How much tiredness is normal?

How much tiredness is normal?

Posted by SpearJanis on Dec 28, 2017 7:35 am

Hi again Nurse Linda.

I trust you and yours are all well, and have had a lovely holiday season.

I was just wondering how much sleep is normal for a person with an SCI?  My hubby, Colin, always slept very little before the addicent, and used a lot of those energy drinks to get through the days when he used to go to work; and he seemed to have some improvement when fitted with his CPAP mask.  His sleeping patterns have always been strange, and he is not the type of person to sleep for long periods of time, nor to stay in bed once he has woken up.

Since the accident, he sleeps a bit more, but perhaps in the last month or two, since he has started being able to do more and more physical things for himself with the improvement of his left arm, and possibly with the increase of the Baclofen perhaps 3 or 4 months ago from 10 to 20 mgs three times a day, he seems to be very tired a lot of the time, and often goes back to sleep halfway through the day.

Some days he wakes up having had a good night, and then feels terribly exhausted after physio (we do about an hour of range of motion exercises as well as specific stretches and exercises given by the Physios and OTs) and then wants to go back to sleep.  Some days he is in the chair for a few hours and then wants to go back to bed early.  Mostly he naps on and off when he goes back to bed, and woorks on his tablet computer playing games or chatting with people.

I just wonder if it is normal for him to seem to be so tired.  He doesn't have any signs of anything wrong - no AD starters which we can usually identify, he is eating well, his bowel movements seems regular (although our programme is still not 100%, there are no problems, jsut not where it needs to be if he wants to go back to work etc), and there don't seem to be any other things bothering him.

There are a few family issues that cause him sopme distress and even emotional hurt - specially now over the holidays, as you mentioned in your most recent post.  But I wonder if it is more than just that his body is trying to heal, he is getting stronger and exercising more and more, therefore needing more rest, etc.

Without having any additional information, do you think it is probably all ok, or do we need to consider the possibility of going to see our healthcare professional?

Thanks in advance, and I wish you all a prospoerous new year, and a safe time if you travel. :D

Re: How much tiredness is normal?

Posted by AskNurseLinda on Dec 28, 2017 1:57 pm

Hello, Janis, happy holidays.
You have a lot of reasons in your email that could lead to fatigue. Medications, such as  baclofen, can lead to fatigue and can take up to six weeks or longer to become adjusted. Every time you up the dose, a new six week period begins again.
Return of function can be exhausting as well. He is doing more things but with less function, it can be difficult to do the activities that used to be taken for granted so moving an arm can use much more energy than before. The same with physical therapy, the energy used to create movement can be tiring even after a while. All people who have therapy for any reason will comment on the exhaustion of muscles not used for even a short period of time.
A good amount of sleep for people is eight hours. Sometimes this is difficult to achieve with turning schedules (this is the same for caregivers who have to be up to do the turning).  It can take some time for form a habit of obtaining this much sleep. With physical exercise of therapy or even functional movement, the body can become tired and need rest in the daytime.
You also mention the stress of the holidays which can affect anyone. So much to do, moving from place to place and mental stress of events and parties. All this can play into fatigue and sleep.
Colder weather can make people want to 'hibernate'. Keeping warm in this cold weather crossing the Northern Hemisphere can lead to use of a lot of energy to keep our bodies warm.
Another issue that can lead to sleep is depression. Anyone with a life altering catastrophe can use sleep as an escape from reality. It can happen with illness, changes in life structure or spinal cord injury. The person might not feel or report being depressed but they can be in a depressive situation. Sleep is a common escape method. I know your husband is early in his rehabilitation. Sometimes depression takes a while to become noticeable. You two have such good attitudes that this delayed response might be occurring. It is not unusual. You can speak with your healthcare professional to have them assess for depression. It is an issue that can be treated. It is not a situation that you can or should 'tough it out'.  It is a medical condition. You will need to decide with your healthcare professional how you would like to treat depression if it is present. Nurse Linda


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