Understanding sleep with osteogenesis imperfecta

Top tips for sleep in children with osteogenesis imperfecta

Muscular aches and pains are common in OI especially if you have had an active day. These can be worse at night as this is a time to switch off and relax, distractions are less, which can make aches and pains more noticeable.

Ideas which may help:

• Understand and use pacing strategies to help ensure you are not overexerting your body during the day, causing excessive muscle soreness.
• Massage
• Hot bath
• Pain relief
• Stretching and relaxation before bed

Heat regulation

Sweating

Children with osteogenesis imperfecta often experience this overnight. Make sure the bedroom is the right temperature, not too hot or cold, around 16 to 18 degrees.

Pyjamas

Make sure they are made of natural fibres and not synthetic material, which increases heat, as they are not as breathable. Make sure these are also appropriate for the weather. For example thin in the summer, thicker in the winter.

Bed sheets

Making sure they are made of natural fibres, and not synthetic material, can reduce heat retention. Coolmax bedding is specially designed to help wick away moisture from the body when in bed.

Duvets

Having a summer and winter duvet with different tog ratings can help ensure you do not get too cold in the winter or hot in the summer.

Mattresses

Making sure you have a good quality mattress that is comfortable and supports your spine is important to reduce back pain. Mattresses should be replaced every 10 years or in line with manufacturer’s guidelines. Memory foam or mattresses made of synthetic fibres are generally warmer than a pocket sprung mattress made of natural fibres.

If you are buying a memory foam mattress make sure it has cooling properties such as Coolmax.

Understanding sleep

Sleep can be divided in to non-REM sleep and REM sleep. REM stands for ‘rapid eye movement’ and is a phase of sleep closest to being awake, where your brain is more active and you are likely to have dreams.

Different sleep stages are thought to have different functions and during sleep you will cycle through all stages. This is known as a sleep cycle. You will have 4 to 5 sleep cycles per night, with brief awakenings during the night.

Non REM

A mixture of light (stage 1 to 2) and deep (stage 3) sleep.

Stage 1, 2 and 3 are when your body becomes restful and muscles relax, and your breathing, eye movements and brain waves all slow down. Stage 3, the deepest sleep stage, is when growth and repair happens.

If you have an injury or high level of fatigue the body is working harder to repair itself. Not enough time in this restorative sleep stage may affect the body’s ability to repair itself, grow and fight infection. You may spend less time in this deeper restful sleep due to aches, pain, heat regulation, worries and anxiety. Stage 3 sleep occurs more in the early part of the night.

REM sleep

This sleep stage is when your muscle tone is at its lowest — so that you don’t act out your dreams! REM sleep is when the brain consolidates its learning from the day and improves memory. It is also when most of the dreaming takes place. Children spend more time in this stage than adults. As the night goes on you spend more time in REM sleep and this is often why you may wake from a dream. Not enough time in REM sleep can influence learning consolidation, and processing of anxiety and worries.

Brief awakenings overnight

When moving through the different sleep stages that your body and brain need overnight, it is normal to wake up briefly whilst changing sleep stage.

Sleep hygiene tips

Structure

A structured relaxing bedtime routine with a set time to go to bed and wake up will help with the body’s natural circadian rhythm (the brains internal clock which moves between sleepiness and alertness).

Lights

Dimming or turning-off bright lights and avoiding screen time (at least 1 hour before bed) will help with your brains natural release of melatonin — the natural hormone released in the brain when the sun goes down or in darkness to help you sleep.

Snacks

Having a light snack 30 minutes before bed can be part of a healthy bedtime routine. Bananas, cherry juice, and milk have all been shown to have an effect on the natural release of melatonin and tryptophan which help you sleep. Avoid sugary or caffeinated drinks and foods before bed.

Relax

Avoid high levels of activity and excitement during the run up to bed time (at least 1 hour before bed). High levels of activity and excitement before bed may stop the release of melatonin and may release hormones to make you more alert such as adrenaline.

Bedroom

Create a calm bedroom environment. Bedrooms should be a place for sleep. Reduce the amount of toys, TVs, bright wall colour or pictures and other stimuli in the bedroom to provide less distraction.

To help a child associate their bedroom with sleep this space should not be used as a place to play or as a punishment such as ‘go to your room’.

Consistency

Any sleep strategies you put in place to help your child get to sleep such as a teddy or night light should remain in place all night. A change to the surrounding could disrupt your child’s sleep or cause them to wake up more during the night, as the surroundings have changed and the brain is trying to respond to this change.