Sleeping and ALS

Copyright ALSA Oregon and Southwest Washington Chapter

As ALS progresses, sleeping becomes more of an issue. As the patient becomes unable to turn or move, sleeping comfortably in one position for extended periods becomes more challenging and the possibility of pressure sores becomes more likely. As respiratory weakness progresses, proper positioning to make breathing easier also becomes more important. Luckily, adaptive equipment is available which should enable the patient to comfortably sleep even in the advanced stages of ALS.

Hospital Beds

A hospital bed can make a big difference in comfort for ALS patients. These beds have adjustments for raising and lowering both the head and the foot sections. Sleeping with the head raised 10-40 degrees allows for easier breathing. Sleeping with the legs raised slightly will help reduce the common problem of swollen feet. There are three types of hospital beds: manual, semi-automatic, and fully automatic. A semi-automatic model with electrical controls to raise and lower the head and the foot sections is the most appropriate type for an ALS patient. A fully automatic bed which will also raise and lower the entire bed to facilitate transfers and aid caregivers is nice but not necessary. Hospital beds should be ordered with half linked side rails that can be raised or lowered as desired. These give the patient something to grab when transferring and turning or repositioning. Insurance companies will usually cover the cost of a semi-automatic hospital bed. In most cases, the beds are provided on a rental basis.

Mattresses

As PALS become weaker and unable to turn in bed by themselves, a low air loss mattress or alternating pressure mattress becomes essential. Laying in the same position all night long on a conventional mattress is not only very uncomfortable, but can also lead to painful pressure sores. The only way to minimize this discomfort is to have someone reposition the PALS several times a night or use one of these special mattresses. The alternating pressure mattress is a special air mattress which has many cells which alternately inflate and deflate slightly. This prevents too much pressure building up in any area of the body. An even better option is the low air loss mattress made by companies such as Sunrise Medical and Kinetic Concepts (KCI). This is a high-tech air mattress made of a material that allows air to seep out slowly. An electric pump keeps the mattress inflated. The constant slow air loss keeps the skin from sweating and prevents pressure points. Both the alternating pressure mattress and especially the low air loss mattress are expensive but insurance companies will often provide them for ALS patients. This is because the cost of treating skin breakdown as a result of pressure sores is even more expensive for the insurance companies.

Posted by Editor at April 3, 2004 01:07 PM

To post comments and questions send an email to the Editor who will publish them for you. Be sure to reference the title and date of the article on which you would like to comment. Thanks!