About Mind/Body Consultant Services & Protocols
Protocols: Suggestions For Better Sleep
If you often find yourself without sufficient sleep you are not alone. Insomnia and chronic fatigue are becoming a national health crisis with two out of three persons in North America chronically sleep deprived. The National Traffic Safety Administration estimates that more than 100,000 automobile crashes annually are caused by drivers falling asleep while driving, thousands die in these accidents. The following are suggestions we have found helpful for Mind/Body Consultant Services patients who are seeking more robust and complete sleep.
- Sleep as much as needed to feel refreshed and healthy during the day, but not more. Everyone has his or her optimal amount of sleep (usually between 7 and 9 hours) that can be determined based on how you feel during the day. If you are able to wake normally at the correct time without an alarm you are getting sufficient rest.
- A natural circadian trough occurs in mid afternoon between 1 and 4 p.m. This is a good time for napping but not for exercise and high activity. Naps should be 30 minutes or less.
- Sleep tends to decrease with age while sleep problems increase and delta sleep decreases. The optimum sleep-wake cycle is obtained around 10 or 12 years of age. Having realistic expectations reduces anxiety.
- Curtailing the time in bed seems to solidify sleep while excessively long time in bed seems to be related to fragmented and shallow sleep. Too much sleep can be as tiring as too little.
- Naps over 20 minutes and later during the daytime (after 3 p.m.) tend to disturb nighttime sleep patterns and are not recommended for most individuals.
- Delta, or slow-wave sleep (Stages 3 and 4) replenishes body's physical needs. REM sleep replenishes body's psychological needs.
- A regular arousal time in the morning (same on weekends as weekdays!) strengthens circadian rhythms and. eventually leads to regularity in time of sleep onset. Regular work, exercise and meal hours can also help to "set" the body's biological clock.
- Steady, long-term, aerobic exercise seems to deepen sleep. It is better to exercise in the morning or early evening. Early afternoon or late evening exercise can disturb sleep.
- Occasional loud noises (e.g.. aircraft fly-overs) disturb sleep even in people who are not awakened by noises and cannot remember them in the morning. Sound-proofing and "white noise" can help to counteract nocturnal auditory disturbances.
- Excessively warm temperatures (e.g., above 75 degrees Fahrenheit) disturb sleep as do excessively cold temperatures (e.g., below 54 degrees Fahrenheit). It is best to keep the bedroom slightly cool (e.g.. 68 degrees Fahrenheit).
- Preparing the sleeping environment to provide maximum comfort and a minimum of distraction is beneficial to sleep.
- It is best to spend the final two hours of the waking day in quiet and non-stressful activities in preparation for bedtime. Two hours prior to bedtime make a list of any worries that may carry over to the next day and ideas for solutions, then put the list aside physically and mentally.
- Dietary factors may have a strong influence on health sleep. Hunger may disturb sleep due to the release of the hormone glucagon, which has effects similar to adrenaline. One the other hand a large undigested meal or large quantities of liquid in the bladder can interfere with sleep due to excess acid production or a over-full bladder respectively. A meal around 4 or 5 hours before bedtime followed by a light snack just before turning in may aid sleep especially if either or both include foods containing the chemicals melatonin or tryptophane. High melatonin foods are (in descending order of strength): Oats, sweet corn, flee, ginger, tomatoes, bananas, barley. Serotonin-rich foods are (in descending order of strength): Spirulina seaweed, soy nuts, cottage cheese, chicken liver, pumpkin seeds, turkey, chicken, tofu, watermelon seeds, almonds, peanuts, brewer's yeast, malted milk, milk, and yogurt. In addition, for those suffering from insomnia, the following dietary supplements should be taken at bedtime: 100 mg niacinamide, 750 mg. calcium, 500 mg magnesium and (in the a.m. 25-50 nig. vitamin B-6.
- An occasional sleeping pill may be of some benefit, but their use~ over two nights is not very effective inmost insomniacs. Use of sleeping medication (prescription, or over-the-counter) for periods over two days can exacerbate the problem further and result in serious complications.
- Caffeine or sugary rich foods in the late afternoon, or evening disturbs sleep, even in those who feel it does not. Caffeine effects normally last 6-7 hours but for some individuals caffeine at any time of the day will disturb sleep at night. One cup of coffee contains an average of 85 milligrams of caffeine.
- Small amounts of alcohol can help tense people fall asleep more easily, but the ensuing sleep is "deep" and fragmented. As alcohol wears off (3-4 hours) anxiety levels increase causing mid-sleep wakening with difficulty returning to sleep.
- People who feel frustrated because they cannot fall asleep should not try harder and harder to fall asleep. If sleep is not obtained within 30 minutes of lights-out it is best to get out of bed and do something relaxing before trying to fall asleep again.
- It is best not to spend much time in the bedroom that is not devoted to sleep, or sex. Stay up until you first become tired. Reduce activity and do not work within 2 hours of attempting sleep. Watching TV, eating, or doing homework in bed can interfere with sleep.
- Continued reference to a clock increases anxiety about sleep difficulties. Turn the clock face away from the bed.
- The chronic use of tobacco disturbs sleep.
- It generally takes up to 50 days to fully adjust to new sleep-wake schedule. Most of the observable signs of disturbance will dissipate m 4 to 5 weeks.
- Deep breathing, autogenic training, relaxation procedures and "thought-stoppage" techniques can all aid sleep onset. For example: Breath in as you count down from 50 and repeat "relax" on each exhale. Format is not important but repetition is. See our office for other specific suggestions.
- Those who have difficulty sleeping do well to remember that (except in the case of some physiological disorders) it is not possible for the body to injure itself because of too little sleep. The body will do what it needs to obtain sufficient sleep to maintain minimum health.
- The essential oil of lavender promotes calming that leads to sleep.
- A drop in body temperature leads to sleep onset. Taking a hot bath for 15 minutes. 60 to 90 minutes prior to bedtime triggers brain to lower basal body temperature. The resulting overcompensation by the body results in sleep onset.
- Persons with significant insomnia may benefit from "sleep restriction" plans. (Keep sleep log. Remain awake late enough to match actual hours of sleep currently produced. Increase by 30 minutes per day when insomnia has been cleared for 5 days.)
- Over-the-counter pain relievers often contribute to insomnia due to high caffeine content. A two-tablet dose of Extra Strength Excedrin, for example, contains 130 milligrams of caffeine. Anacin contains 64 milligrams - almost as much as a cup of regular caffinated coffee. Taken as recommended the caffeine in such pain killers can add up to the equivalent of half a dozen cups of coffee per day.
- Over-the-counter cold medicines can also contribute to sleep-loss. Many contain nasal decongestants such as pseudophedrine and phenylpropanolamine which act as stimulants. Often over-the-counter drugs designed to allow for a better night's sleep during a cold or flu help at first but actually cause sleeplessness after a few nights use.
- Many prescription medications can cause insomnia. Among these are common antidepressants such as Prozac, thyroid medications and hormone drugs, diuretics and even antibiotics. If you are taking prescription medication and having difficulty with sleep consult with your physician.
- Some individuals experience insomnia due to what is known as "restless legs syndrome" or from a similar disorder called "nocturnal myoclonus". There is some evidence that dietary supplementation with Vitamin E (400 IU a.m. and p.m.) and, or Iron (if levels are found to be low on a serum ferritin test) can be helpful in these conditions.
- The herbs Valerian Root, Hops and Chamomile can be taken alone or in combination to induce sleep without ill effects on sleep quality or grogginess on wakening. The hormone Melatonin (0.5 mg taken 20 minutes before bedtime) can be helpful in inducing sleep. If you are interested in such a supplement our office can provide specific protocols for you to use. We do not recommend the use of supplements such as these without such specific instructions for use and medical clearance from your physician. It is also unwise to take any sleeping medication for over three weeks without addressing the underlying cause for the sleep loss.
- Persistent sleep difficulties may require psychological intervention, or referral to a sleep disorder center. Sleep therapy may initially cause increase in problems until new routine established. If the sleep problem is related to situational stress the above suggestions should be sufficient to resolve the problem within 2 to 5 weeks. If this is not the case, underlying psychological problems (e.g. post-traumatic stress disorder, depression, anxiety) or medical conditions (e.g. sleep apnea) should be investigated.
Warnings: The information above is provided for educational purposes and may not be construed as a medical prescription or as a substitute for the advice of your physician. Do not use this product without first consulting your physician especially if you are pregnant or lactating. You should regularly consult your physician in matters regarding your health and particularly in respect to symptoms and conditions which may require diagnosis or medical attention. Reevaluate use of this product after 6 months.
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