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Sleep is extremely important to your health and wellbeing, but some people who have stomas feel anxious about sleeping, or find that problems with their stoma (such as leaks) disrupt their slumber.
While you are asleep, your body is busy restoring and repairing, which promotes better physical and mental performance and improves mood. Not getting enough sleep can affect your concentration, how you feel and your energy levels.
Everyone has a night-time routine, but those with a stoma may benefit from adding a few extra steps before settling down to ensure a good night’s sleep.
Always change or empty your bag before going to sleep. If your bag overfills at night you are at risk of a leak. Going to bed with an empty bag can reduce anxiety about leaks and significantly improve the quality of your sleep.
It sounds obvious, but check and double check that your bag is secure before you go to sleep. When you put the bag on, make sure your skin is completely dry. Avoid using creams on the skin that could interfere with adhesion. Ensure the hole for your stoma is the right size and fits snugly around your stoma. If the hole is too large, it can cause leaks, affect adhesion, and harm the skin. If you have dips and creases that are causing leaks, there are products that you can use to level out uneven skin surfaces and ensure a good seal. Flange extenders may also help – especially if you have a hernia. Speak to your stoma care nurse for advice on ensuring that your bag is secure.
If you have a high output stoma, then a high output bag which has increased capacity, will reduce the number of times you need to get up in the night to empty your bag. Your stoma care nurse will be able to advise you on bags, and you can also order samples from different suppliers until you find the best night-time bag for you.
If you have a large meal before bed, this could increase your output overnight and disrupt your sleep. You could choose to have your main meal at lunch time and a smaller evening meal a few hours before bed or have your dinner earlier. Experiment and find out what works best for you.
Avoiding foods that produce wind can help to prevent ballooning (where your bag fills with gas)– see our Ballooning guide.
If your stoma is still very active, you could speak to your stoma care nurse about over the counter treatments which could slow your output down over night. If your output is very liquid, you could consider output thickeners.
The best position to sleep in when you have a stoma is on your back, or on your side. If you prefer to sleep on your stomach, this will be fine at the beginning of the night but increases the chances of leaks as the night progresses and your bag fills. To overcome this, you can modify your sleeping position by bending the leg on the side with your stoma. This creates some space underneath your abdomen that allows the bag to fill.
Sleeping on either side of your body is fine. On the side with your stoma, your mattress will support the bag as it fills. If you sleep on the other side, you can lay next to a pillow to support the weight of your bag.
If you are worried that you will not stay on your side during the night, use a pillow/body pillow/V-shaped pillow to keep your body in place.
Try not to allow your bag to get too full in the night before emptying. In the early days after your surgery, it may help to set an alarm or two during the night to prompt you to get up and empty your bag.
Accept that leaks will happen and be prepared
• Keep a change of pyjamas, stoma supplies and spare bed sheets on hand. This will make it easier to deal with a leak in the middle of the night.
• Sleep on top of an incontinence sheet, puppy pad or dark towel. (Some people fold a puppy training pad and tuck it between their pants, ensuring that it covers the stoma bag – if you do have a leak, it then goes onto the pad, rather than your clothes.)
• Use a waterproof mattress cover.
• Dark fitted sheets and patterned duvet covers can help to disguise stains caused by bag leaks so that you don’t have to throw your bedding away.
You may find that you are struggling to sleep and it has nothing to do with your stoma management. Good sleep hygiene can help:
• Sleep at regular times – routine helps to get a good night’s sleep.
• Make sure you wind down properly before bed. This could be achieved with a warm (not hot) bath, or by writing “to do” lists for the next day. This can organise your thoughts and clear your mind of any distractions. Avoid using smartphones, tablets or other electronic devices for an hour or so before you go to bed as the light from the screen on these devices can have a negative effect on sleep.
• Make your bedroom sleep friendly. This means creating a relaxing environment. Your bedroom ideally needs to be dark, quiet, tidy and be kept at a temperature of between 18C and 24C.
Check out the NHS’s full guidance on getting a good night’s sleep.
Everybody is different, and the key is finding a routine that works for you. If you are struggling to sleep, speak to your stoma nurse or call our Stoma Helpline on 0800 328 4257