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A Day in the Life of a "Night Garment"

By: Tracey Podolsky,  MPT,  CLT-LANA,  CLM

Lymph e-Channel Vol 6 Reprint - Archived January 2013

What is a "Night Garment"? When I first began treating lymphedema, I never used the terminology "Night Garment". I used to teach all patients how to remove the elastic compression garment that was worn during the day and then self bandage the limb at night before going to bed. Over the years, however, there has been a burst of alternative options to use in place of self-bandaging during Phase II of Complete Decongestive Therapy - Self-Care Management. I began referring to these garments as "Night Garments" because they are most commonly used at night during sleep.

Night garments can be described as alternative nonelastic compression garments that are made to replace bandaging in order to improve quality of life by making the process of compressing the limb at night easier and faster to apply. Over the years, I have been able to incorporate the use of so many of these night garments successfully in self-care management. I almost always recommend the option of using a night garment somewhere in the patient's self care regimen because I feel it does allow the patient to be more compliant.

What I have learned by using night garments is that you must be attentive to how many hours you are averaging in the night garments per night. When I see patients for follow up in self-care management and they are struggling, I ask them a plethora of questions to figure out why their self-care regimen isn't working for them.

Compliance to wearing the night garment every night is only one of the questions that should be asked during a self-care management follow up appointment with your lymphedema therapist. The most important question is how many hours are you averaging each night in the night garment? The reason why this question is so important is because some patients only sleep 3-4 hours a night.   If a night garment is mistakenly understood as a garment to be worn only when you are sleeping, the effected limb may not be getting as many quality hours in the night garment as it should be.

This simple but extremely important question has solved issues that arise in self- care management much quicker. I make a conscious effort to educate my patients about how many hours of use are recommended for any of their compression garments when I am teaching them how to independently manage their swelling. I typically recommend that my patients shoot for 12 hours in the night garment which gives them less than 12 hours in the daytime elastic compression, given that you will be showering or cleansing the skin in between. This may vary per patient depending on the lifestyle, assistance needed, severity of lymphedema, and willingness to comply.  

Some patients must use night garments 24 hours/day. Some other patients may only use the night garments when they need a break from self-bandaging for a night.   Others may use the night garment during the day to add to the number of hours in a night garment within a 24-hour period. Regardless, it is important to ask your lymphedema therapist how long they recommend you use the night garment because success in self-care management could depend on it.

Because different patients perceive the use of the term "Night Garment" differently, I have changed my terminology with patients from "Night Garment" to "Alternative Compression Garment" or "Nonelastic Compression Garment". This doesn't cause any confusion or misunderstanding when instructing a patient when or how to use the garment.