Sleep

Patients with sickle cell disease are disproportionately affected by sleep disorders, especially sleep-disordered breathing. A study in the Journal of Clinical Sleep Medicine reported that 44% of adults with sickle cell disease experience sleeping problems (Sharma et al., 2015). However, since patients with sickle cell disease are not typically obese and do not take any medications that may affect their sleep quality, sickle cell patients often are not screened for sleep disorders.

Poor sleep can exacerbate some of the symptoms associated with SCD (sickle cell disease), including:

• Pain: Chronic pain can reduce sleep quality, and poor sleep can worsen pain. Over time, a consistent lack of sleep can trigger chronic pain.
• Fatigue: Many people with chronic pain experience significant physical, mental, or emotional fatigue that interferes with their daily lives. Poor sleep can exacerbate fatigue.
• Mood: Anxiety and depression can prevent a good night’s rest, and lack of sleep can dampen one’s mood the next day. Consistently poor sleep can trigger mood disorders. Sleep problems in sickle cell patients have different implications for children and adults.

Children with sickle cell disease have a higher prevalence of sleep-disordered breathing compared to children who do not have the disease. Sleep disordered breathing can cause behavioral problems, learning difficulties, high blood pressure, nighttime bed-wetting, and impair growth.

Adults with sickle cell disease may experience a decreased duration of sleep, require more time to fall asleep, and/or spend more time awake during the night. Sleep disturbances are often thought to be a contributing factor to pain experienced during the day, resulting in an increase in pain episodes. Because of this, adults with sickle cell disease are at risk of developing chronic pain.

Getting enough sleep, and the right kind of sleep may help you manage sickle cell symptoms. If you are having trouble sleeping, there are some ways to improve your quality and quantity of sleep.

1. Keep a Schedule

   • Go to bed and wake up at the same time each day. Set an alarm. This will help your body establish a pattern.

   • If you must nap, do so for only about 10-20 minutes, preferably in the afternoon.

2. Prepare Your Bedroom

   • Adjust your room temperature, lowering the temperature of the room will signal to your body that it is time for sleep.

   • Use drapes, shades, or an eye mask to keep the room dark. If you use an eye mask, try to avoid masks that are flat. Look for ones that have cushions around your eyes can still move comfortably while you sleep.

   • Use a fan, ear plugs, play white noise, or sleep music to help keep your room quiet and free from distractions while you sleep.

   • Make sure the padding thickness on your mattress feels comfortable. If you have pain or soreness, adjust your pillows or mattress to support those areas.

   • Keep pets off the bed if they disrupt your sleep.

3. Prepare Your Body

   • Avoid using electronics with artificial light in the hour before bedtime. The “blue light” from the screens can disrupt your sleep. Some devices, like Apple Devices, will have a Night Mode setting that you can schedule turn on an hour before your bedtime if you must use your phone.

   • Take a bath before bedtime to relax and prepare your body for sleep.

   • If you exercise in the evening, try to do so at least two hours before bed.

4. Food and Drink

   • Having a light snack before bed can help you fall asleep. However, heavy foods and drinks may make it hard for you to fall asleep or stay asleep. Take only small sips of water or another beverage before bed to limit how often you need to use the restroom during the night.

   • Avoid any caffeine, including coffee, green or black teas, and dark sodas four to six hours before bed. If you take an herbal supplement, check to see whether it interferes with sleep.

   • Avoid alcohol before bedtime. It might wake you up in the middle of the night or make you use the restroom more often.

   • Avoid cigarettes and other nicotine products. Nicotine, as well as other stimulant drugs like Adderall, stimulate wakefulness and arousal which will interfere with your ability to sleep.

5. Relaxation

   • Do a calming activity that you enjoy: listen to music, read a magazine, or meditate.

   • If you are stressed, jot down what worries you. Then, set aside time for the next day to think about the problem(s) you wrote down and how to solve them. Problems that cause worry at night often seem smaller in the daytime.

6. Be Patient

   • It takes time and effort to improve your sleep patterns.

   • Pace yourself to keep symptoms from flaring up. Flare-ups, or periods when your symptoms are more intense, may interfere with sleep.

   • Track your progress.

   • It may take up to several weeks to notice improvements in your sleeping habits.

   • Even small improvements in your sleep can help your SCD symptoms.

MYTH #1: “I should sleep whenever I get a chance.”

FACT: Going to sleep and waking up at the same time every day helps your body learn a pattern of sleep.

While you might feel overwhelmed with responsibilities and unable to prioritize sleep, a good night’s rest can help you perform better during the day. Skipping sleep to work is counterproductive, and quality sleep is essential to both your well-being and success.

MYTH #2: “I’ll be tired the next day if I change my sleep habits.”

FACT: It is true that when you change your sleep pattern, you may be a bit more tired at first. Changing old habits and learning how to get a good, restful sleep does not happen immediately. Give yourself a few weeks to get used to the new pattern and for your body to adjust.