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Sleep, Activity, and Health Behaviors in Young Adults with Spinal Cord Injury
Dr. Alicia January explains how a spinal cord injury might affect sleep, and if there are any ways to improve sleep behaviors in young adults with a spinal cord injury.
Featuring:
Alicia January, PhD
Alicia January is an assistant professor of psychology at Purdue University Northwest and a member of the scientific and medical staff at Shriners Hospitals for Children, Chicago. In both roles she is actively engaged in scholarly activities, including conducting research in applied psychology, specifically with a focus on multidisciplinary research in the area of assessment and pediatric rehabilitation outcomes. She has received funding from Shriners Hospitals for Children, NIH Loan Repayment Program, and The Craig H. Neilsen Foundation to conduct research evaluating the medical and psychological outcomes of children and adults with pediatric-onset SCI. Transcription:
Melanie Cole, MS (Host): Sleep problems that occur frequently in the general population an be even more common in individuals with spinal cord injury. Here to tell us about sleep, activity, and the health behaviors in young adults with spinal cord injury is my guest Dr. Alicia January. She’s a research psychologist at Shriner’s Hospitals for Children in Chicago. Ali, I'm so glad to have you with us today. What a great topic this is. Let’s start by setting the stage. How does spinal cord injury effect sleep and health behaviors, and what type of problems do you commonly see?
Alicia January PhD (Guest): With spinal cord injury—As you mentioned already, sleep issues are important for everyone even in the general population. But in spinal cord injury, there’re unique problems that can make individuals with SCI even more prone to sleep problems. Things like pain that individuals with spinal cord injury may make it difficult to fall asleep or to stay asleep for explain. There are other secondary conditions that can interfere with sleeping. Things like spasticity or needing to wake in the middle of the night to do your nighttime cathing routine, for example. There’s also hormones that can be a problem in spinal cord injury that can make it more difficult to fall asleep and stay asleep.
Host: Well, certainly I hear what you're saying, and these problems can be so pervasive and really effect the whole quality of life, which could already be so compromised with spinal cord injury. So tell us about your study that aims to investigate the sleep activity and health behaviors of these young adults compared to their peers?
Dr. January: Because we know that sleep is essential for good physical health and sleep is essential for good emotional and psychological health, what we wanted to do is we want to look at these sleep patterns in individuals with spinal cord injury compared to their peers without spinal cord injury to see if indeed they have more problems with sleep compared to their peers who do not have an injury. Then we want to have people paired up with a health coach to see if they can identify something that they could change to improve their physical health and wellbeing. That might be sleep. As I mentioned, that’s a focus of this study, but it could also be another element of physical activity, being involved in their community, for example. Other health behaviors that they might want to target for change in working with a health coach.
Host: So how are you conducting this study? Are they completing surveys? Are they wearing trackers? How are you conducting this study?
Dr. January: We are conducting this study by recruiting individuals with spinal cord injury and those without. We’re having them do a combination of exactly what you just mentioned. So they're gonna fill out surveys that are related to their own report of sleep as well activity behaviors. Then also, you mentioned a tracker. They're also going to wear a tracker that’s kind of like a Fitbit device, which I think most people are familiar with, but it’s much more sophisticated. So it gives us a better breakdown of when people are being physically active and how physically active they are as well when they're sleeping. So we’ll get a good sense of both their subjective or their self-reports of sleep as well as that objective measure of using the tracker.
Host: Well, what other health concerns do you feel are so important as far as activity, diet, other health behaviors? Do you feel that some of these are due to psychosocial aspects of the condition? Feelings of depression, anger, denial? Any of these kinds of things that can effect not only our health behaviors but certainly sleep.
Dr. January: It’s kind of a cycle, right. You mentioned emotional or psychosocial issues as well as physical health. Those two things are incredibly interrelated. If you are feeling depressed or anxious, you're less likely to engage in physical activity. You're more likely to have poor sleep. Then when you don’t engage in activity, you have poor sleep, you're more likely to have more health issues. So it can be really a cycle.
Host: So when we’re looking at those challenges, accessibility or engaging in physical activity and exercise, the expertise needed to help people exercise—You know, these young people really need somebody to be with them. Do you feel that this is one of those challenges that could limit those health behaviors?
Dr. January: Absolutely. That’s actually one of the things that we are looking at in the study is that we are asking people specifically to report back on some of the barriers to being more physically active in their life so that we can get a better understanding of that as well.
Host: Do you feel that a simple brief educational intervention such as this podcast can help improve health and sleep behaviors among young adults? What would you like them to know about being involved in this and about education. Not only for the young adults but for their families as well so they can get involved and it can be a family affair.
Dr. January: I think there’s two things. One, where I’d want them to know that we’re recruiting for this study of course. But two, I think it’s important to know that when we sleep, when we’re active and have enough energy to participate in the community, we feel better both emotionally and physically. So it’s really important that we’re doing all the things that we can to sleep well and be active and be as healthy as we can. That’s true as I mentioned before and as you mentioned. That’s true of everybody. But knowing that it can be a particular risk in spinal cord injury, it’s important to be aware of it.
Host: Well, it is. Have you noticed, Ali, that the age at injury, duration of the injury, has any of this impacted the information? As you're conducting this study, are there certain groups you're looking for that you would like them to get involved or is it just a general SCI population?
Dr. January: Well, we’re particularly interested in working with young adults for this current study, although I think it’s important to look at this across the age span. For various reasons, we’re really interested in young adults.
Host: So as we wrap up, what do you want us to learn about young adults with spinal cord injuries and how we can provide them with support to make healthy sleep, diet, and activity choices. Tell us about your team at Shriners.
Dr. January: One of the things that I want people to know is that we need to be alert for doing all the behaviors that we know are related to getting better sleep, having a regular sleep schedule, trying to avoid or to come up with a good night time routine to minimize disruptions, even if you might—as I mentioned, sometimes for our patients with SCI they might have to schedule a catheterization in the middle of the night. So how do you come up with a schedule to minimize that disruption to your sleep? So those are some things that I want people to be aware of. Just be aware of that sleep can be so common in spinal cord injury, but that there's tips and there's ways to improve sleep. That physical activity is also incredibly important. We don’t want people living sedentary lives, right, whether or not they have a spinal cord injury. So staying active, staying involved, getting good sleep, all related to good physical function, good emotional function. So I should, of course, mention the team here at Shriners. In this study specifically we have a wonderful team put together. I'm working with Kathy Zebracki, who’s a clinical psychologist here at the Chicago hospital who has a ton of experience working in outcomes, research with spinal cord injury and psychosocial wellbeing and spinal cord injury. Of course, Dr. Lawrence Vogel who is well known in the spinal cord injury, pediatric spinal cord injury world. Then our health coach, Trish Ryan, who’s going to be the one who’s going to be working with people and coming up with plans to address a health behavior to kind of improve their functioning.
Host: So well said. Thank you so much, Ali, for coming on with us today and sharing your expertise. What an interesting study. Please let us know how this turns out and come back on and join us again. That concludes this episode of Pediatric Specialty Care Spotlight with Shriners Hospital for Children in Chicago. Please visit our website at shrinerschicago.org for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Shriners Hospitals for Children Chicago podcasts. For more health tips and updates, please follow us on your social channels. Until next time, I'm Melanie Cole.
Melanie Cole, MS (Host): Sleep problems that occur frequently in the general population an be even more common in individuals with spinal cord injury. Here to tell us about sleep, activity, and the health behaviors in young adults with spinal cord injury is my guest Dr. Alicia January. She’s a research psychologist at Shriner’s Hospitals for Children in Chicago. Ali, I'm so glad to have you with us today. What a great topic this is. Let’s start by setting the stage. How does spinal cord injury effect sleep and health behaviors, and what type of problems do you commonly see?
Alicia January PhD (Guest): With spinal cord injury—As you mentioned already, sleep issues are important for everyone even in the general population. But in spinal cord injury, there’re unique problems that can make individuals with SCI even more prone to sleep problems. Things like pain that individuals with spinal cord injury may make it difficult to fall asleep or to stay asleep for explain. There are other secondary conditions that can interfere with sleeping. Things like spasticity or needing to wake in the middle of the night to do your nighttime cathing routine, for example. There’s also hormones that can be a problem in spinal cord injury that can make it more difficult to fall asleep and stay asleep.
Host: Well, certainly I hear what you're saying, and these problems can be so pervasive and really effect the whole quality of life, which could already be so compromised with spinal cord injury. So tell us about your study that aims to investigate the sleep activity and health behaviors of these young adults compared to their peers?
Dr. January: Because we know that sleep is essential for good physical health and sleep is essential for good emotional and psychological health, what we wanted to do is we want to look at these sleep patterns in individuals with spinal cord injury compared to their peers without spinal cord injury to see if indeed they have more problems with sleep compared to their peers who do not have an injury. Then we want to have people paired up with a health coach to see if they can identify something that they could change to improve their physical health and wellbeing. That might be sleep. As I mentioned, that’s a focus of this study, but it could also be another element of physical activity, being involved in their community, for example. Other health behaviors that they might want to target for change in working with a health coach.
Host: So how are you conducting this study? Are they completing surveys? Are they wearing trackers? How are you conducting this study?
Dr. January: We are conducting this study by recruiting individuals with spinal cord injury and those without. We’re having them do a combination of exactly what you just mentioned. So they're gonna fill out surveys that are related to their own report of sleep as well activity behaviors. Then also, you mentioned a tracker. They're also going to wear a tracker that’s kind of like a Fitbit device, which I think most people are familiar with, but it’s much more sophisticated. So it gives us a better breakdown of when people are being physically active and how physically active they are as well when they're sleeping. So we’ll get a good sense of both their subjective or their self-reports of sleep as well as that objective measure of using the tracker.
Host: Well, what other health concerns do you feel are so important as far as activity, diet, other health behaviors? Do you feel that some of these are due to psychosocial aspects of the condition? Feelings of depression, anger, denial? Any of these kinds of things that can effect not only our health behaviors but certainly sleep.
Dr. January: It’s kind of a cycle, right. You mentioned emotional or psychosocial issues as well as physical health. Those two things are incredibly interrelated. If you are feeling depressed or anxious, you're less likely to engage in physical activity. You're more likely to have poor sleep. Then when you don’t engage in activity, you have poor sleep, you're more likely to have more health issues. So it can be really a cycle.
Host: So when we’re looking at those challenges, accessibility or engaging in physical activity and exercise, the expertise needed to help people exercise—You know, these young people really need somebody to be with them. Do you feel that this is one of those challenges that could limit those health behaviors?
Dr. January: Absolutely. That’s actually one of the things that we are looking at in the study is that we are asking people specifically to report back on some of the barriers to being more physically active in their life so that we can get a better understanding of that as well.
Host: Do you feel that a simple brief educational intervention such as this podcast can help improve health and sleep behaviors among young adults? What would you like them to know about being involved in this and about education. Not only for the young adults but for their families as well so they can get involved and it can be a family affair.
Dr. January: I think there’s two things. One, where I’d want them to know that we’re recruiting for this study of course. But two, I think it’s important to know that when we sleep, when we’re active and have enough energy to participate in the community, we feel better both emotionally and physically. So it’s really important that we’re doing all the things that we can to sleep well and be active and be as healthy as we can. That’s true as I mentioned before and as you mentioned. That’s true of everybody. But knowing that it can be a particular risk in spinal cord injury, it’s important to be aware of it.
Host: Well, it is. Have you noticed, Ali, that the age at injury, duration of the injury, has any of this impacted the information? As you're conducting this study, are there certain groups you're looking for that you would like them to get involved or is it just a general SCI population?
Dr. January: Well, we’re particularly interested in working with young adults for this current study, although I think it’s important to look at this across the age span. For various reasons, we’re really interested in young adults.
Host: So as we wrap up, what do you want us to learn about young adults with spinal cord injuries and how we can provide them with support to make healthy sleep, diet, and activity choices. Tell us about your team at Shriners.
Dr. January: One of the things that I want people to know is that we need to be alert for doing all the behaviors that we know are related to getting better sleep, having a regular sleep schedule, trying to avoid or to come up with a good night time routine to minimize disruptions, even if you might—as I mentioned, sometimes for our patients with SCI they might have to schedule a catheterization in the middle of the night. So how do you come up with a schedule to minimize that disruption to your sleep? So those are some things that I want people to be aware of. Just be aware of that sleep can be so common in spinal cord injury, but that there's tips and there's ways to improve sleep. That physical activity is also incredibly important. We don’t want people living sedentary lives, right, whether or not they have a spinal cord injury. So staying active, staying involved, getting good sleep, all related to good physical function, good emotional function. So I should, of course, mention the team here at Shriners. In this study specifically we have a wonderful team put together. I'm working with Kathy Zebracki, who’s a clinical psychologist here at the Chicago hospital who has a ton of experience working in outcomes, research with spinal cord injury and psychosocial wellbeing and spinal cord injury. Of course, Dr. Lawrence Vogel who is well known in the spinal cord injury, pediatric spinal cord injury world. Then our health coach, Trish Ryan, who’s going to be the one who’s going to be working with people and coming up with plans to address a health behavior to kind of improve their functioning.
Host: So well said. Thank you so much, Ali, for coming on with us today and sharing your expertise. What an interesting study. Please let us know how this turns out and come back on and join us again. That concludes this episode of Pediatric Specialty Care Spotlight with Shriners Hospital for Children in Chicago. Please visit our website at shrinerschicago.org for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Shriners Hospitals for Children Chicago podcasts. For more health tips and updates, please follow us on your social channels. Until next time, I'm Melanie Cole.