Sleeping With a Chiari Malformation: Five Steps That Could Help

A Chiari malformation is a congenital condition which often goes undiagnosed until later in childhood or during the teenage years. It is measured in certain degrees, and each affects the body in a more severe way.

It occurs when there is a malformation at the base of the skull where the spinal cord enters the skull and connects to the brain. This affects all areas of life and can have a range of symptoms that are constant, or ones that get worse between periods of improvement.

One of the areas it impacts is sleep, and so knowing the best ways of sleeping with a Chiari malformation is crucial to helping quality of life. We cover that right here.

Sleeping With a Chiari Malformation

But First: What are the Symptoms?

Though there are different degrees of a Chiari malformation, many of the symptoms are the same for each. This includes headaches that can be severe, as well as neck pain. The more severe the malformation the more severe and constant the headaches are likely to be. Often coughing, straining the neck in some way, or sneezing, will also cause an increase in pain at the base of the skull and worsen any headache that is present.

There may also be a loss of feeling, and sensitivity to temperature including heat and cold. Muscles throughout the arms and hands may lose strength, and there can be moments where there is a full body collapse to the ground which is caused by weakness in the muscles.

Affects on balance can be noticed too, and dizziness can occur alongside affects on vision such as blurred or double vision, as well as extreme sensitivity to light.

Type III Chiari malformation is the most severe type and can include a reduced sensitivity to temperature and weakness in the muscles. There can be a loss of control in the bowel and the bladder, as well as motor impairment and chronic pain.

Another common symptom with a Chiari malformation is sleep apnea – where breathing can stop and start during sleep. That makes sleeping with a Chiari malformation difficult – we give you techniques to help with that further down.

Sleeping with Chiari Malformation: Sleeping Disorders

The vast majority of those with a Chiari malformation will have a sleep disorder, with sleep apnea being the most prevalent.

In some situations, the only sign that a malformation is present is actually the occurrence of sleep apnea.

Types of sleep apnea include central sleep apnea which involves a pause during breathing that is caused by a missing signal from the brainstem to breath. While obstructive sleep apnea is a result of a blockage in the airway.

Each of these sleep apnea conditions can be present in a person with a Chiari malformation, and in many cases, both will occur in the same person at the same time. Additionally, the malformation may cause a weakness in the muscles of the throat, which will increase the risk of obstructive sleep apnea.

Thankfully there are treatments that will reduce sleep apnea occurrences, causing it to be less frequent, and to reduce the effects of sleeping with Chiari malformation.

Studies have shown that the further the protrusion of the brain into the spinal canal, the higher the risk that there will be a sleep disorder present. So treating these sleeping disorders frequently involves a continuous positive airway pressure machine or adaptive servo ventilation. But in some cases surgery may be performed to decrease the pressure in the area and allow breathing to improve.

Sleeping With a Chiari Malformation

Sleeping with Chiari Malformation: Five Steps That May Help

There are several ways to make sleeping with a Chiari malformation easier and improve overall sleep quality.

1. Use a CPAP Machine or ASV

A CPAP machine, or a continuous positive airway pressure, is used for treating obstructive sleep apnea. It will continually push air through a mask and into the system of the person who is wearing it. That will reduce the effects of decreased oxygen due to sleep apnea. It also helps to keep the airway open and allows air to flow through the respiratory system.

An adaptive servo ventilation system, or ASV, is often used for central sleep apnea, as well as after surgery for a Chiari malformation. It pushes air through the airway by way of a mask, and it will adapt to the changing breathing patterns that are present in central apnea – especially those with Chiari malfunctions. It can change the pressure at which the air is suppled as well as the pattern at which it is working, to adapt to the breathing patterns that are occurring naturally.

Both of these can be utilized to improve quality of sleep and help address the issues of sleeping with a Chiari malformation.

The most important thing to do when there is a sleeping disorder related to a Chiari malformation is to address the blockage, or to force air with one of the above machines.

2. Sleep Propped Up

Obstructive sleep apnea can also be treated by addressing all causes, and alternative treatments to a CPAP or ASV may offer some improvement for those who have a Chiari malformation.

This includes sleeping propped up in a way that keeps the airway as clear as possible, allowing for air to better enter the airways and flow to the lungs.

Sleeping With a Chiari Malformation

3. Use a Mouthpiece

You can also use a mouthpiece to help create the correct alignment of your jaw. That will keep your tongue in a position that will not block the airway. This can relieve some of the symptoms and reduce obstructive sleep apnea for some.

4. Sleep With Your Head and Shoulders Elevated

It may be necessary to sleep with your head and shoulders elevated in order to keep your neck straight. That will allow for the best possible air flow.

This can also help reduce sinus drainage and blockages that can occur, and will provide room for air to pass through your body.

A special pillow may also be required to obtain the correct neck and head alignment for someone with a Chiari malfunction.

5. Maintain a Sleeping Pattern and Healthy Diet

Maintaining a regular sleeping pattern can also help adjust your body to a regular sleeping pattern, which will improve quality of sleep as well as decrease time spent falling asleep.

Having a healthy diet and exercise will also improve sleep. That can help you maintain a healthy body weight too, which will reduce pressure on your body and improve sleep.

Sleeping With a Chiari Malformation

Chiari malformation: Complications

Unfortunately there are several complications that can occur as a result of a Chiari malformation.

Hydrocephalus occurs when the fluid from the brain occurs in excess and requires draining from the body.

Spina bifida is a complication in which the spinal cord or the covering for the spinal cord is not correctly developed and may leave a portion of the spinal cord uncovered. This can potentially lead to paralysis as well.

Syringomyelia occurs when a cavity or a cyst is formed within the spinal column, and tethered cord syndrome is diagnosed when the spinal cord becomes attached to the spine. This interrupts the nerves and can lead to nerve and muscle damage.

Often surgery is required for a Chiari malformation and to help return regular functioning to some of the body. When a surgery is performed, it is intended to slow progression and to improve daily function. This includes reducing pressure on the spinal cord and allowing for the flow of spinal fluid to return to normal, improving muscle and nerve functioning.

In some surgeries small bits of bone are removed to create space around the spinal cord and to remove the pressure. Some cases may involve a removal of a section of the spinal cord to create more space, or an expansion may be created around the covering of the brain. Where there is excess fluid on the spinal cord or around the brain a stent may be installed to drain the fluid.

Sleeping with Chiari Malformation: Our Final Thoughts

It’s tough having a Chiari malformation, and sleep can be greatly affected mainly due to sleep apnea being a common occurrence.

If you follow our suggestions above, it’s possible that sleeping with a Chiari malformation may get easier.