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Sleep and CP

Many people with Cerebral Palsy (CP) have trouble sleeping. There are however several things you can do to improve your sleep.

Problems with falling asleep or sleeping well are common in children, adolescents, and adults with CP. A lack of sleep can lead to fatigue and impaired attention during the day. It can also limit one’s ability to learn new things. Many parents of children with CP are frustrated because they feel they can’t help their children sleep through the night.

There are no known neurological explanations or documentation suggesting that brain injury is the reason people with CP can have trouble sleeping. The areas of the brain that help regulate sleep are not in the areas usually affected by CP. Regardless, the problem is quite real. In this article, we will examine what sleep is, why it is important, and what you can do to improve it.

What is sleep?

Briefly, sleep is a consequence of the inner clock in all of us. This clock regulates the nerve cells in the brain that are responsible for whether we are awake or asleep.

The nerve cells are rhythmically active, even in the absence of an alternating pattern of darkness and light, which normally happens because the earth rotates on its axis. Research has shown that our brain’s inner clock is set to the duration of approximately one day on earth, and that we maintain this same rhythm even if we stay in the same lighting for many days.

If our brain had developed on Venus, the rhythm would be slightly over 5832 hours because Venus rotates very slowly on its axis.

Why is sleep important?

There is no doubt that sleep is important. Scientists don’t yet know exactly why, and which precise function it has for the brain and body, but a single night with poor or insufficient sleep makes us tired, uncomfortable, and inattentive the next day.

If we experience reduced or poor sleep over weeks, months, or years, it also affects our health. Poor and deficient sleep has been associated with increased blood pressure, increased risk of blood clots in the heart and brain, diabetes and other metabolic disorders, reduced immune response, and development of dementia.

Based on the negative effects of a lack of sleep, there is a consensus among scientists that sleep is important for recovery of the brain and body. What this precisely entails is unclear. One theory is that sleep helps the brain to remove waste products from the day’s processes – as a nightly ‘washing machine.’

Much evidence also suggests that different parts of the brain ‘replay’ what we have experienced and learned during the day, and that it is an important function to consolidate what we have learned and experienced that day in our memory.

Why do we sleep poorly?

Difficulty sleeping is prevalent in the entire population, not just in people with CP. It is typically attributed to our ‘modern lifestyle’ - the stress and worries that prevent the necessary mental peace and quiet to fall asleep – regardless of whether you go to kindergarten, to school, or to work.

Artificial light from computers and mobile phones can also contribute to poor sleep. Sleep is also influenced by nutrition and physical activity.

Reduced sleep and poor sleep quality are also part of aging. The mechanisms in the brain that control sleep and help us fall asleep don’t work as well when we get older. We don’t know exactly why.

It appears that there are particular reasons why many people with CP have sleep problems. Most studies indicate that pain is the most frequent cause. The reason for the pain is unclear, but it may be related to joint- and muscle pain that can arise from excess strain on muscles.

Read about CP and fatigue

How to improve your sleep

Many of the challenges to getting a good night’s sleep can be difficult to address. Stress and worries in everyday life cannot typically be solved quickly and easily. But we do have enough knowledge to suggest several tips to getting a good night’s sleep.

Light and dark

The brain’s inner clock reacts to light and dark. Light helps keep us awake and the absence of light helps us sleep.

In the dark periods of the year, it is important to use artificial light sensibly. Avoid bright light, whether it is from home lighting, streetlights, a computer screen or a mobile phone, several hours before you go to sleep. It is a good idea to gradually dim the lights before bedtime or turn off any unnecessary lights.

Conversely, you can gradually increase the brightness of the lights in your surroundings around the time you wake up.

Regular rhythms

The brain’s inner clock likes regularity. If we go to bed and wake up around the same time each day, it helps the clock keep its rhythm regular.

Changing work hours or time zones can make sleep problems worse. Try to keep a relatively regular bedtime each day, including on the weekends, even though it can be tempting to stay up later when there is no kindergarten, school, or work the next day.

Physical activity

Regular physical activity can also improve your sleep. Increasing your heart rate a little bit at the same time every day can help to keep your inner clock regular.

The long-term changes that happen in your body after regular physical activity make it easier for us to fall asleep and sleep through the night. It doesn’t necessarily happen after just a single day with extra physical activity. In fact, it can have the opposite effect in the beginning, making it harder to sleep. But over time (weeks to months) you can feel a positive effect with light to moderate physical activity every day.

Some studies indicate that you can get about 45 minutes of extra sleep per night by integrating physical activity into your everyday life.

Food and drink

The things we eat also affect how well we sleep. Regularity is also important in this context. Try to eat around the same time each day. Avoid going to bed hungry, but don’t eat too large of a meal just before you go to bed either. Try to wait 1-2 hours after your last main meal before you go to bed.

Several studies suggest that the old advice about drinking a glass of warm milk before going to bed can work. The milk doesn’t even need to be warm. Milk contains relatively large amounts of melatonin, which is one of the chemical messengers in the brain involved in falling asleep.

The most important thing to avoid is drinks that contain caffeine. Caffeine (and the related theobromine, which is found in tea) activates the connections in the brain that keep you awake. Many energy drinks also contain very large amounts of caffeine. The brain can get used to relatively a large caffeine intake; some people can sleep well, even if they drink coffee late at night

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