Time and again members complain about not being able to sleep and after a while, that it gets to making them feel frustrated, despairing, depressed and even ill. I thought perhaps a short treatise on the reasons for disturbance of sleep patterns was long overdue. It won't help you to sleep but it might help you to understand why it is happening and, if you are still on the wrong side of your surgery, to be prepared for this more unpleasant side effect of major surgery. Humans have biological rhythms, known as circadian rhythms. These are important in determining the sleeping and feeding patterns of all animals, including human beings. There are clear patterns of brain wave activity, hormone production, cell regeneration and other biological activities linked to this daily cycle. Numerous issues and events can disrupt this pattern and in the case of major surgery, they are as follows: pre-op ~ the stress and anxiety in the run up to the surgery ~ the degree of pain and disability being experienced ~ the amount and type of pain meds being taken and the period of time over which they a were taken post-op ~ the stress and anxiety of the surgery itself ~ the drugs administered for the purpose of the anaesthetic ~ the inherent fear of submitting ones life and safety into the care of total strangers ~ the assault of the surgery ~ the hypothermia or low body temperature experienced during surgery ~ hypovolaemia or fluid loss incurred during surgery - this will be evaporation from skin and exposed tissue as well and blood loss and the reason why all surgery patients have an IV ~ being unconscious and then sedated for most of the day ~ being in a strange environment ~ being amongst strangers, staff and other patients ~ loss of appetite ~ unfamiliar food ~ unfamiliar daily routine ~ more drugs ~ constipation ~ disturbances during the night in hospital ~ being estranged from family and familiar surroundings and routine back home ~ loss of the reassuring presence of hospital environment and staff ~ a sense of vulnerability like 'what if' and 'just suppose ... ' ~ fear of being able to manage pain adequately ~ inability to assume normal patterns like sleeping positions and places ~ loss of appetite ~ constipation ~ frustration at being dependent on others for the simplest things ~ frustration at not being able to resume normal activities quickly enough All of these things contribute to the dreaded sleep deprivation. You may not have all of them but chances are, you will have at least half of them and quite enough to ensure that you join the ranks of 'night walkers' who despair of ever getting a good night's sleep again. But have faith! You will sleep normally again, it just takes time for all those intrusions to fade into the background and become even less than a faint memory! It takes time - some people adjust more quickly than others but all of us will get back to normal eventually. here are some tips on coping with disturbed sleep patterns ~ the main trick is to not let it get to you. There is a jokey saying "It's mind over matter - if you don't mind, it won't matter"! I know that sounds trite but it's also very true. ~ be prepared for this and determine that you are NOT going to let it get to you ~ give yourself permission to nap anytime and anywhere you feel you can ~ plan for wakeful nights by having some things to do: read, play games, watch tv, watch a movie, post on BoneSmart and finally, use the BoneSmart Games Room, that's what it's there for!