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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Tool to kick start the relaxation response

10/2/2013

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Many clients come to me with a lot of anxiety, panic attacks, difficulty falling asleep, or feeling keyed up. One of the things we talk about is the "stress response" and its effects on the body - both short term and long term. Then we talk about how to induce the "relaxation response" and how controlling your breathing can achieve that. I've decided to share my handout on this breathing technique so you can use it too.

Breathing exercise to trigger the relaxation response

As you learn how to use this technique, it is helpful to find a comfortable place to sit where you can close your eyes. Once you’ve mastered this technique and are able to trigger the relaxation response through breathing, you will be able to use it anytime and anywhere.

Second, it is also helpful to visualize a place that feels safe and peaceful to you so that while you are trying to calm yourself down, you have a place you can imagine yourself in. For example, you could be lounging on a beach watching the waves, hiking through a forest, sitting atop a mountain, or hiding under the sheets in your bed. Any scenario works as long as it’s your safe space.

Third, some people also benefit from thinking of some positive thoughts or positive statements while they do this breathing exercise. It is not unusual for our minds to wander back to whatever is making us anxious, so you can use these positive thoughts to redirect your attention back to your breathing. For example, if you’re worrying that you’ll never calm down, or that the breathing won’t help, replace those thoughts with positive ones such as “this too shall pass,” or “I am in control,” or “calm calm calm.” 

Finally, as you breathe, try to keep your breathing smooth and try to breathe using your whole abdomen - lungs and belly. When we are anxious, our body breathes shallow and only from the lungs, so placing a hand on your belly to remind yourself to take full breaths is helpful.

So here is the exercise: close your eyes, think of your safe place, and breathe in slowly while counting in your head. When your lungs and belly are comfortably full, breathe out slowly to the same count. How deep the breath is doesn’t matter - it will naturally get deeper as the relaxation response kicks in - don’t waste energy worrying about that. All that matters is that the breath in is the same length as the breath out. 

Don’t worry if it seems too complicated to do all at the same time - the visualizing and the positive thinking and the counting. Use whichever aspects of this exercise work for you. Some people don’t need to count, and some people are distracted by the visualizing. Some people combine these together, like counting with a positive thought “one calm two calm three calm.” These are guidelines to help you figure out what will work for you.

I recommend practicing this twice a day - once when you get up, or sometime during the day, and once before bed. The more you practice it, the easier it’ll become, and this will be a tool you can use in any stressful, anxiety provoking, or angering situation from here on out.  

Please don’t hesitate to let me know if you have any questions or concerns about this technique.
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