We need sleep to recharge and repair our bodies. It is meant to be an automatic function, triggered by the circadian rhythm, which controls our internal clocks. We can appreciate this when we have the opportunity for distance travel and it takes a few days to accommodate to a different time zone. For others, sleep eludes them for many reasons, including: they can’t turn their thoughts off; they are very anxious or stressed; they can’t get comfortable; and some are in such pain that they can’t settle. Really, anything that disturbs homeostasis, the steady-state of our bodies’ operations, has the potential to disturb sleep. For our clients, in the St John’s NL area, we always ask about sleep because we expect that sleep could be impacted by the pain that brought them to the clinic. It is surprising how many have pre-existing sleep problems! It is concerning because disturbed sleep is a reason for delayed healing; and that can certainly affect treatment success.
Beyond the reasons already mentioned, an emerging and important reason for disturbed sleep is the blue light emitted by computers, which associates with an emerging health concern – named by some authorities as digital dementia. Essentially this refers to the breakdown of cognitive abilities as a result of the overuse of digital technology. This breakdown of cognitive abilities is similar to what is more usually seen following a head injury or Alzheimer’s. When excessive computer use is the cause, it is generally reversible. Other reasons for poor sleep relate to automatic functions, over which we don’t have such easy control. This refers to balance within the area of the brain responsible for sustaining life, such as breathing, heartbeat, blood pressure, sleep … and many, many reflexes. Powered by the autonomic nervous system, and generally responsible for our ‘flight or fight’ response to danger, much has been written about dampening this sympathetic ‘flight or fight’ response to attain a parasympathetic state of calm. Meditation is the exercise of attempting to focus conscious thought to invoke the parasympathetic state of calm. There are decades and centuries of experience that support this practice; and while not originally intended to induce sleep, it is a much written about strategy for sleep management.
Did you know there is considerable sleep help available to clients within our clinic, and most health care clinics? Both acupuncture and massage very directly induce calm and the parasympathetic response, which can last up to a couple of days after treatment. In our clinic, clients who are being treated with Laser often report improved sleep. Muscle work and fitness strategies, selected and graded to match injury, have a huge and increasingly lasting impact when repeated over time. In fact, our control of muscles represents the primary way in which we can influence baseline factors which can influence both automatic and conscious brain function. Within our clinic, we appreciate there are multiple potential contributors to disturbed sleep, and strongly advocate for a collaborative approach to care for our clients with disturbed sleep.
Our clients with disturbed sleep are also offered home management strategies, which target righting, sleep and respiratory reflexes of the brainstem; glymphatic (lymph) drainage of the brain; and home exercise to prolong treatment effects.
So….the tips from our team are:
- Sleep position: Your best rest comes when your head and spine are in a neutral (extended) line. In side-lying, this means your neck is supported so your nose and ears are in the same plane, and parallel with the floor. In back-lying, your head is not elevated and your ears are in line with your spine; for people with rounded shoulders, this often requires a small pillow so that your head doesn’t drop back below the level of your shoulders. Stomach lying is generally not a healthy sleep position. A good sleep position allows for best drainage of the brain, which occurs mostly at night.
- Small things to do throughout the day…as many times as possible (think every hour)…put yourself in an extended position. Our need and ability to withstand gravity is a powerful reflex, and we can use it to modulate brainstem activity.
– stand with you back to the wall (for feedback) and actively practice good posture. Feel your hip and shoulder blades against the wall. Make sure your feet and knees are in line with your hips. Let your ears pull your head closer to the wall (don’t tip your chin up) and hold the position for up to 2 minutes.
– standing on one leg for 10 to 40 seconds. Be careful not to twist. Use the back of a chair or the wall, if you need help to balance. Be careful not to lean forward to take weight through your arms and lose your extended position.
– take time for a walk, the more often and longer, the better.
- Deep breathing – this can be done in isolation, but it is also a part of all exercise …. Breathe In with effort and breathe out with a release or relaxation of effort, to the rhythm of 1:4. Breath in slowly, then exhale to the count of a slow 4. Deep breathing can be performed in association with hold and relax of muscles, one pair at a time, in a process called progressive relaxation; often with a relaxation tape. This works because breathing also stimulates normal activity within the brainstem and has a calming effect.
- Research and manage blue light from the computer – Use tinted glasses or tinted computer screen covers to negate the blue light; and turn off your devices 30 minutes or more before bedtime. This is a big consideration, given that early research is associating poor sitting posture and excessive computer time with neurodegenerative conditions, including Alzheimers. It’s very worthwhile to do your own research with respect to this.
- Do your physio exercises – All of the above activities could contribute to improved sleep, especially if pain or discomfort hasn’t been the factor which tipped you into disturbed sleep. That said, physio exercises are always given to correct muscle balance around a joint; whether that is the result of trauma, a repetitive strain injury, or a degenerative joint condition. etc. What is significant is that using the muscles impacted by injury has a positive effect on pain and a calming effect on the brainstem. Physio exercises are graduated to take into account the degree of injury…just exercising often exaggerates the problem, and can be counter-productive. Your physio will modify exercise to match the ability of healing muscles. These exercises are unique to your injury.
- Massage & Acupuncture; and Laser. With physio, a client has to do the work to derive the benefit; it requires you use your muscles. Massage & acupuncture are passive therapies, in that the therapist does the work. They can, however, directly impart a parasympathetic calm, and improved sleep, which can last a couple of days. There are many reasons why these modalities may be recommended as part of a treatment plan. A very good reason is the identification of disturbed sleep. Laser is an electrotherapeutic modality, like TENS in that it is powered by electricity or battery; but very, very different in function. Laser supplies additional ATP, cell fuel, to injured or underperforming cells within muscles, joints and most other tissue types within our bodies. This stimulates cell metabolism and healing. It stimulates brain-stem activity and improves lymph drainage which is probably why our clients often report improved sleep following laser treatments.
- Control Sound and Scent, etc. Your general sleep environment is also an area to consider when sleep is elusive. For instance, window open/window closed; sleep with your back to the wall / or facing the wall; and pillows between your knees, etc. All of these strategies can be impactful. Two areas of consideration which also have considerable potential to be effective are sound and scent. With sight (mentioned above), these senses have direct access to your brain and can also impact steady-state operations. Lavender is reported to be a particularly effective scent for calm and relaxation. Classical music is calming for many. However, scents and sounds are individual preferences; and what works for one may not for another.
- Professional psychological Counseling. When simple strategies don’t work and/or when the issues driving poor sleep are more related to stress, anxiety or emotional drivers, counseling may offer the sleep assistance you need.
To summarize, poor sleep is significant, both to overall and future health but also to healing from any particular pain or injury. It is very personal, yet often benefits from inputs and therapies across several disciplines to understand and manage. When poor sleep hampers recovery, we believe it is really important that our client’s confide in us; not so much about the details of an emotional crisis as the fact that they are dealing with one. We can personalize the helpful strategies within our sphere of influence to best effect. And we know that a problem with many inputs often needs a multi-dimensional solution. We will always respect your confidences!
We always welcome new clients! Please call if you think that, working together, we can help you. Call 753-0155 or email: email@example.com
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