Concerned About Having A Night Terror Post-surgery. Any Ideas?

[barefoot]

I have a practical concern about an orthopaedic surgery I'm having in a few weeks.

I have night terrors. Sometimes two or three in a week, other times I can go months without one. So, it's inconsistent and unpredictable.

I had one last week having not had one for a few weeks. The next day, my partner asked what would happen if I had one post-surgery. I'm not sure what, if anything, I can do to safeguard against it...?

There are some general practical sleep hygiene things e.g. if I get too hot in bed, it seems to make a night terror more likely. So, I can be extra mindful of things like that. I can do whatever I can to manage my stress/anxiety levels around the surgery, which might fend it off. But I'm not sure what else I can do that might help?

I have to avoid putting any weight on that leg for at least the first two weeks after the op and have to use crutches during that time. If I have a night terror, it's very possible that I will sprint out of the bed and start running (or fall over!) without knowing what I'm doing. I'm worried that, if that happens 1) I could hurt myself (probably not a huge deal - the pain will probably wake me up and I'll feel pain in the short term but I can take a pain killer and then eventually go back to sleep) and, more importantly, 2) I could do some damage.

My partner is usually pretty good at nipping my night terrors in the bud and keeping me in bed but sometimes I am super-speedy and I'm out the bed and running before she knows what's happening. Also, I'm not sure that we will be sleeping in the same bed when I first get out of hospital - we think we might both sleep better if we're in separate beds so that I have more room to try to get comfortable. She did jokingly suggest that we could strap me to the bed...I don't think that's a good idea! ;-)

Have any of you come up against this and, if so, how did you approach it? Any thoughts or ideas that might help or is it just a case of crossing my fingers and hoping for the best?

Thanks!

 

[Fadeaway]

I would explain the situation to the surgeon. Tell him that you are afraid of re-injuring your leg and ask if prazosin or extra sedation would be possible during this time. I think the big concern isn't pain but causing damage that would interfere with healing from the surgery.

 

[user27357]

practice a wake-up regimen.

I habitually have a radio going at night. The first thing I do when I wake up- everyday- is listen to the radio. The planet is still spinning.
Then I concentrate on feelings like warm, cold, comfortable, hungry etc. I am alive, in bed.
Then I open my eyes and look at my wife or my alarm clock, depending on wich side I am sleeping on. I am aware of time and place.

It's like muscle memory. If you practice it, try to remember to do it every morning, every wake up, eventually it becomes the act you do when woke up, without seeming like an act. kind of like a soldier springing to muster or a firefighter jumping into boots and turnouts from a dead sleep, not a natural act but almost unstoppable once learned.

It helps. I still find myself standing in the hall sweating or trying to climb out a window or up a wall from time to time, but I get grounded faster and most times I am aware of my surroundings and my situation before I even get out of bed.

I can relate to the post op terrors, personally I have major trouble after strong opiate medication and in your spot I would be concerned as well. I have also voiced these fears and asked for advice and gotten back "pray" or just plain "pain will stop you, thats what it is for". I hope I have been a bit more helpful.

 

[barefoot]

Yes @Fadeaway - it's definitely the prospect of causing some damage rather than potentially experiencing some short term pain that I'm concerned about. Stupidly, it hadn't crossed my mind to mention this to my consultant! But you're right - they may be able to give me some kind of sedative to take at home, which may prevent me leaping into action in my sleep!

That may also help with another thing that's been on my mind too. The pain medication the surgeon generally recommends is Tramadol, which I find is a really, really effective pain killer but I experience a few side effects with it (it makes me hot and itchy and can make me very wired so, if I don't fall asleep soon after I take it, I tend to be awake and on high alert for hours, unable to sleep) I did briefly mention this to him and I was thinking that maybe I should just go with Tramadol as it works pain-wise and I'll just have to suck up being hot, itchy and losing sleep for a while. But if he could prescribe some kind of sedative as well, that might help with both the night terror situation and it may help counter getting hyper on Tramadol?!

Thank you!

 

[Jadie Rose]

Hi Barefoot, I've had four musculoskeletal surgeries just in the past year and a half and Ativan works great for staying asleep for me. Just thought I would share what my surgeons use for me (even after major surgeries, I CANNOT sleep in the hospital without it).

 

[barefoot]

Thanks @enough

Your post has reminded me that I've had some weird sleep experiences after some pain medications too. As well as Tramadol, which tends to keep me awake and feeling wired most of the night, there was another pain killer I took sporadically years ago, which I almost always had a night terror or intense night time hallucination with when I took it.

So...yes...I think it probably is worth me mentioning to the consultant!

I'm a bit confused about your suggestion to practise a wake up regime, so I'm not sure if I am misunderstanding. I can see how having that kind of routine could help me to ground more quickly/feel less disorientated etc if I wake up during a nightmare, night terror, sleep walking episode etc. But usually when I have a night terror, I don't wake up, I have no conscious awareness of what I'm doing and I'll then just lay down and return to "normal" sleep again and have no recollection of it happening the next day. So I'm not sure how the wake up regime and trying to reduce occurrences of night terrors connect? Sorry if I'm misunderstanding what you're saying!

 

[Jadie Rose]

When you've been up all night, four nights in a row, and your highlight of the day is saying good morning to the sun each morning ;-p

 

[barefoot]

Thanks @Jadie Rose - that's helpful to know.

Ok, so it looks like getting some kind of sedative from the hospital to help me stay asleep and stay in bed might be a good way forward.

 

[Jadie Rose]

Sorry, that post above was a mistake LOL. Wrong thread :D

 

[barefoot]

It still sort of made sense in the context of this one though! :-)

 

[Jadie Rose]

LOLOL..at least I made you smile :p

 

[user27357]

@barefoot
My wake up is just a habit I have developed that helps me get from sleep to safety with a kind of trail to follow, a rut I fall into easily and hopefully subconsciously. My terrors have been almost life-long, but I have some recurring thought/feeling kind of dreams that I used to wake up violently from and now just find myself listening to my quietly playing radio almost not even remembering that I just had another occurence of an old nightmare.

My worst hospital terrors happened with a week long epidural of Dilaudid. I woke up several times to the sound of a voice telling me to keep a civil toungue and hands holding me down from all sides. Horrible, but once awake, I did find myself calmly taking stock of my feelings and aware of my surroundings and pretty quickly able to convince everyone that the beast was calm now (I am a pretty big guy). Thats when they told me to pray-Hah!