Published on: March 19, 2020
Nighttime Compression Garment: Your Secret Ally
One of the best ways to manage your lymphedema is with a good nighttime compression garment. However, most lymphedema patients know very little when it comes to these compression garment superheroes and just how effective they are when it comes to maintaining a healthy lymphatic system.
In this article you will learn:
- Why nighttime compression is so important.
- Different types of nighttime compression garments.
- Choosing the correct nighttime compression garment for you.
Why Nighttime Compression Garments?
Around-the-clock management of lymphedema is important because it helps prevent re-accumulation of fluids while we sleep. For most, lymphedema patients, elevation is just not enough. Bandaging is also an option for nighttime compression, but that can take anywhere from 30 to 60 minutes even for the most experienced lymphedema patients.
Why Can’t I Wear My Daytime Compression Garments At Night?
There are two important reasons not to wear your daytime compression garments at night. First, daytime compression is much too high and if they roll down during the night, they could potentially cause a tourniquet, cutting off circulation to your vascular and lymphatic systems. Second, custom made flat-knit compression garments, made with nylon and spandex, are the most valuable garments. Wearing these garments during the night will stretch them out to the point of no return, making them less compressive for when you need them the most, i.e. when you are vertical and mobile.
If you or a loved one is bandaging your limb(s) every night, nighttime compression garments can be a beneficial break to your nightly routine.
Nighttime Garments: A History
Innovators, patients, therapists, family members, and garment manufacturers have been trying to come up with an alternative to the multi-layered bandaging technique for years. Most were expensive, cumbersome, heavy, hot, and would irritate the skin.
Picture a giant oven mitt for either your arm (fingertips to armpit) or your leg (toes to the top of calf or toes to the groin). Then velcroing a series of straps up the arm or leg, one after the other until limb movement was impossible. Luckily, nighttime compression garments have come a long way!
Different Types of Nighttime Compression Garments for Lymphedema
- Quilted Nighttime Compression Garments
- Short Stretch Velcro Wraps
Quilted Nighttime Compression Garments
Many years spawned quilted flat knit garments with the same sophisticated pressure mapping technology used to make custom daytime flat knit garments (i.e. Jobst Elvarex, Medi 550, Juzo Strong) but without Velcro straps.
Foam elements are formed into clever ‘channels’, that when in contact with the skin, apply directional or bidirectional compression to the tissues. This design feature helps to stretch the tissues and stimulate lymph flow by encouraging it to move through alternative pathways (Lohmann-Rauscher, 2017).
Without Velcro to adjust the size, the patient will need to be measured when fully, nearly fully decongested just like when a lymphedema patient is being measured for custom flat-knit daytime garments.
Benefits of Quilted Nighttime Compression Garments
- Foam channels that encourage lymph to flow towards alternative functional pathways.
- These foam channels create tissue stretch, which contributes to the reabsorption of interstitial fluids and particles back into the circulatory system.
- They are made with textured fabrics which create a micro-messaging effect and stimulate lymph flow.
- Better anatomical fit thanks to custom-made measurements
- Flat knit technology with gradient compression
Short-Stretch Velcro Wraps
Short-stretch velcro wraps were originally designed for daytime wear only, as an alternative to short-stretch bandaging and circular or flat-knit compression stockings. Lymphedema and venous patients alike achieved great results due to increased compliance since for most patients, they were easier to put on and take off. These garments not only maintained the reduction of their swelling but also continued to reduce swelling.
Patients eventually started wearing them at night. Please note that this isn’t always recommended because these neoprene garments do not breathe well and the compression is too tight for nightwear. Most properly fitted nighttime garments are around 12-20mmHg. Short-stretch velcro wrap garments can reach up to 40-50mmHg, depending upon how tightly the straps are pulled by the person donning the garment. If someone is going to wear these garments for nightwear, please seek the advice of a lymphedema therapist or doctor. It is usually recommended to apply the garments with much less tension than you normally would for daytime wear.
Benefits of Velcro Wrap Garments Include:
- They exert higher working pressure and lower resting pressure
- They can be used during the daytime, resting periods or sleeping
- It makes dealing with size fluctuations easier, as the devices are easy and quick to adjust
- The overlapping system helps to prevent gaps forming in the wrap
- They provide certain patients with more independence to manage their lymphedema
- They are available in custom measures or off-the-shelf versions
- Certain products are available in all four levels of compression (20-30, 30-40, 40-50 and 50+ mmHg).
Choosing the Right Garment to Suit Individual Needs
It is important to always remember that no two lymphedema limbs are the same! Furthermore, a night-garment that works for one person may not be ideal for another. There are many things to consider when choosing a night-garment, including the stage and severity of the lymphedema, the patient’s ability to tolerate night compression, skin condition, lifestyle factors, and physical ability to don certain garments. All these points should be assessed by a qualified garment fitter in order to determine the most appropriate product for a patient’s needs. Before purchasing any kind of compression wear, it’s best to check with your caregiver that you do not have any health issues that may contraindicate the use of a night-garment.