Crohn's Sufferers: Overcome Sleep Deprivation with a Series of Small Changes

The alarm clock reads 2:40 AM. In less than three hours, it will scream at you that it's time to get ready for work.

If you're like many people with Crohn's disease, this is just one of the many times you've awakened during the night. Unfortunately, sleep deprivation for these patients usually isn't due to insomnia. They're often just plain uncomfortable.

Here are the main sleep thieves for patients with inflammatory bowel disease (IBD):

Night sweats: They're a common side effect of Crohn's disease. No matter what the temperature is when you hit the sheets, you awaken one or more times a night sweating like you're in a sauna. The night sweats go away once the flare is under control. In the meantime, choose lightweight bedclothes and consider taking a shower or bath (which can also make you drowsy) to cool off before bedtime.

Pain: Whether it's from active disease in your gut, adhesions from surgery or joint aches associated with the rheumatism so common to Crohn's patients, pain can awaken you repeatedly during the night. If your doctor has prescribed a narcotic painkiller during a particularly tough episode or just after surgery, take it prior to retiring. For joint pain or discomfort from a prior operation, consider an over-the-counter drug such as Tylenol. Just be sure not to pick one that carries a warning of digestive upsets. If in doubt, ask your physician for suggestions and whether prescribing a sleeping pill is warranted. If you still toss and turn endlessly, consider purchasing a body pillow. Wrapping your hurting parts around one often enables you to relax and drift off to sleep.

Steroids: They bring some relief from IBD symptoms almost immediately. However, the high-end doses make you feel like vacuuming at 5 a.m. but jumping off a bridge an hour later. Steroids such as Prednisone at doses of at least 20 mg per day can keep you awake for hours on end. One way to try to counteract that side effect is to ask your doctor how soon you will be able to split the daily dose between morning and evening and still get an effective therapeutic result. In the meantime, if you're home when you become drowsy during the day, consider even a 15-minute nap to recharge.

Meals: Your angry gut might rumble and awaken you many times during the night if you eat a late dinner or supper. The digestive tract works most efficiently in the morning, so one tactic is eating larger meals during daylight. Many Crohn's patients never eat solid food after 8 p.m. to avoid the problem. The exception occurs when a patient who awakens frequently to nausea during the night finds it disappears after eating a few bites of a cracker or a piece of bread.

Reflux: Gastric reflux is a common problem among Crohn's patients. It increases when there's a partial obstruction or narrowing of the small intestine, causing food to back up in the esophagus. If you're experiencing a lot of burping or belching, mention it to your doctor so that you can be evaluated for reflux. Both prescription and over-the-counter medications can work wonders.

Diarrhea: It's at its worst during a flare of after surgery resulting in a shortened small bowel. It deprives patients of sleep by causing them to repeatedly get up and stumble toward the bathroom. Accidents resulting in a shower and a change of clothes are also common during the night. Minimize your treks to the powder room by avoiding eating right before bedtime and by taking an anti-diarrhea medicine such as Imodium before you retire. Make it a point to go to the bathroom before you actually crawl into bed. It's also a good idea to keep a spare set of linens and bedclothes within arm's reach.

Sleep apnea: It's easy to blame all wakefulness on suffering from Crohn's disease. However, it's important to have a thorough evaluation by your internist or family doctor - not your gastroenterologist - to rule out sinus problems, allergies or symptoms of obstructive sleep apnea. If he or she suspects any of them, you should get a referral to a specialist in the discipline that treats the respective condition.

Worrying: For many Crohn's patients, bedtime is what if time. They wonder what will happen if the higher dose of their medication doesn't bring any improvement. They stew over what the boss will say when they have to take another day off for an endoscopic evaluation. They make themselves crazy worrying about the appeal they need to file with their health insurance company. Developing some basic meditation techniques can help diffuse the focus on worry. You can start with something as simple as visualizing your ideal place on earth and keeping the focus until the worries start to slip away.

Rest patterns: Sleep disturbances over time result in poor rest patterns. One way to break the pattern is to periodically change where in your home you sleep and the hours when you're between the sheets.

Crohn's disease is a condition in which the patient is deprived of a lot of control over life. Making small changes that result in any improvement in sleep deprivation is an important way of regaining some control.