Karine L. Toussaint, Ph.D.
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Healthy Sleep Facts

2/5/2014

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This weekend I had the pleasure to attend Dr. Catherine Schuman’s fascinating presentation “Integrating Sleep Management Into Clinical Practice” at the annual Massachusetts Psychological Association conference. Dr. Schuman was the Director of of Behavioral Medicine and Behavioral Medicine Training at Cambridge Health Alliance, Assistant Professor at Harvard Medical School, and has been an expert on sleep for many years. I wanted to share with you some of the very interesting facts she talked to us about, and hope this will motivate you to stop shortchanging yourself on sleep.

  • Insufficient sleep is associated with mood and cognitive disturbances, behavioral and academic problems, the onset of diabetes, lowered metabolism, high levels of cortisol, and increased hunger paired with a decreased ability to burn calories (how cruel!), among other things. (For more info you can also watch the 60 Minutes video from my previous post.)

  • We go through 3 stages of sleep - the first lasts just a few seconds or minutes and is the transition to sleeping. The second is a sounder sleep. And the third stage is the “deep” sleep we all need to recuperate and heal. If are deprived of our deep sleep, as you saw in the 60 Minutes video, we can get into big big trouble.

  • Until the age of 3, humans have a 50 minute sleep cycle. This means that infants and toddlers will go through a full round of sleep stages and then wake up every 50 minutes. Children 6 years old and older, as well as adults, have a sleep cycle of 90 minutes. Do the math and that means that if we wake up to soothe our infants and toddlers every time they wake up during the night, we will never reach our stage 3 sleep!! Take-away lesson? Train your infants early to self-soothe and fall asleep on their own so that you only need to get up when they need to eat or be changed. Tip: don’t train them to fall asleep in your arms! When they get drowsy and start nodding off, put them to bed.

  • How much sleep do we need? Newborns need 10-19 hrs every 24 hrs. Infants need 9-10 hrs/night, plus 3-4 hrs/day in naps. Toddlers need 9.5-10.5 hrs/night plus 2-3 hrs/day in naps. Preschoolers and 6-12 year olds need 9-10 hrs/night. Adolescents need 9-9.5 hrs/night. And finally, adults need 7-9 hours of sleep per night.  

  • Clients tell me over and over that they have adapted to having less than 7 hrs/night of sleep, but ALL the research out there says humans cannot function on less than 7 hrs in the long term. If you try to do it for more than a couple days in a row, your body will begin to show the signs of sleep deprivation and you will begin to suffer - physically and mentally. If you don’t get your deep sleep regularly, your body will reset itself and make you sleep, and all you can do is hope it’s not while you’re driving or in a meeting with your boss.

  • Some medications and substances will disrupt your sleep: alcohol, caffeine, diet pills, Ritalin, steroids, albuterol, theophylline, quinidine, and many others. Check with your doctor or pharmacist to see if your meds are the problem, and limit your alcohol and caffeine intake.


So ask yourself - are you drowsy or overtired during the day? Do you have problems going to sleep or staying asleep? Do you snore or have any unusual behaviors during the night? Do you wake up gasping for breath? Do you fall asleep easily during quiet moments in the day time? If you’ve answered yes to even one question, you may have a sleep problem. I encourage you to take this seriously, talk to a professional, and make time in your schedule for sleep, just as you would for healthy diets and exercise.

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How to help a grieving friend

11/6/2013

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This is a letter I sent to an inquiring stranger who asked me for advice via my webpage. She wanted to know how to help a friend of hers whose husband just died. I thought I’d post this here since it contains useful information for anyone trying to help a grieving friend. 

“I'm sorry to hear of your friend's loss, and commend you for caring so much for her that you are researching and reaching out for help - you are a good friend. 

Alas, there is never an easy answer to an inquiry like yours, especially since I don't know either of you. People can vary so much in their grief - what they will or won't talk about, who they'll lean on, how they are actually experiencing their loss, and how they handle the loss day-to-day. 

A first rule of thumb when supporting our grieving friends is to follow their lead - do they want to talk? Do they want to be distracted? Do they just want company? Do they want help with their chores? While talking about our feelings can be very helpful, you can also offer support in more ways than talking about the hard stuff.  

A second rule of thumb that may be useful to you is to practice active listening. Supporting a grieving loved one can be challenging, and it's very hard to see them in so much pain. Our instinct to help sometimes gets in the way, and instead of truly listening to what they want, we try to fill the silence and offer them what we think will help. The catch here is that we know ourselves best, so our first instinct is to tell them what we think would help us if we were in their shoes. Alas, that sometimes backfires since what might comfort you may not comfort your friend. So practice sitting with the silence and letting her fill it - then you'll have a better sense of what she wants. 

This also brings up the important point that you should take good care of yourself while you take care of her. This is a trauma for you as well, and being there for her may be draining for you. If you want to be there for her in the long-haul, pace yourself and make sure you have support as well. The last thing you want to do is burn out.

Finally, a last rule of thumb is that grief changes over time. This means that what your friend will be experiencing, and what she will need, will change over the course of the next few days, weeks, and months. So if your friend isn't comfortable talking about her thoughts and feelings now, she may be later. One of the things grieving people tell me all the time is that they get a lot of attention and support in the first couple of months, and then people disappear. So hang in there - if she's not ready to talk now, be patient and check in with her periodically.

With all that said, I think you were looking for some prompts to use too? If she does want to talk, it may be as simple as asking her "How are you holding up today?" or "How are the kids today?";  Or you could open it up with a statement such as "I was just thinking of John today when [fill in anecdote]." Or "I miss John. I can't imagine how you feel." Or share a good memory of him, and see if she goes with that. As long as you keep in mind the general rules of thumb, you don't start speaking in clichés, and your friend feels your support by her side, then you've done well.

I hope this was helpful. Don't hesitate to be in touch if I can be of further assistance, or if your questions wasn't fully covered. I wish you and your friend all the best on this difficult journey.”

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