Functional and Dissociative Neurological Symptoms : a patient's guide

Hemi

Sleep Problems

Like fatigue, sleep problems are very common in patients with functional neurological symptoms.

Insomnia – can mean difficulty getting off to sleep, staying asleep or waking up to early

Hypersomnia – means sleeping excessively, usually waking up still tired

Sleep problems may occur as part of anxiety or depression, although its important to say that you don’t need to be anxious or depressed to have sleep problems.

Here are some tips for sleeping. This is sometimes called ‘basic sleep hygiene’

Basic tips for a better night's sleep

• Keep regular hours. Going to bed and getting up at roughly the same time, all the time, will programme your body to sleep better.

• Create a restful sleeping environment. Your bedroom should be kept for rest and sleep and it should be neither too hot, nor too cold; and as quiet and dark as possible.

• Make sure your bed is comfortable. It's difficult to get deep, restful sleep on one that's too soft, too hard, too small or too old.

• Take more exercise. Regular, moderate exercise such as swimming or walking can help relieve the day's stresses and strains. But not too close too bedtime or it may keep you awake

• Cut down on stimulants such as caffeine in tea or coffee - especially in the evening. They interfere with falling asleep and prevent deep sleep. Have a hot milky drink or herbal tea instead.

• Don't over-indulge. Too much food or alcohol, especially late at night, just before bedtime, can play havoc with sleep patterns. Alcohol may help you fall asleep initially, but will interrupt your sleep later on in the night.

• Don't smoke. Yes, it's bad for sleep, too: smokers take longer to fall asleep, wake more often and often experience more sleep disruption.

• Try to relax before going to bed.. Have a warm bath, listen to some quiet music, do some yoga - all help to relax both the mind and body. Your doctor may be able to recommend a helpful relaxation tape, too.

• Deal with worries or a heavy workload by making lists of things to be tackled the next day.

• If you can't sleep, don't lie there worrying about it. Get up and do something you find relaxing until you feel sleepy again - then go back to bed.

Insomnia - being worried about going to sleep

One of the commonest causes of insomnia is the development of anxiety about sleeping.

Often what happens is that someone finds they feel really tired but then as soon as they get in to bed they start to worry about how they can't get to sleep and what a terrible night they are going to have.

Falling asleep should be an automatic process. If you start thinking about it too hard then it doesn't work as well. In that sense its not that different to the problem in functional weakness where the more you think about the leg the weaker it gets.

Learning to undo this can be difficult, but understanding what has gone wrong is the first step.

I recommend the approach taken by Professor Colin Espie who wrote this article for the Guardian newspaper in the UK.

The self help book available via this link is also a good place to look.

http://www.sleepcouncil.org.uk/SleepAdvice/sleep_tips_2.cfm

http://www.moodjuice.scot.nhs.uk