Getting a good night’s sleep is important all of the time, as we know from our work with people with brain injury, but some people have seen their sleep pattern alter during the pandemic.
This change to the normal time people go to bed and fall asleep and/or wake up in the night, may be due to several factors, including changes to the way the person spends their day in terms of education, work, meeting up with family and friends, seeing support workers and / or attending rehabilitation sessions. Also they are perhaps exercising, playing sport or doing other activities less.
Lower mood, such as feeling sad, having worries or feelings of uncertainty, can also impact on your ability to get to and stay asleep.
Changes to our sleeping habits can lead to a poor sleep-wake cycle, otherwise known as our body clock. Not getting enough sleep, or good quality sleep, can cause fatigue and tiredness throughout the day. You might feel unwell as a result, and this can increase anxiety and worries further, making getting through the day more difficult. It might also mean that relaxing to sleep becomes harder, and a vicious downward spiral can follow.
Fortunately, there are some very simple things we can all do to support a good night’s sleep. These include going to bed and getting up at the same time each day to support your body clock, exercising during the day if you can safely do so and trying not to exercise too close to bedtime. Avoiding caffeine or nicotine close to bedtime – or reducing them if you can’t stop completely – can also help.
Be aware that alcohol might mean that you fall asleep faster, but it can disrupt the second stage of sleep, meaning that the quality of your sleep may be reduced, which can then lead to you feeling tired the next day.
It’s generally best to avoid things that may cause you upset or stress before your usual bedtime, like a difficult phone call or a scary TV programme. It is also important to reduce your exposure to blue light, for example from smartphones and laptops, before bedtime.
Blue light tricks your brain’s body clock into thinking it’s daytime and suppresses the production of melatonin. This is the hormone you need to feel sleepy.
Try to have a bedtime routine that supports you in winding down, whether that means a bath, listening to music or a relaxation CD. It’s also really important to ensure that your bedroom supports your sleep, so consider things such as lighting and temperature. Most people tend to find that a tidy bedroom can help the room feel more relaxing too.
Of course, many people with an acquired brain injury tend to experience fatigue and often find having a nap in the day can help them to manage this. But an afternoon nap should end before half past three in the afternoon at the latest, with your next sleep being in bed for the night. Headway has a very helpful section on its website regarding managing fatigue.
While bedrooms should predominantly be for sleeping, some people have been spending more time in them during the pandemic doing other things – perhaps using them as a quiet space to complete education or work.
For those in hospitals or care homes, increased bedroom time may be due to isolation procedures. If this is the case, perhaps consider having a chair or a beanbag to sit on, rather than lying on your bed during the day. Where possible, try to come out of your room for meals.
If you find it is taking a long time to get to sleep, try getting out of bed and doing something else, like reading a book or a magazine, and then return to bed when you are feeling sleepy.
The advice we have given here is in line with the recommendations on the NHS website.
A good night’s sleep is crucial to thinking at our best, which is especially important if you are working or being educated at home; and there are some other simple things that you can do to boost your productivity in these scenarios.
Firstly, make sure you have a shower and get dressed rather than working in pyjamas or dressing down. Getting dressed helps you to psychologically get into work mode. Have a designated workspace and, if possible, keep the area tidy.
Have a timetable of when you’re going to work and try to stick to it. As we’ve mentioned, writing a timetable down and ticking off jobs completed supports feelings of achievement. Make sure you schedule regular breaks during which you move away from the workspace. You might go into your garden or make a drink, for example.
Try to minimise distractions. That might mean moving your mobile phone out of reach, turning off the TV and considering where the quietest places are. If you live with other people, you might want to consider how to ensure they don’t disturb you. This might just mean letting them know what your work timetable is.
One distraction that can’t be ignored, however, is the need to wash our hands to prevent the spread of the virus.
We hope you have found this guide useful and wish you a safe and happy summer as we all continue to rise to the challenges presented by COVID-19.
This is one of five blogs in a series on living in the new ‘normal’ with a brain injury, based on a webinar produced for ABI London (ABIL). See below for links to other articles in the series. Dr Keith G Jenkins is consultant clinical neuropsychologist at St Andrew’s Healthcare and chair of Headway East Northants. Dr Jenny Brooks is a consultant clinical psychologist working independently and a director of The ABI Team. For any questions about this topic email email@example.com.
Non-invasive technique ‘could replace need for brain surgery’
The new PING approach could help treat some of the most challenging and complex neurological diseases
A new non-invasive technique has been developed to remove faulty brain circuits that could allow medics to treat debilitating neurological diseases without the need for conventional brain surgery.
If successfully translated into operating theatres, the breakthrough has been hailed as potentially revolutionary in the treatment of some of the most challenging and complex neurological diseases, including epilepsy, movement disorders and others.
The PING approach, developed by the University of Virginia and Stanford University, uses low intensity focused ultrasound waves combined with micro-bubbles to briefly penetrate the brain’s natural defences and allow the targeted delivery of a neurotoxin.
This neurotoxin kills the culprit brain cells while sparing other healthy cells and preserving the surrounding brain architecture.
“This novel surgical strategy has the potential to supplant existing neurosurgical procedures used for the treatment of neurological disorders that don’t respond to medication,” said researcher Dr Kevin S. Lee, of UVA’s departments of neuroscience and neurosurgery and the Center for Brain Immunology and Glia (BIG).
“This unique approach eliminates the diseased brain cells, spares adjacent healthy cells and achieves these outcomes without even having to cut into the scalp.”
PING has already demonstrated exciting potential in laboratory studies. For instance, one of the promising applications for PING could be for the surgical treatment of epilepsies that do not respond to medication.
Around a third of patients with epilepsy do not respond to anti-seizure drugs, and surgery can reduce or eliminate seizures for some of them.
Dr Lee and his team, along with their collaborators at Stanford, have shown that PING can reduce or eliminate seizures in two research models of epilepsy.
The findings raise the possibility of treating epilepsy in a carefully-targeted and non-invasive manner without the need for traditional brain surgery.
Another important potential advantage of PING is that it could encourage the surgical treatment of appropriate patients with epilepsy who are reluctant to undergo conventional invasive or ablative surgery.
A key advantage of the approach is its incredible precision. PING harnesses the power of magnetic-resonance imaging (MRI) to let scientists peer inside the skull so that they can precisely guide sound waves to open the body’s natural blood-brain barrier exactly where needed.
“If this strategy translates to the clinic,” the researchers write in their new paper, “the noninvasive nature and specificity of the procedure could positively influence both physician referrals for and patient confidence in surgery for medically intractable neurological disorders.”
“Our hope is that the PING strategy will become a key element in the next generation of very precise, noninvasive, neurosurgical approaches to treat major neurological disorders,” said Dr Lee, who is part of the UVA Brain Institute.
QEF’s accessible technology wins international awards
The new Care and Rehabilitation Centre in Surrey, developed by Queen Elizabeth’s Foundation for Disabled People (QEF), has won 2 international CEDIA awards for its innovative use of accessible technology, which was supplied by technology solutions partner Imperium Building Systems Ltd.
These awards recognise the improvement technology can make to the lives of disabled people, which is reflected at a UN event that forms part of this year’s International Day for People with Disabilities. The global UN awareness day today (December 3) highlights the challenges and discrimination disabled people face around the world, and pushes for positive change towards greater inclusion, accessibility and equality for disabled people.
This year on December 3, the UN is co-hosting an event specifically looking at ‘Reducing Inequalities through Technologies’ noting that: ‘persons with physical, sensory, cognitive/learning or invisible disabilities represent nearly 15 per cent of the world population’ 1 and that ‘for some kinds of disabilities, assistive devices/technologies are key “equalizers” that promote inclusion and full participation in all industries and dimensions of life’. 1
The event also highlights that ‘One billion persons with some form of disability can benefit from assistive technologies that can facilitate their social, economic and political engagement, including their participation in decision-making processes that affect their lives and ambitions’ 1
QEF’s Care and Rehabilitation Centre provides neuro rehabilitation for people after an acquired brain injury, stroke, incomplete spinal injury or other neurological condition and clients are supported by expert staff to relearn core skills, so they can rebuild their lives and be as independent as possible.
QEF’s vision for the new Care and Rehabilitation Centre was to use technology to give each person greater control over their personal space, no matter what a person’s impairment may be. It’s easy to take for granted being able to close the blinds when the sun is in your eyes or turn the lights off when you want to go to sleep – until you can’t do it for yourself. QEF wanted a system that empowered clients to have a greater sense of self-determination and influence over everyday activities during their rehabilitation.
Imperium developed the project with QEF, producing a cost-effective ‘smart home’ solution, using easily available technology that is adaptable to each persons’ specific requirements. Five connected smart devices have been installed in each bedroom which can be controlled in different ways; either with standard voice commands, pre-programmed accessible switches or programmable text to talk commands.
Ann, a client at QEF’s Care and Rehabilitation Centre, says: “I wasn’t sure about it at first – it was odd to sit in my room on my own and talk to something, but now I use it all the time. You can have the blinds down, lights on or off or the TV on or off. It’s another step on the journey of independence, so I don’t have to ask someone to do it for me.”
Chris Thorne, director of Imperium, says: “The technology we have installed for QEF will allow service users to have control over the lights in their room, temperature, day light via shading blinds, and audio-visual equipment. So, someone could stay in one position and manage their entire room, either with switches or voice controls. It also needed to be technology that service users could easily access after they left the service; creating independence that could continue beyond QEF’s walls.”
The international CEDIA awards recognise technical excellence and product innovation in the home technology industry. Imperium’s project with QEF was announced in November 2021 as winners in the ‘Multi Dwelling Unit Design’ category and also went on to win the overall award for ‘Life Lived Best at Home’ which reflects the project that gives the best experience for a client.
Judges for the Life Lived Better at Home award said: “This entry is outstanding for its sensitive and pragmatic response to the brief and for the way the technology meets the changing needs of the users. And all this achieved on an extraordinarily tight budget. I hope there will be many more projects like this in the future!”
Karen Deacon, QEF’s chief executive, says: “Our new Care and Rehabilitation Centre gave us an opportunity to use technology in an innovative way that would directly benefit clients as they relearn core skills. Adapting to life after an acquired brain injury is challenging for anyone and if technology can help give someone back their sense of control over everyday activities then we wanted to be able to offer that as part of our neuro rehabilitation programme.”
- Reducing Inequalities Through Technologies: A Perspective on Disability Inclusive Development https://www.un.org/development/desa/disabilities/wp-content/uploads/sites/15/2021/11/IDPD2021ConceptNote.pdf
Webinar to explore the future of brain injury rehab
Join our panel of expert guests as we discuss the challenges and opportunities in improving patients’ lives
The future of brain injury rehabilitation and how patients can be supported in new ways is to be examined by leading experts from across the sector at an event held next week.
Brain injury rehab has made huge strides over the years, innovating and developing to better meet the needs of people living with life-changing injuries.
Through changes in technology, developments in medicine and the advances in neurorehabilitation, brain injury patients should face an outlook which is better than ever before.
However, the lack of resource within health services, exacerbated by the ongoing impact of COVID-19 and mounting pressures on the NHS, mean that progress and change is not being seen at the rate many would hope for.
In 2020, the British Society of Rehabilitation Medicine (BSRM) identified the increased pressure on neurorehabilitation, highlighting the “unquantifiable additional case-load of patients with post-Covid disability presenting with a wide range of problems due to cardio-pulmonary, musculoskeletal, neurological and psychological/ psychiatric complications of the disease.”
In an upcoming webinar – What does the future of brain injury rehabilitation look like? – to be held on Wednesday next week (December 8th) and organised by NRC Medical Experts in association with NR Times, this matter will be examined to assess the scale of the challenge, the opportunities that exist, and what more can be done to better support patients.
The panel will comprise:
- Dr Edmund Bonikowski, founder of NRC Medical Experts, who will chair the event
- John Davis, consulting principal lawyer at Slater + Gordon
- Catrin May, co-founder and director of Breakthrough Case Management.
- Ian Pearce, director of NeuroProactive
The live hour-long event, from 4.30pm to 5.30pm, will include a panel debate, with questions welcomed from the audience.
“Health and social care services have been under increasing pressure from an ageing population for decades and this has now been exacerbated by the disruption created by COVID-19,” says Edmund.
“Brain injury rehabilitation services have always been poorly resourced in the UK, and are now under increased strain while professionals are diverted into the acute management and rehabilitation of COVID-19 patients.
“It is essential therefore that we consider how to improve service delivery models so that people with brain injury do not fall further behind in the queue.
“Technological innovation in its many forms offers much potential here, but realising this will be a substantial undertaking for which we are as yet ill-prepared.
“During this webinar we will explore some of the major opportunities and problems.”
To attend the webinar, registration is required in advance. To sign up, visit here
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