Sleep-more in Seattle: Better Sleep Strategies

Sleep hygiene is a term that is becoming more popular as we learn how important sleep can be for our health. This term encompasses different strategies to establish daily habits that can ultimately increase the quality and quantity of your sleep providing you the necessary rejuvenation after a long day.

● Exercise

● Relax the mind

● Limit alcohol and caffeine

● Set your biological clock

● Set up sleep-friendly environment

● Limit naps and manage restlessness

Exercise Helps

The research shows that moderate to vigorous intensity exercise helps with sleep.1 Scientific reviews report that exercise can help shorten sleep onset at night and wakefulness onset in the morning.2 Also a 2013 Sleep in America poll reported that there were no differences in sleep quality between individuals who engaged in moderate to vigorous exercise within 4 hours of bedtime and before 4 hours of bedtime.

This suggests that exercise is good regardless time of the day. However, some experts suggest that moderate to vigorous exercise 2-3 hours before bedtime may negatively affect your sleep because it alters your normal body temperature prior to sleep and may be too stimulating, keeping the mind awake.

Relaxing the Mind Before Bedtime

If the mind is active, the body will not rest. Try to not watch or partake in stimulating activities before you sleep. This includes blue light emitting devices like your smartphone or tablet. Your brain needs to be at its lowest amount of cognitive activity to assure a nice transition into sleep. Establish a relaxation routine including activities like journaling, reading, taking a warm bath, or meditating.3,4

Limit Alcohol and Caffeine

What you consume and when you consume something can affect your sleep.

Let’s first talk about the fabled nightcap. Having alcohol before bed actually negatively affects your sleep. Even though the effects of the depressant may make you feel drowsy, sleep scientists have found that alcohol prevents you from entering the most important stage of sleep, REM. It isn’t until the alcohol is metabolized when you can enter that fourth and final stage, and this is where the brain tries desperately to make up for the lost time leading to multiple vivid dreams before you wake up.4

Caffeine has a half-life of 5-7 hours, meaning that 50% of the caffeine you ingest is used up in your body within those hours. Understanding this, having an afternoon coffee, you’ll find yourself combating a substantial amount of caffeine at bedtime, disturbing the quality of your sleep.4

Other things that you can control is to avoid consuming large meals or excessive fluid 2-3 hours before sleep. The body performs the least amount of digestion while you sleep. Also you don’t want to wake up in the middle of the night to use the toilet.

Setting your Biological Clock

One of the main strategies for better sleep is through regulating your biological clock. Choose a bedtime and wake time and stick to it every single day. Though this may seem very silly at first, your body adjusts and creates the sensation of sleepiness close to those times once it acclimates. The body craves consistency for many things, sleep is no different.

Setting up a light that turns on at a specific time everyday also helps set your waking clock. So when the body responds both to hour of the day and amount of light exposure, it can regulate a steady biological cycle of sleep.3

Setting up a Sleep-Friendly Environment

Adjust your sleeping quarters. Assign the bedroom only for sleeping and intimate activities. Removing other activities like watching TV, responding to emails, or eating from the bedroom will help create an environment that triggers the body to feel sleepy.3

The darker and quieter the bedroom, the better. As an avid listener of the Tim Ferriss show, I learned that you can make a few purchases to help achieve this ideal environment. While I was living in New York City, I learned it was impossible to avoid the bright lights and constant blaring of sirens, so I invested in quality earplugs, blackout curtains, and an eye mask.5

What some have found helpful is to dim the lights or turn off brighter lights in their home 2 hours before bed. This again can trigger your body into recognizing that it’s almost time for bed.

Generally, experts found that having the room at a cooler temperature helps as well. A drop in temperature helps initiate sleep. Some experts propose this taps into our primitive selves who would naturally go to bed at night when it’s cooler outside.4

Naps and Difficulty Falling Asleep

Avoid long naps (greater than 20 minutes) throughout the day. Essentially taking a nap during the day creates a sleep debt where you will have a difficulty falling asleep later that night.

If you’re laying in bed and you cannot fall asleep for 20-30 minutes. Get out of bed and do one of those relaxing activities that worked for you. Return back to bed when you’re sleepy. This helps maintain that mental attribution of bed equals sleep.3,4

References

1. Yang, P., Ho, K., Chen, H. and Chien, M. (2012). Exercise training improves sleep quality in middle-aged and older adults with sleep problems: a systematic review. Journal of Physiotherapy, 58(3), pp.157-163.

2. Uchida S, Shioda K, Morita Y, Kubota C, Ganeko M, Takeda N. Exercise Effects on Sleep Physiology. Frontiers in Neurology. 2012;3. doi:10.3389/fneur.2012.00048.

3. Siengsukon PT, PhD, K. and Bezner PT, DPT, PhD, J. (2017). Sleepless in San Antonio: Guiding Patients to Better Sleep & Wellbeing.

4. Walker MP. Why We Sleep: Unlocking the Power of Sleep and Dreams. New York, NY: Scribner, an imprint of Simon & Schuster, Inc.; 2018.

5. Ferriss, T. (2015). 5 Tools I Use For Faster And Better Sleep. [online] The Blog of Author Tim Ferriss. Available at: https://tim.blog/2015/10/17/5-tools-i-use-for-faster-and-better-sleep/ [Accessed 8 Aug. 2017].

Information provided on lakewashingtonPT.com and all of its web pages is intended for general educational and entertainment purposes and is not intended to be medical advice to you or any other person. You should always consult with your own medical provider about your health and medical questions and never rely on this or any other web site alone to make medical decisions. Never delay seeking medical advice or disregard any medical advice you have received from your provider because of anything you read or hear on this website.

Sleep-more in Seattle: Sleep and Your Rehabilitation

BY: JUSTIN HO, PT, DPT, CSCS

#NoTime2Sleep

Despite the motivational claims of our Seattle Seahawks quarterback Russell Wilson, sleep plays an integral part in the success of rehabilitation. Science backs the importance of sleep for everyday individuals. Other than the household numbers of 7-9 hours of sleep recommended, generally we don’t know much about sleep. This is a multi-part series covering sleep.

Lack of Sleep and Your Rehab

We’ve all been in that situation... a bad night of sleep or staying up later than we should with an early rise time the following day. However we experience it, sometimes we are not aware how much it affects us the following day. Sleep can have a huge effect on our body’s road to recovery, thus sleep is an essential part of the rehab process.

What happens when you don’t sleep well? According to some of the literature1, chronic sleep deprivation can lead to multiple problems within our bodies including: 

• Increased muscle tone and decrease in postural maintenance

• Decreased oxygen uptake

• Increased sensitivity to pain and sensation of numbness

• Decreased alertness and cognitive processes

• Increased appetite, hunger, and risk of weight gain

• Decreased immune system function.

• Decreased emotional intelligence and interpersonal relationship communication

• Increased perception of anxiety and depression

• Decreased memory retention

Experts juggle with the idea of intermittent pain causing disturbed sleep and vis versa in a chicken-or-egg-type of discussion. Though it may seem intuitive that pain would wake you up at night, they found that the opposite is also very possible where lack of sleep can continue the cyclical nature of your pain.

An article published in 2016 about sleep deprivation after surgical procedures, nearly 50% of patients reported that pain was the main factor to their sleep disturbances with environmental factors at a distant second of 23%.

If you can help yourself get a better night of rest, you’ll provide a better environment to heal. The body heals best when it’s in balance. As stated above, sleep deprivation affects nearly all of the systems in your body. 

 As a metaphor, imagine that your body has a certain percentage of energy and effort allocated to each system in your body, each system intertwining with each other. If other systems are demanding more percentage, only so much can go towards your rehabilitation. With a less than optimal immune system, cardiovascular system, emotion and cognitive network at play, your body is nowhere near its optimum and is pulled in directions away from the goal of getting you better

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Sleep and Physical Therapy

 What does physical therapy have to do with it? One of the many things that could help you get a better nights rest is with exercise. It is difficult to really get a good workout in, let alone move, when you’re experiencing pain from general musculoskeletal conditions.

That’s where your physical therapist can step in to provide strategies and a program to perform exercises daily to encourage activity and help you navigate safe and less threatening movements.

Briefly explaining how pain works, your body is designed to use pain as a protector. The internal alarm system is always on the watch for your well being. Whenever your body is threatened, all of the signals sent from you muscles, ligaments, and tendons can be interpreted as pain.

Intuitively, you naturally try to rest, do nothing, and let the body do it’s magic. But in reality most movements aren’t damaging. Physical therapists are in a great position to address you as a whole person and help decrease the sensitivity of your alarm system. We can help you set your goal posts to what is safe. This will keep the the affected area and the rest of your body in good shape as your body naturally heals itself. Using strategies to get you moving safely, we are able to help you give yourself permission to relax and as a whole create the best healing and sleeping environment.

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References

1.    Orzeł-Gryglewska, J. (2010). Consequences of sleep deprivation. International Journal of Occupational Medicine and Environmental Health, 23(1).

2.    Dolan, R., Huh, J., Tiwari, N., Sproat, T. and Camilleri-Brennan, J. (2016). A prospective analysis of sleep deprivation and disturbance in surgical patients. Annals of Medicine and Surgery, 6, pp.1-

3.    Finan, P., Goodin, B. and Smith, M. (2013). The Association of Sleep and Pain: An Update and a Path Forward. The Journal of Pain, 14(12), pp.1539-1552.

4.    Uchida S, Shioda K, Morita Y, Kubota C, Ganeko M, Takeda N. Exercise Effects on Sleep Physiology. Frontiers in Neurology. 2012;3. doi:10.3389/fneur.2012.00048.

Information provided on LakewashingtonPT.com and all of its web pages is intended for general educational and entertainment purposes and is not intended to be medical advice to you or any other person. You should always consult with your own medical provider about your health and medical questions and never rely on this or any other web site alone to make medical decisions. Never delay seeking medical advice or disregard any medical advice you have received from your provider because of anything you read or hear on this website.