"To sleep? perchance to dream!
Ay, there's the rub."
— William Shakespeare
Hamlet, III:1 (1601)
It's entirely possible that Shakespeare wrote these words while fighting a bout of insomnia. But even if they were written during the day it's obvious that, more than 400 years ago, the Bard understood the importance of getting a good night's sleep.
According to surveys conducted by the National Sleep Foundation, 60 percent of adults have sleep problems a few nights a week or more, with more than 40 percent reporting daytime sleepiness severe enough to interfere with their daily activities. In October 2000, Quest looked at some of the reasons why people affected by neuromuscular diseases often experience trouble sleeping (see "Better Nights for Better Days"), including breathing abnormalities, stress, depression and daily habits.
For people with neuromuscular diseases, the diminished mobility that comes as a result of muscle wasting can affect sleep. Even the most comfortable resting position can cause soreness after a while. And while most people can (and do) change positions frequently during the night without even waking up, many people with neuromuscular diseases can only do so with great difficulty — if at all.
What to do?
If you or someone in your family is affected by a neuromuscular disease and is having trouble sleeping, contact your doctor (or your local MDA clinic) as soon as possible. Lack of sleep causes much more than a grumpy disposition; it's a potentially serious medical problem.
Today we have many more tools to combat this problem than were available in Shakespeare's day. Working closely with your doctor and with a licensed physical therapist, you can find a variety of solutions.
Support designed for your body
It's important that you seek professional advice on how to achieve the optimum degree of support for your body, in order to be able to get the best sleep possible.
Everyone is different, and sleep solutions will vary. For some, the solution could be as simple as obtaining an extra pillow or two to provide additional support. Others may need to investigate specially designed beds.
A medical necessity
Since sleep problems can be considered a medical issue, your doctor can write a prescription for a bed, if that's what he believes is needed to help you get full, restorative sleep. To get coverage by Medicare, Medicaid and some forms of private insurance, the medical necessity has to be carefully documented, and you may have to appeal some rejections of coverage.
The staff at your local MDA clinic may be able to help you explain to your insurance company why sleep support is an important part of treating your neuromuscular disease.
|You can customize your Stimulite Mattress Overlay, from Supracor, by adding extra ventilated honeycomb sheets where you need them the most.|
Mattresses and mattress covers
For someone affected by a neuromuscular disease, remaining in one position can make sleeping through the night difficult — not just for the person affected, but for a caregiver as well.
That's where the Völkner Turning System comes in. This innovative powered mattress overlay will automatically turn the patient every 4 to 6 minutes during the night.
Available from James Consolidated and starting at $3,495 for adults, this unit consists of a double row of air chambers, side by side, divided in the center to provide pressure relief along the central axis of the body. Two air hoses connect the air chambers to a control unit containing microprocessors and an air pump. Each side is alternately inflated and deflated, turning the sleeper gently from side to side up to 30 degrees.
Another problem faced by those with limited mobility is the dreaded decubiti — bed sores. But Rand-Scot has an easy answer for this painfully uncomfortable problem, offering a line of seat cushions and mattress overlays called, fittingly enough, Bye-Bye Decubiti (BBD).
The BBD Mattress Overlay features five soft rubber bladders that can be individually inflated to the pressures required by different areas of the body.
The overlay fits standard hospital beds and twin beds, and measures 38 inches wide and 80 inches long. The covering is made of synthetic "sheepskin-like" pile on the top and a durable nylon-reinforced bottom. A complete kit, which also contains an air pump and patch kit, starts at $1,290.
Another possible solution comes from Supracor, in the form of the Stimulite Mattress Overlay.
Weighing only 12 pounds and measuring 3 inches thick, the lightweight 36-by-80-inch Stimulite Mattress Overlay, which fits a standard hospital bed, is made from an antifungal, antibacterial and odor-resistant honeycomb biomaterial. An incontinence pad can be placed beneath the overlay, enabling fluid to drain while keeping the skin dry.
A ventilated honeycomb sheet ($77 to $100 each) works in conjunction with the overlay to complete the Stimulite ventilation system. The whole thing can be washed in a commercial washer and dryer. The complete mattress overlay and cover costs $4,650, and can be augmented with extra cushions at $615 each.
|One customer is so pleased with the pressure relief offered by his Tempur-Pedic bed, he plans to ask the company to make a cushion for his new wheelchair.|
The Roho Group offers three mattress overlay options, ranging in price from $295 to $5,000, that use Roho's air flotation technology. Adjustable air cells allow the overlay to be custom-tailored to the contours of your body. Complete systems range in weight from 6 to 32 pounds, and come with hand inflation pump, repair kit and simple operating instructions.
From Sweden comes the Tempur-Pedic Collection — a variety of pressure-relieving products, all featuring a material made up of billions of high-density memory cells. These temperature-sensitive cells are spherical with windows, allowing them to shift position and reorganize to conform to your body contours for maximum support and comfort.
In addition to mattresses and mattress overlays priced from $530 to $3,000, Tempur-Pedic offers everything from individual pillows to fully self-contained, adjustable sleeping systems.
Beds and accessories
|Sleep Safe Beds from English Ave Industries offer comfort, safety and rails that could be used in helping a person turn.|
|The Single AbleRise Bed Rail from Ableware also features a handy pocket to store reading materials.|
|The BBD Mattress Overlay, from Rand-Scot, can be augmented with additional cushions for extra support.|
|Neuropedic's Electric Adjustable Bed keeps your spouse/caregiver close at hand.|
|The Völker nursing bed from Hertz Supply is so adjustable, it helps you get up in the morning.|
This product may not help you sleep easier, but the Freedom Grip 501 from Mobility Transfer Systems does offer the safest and easiest way to get out of bed in the morning. Excellent for people concerned about falling, this economy bed handle will fit any size or style of home bed. The handle snaps into a receiving tube mounted to a bed board (included) that slides between the mattress and box spring — no tools required. Prices start at $59.95.
Transfer Master Products offers a full line of adjustable beds and Hi-Low beds for ease of transfer. The company also offers a wide range of bed options including big-button or joystick controls, head and foot boards, and dual massage. The Original Transfer Master Adjustable Bed can lower to a point at which the top of the mattress is 15 inches from the floor, thus facilitating unaided transfer to and from a wheelchair; the bed is available in twin, full and queen sizes.
Transfer Master also offers the option of creating a Dual King bed, which makes it possible for a couple to accommodate the needs of one partner's disability. Two twin beds side by side, each with independent controls, combine to create a Dual King measuring 78 by 80 inches.
Neuropedic makes support surfaces, mattresses, pillows and electric beds. The latter category includes the Hi-Lo Rehabilitation Bed, which comes with a Neuropedic multidensity mattress, easy-touch controls, anti-skid floor-locking device, wood grain headboard and footboard. It features two safety rails, and more can be added.
Neuropedic's Electric Adjustable Bed offers an adjustable head and foot, and has a gentle 3-speed vibration system that massages muscles and enhances circulation. Neuropedic products are available through a nationwide network of dealers. Call (800) 327-6759 for the nearest dealer and prices.
If the thought of falling out of bed in the middle of the night is keeping you from falling asleep, check out the Sleep Safe from English Ave Industries. Constructed of solid maple or red oak and featuring full or partial adaptive side safety rails, the Sleep Safe is both attractive and effective — all for a starting price of $2,050.
Designed to eliminate the gaps between the headboard and the mattress, as well as those between the mattress and the side rails, the Sleep Safe also incorporates locking safety rails and head and foot boards that extend below the mattress to prevent entrapment.
Finally, from Hertz Supply comes another home health care bed that looks less like a "hospital" bed than like a piece of fine furniture — the Völker Nursing Bed.
As part of its continuing effort to offer the latest in bed innovation, Völker is set to introduce a new lying surface that will increase personal comfort by distributing pressure. In addition, Völker offers integrated lighting, hidden casters and side rails, reclining chair position, and electric braking of all wheels at the same time. Völker beds are priced between $3,500 and $4,500, and come in a variety of styles and colors.
"...the innocent sleep, Sleep that knits up the ravell'd sleeve of care, The death of each day's life, sore labour's bath, Balm of hurt minds, great nature's second course, Chief nourisher in life's feast..."
— William Shakespeare
Macbeth, II:2 (1605)
Four years and five plays later, we find Shakespeare still searching for a decent night's sleep.
Shakespeare wrote 13 comedies, 13 historical plays, six tragedies, four tragicomedies and 154 sonnets before he died on his birthday in 1616 at the age of 52. Just imagine what he could have written if he'd had some of these products available to help him get to sleep at night.
So don't let your "Midsummer Night's Dream" turn into a nightmare of fitful, restless sleep.
With all the strategies and products available today, you and the health care professionals at your MDA clinic should be able to develop the program that best suits your unique needs, backed by products that will have you sleeping like a baby in no time.
American Academy of Sleep Medicine
American Board of Sleep Medicine
National Sleep Foundation
English Ave Industries
Mobility Transfer Systems
The Roho Group