TKR Lindajill - Sleeping problem

lindajill

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I am four weeks post surgery. My lack of sleep is really affecting and my nerves. I'm off pain medications, tried taking 5mg of melatonin, and some nights still am awake at 4 am. I have suffered from depression for over 20 years, but that is under control with medication. Help, I need tips for getting to sleep.
 
Hello @lindajill - and :welome: to BoneSmart.

I have moved your post from where you placed it and started a recovery thread specially for you. That way, we'll be able to discuss your concerns and advise you, without taking the other thread off topic.

I'm afraid thta sleep disturbance is a very common thing during recovery from a knee replacement. There's an article about it in the reading I'll give you soon.

Try not to get too concerned about not sleeping for a full night. As time passes, your sleep pattern wil limprove. Until that happens, make up for lack of night-time sleep by taking daytime naps.
Don't try to stay awake during the daytime, thinking thta you'll sleep better at night. That just doesn't seem to happen.
If you can't sleep, get up, try a different place to rest, watch mindless TV - do anything except lying in bed watching the clock.

Sleep where you can, when you can, and how you can. Things will improve, but it may take a while yet.

Here is the recovery reading I promised you:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
Sleep when and where you can. It doesn't matter if it's daytime or nighttime, sleep is sleep. Some people find Benedryl helps or Tylenol PM. I suffered from lack of sleep for months and just took lots of naps. Maybe your PCP will give you some sleeping meds for temporary use to get you through this.
 
Another OTC is Unisom, and I've found a half a tab works very well. I take a prescription drug for sleep, it's a low dose of a tricyclic (Doxepin), very safe and well tolerated. I bet you just need a little help to break the cycle, and agree that seeing your PCP is a good idea.
 
I find reading is the best thing to clear my mind. I read until my eyes start dropping, sometimes even fall asleep with my book or kindle in my hand. Someone else I know uses audio bedtime stories and says she never gets to the end. There are also apps to help. Is it because of discomfort that you can't fall asleep or because your mind is too active? It seems we all have trouble sleeping after this op. I don't have trouble going to sleep initially, but once I'vevwoken I can't always go back to sleep. I try not to worry about it even if I only manage a couple of hours. I figure at least I'm in bed resting and either read or do something on the iPad. Failing all that, have a word with your GP and maybe they can prescribe something to help.
 
@lindajill
As others have said lack of sleep is very common after these ops. I think it's a combination of meds, trying to sleep in a different position, pain/being uncomfortable.
When I left hospital the first time a friend bought me an adult colouring books with pencils thinking I could while away my time during the day but in fact I found it most useful at night. When I couldn't sleep I would get up and sit at the table colouring until my eyelids drooped.
 
It took me about 6 weeks to get onto a normal sleep schedule. I just counted on taking naps. I think once you start reducing/going off the pain meds the sleep naturally gets better. Hang in there!
 
I'm at 4 weeks post-op tomorrow and still can't get a decent night's sleep, all I take for pain is tramadol (2 every 6 hours) and before I go to sleep at night I will take two tabs of (generic) Tylenol PM. Not sure if that does anything to help. For some reason I find it easier to sleep during the day so I try to take naps.
 
@lindajill I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
I'm 6 days post op and sleeping great thanks to taking an Ambien every night at bedtime. works like a charm!
 
I can certainly relate to that, but I've read that sleeping is problematic.

Pre-op, I used to nap very easily. Now, I cannot nap. Night time is difficult, because I wake up, because I'm uncomfortable. I can't seem to get a comfy position no matter what I try.

I'm trying to think that this too shall pass. Last night was terrible. I woke up a couple of times screaming. I never scream. I have never screamed post-op. I have found practicing the LaMaze training I learned for childbirth works like a charm.

As my life has little going on, and I'm not stressed out about anything, I can manage the sleep deprivation a bit better.

Don't worry. This too shall pass.
 
Help, I need tips for getting to sleep.
Linda, quite often sleep problems are related to under-medicated pain which is why I would like you to let me ask you some questions so I can help you.
 

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