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Sleeping with a stoma bag – how best to manage your stoma overnight

There is nothing we all look forward to more than a good night’s sleep! Sleep is an essential function that allows your body and mind to re-charge, leaving you feeling refreshed and alert when you wake up. For those who are recovering from stoma surgery, sleep is part of the healing process and vital for recovery. However, having a stoma can make sleep a little trickier and for some ostomates going to bed can be a time filled with worries.

By simply tweaking your routine slightly you can often help prevent any mishaps which may happen. Here are a few tips on sleeping with a stoma bag and how best to manage your stoma overnight. They will help guide you towards a restful night’s sleep.

Sleeping position:

Finding a comfortable sleeping position with a stoma is an important factor. Sleeping on your back is a safe option, especially in the days and weeks after surgery. If you are sleeping on the same side as your stoma, you may feel a little vulnerable and worry that it may either hurt or you might roll onto your stoma and even your pouch. The mattress will support the ostomy pouch as it fills. Sleeping on the opposite side from your stoma is fine too, you can just hold a pillow up against your abdomen or set your pouch on a pillow next to you so the weight as it fills does not wake you up.

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 up. So, try to roll onto your side or back before you fall asleep. Try popping a pillow between your legs or under your back as this will help you get into a comfortable position for a good night’s sleep.

Emptying your pouch before going to bed:

It’s always a good idea to empty or change your stoma bag before you go to bed as it will help to prevent your bag from filling up too much overnight and disturbing your sleep. A full stoma bag is always at risk of leaking and that’s not something you want to experience during the night. You may find that by doing this, your stoma bag may last you through till the morning, it is very dependant how active your stoma is overnight.

In the early days, following your surgery, you may feel happier setting alarm to wake up and check/empty your stoma bag during the night until you establish a routine. If you are awake anyway it can be emptied or changed then. Many people find their body naturally alerts them to their stoma bag being full overnight…. almost like a sixth sense!

Making sure your stoma bag is secure:

If you wear a drainable appliance, changing your stoma bag before bed time is an option to make sure it is all secure for the night. It all depends on what type of bag you are wearing and what your routine is like and whether you want to change your pouch every day or whether you are happy with it being in place for a little longer. If you are changing your bag before going to bed, it is important to spend some time making sure that the pouch is fully secured so there are no chances of leaks overnight.

Planning meals:

Where possible try to plan your meals. Eating a heavy meal before bedtime will make your stoma more active through the night, resulting in you needing to get up and drain or change your stoma bag more often than usual (depending on which type of bag you use).

Aim to eat your main meal before 7pm in the evening to allow your stoma to do all the work before you settle for bed. Another option is to eat a lighter meal of an evening and the heavier meal mid-day as this will help with the output slow down overnight.

Avoid anything fizzy or fibrous to eat in your last meal before bed as this could also keep your stoma active with excessive gas which will inflate your bag.

Tip: Try to leave 2 hours between eating and going to bed

Preventing night-time leaks:

Leaks from your stoma bag shouldn’t happen, but unfortunately can happen on rare occasions. Do reach out to your Stoma Care Nurse if you experience leaks at night as you will soon start feel tired and fed up. If you have just had recent surgery, your bowels maybe a little unpredictable for the first few weeks until things settle down. You may want to use some large pads to lie on and rest your stoma bag on, for reassurance during this time, but rest assured these leaks will only be short term until the right stoma bag works for you. Having everything to hand such as a change of pyjamas and your stoma equipment, will help you feel prepared if you experience a night-time leak from your stoma bag.

Your Stoma Nurse will help guide you with stoma bags which suit your needs. She/he may also recommend using a solidifying agent in your bag at night which will help thicken the output so that it is less likely to leak and gives you a few more hours of wear time before needing to drain it. These are beneficial to those with an ileostomy as the output is more prone to be on the loose side.

For those with a urostomy, your stoma bag will continue to collect urine and will need emptying during the night. To save you getting out of bed to empty your pouch every few hours overnight, many people prefer to use a night drainage bag which is simply a larger bag. This night drainage bag is attached to the drainage end/tap of your body worn stoma pouch before you go to bed and can collect up to 1-2litres of urine during the night whilst you are asleep.

General tips for a good night sleep:

  • Make sure your bedroom is dark and cool
  • Have a fixed wake up time during the week so you are in a routine
  • The right amount of sleep is personal to you, we are all different and some need more/less
  • Avoid alcohol before sleep, it may help you sleep initially but you often wake dehydrated
  • What you eat can also affect your sleep
  • Make sure you get enough sunlight during the day
  • Put screens down 45-60 mins before bedtime
  • Don’t force sleep
  • Have a pen & paper beside your bed to write down any worries
  • Be physically and mentally active during the day to ensure you are tired later
  • Avoid napping during the day as you may be less tired at night
  • Watch your caffeine consumption
  • Don’t exercise too close to bedtime as it may keep you awake

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