Holistic Sleep Therapy

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HOLISTIC SLEEP

THERAPY THE AND FIELD OF SLEEP MEDICINE WAKEFULNESS ARE FUNCT IS IO NE NS W AND THAT A IS RAPIDLY CHAN RE CONTROLLED GING. SLEEP BY THE BRAIN VIA NEURAL PATHWAYS MEDIATED BY A VAST ARRAY OF NEUROCHEMICALS. IT HAS BEEN SHOWN THAT A DECREASE OR ABSENCE OF CERTAIN OF THESE CHEMICALS DIRECTLY LEADS TO SPECIFIC SLEEP DISORDERS, WHEREAS AN EXCESS AMOUNT OF THESE NEUROCHEMICALS CAN BE EQUALLY PROBLEMATIC IN TERMS OF DISRUPTION OF NORMAL SLEEP AND WAKEFULNESS.

“While medication can provide a “quick fix,

” individuals with sleep disorders would benefit by considering holistic treatments as a viable, long-term solution.

The ability to treat sleep and wake disorders can and should rely on the basic premise of medicine: “First do no harm!” If a disorder can be managed without introducing a drug or other external compound, more natural remedies should be tried first. As such, holistic treatments for sleep disorders are gaining in popularity. Because sleep afects our daytime functioning, and daytime functioning afects the quality and quantity of our nocturnal sleep, it seems reasonable to treat sleep disorder patients as a whole, looking at all aspects of their lives and looking at ways to change habits and diet that can afect nocturnal sleep as a first step. Prescribing medication, which often treats limited symptoms while leaving the root cause of sleep trouble unresolved, is typically a short-term remedy; in fact, medication can cause even more serious, long-term problems.

Holistic treatments take into account not only sleep patterns but also a person’s lifestyle, including work, school, interpersonal relationships, and social issues. Holistic treatments also involve evaluating physical qualities that might not seem immediately tied to sleep, such as weight, diet, level of physical activity, and stress.

Conditions such as insomnia and sleep apnea don’t just afect night time sleep; there are significant daytime conse-

Dr. Todd Swick

This article was written using information from an interview with Dr. Todd Swick. Dr. Swick is a board-certified neurologist, sleep specialist, and assistant clinical professor of neurology at the University of Texas Medical School at Houston. quences such as excessive daytime sleepiness, loss of concentration and impaired motor reflexes, leading to an increase in depression, anxiety, physical illnesses and motor vehicle accidents. There is clearly an interaction between sleep and mood disorders. What is not clear is the exact cause and efect. Does impaired or fragmented sleep lead to depression, or does depression cause poor sleep? Treatments that improve sleep have been shown to improve depression, and vice versa, so it can be helpful to consider both conditions before treating either.

While medication can provide significant benefits for people with sleep disorders, there is merit to a form of treatment known as cognitive behavioral therapy for insomnia (CBT-I). CBT-I is an interactive and collaborative process that gradually changes the patient’s lifestyle and habits resulting in improved quality and quantity of sleep. Studies have shown that CBT-I is as efective as pharmaceutical therapy for insomnia; in many cases, CBT-I is more efective. CBT-I has longterm applicability in that an individual who completes CBT-I is armed with an understanding of how diferent behaviors—such as sleep patterns, alcohol consumption, medication, job stress, and so forth—can afect the quantity and quality of sleep. Further, the patient knows how to adapt behavior to improve sleep.

While medication can provide a “ quick fix, ” individuals with sleep disorders would benefit by considering holistic treatments as a viable, longterm solution. S&W

SPORTS’ SPORTS’ SECRETSECRET WEAPON:WEAPON: SLEE SLEEP

EPSLEEP

BY MICHAEL J. BREUS, PH.D. (THE SLEEP DOCTOR™)

THE SEARCH FOR PERFORMANCE ENHANCEMENT LEADS SOME ATHLETES TO TURN SOME PRETTY DARK CORNERS. IT’S A SHAME, AND NOT JUST BECAUSE DOPING IS DANGEROUS, UNETHICAL,AND FREQUENTLY ILLEGAL. IT’S ALSO A SHAME BECAUSE ATHLETES AT ALL LEVELS OF PLAY HAVE ACCESS TO A POWERFUL TOOL TO IMPROVE THEIR PERFORMANCE,ONE THAT WON’T BREAK ANY LAWS OR PUT ANYONE’S HEALTH AT RISK.

CONTINUED H

C O N T I N U E D H

SPORTS’ SECRET WEAPON: SLEEP

WHAT’S THIS WONDER DRUG? SLEEP.

There’s been a welcome uptick in the attention paid by the media and athletic professionals to the benefits of sleep for competitive athletes, and to the research that shows just how sleep can improve physical performance in sports. The NY Jets brought sleep specialists into the locker room, signaling their intention to use sleep as part of their training strategy. At the other end of the spectrum, I was disappointed to read that Manchester United is addressing its players’ sleep problems by issuing sleeping pills. This strategy—and the coach’s seemingly cavalier attitude toward medicating players for sleep—is not what I recommend when I suggest that athletes and coaches pay more attention to sleep.

In recent years, Stanford University ’s Center for Sleep Sciences and Medicine has been at the leading edge of examining the sleep-sport performance connection. Researchers there have conducted studies with several groups of Stanford student-athletes, examining the efects of extended sleep on athletic performance.

“SLEEP PROMOTES MUSCLE RECOVERY.

SLEEPISA CRITICAL TIMEFOR CELL REGENERA TIONAND REPAIRIN THEBODY. ”

HERE’S A SAMPLING OF THEIR RESULTS, WHICH SHOW IMPROVEMENTS ACROSS A VARIETY OF SPORTS:

SWIMMING

Five members of the Stanford men ’ s and women ’ s swimming teams increased their sleep goal to 10 hours per night for a period of 6-7 weeks. This led to improvements in speed, reaction time, turn times and kick strokes. Swimmers shaved an average of .51 seconds off a 15meter sprint, they left the blocks .15 seconds faster, shaved .10 seconds off their average turn time, and added an average of 5 kicks to their stroke frequency. Out of the water, swimmers reported reductions in their levels of daytime sleepiness, improvements to their mood, more energy and less fatigue.

BASKETBALL

For 5-7 weeks, 11 members of the university ’ s basketball team extended their nightly sleep to 10 hours. As a result, shooting accuracy among the players improved significantly: Free throw shooting improved 9%, and three-point shooting 9.2%.

TENNIS

Researchers asked five members of the women ’ s tennis team to increase their sleep goal to 10 hours per night for 5-6 weeks. Players improved their sprint times, dropping from an average of 19.12 to 17.56 seconds. They also increased their serve accuracy, going from an average of 12.6 valid serves to 15.61.

FOOTBALL

Seven players on the Stanford football team spent 7-8 weeks attempting to sleep for 10 hours per night. Their extended sleep resulted in improvements to their 20yard shuttle—average time decreased to 4.61 seconds from 4.71—and to their 40-yard dash, which dropped to an average of 4.89 from 4.99 seconds. (Both the shuttle and the dash are among the drills conducted at the NFL Scouting Combine.) Players also reported improvements to their daytime energy levels and mood, and reduced daytime fatigue.

Sensing a pattern? Extending sleep times translated into significant improvements to critical game-day skills. Worth noting: not all athletes across these studies actually slept for 10 hours per night, but attempting to sleep for 10 hours per night got them additional sleep compared to their regular routine. According to researchers, many of these athletes came to their sleep-sport studies already sleep deprived.

And that gets to the flipside of the advantages that additional sleep can give to athletes. Sleep deficiency can inhibit performance. Research shows lack of sleep can also afect the longevity of players’ careers. Two recent studies investigated the relationship between sleep and career duration and stability among NFL players and MLB players. The NFL study looked at 55 players from across the league. Those who reported higher levels of daytime sleepiness were less likely to remain with the team that drafted them than those players who reported lower levels of daytime tiredness. And MLB players who reported higher levels of daytime tiredness had attrition rates far higher than league averages.

There’s also evidence that sleep can increase the risk of injury among athletes. In this study of teenage student-athletes, those who slept at least eight hours per night were 68 percent less likely to injure themselves playing sports than those who slept less than eight hours nightly. Researchers examined the sleep patterns and sports-related injuries of 112 male and female athletes from grades 7-12. They discovered that sleep and age were the most significant factors in assessing injury risk. (In addition to being more injury-prone when short on sleep, students were also more likely to injure themselves as they moved to higher grade levels.) The cognitive benefits of sleep translate onto the field. Memory, learning, reaction time and focus: sleep is critical to the brain’s ability to perform these mental tasks efciently and well. The brain uses sleep to consolidate memory into longer-term knowledge, clearing the area of the brain used for short-term memory in preparation to absorb new information. During sleep, the brain also works to prioritize the information it thinks will be important in the future. Sleep deprivation has well-studied negative efects on reaction times—and even a single night of sleep deprivation can slow quick response times.

Sleep promotes muscle recovery. Sleep is a critical time for cell regeneration and repair in the body. During non-REM stages of sleep, cell division and regeneration actually becomes more active than during waking hours. Insufcient sleep, on the other hand, hinders muscle recovery.

Sleep is a stress reducer. Sleep and stress have a tangled relationship—and both are dangerous to healthy immune function when we don’t get enough (sleep), or have too much (stress). Stress can interfere with sleep. This study ranked worry as the most common cause of sleeplessness among adults 34-79, but lack of sleep can also afect mood and make us more susceptible to stress and anxiety.

Is sleep the next big thing in sports? I’d say it’s more than earned its shot in the big show.

Dr. Michael J. Breus

This article was originally published on www.theinsomniablog.com on November 19, 2012, where you can see details of the research for this article. You can read more of Dr. Brues ’ insights on his web site, www.thesleepdoctor.com, or by following him on Twitter @thesleepdoctor.