post-op steroids and sleep

[RGG]

Hi all,

I'll be having AN surgery in the coming months, and have some concerns about post-op steroids and sleep.  My surgeon told me that I'll be on a high dose of steroids for the first two days, and they'll start tapering after that. 

I tried taking a dose of steroids about a year ago (50mg prednisone) when I had some sudden facial weakness (this was before my AN diagnosis), and I stopped after the first day because I couldn't sleep at all and had a lot of other physical symptoms like muscle aches and a racing heart.  I tend to have problems with insomnia at the best of times, and have suffered from panic attacks in the past, and taking prednisone felt terrible.

I'm worried now about how I'll survive taking steroids post-op, even if everything goes well with the surgery.  It sounds to me like Decadron is normally prescribed, and that it's stronger than prednisone.  Does anyone remember what kind of doses they were given?

My main worry is about not sleeping for multiple nights in a row and having panic attacks or going nuts  .  I know that the first night in ICU they keep you up all night, but afterwards, is it usually possible to get sleeping pills or xanax/valium for sleep?

Thanks for any input!

Rumen
 

 

[thebirdsanc]

I just had my surgery last week.  Decadron taper from 4mg 4 times daily to 1 mg 4x daily x 6 doses.  Tonight will be my last dosing.  It def messed with my sleep.  i slept maybe 4 hours each night, waking up in pain pretty much after every sleep cycle.  They also have me on valium 5mg every 6 hours and oxycodone 5-10mg every 4 hours, but they didnt help much at all TBH, especially at first.  I found myself taking more of the oxy than the valium just because I was scared about mixing benzos and opioids and found myself in a great deal of discomfort trying to find sleep positions at night.  My psych recommended doubling up on the valium, which still didnt help when I was on my 3mg doses, but I took 15mg of the valium across the day yesterday (last day of 2mg decadron dose) and slept more than I had all week, prob about 6.5 hours total.  This week def sucks for sleep, so I am hoping that next week will be better.  More than happy to answer any specific follow up questions you may have with personal experiences while they are fresh in my mind.

[caryawilson]

Sleep will be tough for the first week at least.  The steroids do NOT make this easier, and it will be tough to find a comfortable spot.  The pain drugs will help, but in my experience, I eliminated the pain drugs after four days.  Sleep for the next two weeks, would only occur in small 1-3 hour increments.  Few points to consider:
* bathroom trips.  By the time I would get to sleep, I would need to go to the bathroom
* medication.  Medication schedule would wake me at "inconvenient" times.  This was NOT easy for me and was also tough for my girlfriend.

Good luck.  Sleep will suck. However, it will get better, and it should be better than you anticipate.

[mroker]

I just had my surgery on the 8th and was taking Decadron. I stopped 3 days ago and last night was the first night I fell asleep without taking sleeping pills. I still woke up at 4, but went back to sleep eventually and slept a few more hours. I think it's finally getting out of my system but it sure wasn't fun coming off of them.

[Gr8fulDad]

The steroids will definitely cause havoc on your sleep.

I had retrosigmoid 6 months ago and I remember my problems sleeping very vividly.  They actually kept me out, intubated and on propofol for about 15 hours after my surgery because I had fluid in my lungs.  The steroids caused me to come through the propofol and I was awake in a drugged out state. I was very agitated because I could see what was going on, I had a breathing tube down my throat and couldn't talk and my arms were in restraints because I was trying to pull the breathing tube out.  They gave me as much propofol as any human being can take and I was still coming through.

Until the steroids were fully tapered off, I definitely understood how sleep deprivation is used as a form of torture.  In the first week or two, I got about 3 hours of sleep a night.  My left side was all bruised from being in the park bench position for almost 14 hours.  I couldn't lie on my right because of the incision.  Lying on my back or stomach was painful because of my neck.  I used to sleep one hour on my left side.  I would then wake up and sleep for about an hour on my back.  I then went and sat in a rocking chair with an ice pack behind my neck and  sometimes I slept for another hour.

You just need to be patient.  I tried a sleeping pill a couple times and it worked, but I hated the groggy feeling I had when I woke up in the middle of the night.  Sleep will come again when the steroids are tapered off.  The light at the end of the tunnel is that the first night of real sleep you get will be the greatest feeling ever!!