“There is a time for many words, and there is also a time for sleep,” wrote Homer – the ancient Greek poet, not the Simpsons character with the donut addiction.
We all know sleep is good for us, especially after a taxing event like surgery. Good sleep helps the body repair itself faster, increases mental wellbeing and even boosts our immune system.
But when it comes to a major operation like a knee replacement, there’s an obvious catch. Discomfort, new medications, an unfamiliar hospital bed, a noisy ward – all these things make it harder to sleep than before. So how do you square the sleep circle? If you’re having knee surgery, or considering it, here are some things to consider.
Hospitals are not conducive to great sleep. Beeps, clicks, trolley wheels and nurses going to and fro with medications make noise a 24/7 issue. Earplugs, a sleeping mask and even a white noise app on your mobile phone will help you to stay a little more in control of your surroundings.
In the first days after surgery, many patients find sleep medication can be very helpful. In the short term, that’s OK – and your hospital will stock standard ones like temazepam and zopiclone in case you need them. Be aware that you’ll need advice if mixing medicines. If you’re taking other pills or sleeping tablets prior to surgery, make sure your doctors know about them.
What’s the best sleeping position after a knee replacement? To begin with, probably on your back. There’s usually no reason to avoid lying on the side or stomach after a knee replacement, but most people find it’s more comfortable to be on their back at first. The key thing is to keep your leg straight. Bending the knee encourages contracture (where the muscles or tendons become harder to stretch).
Some patients find it more comfortable to sleep with a pillow either side of their operative knee. This also stops it knocking against the other leg, which can be painful. You might like to raise your leg by placing a pillow underneath your foot or calf. But, again, make sure the leg stays straight. Don’t put a pillow behind the knee, where it will keep the leg bent.
There’s no avoiding the fact that, when you’ve been under a general anaesthetic for two hours or so, you’ll find it harder to sleep that first night. So prepare for disruption by arming yourself with things to do in the hospital bed. Many patients like to bring a tablet with movies or audiobooks. Download them ahead of time so you’re not reliant on hospital wifi (and remember the earphones!).
Pain relief medicines have varying effects on sleep. Some are sedatives, so if it’s possible to take them an hour before you go to bed you should get the added benefit of being drowsier. Others however, such as morphine-based medication, can disrupt sleep. There’s a balance to be struck between pain relief and sleep interference, so it’s a good idea to discuss this with your doctor.
Immediately after an operation, your body is in recovery mode. This means you’ll probably want to sleep during the day. That’s OK. But as time goes by it’s a habit you should try to break. Long naps in the daytime break the circadian rhythm that guides our night-time sleep. When the time feels right, try to get back to a normal pattern.
If you want to maximise the opportunity for sleep, steer clear of alcohol. Alcohol may help you nod off but it can play havoc with the sleep cycle, disrupting the restorative REM stage of sleep – and making loo visits more frequent. Think too about your tea and coffee intake. One study found that drinking caffeine six hours before bedtime reduced the total night’s sleep by an hour.
Are you worried about sleep after surgery? Our patients often want to know what they can do to offset the likely disruption from their operation. We’re always happy to chat and offer advice about this and any other concerns you have. Call the CBO team on 01962 826107 – or book an appointment with Mr Bailey through the website.