This email came across my desk today. If you are disabled, or you care for someone disabled, this will have meaning to you…
According to the most recent findings from the U.S. Census Bureau, 56.7 million disabled adults and children reside in the United States. This figure accounts for roughly 19% of the country’s total population. Of these 56.7 million:
- 8.1 million have difficulty seeing, and 2 million are considered legally blind.
- 7.6 million have a hard time hearing, with 1.1 million experiencing severe hearing problems and 5.6 million using a hearing aid.
- 30.6 million struggle with walking or stair-climbing; many of these individuals rely on wheelchairs, crutches and other assistive devices.
- 19.9 million have difficulty reaching, holding and grasping objects.
- 15.5 million have trouble with at least one daily task as a result of their disability; these tasks include bathing, eating and dressing themselves.
- 2.4 million have been diagnosed with Alzheimer’s disease, senility or dementia.
- 7 million have depression, anxiety and other mental health disorders that are severe enough to impact their daily lives.
Disabilities impact people in different ways. Disabilities are currently classified into five subdivisions.
|Type of Disability
||Difficulty communicating with others, learning and processing information
||Down syndrome, attention deficit disorder (ADD), Fragile X syndrome, fetal alcohol syndrome disorder (FASD), developmental delays
||A condition that affects physical capacity and motor functions
||Multiple sclerosis (MS), cerebral palsy, paraplegia/quadriplegia, muscular dystrophy, polio, disability due to physical injury
||A condition that affects sight, hearing, taste, smell and/or touch
||Blindness and low vision, deafness and hearing loss, autism spectrum disorders (ASD), sensory processing disorder
||A mental health condition that affects one’s daily life and relationships
||Depression, anxiety, bipolar disorder, obsessive compulsive disorder (OCD), schizophrenia, anorexia nervosa, bulimia nervosa, post-traumatic stress disorder (PTSD)
||A physical condition that arises due to damage to or degeneration in the nervous system
||Acquired brain injury (ABI), epilepsy, other acquired conditions characterized by bodily fatigue, impaired physical capacity, speech difficulties, memory lapses and/or mood swings; also includes Alzheimer’s disease and other forms of dementia
Virtually every type of disability is linked to certain sleep issues. This article will explore the relationship between sleep and different types of disabilities, as well as some popular bedding products and accessories used by disabled sleepers. First, let’s look at some of the latest studies and scientific findings exploring the way disabilities affect sleep and vice versa.
Studies and Findings
In a 2016 study titled, ‘Sleeping while disabled, disabled while sleeping’, Dr. Benjamin Reiss notes that nearly every disability diagnosed today entails some sort of sleep disruption ― although the nature of and reasons for this disruption vary from person to person. The most common causes include “physical pain, exhaustion, and emotional stress of facing obstacles in work and other areas of life, or challenging sleep environments in which many disabled people live”. Dr. Reiss adds that sleep-related issues are often the most difficult aspect of living with a disability. “Night is often when social isolation and vulnerability are most profound,” he writes. “In addition, caretakers themselves often find their own sleep profoundly disrupted, whether this occurs in a family setting or an institutional space.”
Other studies have examined the effects of sleep deprivation in people with different disabilities. A 2002 study published in Pain Research and Management found that roughly 89% of people with chronic pain experienced “at least one problem with disturbed sleep”, and that addressing sleep problems in these individuals can lead to “improvement in patients’ daily activity and a reduction in their suffering”. A similar report found in the Journal of Intellectual Disability Research noted that 16.1% of children with intellectual disabilities had at least one sleep problem ― and that severe sleep issues were linked to health issues like epilepsy and cerebral palsy, as well as overuse of medication. And an extensive study conducted for Archives of Disease in Childhood found that children with autism spectrum disorders aged 30 months to 11 years sleep 17 to 43 minutes less each daythan children who have not been diagnosed with ASD; the subjects in this study also reported higher levels of nighttime waking. Additionally, some sleep problems are largely isolated to disabled populations. Non-24 sleep wake disorder, for instance, is a circadian rhythm disorder that primarily affects blind people.
The general consensus among today’s experts: addressing the sleep problems of disabled adults and children can improve their physical well-being, mood and everyday outlook. However, findings remain somewhat limited and sleep experts are still exploring strategies for helping disabled people sleep better. From a studypublished in Research in Developmental Disabilities: “While a number of behavioral interventions have proven effective in the treatment of sleep disturbance and drug therapy involving melatonin appears promising, epidemiologic work on the correlates with sleep disorders appears to have little impact on treatment”.
In the absence of substantive scientific research, people with disabilities may alleviate the symptoms of disordered sleeping with specialized beds, mattresses, assistive devices and bedding accessories. Read on to learn more about some of the most popular products on the market.
Bedding Products for People with Disabilities
Beds and Bedding Accessories
First, let’s look at some types of beds commonly used by disabled sleepers.
Adjustable bed frames are ideal for people with disabilities that affect their physical capacity. Most models sold today are electric and remote-controlled, allowing users to adjust the position and sleeping angle with minimal effort. Many adjustable beds can also be raised at the foot (or bottom), allowing people with circulation problems to elevate their legs and be as comfortable as possible.
Technically a type of adjustable bed, chair beds can easily toggle between a recliner and a horizontal surface. Chair beds are ideal for people with restricted daily mobility.
Similar to adjustable beds, a turning bed features a mattress that can be rotated to accommodate different sleep positions. Since some disabled people cannot easily move themselves in bed, turning beds are a useful way to prevent physical problems that arise from laying in the same position for long periods of time.
Low-profile beds are designed to lay close to the ground — usually 10 inches in height or less. Many disabled people experience pain or pressure when attempting to get out of relatively high-profile beds. Low-profile beds address this concern, and also offer a safer alternative for people who may roll or fall out of bed more easily due to their disability.
Assistive Bedding Devices
In addition to specialized bed frames, disabled people may also get some much-needed help from assistive bedding devices. These include the following:
Bed rails span the length of the user’s bed, and are usually affixed to the mattress or bed frame for maximum stability. Properly installed rails will form a barrier that prevents people from rolling out of bed. These devices suitable for people with sleep disorders that cause them to thrash or act out in the night, as well as anyone who is at-risk of falling out of bed and experiencing a serious injury (such as an elderly person or someone with a physical disability). For optimal comfort, bed rail pads can be used to form a softer buffer between the sleeper and the rail.
Grab handles (also known as lifting poles) come in several different forms. Some are attached to the bed or wall surfaces, while others are freestanding and can be placed on floors near the bed. These handles are especially helpful for people who need assistance getting into/out of bed, laying down and/or sitting upright, including those who get around in wheelchairs.
Hand blocks are compact, portable weighted handles that can be attached to the headboard or other areas of the bed frame. When evenly placed on either side, the blocks allow users to push down and lift themselves several inches with minimal effort. These blocks can be beneficial for people with chronic joint or back pain, as well as people who rely on bedpans.
Rope ladders provide a similar service as hand blocks. Attached to the headboard, footboard or side of the bed frame, these ladders feature rungs to help people pull themselves up. Caregivers and attendants should ensure that at least the first rung is within reach at all times.
Bed steps are essentially step ladders designed for people who need help getting into and out of bed — although these are not normally needed for individuals who sleep in low-profile beds. Steps are suitable for physically disabled people, the elderly and anyone else with knee/joint pain and/or mobility impairments.
Headboard pads are soft cushions positioned against the headboard in order to prevent nighttime head and neck injuries. These pads can also improve comfort for people who spend long periods of time sitting up in bed during the day or night.
Like headboard pads, floor pads are designed to provide cushioning and prevent serious injuries. The pads should be placed anywhere on the floor where someone could land after a fall (both sides of the bed, if applicable). Floor pads are commonly used if rails are unavailable.
Mattresses and Mattress Accessories
Next, let’s look at some specialized mattresses and mattress accessories that can help disabled sleepers.
Due to the prevalence of incontinence and nocturia (or nighttime urination) among disabled individuals, waterproof mattresses are widely used in nursing homes and long-term care facilities across the country. These mattresses are usually made of vinyl/PVC, polyurethane and other slick, durable materials that do not absorb urine or allow puddles to accumulate. When properly cleaned on a regular basis, these mattresses will not stain or acquire a bad smell over time. Waterproof mattress covers, duvets and pillowcases are also widely available.
Often used in hospitals and rehabilitation clinics, specialized air mattresses are designed to improve circulation in people with bloodflow impairments and maximize comfort while sleeping. These mattresses may also prevent conditions that arise from prolonged bedrest, such as shearing or bed sores.
Mattresses made of ultrasoft materials — such as memory foam or latex mattresses — create a contouring surface that is designed to cradle the sleeper’s body and relieve pressure points. These conditions may be ideal for people with certain physical disabilities, or other sleepers living with high levels of chronic back, shoulder and/or joint pain.
Alternatively, exceptionally firm mattresses tend to provide sufficient support for people who weigh 230 pounds or more; this is often the best option for individuals with disabilities that are linked to high rates of obesity, such as Down syndrome.
Mattress elevators are adjustable metal frames that are placed beneath a mattress to provide the best angle for sleeping. They may be placed at the head or foot of the mattress to address different disabilities and physical conditions. Mattress elevators are often a cheaper alternative to mechanized adjustable beds.
Pillows and Additional Accessories
Finally, let’s look at some pillows and other accessories that can be used to facilitate and improve sleep for disabled individuals.
Pillows often play a key role in the sleep patterns of disabled people. Neck pillows made of memory foam or other supportive materials can be very beneficial for people who have experienced serious neck injuries, or deal with chronic neck, back and shoulder pain. Likewise, body pillows provide cushioning and support for people with intellectual disabilities and others who are prone to nighttime thrashing.
Pillow elevators, like mattress elevators, are customizable frames used to adjust the angle for maximum comfort. These elevators can be used to prop up pillows beneath the head when the user would like to sit up in bed, or under the knees to improve circulation and sleeping comfort.
White-noise machines are designed to reduce background sounds and replace them with soothing static. These machines are ideal for people with insomnia and other sleep disorders, as well as those with disabilities linked to sleep deprivation or loss.
Snoring is a serious issue for millions of Americans because the staggered breathing associated with snoring can lead to sleep fragmentation or disruption. Higher rates of snoring have been linked to certain disabilities, including Down syndrome and ASD, as well a sleep conditions like apnea. There is no known cure for snoring, but many experts agree that anti-snoring mouthpieces are the most effective way to suppress snoring symptoms; these devices fit between the teeth much like dental retainers. Anti-snoring chinstraps, specialized pillows and nasal plugs are also available.
Another possibility for heavy snorers: continuous positive air pressure (CPAP) machines, which feature a mask that fits over the face to ensure steady airflow throughout the night. CPAP machines are a bit extreme — but this may be the best remedy for people with severe snoring problems.
Visit the online resources below for more information about the link between disabilities and sleep, as well as some products and treatment methods for disabled people with sleep problems. Also be sure to check out our comprehensive guide to Sleep and Aging.
Intellectual Disabilities and Sleep
- Sleep in Individuals with an Intellectual or Developmental Disability: This exhaustive study published in 2014 looks at sleep issues, treatments and intervention techniques for people with different cognitive disabilities, as well as ASD.
- Obstructive Sleep Apnea and Down Syndrome: This article from the National Down Syndrome Society (NDSS) examines the relationship between these two conditions. According to the authors, apnea is quite common in young people with Down syndrome; roughly 60% display abnormal sleep symptoms by age four.
- This Is Why You’re Tired: Originally published in ADDitude magazine, this article explores the most common sleep disturbances — as well as some effective treatments — for adults and children with ADHD who experience sleep disruption or loss.
- Sleep in Children with Fragile X Syndrome: This 2011 study looks at the myriad of sleep problems that generally affect young people with Fragile X Syndrome, a genetic disorder that typically leads to intellectual disabilities.
- Significant Improvement in Sleep in People with Intellectual Disabilities…: Published by the Journal of Intellectual Disability Research in 2009, this extensive study pinpoints some of the most common sleep problems among disabled people living in care-based facilities, as well as some of the most effective, non-pharmaceutical interventions for these issues.
Physical Disabilities and Sleep
- How to Sleep Better: Daytime and nighttime interventions are included in this guide from the Healthy Aging Rehabilitation Research and Training Center, which notes that roughly 40% of people with physical disabilities also experience sleep problems.
- Get the Sleep You Need!: Published by the National Multiple Sclerosis Society, this detailed guide discusses how people with MS can identify a sleep disorder and adopt healthy sleep habits. The NMMS site also features a helpful video tutorial on this subject.
- Cerebral Palsy and Sleep Issues: This article from Cerebral Palsy Guidance lists some common reasons for sleep problems in children with CP — including chronic pain, acid reflux and respiratory issues — and offers some interventive advice for parents.
- For Muscular Dystrophy Patients, Targeted Therapy for Sleep Disorders Helps: This 2017 article from Sleep Review explored some cutting-edge ways that doctors are helping muscular dystrophy patients address their sleep problems. The article notes that 18% of MD patients have OSA, 27% have respiratory failure and 30% experience regular daytime sleepiness.
- Hypermobility Syndrome: This guide from patient.info looks at the condition known as hypermobility syndrome, which typically affects people who live in wheelchairs; disrupted sleep is one common symptom of the condition.
Sensory Disabilities and Sleep
- Non-24: This website is dedicated to Non-24 sleep wake disorder, a condition that desynchronizes circadian rhythms and causes nighttime disruptions; the disorder is highly prevalent in totally and partially blind people.
- Treatments for Delayed Sleep Phase and Non-24: This article from the Circadian Sleep Disorders Network explores the most effective treatments for sleep disorders that mostly affect blind people; techniques include hygiene improvements, light therapy and light restriction (also known as ‘dark therapy’).
- Helping Your Deaf Child Get a Good Night’s Sleep: According to this guide from the UK’s National Deaf Children’s Society, parents of deaf children can improve sleep patterns through soothing techniques, lights and technological devices.
- Sleep Apnea Linked to Sudden Hearing Loss: In some cases, sleep disorders can be used as predictors for late-onset disabilities. That is the hypothesis of this study published in The Hearing Journal, which notes a higher rate of hearing loss in patients (primarily men) who experience sleep apnea earlier in life.
- Sleep Problems in Children with Autism: This study from the European Sleep Research Society identifies some sleep patterns and problems associated with children with autism spectrum disorders (ASD). According to the study’s findings, the most common issues include difficulty falling and/or staying asleep, nighttime waking and enuresis (or bedwetting).
Mental Illnesses, Neurological Disabilities and Sleep
- The Connection Between Sleep and Mental Health: Insomnia and other sleep-loss disorders affect people with many different mental health issues, including depression, anxiety, OCD and PTSD. This thorough guide from the National Alliance on Mental Illness covers causes, symptoms and possible treatment strategies.
- Sleep Deprivation and Depression: What’s the Link?: This article from WebMD examines the relationship between depression and insomnia, and calls out some of the most effective antidepressant medications and non-pharmaceutical treatments available.
- Sleep Disorders: According to this article from the Anxiety and Depression Association of America, mental health issues like anxiety and sleep disorders like insomnia share a complex, ‘chicken and egg’ relationship; the article goes on to explore treatment techniques for people with anxiety who experience insomnia, and vice versa.
- Sundowning, Sleep, Alzheimer’s and Dementia: People with Alzheimer’s and other forms of dementia commonly experience sundowning, or behavioral problems that persist throughout the night. Learn more about sundowning and other dementia-related sleep disorders in this guide from the Alzheimer’s Association.
- Sleep Disturbances: Published by the Parkinson’s Disease Foundation, this article looks at some common sleep issues — including sleep disruptions and daytime drowsiness — that frequently affect people with the neurodegenerative disease known as Parkinson’s.
Resources for Caregivers
- Seeking that Elusive Good Night’s Sleep: This introductory guide from the National Caregiver Alliance discusses some common sleep problems in disabled people, as well as some intervention techniques that caregivers can use to help their patients sleep better.
- Sundowning and Sleeping: Help for Caregivers: A large number of people with dementia receive facility- or home-based care, and this guide from Virginia Navigator explores some effective ways for caregivers to help their patients overcome sundowning and get the rest they need on a nightly basis.
- Sleep and Caregivers: In addition to disabled people, the individuals who care for the disabled also experience sleep problems on a relatively frequent basis. This guide from Canadian Virtual Hospice looks at some ways that some reasons for this trend — as well as effective measures that caregivers can take to improve their own sleep patterns.
Source: Dealing with Disabilities