There was an article recently that stated that 9 million people are receiving prescriptions for sleeping pills. This shows the true issue with healthcare in America. We want an instant solution and we do not want to do any work. We also do not consider that medication does not give us the same type of sleep natural sleep gives the body.
The issue is why do we need to take pill to sleep and is there another solution that works just as well as a pill? I am not saying that there is not a reason for some people to take sleep medication. But it should not be the first choice to treat, poor sleep and fatigue. The physician treats disease and disorder they do not promote wellness. It is most likely that your doctor is as tired and has as poor sleep habits and is walking around as fatigued as their patients.
The first step is to decide if you have a sleep disorder? If you have an answer to the STOPBANG survey of greater than 3 than you need to talk to your doctor:
1. Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?
2. Do you often feel TIRED, fatigued, or sleepy during daytime?
3. Has anyone OBSERVED you stop breathing during your sleep?
4. Do you have or are you being treated for high blood PRESSURE?
5. BMI more than 35?
6. AGE over 50 years old?
7. NECK circumference > 15.75 inches?
8. Male GENDER?
The next step is to look at your sleep routine. Our brains are computers in that they need a routine to slow down and allow our body to release the hormones that promote sleep. A routine is not put on my pajamas and go to bed. It should be 20-45 minutes prior to going to bed. It also should generally occur 7 days a week at the same time each night. Our brain does not know weekdays and weekends it just knows the 24 hours of the day. Choose a specific bedtime. Do the same activities each night for the 45 minutes prior to going to sleep. These should be activities that will help you to unwind. I do ten minutes of yoga because it helps me to relax and allows me to concentrate on my breathing so my mind will stop racing with ideas. Create a routine that works for you that does not include television or computers.
Electronics are the new biggest issue to increase our inability to sleep. Cell phones need to be away from the bed. The light stimulates the brain to not release Melatonin. In order for our brains to transition from wake to sleep we need exposure to dark. Cell phones prevent that. When we check our cell phones during the night we again stimulate the brain confusing it as to whether they it is supposed to be awake or asleep.
Exercise is another factor to help sleep. Studies show that exercise over the long term helps to increase sleep and its quality. That means that if you work out in the morning it might not help with that particular night’s sleep but that if you work out three days a week for a month your sleep will start to improve. You have to decide what exercise you can fit into your life. There is no right or wrong it is about increased movement.
There are many other ways to help you improve your sleep without turning to a pill as your first resource. It is essential that we look at healthcare for what it is disease management not wellness management. It is important for you to do your research and to understand how important it is for you to make an informed decision about healthy sleep and how you can achieve it. If ultimately you need it than a sleeping pill might help. Just remember pills have side-effects you may not be aware of.
One of the most helpful practices is the use of progressive relaxation to deal with the stress at the end of the day. This will help reduce your desire to munch, wine or stair at the ceiling all night. This is not hard to learn and will be an enjoyable part of your sleep routine.
I first learned to do this in a test taking class in high school many moons ago. I later taught my children this as a way to relax. My daughter used it to fall asleep and to help her when her creativity has a momentary block. My son used it when his anger would get out of control. It help me survive their childhood with my sanity.
The first step is to get that comfortable spot. Some people sit up and some lie down. It is a personal preference. It always starts at your feet and tighten them as tight as you can and hold for 10 seconds then relax for 10 seconds. Move to your ankles and do the same thing flex for 10 seconds than relax for 10 seconds. Move up your legs to your bottom. That is a large muscle and will really help you to relax. Move up your abdomen and chest to your shoulders. Then you need to move down your arms. Always tighten for 10 then relax for 10. Finally you need to do your face than your scalp. That is where I start to do visualizations if I am going to.
Visualization is not my strong suit but I imagine a soft while glowing ball growing from the middle of my chest all the way out to my toes and fingers. I see the light heal any soreness and weakness I might have. It is my light so I can make it do what I want.
All of this take about 10-15 minutes and helps me feel very relaxed. It is a tool I am using frequency while I am working and going to school and raising children. It is a great tool for focus and does not require anything special except maybe some music. I have used Jeff Gold’s music to help with my exercise and to relax at night. He has a gift for the beauty that music can lend a relaxation technique.
One of the first issues I hear when a person comes into a sleep lab to be introduced to a CPAP is that they have claustrophobia; that you cannot stand to have anything on your face. There is always an excuse for not tolerating therapy. Most of the reason has to do with feeling out of control. There are so many ways that can create a successful experience.
Let’s start with the mask. It is probably the most important piece of equipment you will use and the easiest to change. If you are unable to use the mask during the night of your study tell your tech, however, what usually happens is that they use the mask for 1-3 days at home and find that it is not the best mask for them. It may move too much causing leaks, it might cause your skin to mark or breakdown, it might make your eyes dry; all these issues can be handles with a change of mask. It is also common for people who are claustrophobic to be much more successful with a full face mask due to the ability to breathe through both the nose and mouth which will make anyone more comfortable. Your insurance will pay for replacement mask during the first thirty days of the therapy. After the first thirty days a new mask must be ordered. At many centers they will allow you to trial or borrow masks to find one that will work for you.
Knowing how to perform relaxation techniques will allow you to be successful when you are trying to fall asleep the first few days. It can also help on days where your stress level is high. The two techniques I have found that help are progressive relaxation. This is easy to learn and allows you to focus on relaxing as well as helping you to focus your thinking.
1. Start at your feet and tighten them as tight as you can, hold for the count of ten and then allow them to relax and go limp
2. Progressively move up the body focusing on one muscle group at a time.
3. To reach the top of your head should be having spent about 10 minutes on deep breathing and your muscles may be relaxed. This centered concentration helps increase oxygen levels and allows the mind to camp down preparing it for bed.
Diaphragmatic breathing is another exercise that will allow you to relax and breathe deeply with a technique that takes focus. Lie flat on your back with your hand on your stomach just below your ribs. As you take a slow deep breath in push your hand out; when you exhale draw in your abdominal muscles so you are pulling your hand in. I usually like to hold the breath 3-5 second between peak inhalation and exhalation. Having to concentrate allows the mind to calm and it increases the oxygen level from doing nice slow inhalations.
If relaxation techniques do not work for you medication or working with a councilor that practices Cognitive Behavioral Therapy. Your physical can help you to find assistance that will work for you. It is not unusual for someone to need a little extra support, this is long term therapy and sometimes it takes a little time to become compliant with it.
Some accessories can help you with some of the small issues. Chin Up strips can help a mouth breather minimize the leak. A Gecko will help with sores on the nose and leaks into the eyes. A heated hose might help with mouth drying.
Overall working with a patient technologist or physician is the best way to be successful when using PAP. The more you communicate about your issues the sooner a solution to help you be successful on your machine, and sleeping a healthy sleep.
As we start the New Year we always make resolutions or goals we would like to achieve during the year. This past year we have all learned that sleep affects all aspects of your health and so you may want to add a better night sleep as one of your goals for the year. The problem is how to approach this to make it practical. Creating SMART goals are usually the most successful goals.
Let’s look at some small changes you can make and add to your daily life that can improve your sleep. These are not big things but small changes you can add to your routine and as you build one on the other you will find that you will sleep better and have more energy during the day.
· Give you your electronics 40 minutes before bedtime. The light given off by your electronics confuse your brain and make it believe it is daytime. If you turn them off 40 minutes prior to bedtime you give you mind time to relax and allow Melatonin to be releases helping you to sleep. Melatonin is released when you are exposed to darkness. So turning down the lights, turning off the electronics and enjoying the quite time during the evening helps to allow this hormone to be released.
· Practice diaphragmatic breathing. One of the great ways to relax is to deep breathe. Lie down, put your hands on your abdomen just below your ribcage as you inhale push out against your hands, as you exhale pull your abdominal muscles in. This exercise helps you to increase your oxygen levels, increase your lung capacity and calm your brain due to your concentration on your breathing. Doing this for 5-10 minutes as part of your bedtime routine will help you especially if you have transient insomnia, or insomnia caused by a particular issue.
· Create a bedtime that is 15 minutes earlier to increase your sleep time. Large changes in bedtime will most likely lead to insomnia but a small change such 15 minutes will allow you to increase your sleep time without adding time just staring at the ceiling.
· Do not use the snooze button. You will find that if you get up at the same time every day and do not linger in bed you will have more energy during the day. It will also help you to not feel so
· Add ten minutes of sunlight to your morning routine. Open the curtains, sit out on the balcony, or take a walk. Any of these ideas will help you to feel more awake and have more energy. Your brain needs the light to tell you to be awake just like it needs the dark to tell it to go to sleep.
These are just a few ideas to add to your life during the New Year. It is not necessary to add all of these ideas or to add them all at once but when you are making a goal using the smart method is the best way to more ahead. Each of these is measurable, sustainable, and very specific. I know improving your sleep will make this year a great your for you.
The more research that is done the more people realize a child’s sleep is essential to their learning and their behavior. Many children have poor sleep habits or have issues such as snoring that disrupts sleep during the years when the child’s brain is developing. We are told it is okay if they snore or you are told that they need to take medications to treat the symptoms. What your child might actually need is a sleep study.
The newest studies say that snoring in children can be an early indication of learning disabilities. Poor sleep has also been linked to inattentiveness, irritability or poor memory. These symptoms may sound familiar to some parents. Evaluating your child’s sleep can be very easy.
You start with keeping a sleep diary to see how much sleep your child is getting. You should also include any out of the ordinary activities and their caffeine intake. It is easier to see if there is an issue when you have something concrete to look at. This can be done on a simple piece of paper or you can download a sleep diary for free from the internet.
Consider the age of your child. Children need different amounts of sleep depending on their age. It can also change depending on whether or not they are getting ready to grow. Since growth hormone is produced predominantly during sleep a child who is about to have a significant growth spurt will want to sleep more often and for longer periods of time?
Listen to your child. If they can not make it until bedtime without a significant meltdown than maybe bedtime is too late or maybe they need a short afternoon nap. A school age child might benefit from a 20 minute nap when they get home from school to help them to recharge. They may not need to take a nap all the time but they may need it because they are growing physically or they are learning a great deal and their brain may need to rest so they can process everything they learned.
Create a good sleep environment for your child. Their bedroom should not be cluttered and there should be minimal light prior to bed. The computer, television and cell phone can disrupt the brain’s ability to produce Melatonin, the hormone that tells your body it is time to sleep, and keep you from falling asleep in a timely manner.
Remember that you are in charge. Children will naturally see your request for them to go to bed as something to challenge. It is up to you to set the limits needed for them to grow and learn. Once they see there is no arguing, a hard lesson for us parents to learn, they will understand it is bedtime and will stop arguing.
In the end we all want what is best for our children and for them to be successful at school. The best thing we can do for them is to teach them that sleep is an essential part of their life and that they can use it as a tool to be healthy and to be successful in school.