Cannot sleep at night

Posted , 16 users are following.

I am now 3 weeks post-op from TKR And I have found it a lot harder than I expected.  I can cope during the day, but just can't sleep at night, or if I do I am awake after 1-2.5 hours.  It is driving me crackers.  A week ago I was very emotional and spent half the night crying but I seem to have got past that bit.

does anyone have any suggestions?

My bend is not great, 2.5 weeks after op. It was 75 degrees.  I do my exercises and feel I push myself but the whole thing is getting me down and at this point I wish I hadn't it done.  Op was on 26th October


0 likes, 54 replies

Report / Delete

54 Replies

  • Posted

    Hi Liz,

    I am 12 wks post tkr and still have problems with sleeping. I really turned the corner last week with my recovery, but sleep is continuing to be an issue for me.

    Hang in there though, because it really does get better.

    Keep up with your exercises, rest when you need to, elevate your leg, and use ice.

    The feelings of frustration and regret WILL pass!

    You will find a lot of helpful encouragement here on this forum.

    Try not to let yourself get too discouraged. It was just a few weeks ago that I was regretting my surgery, now I am so glad I had it and looking forward to being pain free! Not completely there yet, but getting closer.

    Let us know how you are doing!

    Report / Delete Reply
    • Posted

      Thank you Debz.  Try to be positive.  Think part of my problem is that I don't live in the UK now but we still have private medical insurance here and I wasn't keen on the care in Cyprus, where we live, we thought it best I had it done here.

      my hubby is still in Cyorus and I am staying with a very good friend, but it is not the same.  I am missing my hubby, my friends and my own house.  My husband is coming here next month and we will be spending Christmas with our children and grandchildren.

      If I should need the other knee doing, I think I would have to find a good reputable surgeon and stay in Cyprus but that would cost me a lot of money.  At present in the health service here you wait over two years and then not guaranteed a great surgeon.  We don't have private medical care here as neither of us were covered for much at all as they class anything as a pre-condition.

      thanks again for your kind words


      Report / Delete Reply
    • Posted

      Oh Liz, that would certainly add to your trouble. I am in the USA, did a week in rehab after surgery 2 miles from home, then was able to be home. I am certain I would have had a much more difficult time had I been away.

      Luckily you have a good friend to stay with, but of course that isn't as comfortable as your own home!

      Just keep in mind that it isn't permanent!

      You will get better, your knee WILL heal, and you will get back home with a wonderful new knee!

      Report / Delete Reply
  • Posted

    Thought I should post a little bit more.

    i am 68 years old and normally very fit.  The reason I can't sleep is the pain.  I get dreadful pains at back of my knee, inside of calf and the top of my thigh.  I feel I spend half the night massaging my leg, sometimes I helps, often it doesn't.

    i take paracetamol and ibuprofen plus Tramodol.  I had the Tramodol down to just 3 tablets a day but gave just gone back up to 4 a day.  I am terrified of getting addicted to these as keep reading horror stories.

    the bruising was horrific but I used Arnica cream and it is not too bad at all now but when I lie on my leg it still feels badly bruised.

    It is 3.22 a.m at the moment and again I am wide awake.  Pain bearable, but put the lights off and lie down and it just flares up.

    i got my op done in Derby.

    any advice would be much appreciated and ask me anything.  I am new to this.


    Report / Delete Reply
    • Posted

      The pain is normal, unfortunately. Some find relief using pillows under and/or between the knees. That never worked for me. I did a lot of massage, still do, with analegic cream. I just used the store brand. I also got a sleep aid and muscle relaxer from my doctor.

      At this point don't worry about becoming addicted. The pain medication is necessary, and it's important to stay ahead of the pain as much as possible.

      Sometimes I would read or watch an old movie to distract my mind.

      Also did a fair amount of crying.

      Read other posts on here and you will find others who have gone through it and are going through it. I don't think any of us were truly prepared for just how difficult the recovery is.

      Just please know there are many of us here who care!

      Report / Delete Reply
    • Posted

      HI I am 63 and 14 weeks in I still have to take my meds at night I have all sorts of pains in my calf and foot. It all really hurst  in bed and when i get up .. Seems better in the day .. Goodness i also worry about the amaount of tablets i have taken but the doctor tells me its ok when you need them you have to take them 

      Good luck its such a tough journey and one i never ever expected 

      Take care 

      Report / Delete Reply
  • Posted

    Hang in there!  It does get better. I'm at nine weeks now and can finally lay on my side for a little while. I wake up every time I move at night so I still don't get good sleep but I seem to have longer intervals before waking now at least!  At 3 weeks I still slept in a recliner because it was too hard to lay flat. 

    I go back for check up tomorrow and am anxious to see what the doc says about my bend but I think riding a stationary bike has helped me with the bend a lot. 

    Keep exercising!


    Report / Delete Reply
  • Posted

    You are at one of those benchmark periods that most start having concerns. One of the problems, Dr's don't tell us what to expect at given intervals. Its sort of like becoming parents, you learn on the fly. You're handed a kid and sent home , with tkr, you're given a few instuctions, a walker, a riser for the toilet , a couple bottles of pain pills and a little instructional manual and pushedcot the door. The sleeping stuation will take time, weeks or even months. Try a pillow between your knees. You might to check out different thicknesses. Personally, I have found one a foot square and inch thick does best for me. I hope you are still using pain meds especially at night. Too many quit too soon because they are afraid of getting hooked. Taken properly you won't have that problem. Don't just lay th ere thinking its going away, g e t up, stretch, ice ,elevate ,massage & take your pain n meds if applicable. 6 weeks will be your next benchmark then 3 months. Don't be discouragd.....It wil) get better
    Report / Delete Reply
  • Posted

    Hi Liz

    My TKR was 6 July and it took around 8-9 weeks before I had more than a couple of hours sleep at a time. I sleep on my side and that made things worse. Things will improve so do not be depressed this is a major invasion and recovery takes time. I found a codeine or two paracetamol an hour before trying to sleep did help, another version of counting sheep helped!!!

    i tried to recall something enjoyable and followed it through (for me it was a round of golf from the first tee at my club - I can't remember making a full round so I guess it must have helped.

    i am sure others will encourage you and agree the first 8 weeks or so are the worst but by then things improve. Regarding bending, 75 seems OK but you need to work at it and keep to the exercise routine, it's tough but perseverance will pay dividends. Best of luck and think positive thoughts.


    Report / Delete Reply
  • Posted

    Hi Liz, sorry to hear you're struggling. I'm 18 days out from TKR, also done in Derby 😃

    I'm not sure how your primary health care works, not being a permanent UK resident, but if possible I would urge you to get a GP appointment to review your pain and sleep. I had terrible trouble sleeping with my first TKR in March of this year, coupled with severe pain, especially at night. My GP prescribed a low dose of Amitriptyline, which helps with nerve pain, and also helps to relax you a little. I have continued taking them, under GP supervision, and have only had one bad night since my second surgery on October 29th. I'm regularly sleeping 4-6 hours at a time, sometimes up to 8-10 hours in total.

    I know people shy away from taking additional medication, but it's important to try and facilitate some quality sleep as you heal much better when rested. The same goes for pain relief - taken under medical supervision, you should take whatever you need. Please don't think about trying to come off them too soon, you won't be able to do your exercises properly, and your outcome will be poorer for it.

    Interesting to hear you used Arnica cream. I used it for both my surgeries, along with Arnica tablets and Arnica massage balm. I did have some pretty fierce bruising, but it's faded really quickly. Like you, though, my leg still FEELS bruised, although there's nothing visible.

    Reading you describe your pain, it sounds pretty much the same as mine. I also spend a lot of time massaging my thigh, back of knee, you use anything to massage with? I use both Arnica Massage balm (more like a massage oil), which is very soothing and smells lovely, and Tiger Balm, which is very warming.

    It must be very hard for you, being away from family and friends. I'm sure the friend you're staying with is doing a brilliant job, but are you perhaps being "on your best behaviour"? By that I mean are you resting as much as you need? Napping during the day? You may or may not be familiar with the TKR Mantra - "Dont stand if you can sit, don't sit if you can lie down, don't be awake if you can be asleep"! Although it's a little tongue in cheek, the sentiment is right - REST! Whenever, wherever, however, just rest!

    I hope you manage to get some respite from your nighttime pain, and that you can soon start to see the positives from your surgery.

    Terri xx

    Report / Delete Reply
  • Posted

    I just want to say a massive thank you to everyone of you.  What a lovely group of very supportive people on this forum.  Wish I had found it before the op.

    i have just wakened up having a good three hours and feel like a new woman. I found a position, though not perfect, helps me.  I stuck my left leg out of the covers and had it dangling over the edge.  It seems to help the pain in my thigh and calf and with the compression socks on, your leg does not get cold.

    On the subject of the stockings, were you all told to wear them for six weeks both night and day?

    i am just going to have a cup of tea and read all your comments properly.

    thank you all once again.


    Report / Delete Reply
    • Posted

      hi lis, , well I am a year down the line now.   All what you have described is completely normal at your stage.  It  will be painful for a while but as everyone says and I can't stress enough is get good pain relief, exercise and ice.  Most important is rest. There is no comfortable sleeping position at this stage.   It does get better as time goes on.   I wasn't told to wear the stockings at all after I left hospital.  Good news is that I can walk miles, can stand for long periods and do most things.   My bend is ok and enables me to do what I need.   Would I do it again.....not at the moment thank you.   Good luck with your recovery xxx


      Report / Delete Reply
    • Posted

      Hi again Liz

      Yes, I was told to wear the stockings for six weeks and what a struggle it was getting them on and off. They were not the height of fashion but very important. Although 74 I take a number of long haul flights on business and vacation each year and wear black compression flight socks so I had a back up when the white ones were not the best fashion statement.

      Try to have a good laugh at something at least once a day - it helps.

      I am pleased we have helped you in what can be a lonely and distressing time.

      I had to have a catheter and bag for five weeks after my op and then a prostate operation. Regular blocking needing District Nurse visits in the middle of the night added to the discomfort and frustration. Reading the forum was a huge benefit, I thought I was having a bad time but there were always those having a worse time.

      We all agree - take the medication exactly as instructed, persevere with the exerices, rest and rest the leg and raise and support it ( have something handy to throw at the daytime tv) and use the ice pack.

      Report / Delete Reply
    • Posted

      Hahaha Liz, have you been peeping? That's one of the positions I sleep in! In fact I even slept like it in hospital, making sure the nurses couldn't see my leg hanging out the side of the bed 😂

      Re the stockings, I don't have them. Didn't first time round either. Severe swelling coupled with shortness between the knee and ankle, and my surgeon said not to bother, and he was confident I would be fine without them. Yes I AM lucky! Have to take aspirin every day for 6 weeks, and I make sure to keep moving around, but hey, small price to pay to not have to wear them!

      Glad you managed to get some sleep, it makes everything seem so much better. Fingers crossed that it continues for you xx

      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up