.

If you've tried all of the above — and then some — and still can't get enough rest, talk to your doctor. Not all caregiver sleep problems are caused by stress or getting up in the night. There may be an underlying physical problem that can be treated so you can get the zzzzz's you need.