It's never too late to Sleep Straight
What is Night Positioning?
Night positioning is the term used to describe any action or equipment used to place our bodies in comfortable, non-damaging positions while in bed. So, far from being something new or strange to us, we all use some form of night positioning; be that a simple mattress or a combination of pillows to support our bodies.
Some of us require more support in lying in order to maintain a comfortable, adaptive position depending on our physical condition. Our physical condition can be affected by medical conditions, age, and our general health. In the absence of any condition which affects our muscles and joints we can, and usually do, change position frequently while we sleep. However, if we have a muscle co-ordination or control problem, or loss of sensation we may not move as much in sleep and we may also get in to positions which result in fixed changes to our shape.
Night-positioning equipment
In the past twenty years or so there has been an increasing number of companies manufacturing night positioning equipment. The complexity of the sleep system required appears to vary according to the needs of the person requiring the system. Many parents will be working with their child’s physiotherapist and / or occupational therapist using rolled-up towels and pillows to provide support for night positioning. As a child grows they may require firmer support which can be difficult to obtain using soft rolls and pillows so it may be necessary to consider purchasing a system specifically designed for night positioning. The child’s parents and therapist can work together to identify the product which best meets the child’s needs and also source the necessary equipment.
Night Positioning and Adults
If a person requires special seating in order to be able to sit comfortably, the same is often true for lying. The assumption, therefore, is that if adaptive positioning can be achieved in lying while in bed this should have a positive impact on the person’s sitting ability. For this reason, Enable Ireland's adult service users have access to the expertise of SeatTech staff.
24 Hour Postural Management Awareness Training with Parents
As parents are their child’s primary carers it is pointless trying to establish a 24 hour postural management programme if parents do not have a good understanding of postural care. It is an approach which depends absolutely on good team work and communication between the therapists and the family. Over the last few years, staff working in Sandymount Children’s Services have piloted and offered training in this approach to parents of children attending Sandymount School.
John and Liz Goldsmith who developed the 'Symmetrisleep System' have, as a result of their experiences, developed a care pathway and accredited training packages for parents and clinicians. Many clinicians in Sandymount have completed the training in the past and were aware of the standard and ethos of their work and were therefore keen to have this training made available to parents.
In February 2011, two Awareness Training days for parents were held: one for parents of older children attending the Enable Ireland Sandymount School and one for parents of younger children attending the Early Services and Preschool.
The awareness training outlined the current thinking about the causes of body shape distortion, use of therapeutic positioning at night and pain profiling and covered the following topics:
- How and Why Does the Body Change Shape – Can we Protect it?
- The Family Project
- Pain Profiling and Thermal Comfort
- Working in Partnership to Protect Body Shape
- Practical positioning techniques
The feedback from the parents who attended this awareness training was very positive but more importantly, the practical response of families in leading the development of postural care plans for their children, has been phenomenal.
This is a really positive development for all staff and carers working with the children in Sandymount. In planting the seeds of good positioning from an early age we are hopeful that the children will realise the benefits of this approach as they grow and develop into adulthood.
Integrating Training into Real Life: A parent’s perspective on night-positioning
Linda Brien is the mother of a young man, Conor, who attends the Enable Ireland Sandymount School. Linda and her husband attended training courses offered by the service.
Linda explained that as a result of the training they look at managing Conor’s posture in a different light. "I felt the course was brilliant and that the knowledge we gained was excellent. Everything was explained in a simple, practical way which helped us to understand the importance of getting Conor’s posture right at night time. The more information you have about your child’s condition the better and information about how to prevent problems that may occur as they grow is so important."
When asked what they found the most challenging aspect of a 24 hour management approach Linda replied “Sleepless nights”. When they first began to use this approach they tried to correct Conor’s lying posture all at once which led to many sleepless nights for all of them. Now, the Brien's have accepted that the objective is a long term one and that it is all right to correct things in small increments. "This approach is less distressing for Conor and therefore easier for us too. That's important because if your child is distressed and cannot sleep you're more inclined not to continue with the approach. It has to work within the family"
When they began using a sleep system Conor used to sleep on his side so he did not like sleeping on his back as he was not able to move as much. He has become accustomed to this now and the family bring elements of their sleep system everywhere with them now and improvise when abroad using rolled up blankets and tape when necessary to achieve the comfortable and beneficial lying position for Conor. When asked however Conor still maintains he does not like it!
The Future: Sleeping well & living well
The development of night positioning as a way to maintain and improve posture and function is in it’s infancy. Staff at Sandymount Children’s Services and SeatTech believe that there is benefit to be gained for young children by promoting good lying position from an early age.
Achieving a good sleep position can be a frustrating and tiring task for both parents and children. Recognising that parents are the people who are most likely to have to implement and manage night-positioning for their children, Sandymount Children’s Services are committed to offering training to parents in this approach.
They plan to be in a position to train parents and staff in the near future who, in turn, will provide training to parents, children and adult service users about night positioning and 24 hour postural management in an inspiring and empathetic way.
