Category Archives: sleep

Healthier Together Series: Cycle 7C. Relaxation & Sleep – Allow Sleep with Sleep Training

Posted on May 8, 2020 | 1 comment

Bud Winter was one of the greatest Track and Field coaches who developed world class sprinters who competed globally and broke world records. How does a coach produce 37 world record holders, 27 Olympians, facilitate 3 NCAA championships and produce 49 NCAA records? Among with his athletic coaching skills, he helped his athletes master meaningful relaxation and sleep.

It all started in World War II, when he developed a relaxation and sleep training technique that allowed naval pilot cadets to be able to fall asleep within 2 minutes, in broad daylight, sitting upright wherever they landed, surrounded by the sounds of war. After 6 weeks of training, the relaxation and sleep training program demonstrated success in 96% of the cadets.

For those who have heard me speak or who are patients of mine, you know about this and you may have already begun your training. Here’s what you need to know.

  • Every human has the ability to learn how to completely relax the mind and body. However, you may find it takes regular practice before you can appreciate how effective this is.
  • True barriers to sleep:
    • If you believe you can’t or won’t sleep, you won’t.
    • If you move or think about activities or negative thoughts, you will need to settle down to sleep.
    • Certain medications, supplements, drugs, and alcohol can interfere with your mind’s ability to get restful sleep.
    • Untreated sleep apnea.
  • When you can completely relax your body and then clear your mind for 10 seconds, you will automatically drift off to sleep if you need it.
  • Steps to learning to completely relax your body:
    1. Get in a comfortable position, seated or laying down and begin deep belly breathing. Slow down your breathing.
    2. Begin progressive relaxation from your forehead and scalp. Begin by relaxing the muscles so that all the forehead wrinkles release. Breathe slow and steady.
    3. Move down to releasing your jaw muscles, the muscles around your eyebrows and eyes. Let your eyes get limp.
    4. Continue releasing the face, lips and mouth muscles.
    5. Breathe slow and steady as you work your way down your body, progressively relaxing each part of your body until you have relaxed down to your toes.
  • If you want to sleep, after you are completely relaxed, you will then train your mind to be blank for 10 seconds. Bud winter recommends multiple ways to do this like visualizing laying in a canoe on a still lake, staring up at the sky or repeating simple words.

What’s so wonderful about this is, to know what’s possible. It’s possible for almost anyone to learn to completely relax the body AND to be able to fall asleep within a few minutes, no matter how stressful the awake hours might be.

We know the importance of relaxation and sleep on overall health and well-being, but also on performance. The world’s best athletes have learned how to relax completely between moments of competitive, intense focus, and they know how to get restful sleep. In the past, this training was available only to some. Now, we can all learn and benefit. Anyone who wants to, who practices, can and will be able to master this. I have seen the this work for children, adolescents and adults of all ages, for those who are already high achievers, those who are struggling and those who are just looking to acquire more tools for self care.

Allow yourself time for rest and sleep. Then, use that opportunity to master the ability to completely relax your body and be able to drift off to sleep whenever you need it. After you have mastered relaxation and sleep, you can tap into your best self. Think about the possibilities.

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Posted in Habits & Behavior Change, Healthier Together, relaxation, sleep

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A Tool for High Performers: The Caffeine Nap

Posted on July 26, 2019 | Leave a comment

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We’ll keep this quick, because you have things to do. As a physician of high performers, sleep is a common discussion topic. Due to travel across time zones, irregular schedules, long days, responsibilities and/or having lots on the mind, there are times when sleep is limited and yet we need to be able to perform. Here’s a common formula: [Feeling Sleep Deprived & Tired] + [No Time for Full Night’s Sleep] + [Need to Perform at Peak Capacity] = [Unnecessary Unhealthy Stress.] This can be treated or prevented.

Here’s one tool (of many) that you may find helpful for those times: The Caffeine Nap*. (*If you have a caffeine sensitivity, are responsible for operating heavy machinery or are driving or flying, this is NOT recommended.)

1. Set alarm for 30 minutes.

2. Drink an unsweetened coffee or espresso.

3. Nap. (We will review HOW to fall asleep quickly in a future post)

4. Wake up to the alarm as your caffeine kicks in and your mind is in “Game On!” Mode.

5. Know that you’ve got this.

Let me know how you’re doing. Drop me a line.

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Posted in performance, sleep, Travel

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Healthier Together Series: Cycle 3C. Relaxation & Sleep — Missing Nature

Posted on September 24, 2014 | Leave a comment

behzad-ghaffarian-LBjA0WPtUhQ-unsplashAre you wired 24 x 7? Do you ever unplug? Maybe it’s all about missing nature.

We are busy. There’s so much to do & often, not enough time. When we are staring at a screen for much of our day (smartphone or tablet or TV or computer or movie or presentation), we are missing an opportunity to view nature, other beings in 3-D, in real life. We may be focused on driving to our destination or doing a task (often with electronics involved), we may miss the subtle beauty and appreciation of the world around us. We lose the ability to process and recover from our daily events and it becomes easier to close ourselves off to the joy and vibrant world around us and we may gravitate towards UNhealth: increased stress, poor sleep quality, more frustrations, poor nutritional choices, less time spent making healthy choices, increased blood pressure, more chronic disease issues, less enjoyment,  more depressed or anxious moods, diminished sense of humor, fewer interpersonal relationships, decreased sex drive and burn out.

In addition to meditation, journal-ing, listening to beautiful music, singing, dancing, physical activity, connecting with others (people/animals), one of the simplest ways to recharge is by spending some time in nature. Just being in nature. It has been shown that even having a picture of nature in plain site, improves overall well-being in those who see it, so imagine how powerful it is if you can see it in real life. All it takes is a few potted plants outside where you can sit or stand. Or a small path you can walk along with plants or pond or water along the way. A place where you can feel the wind on your skin and hear the birds or the waves or the movement of water or leaves.

This small but powerful exposure to nature doesn’t have to be exotic or take a long time or require time off from work. In fact, put some plants in your office or home. Put a cut flower in a vase. Step outside into the sun (or rain or snow) for a midday break. Take a walk in the woods or arboretum or park or neighborhood. Allow yourself to pause and notice the nature around you. Seeing and appreciating the natural world around you will nourish you. Think about whatever you want. Spend as much time as you plan – whether it is based on need, ability or desire. Nature accepts you as you are and you are part of nature. Remind yourself that you are human and it’s OK to take a small break and recharge.

Over time, if you allow yourself regular exposure to nature, no matter how brief, you will notice a small change inside of yourself. That internal flame, your life source can glow and grow. Then there’s the ripple effect. Things will start to improve. You will start to feel better. You can gain perspective, remember the beauty and awesomeness of nature and learn to love and accept yourself and others as nature intended. There is always change around us, and we can’t control it all and that is how life is supposed to be. We can more easily accept and adapt to those changes, improve our sleep, enjoy more relaxation and our continue to improve our overall well-being by allowing nature to recharge us. We are natural beings. Give nature a chance. You may just be missing nature.

Photo by Behzad Ghaffarian on Unsplash

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Posted in Habits & Behavior Change, Healthier Together, relaxation, sleep

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Healthier Together Series: Cycle 2C. Relaxation & Sleep — How much is enough?

Posted on April 15, 2014 | Leave a comment

jordan-whitt-EerxztHCjM8-unsplashToday’s notes are about sleep.

Everyone needs it. Your brain is very active during sleep & it helps process all the events of the day, create memories and it performs repair, healing, maintenance and building functions during sleep.   Without adequate sleep, our body & mind suffers. We make mistakes not only in our awake activities, but our body cannot repair, heal or perform maintenance or building functions as well and may also make mistakes. With chronic sleep deprivation, our body and mind starts to wear down from the daily stresses and we may develop mental & physical health problems including weight gain, chronic diseases, illnesses, depression, anxiety, fatigue,  etc.

At different times in our life and depending on different circumstances, our  needs for sleep will change. During times of intense brain growth and development, we need more sleep (think babies, toddlers, children & adolescents). When we are sick or have chronic diseases, we may benefit from more sleep as we need more time to repair, heal and maintain. When we travel across time zones or have shift work, we may need more sleep because we often develop a sleep debt (I will talk about shortly). We may need more sleep in the colder, darker months than in the warmer, lighter months.

The average adult needs 7.5 – 9 hours of sleep a night for optimal function. [**NOTE: If you are fit, you may be able to get away with less sleep as your sleep is more efficient.] Each sleep cycle is approximately 90 minutes and is divided into deep sleep stages and then REM (rapid eye movement) sleep stage.

Note that sleep is different throughout the night. In the earlier cycles of sleep, more of the 90 minute cycle is spent in deeper sleep stages which are restorative. Later sleep cycles have more of the 90 minutes spent in REM sleep, when you are dreaming. If you have missed sleep, your body naturally will try to make up the sleep stages it is missing, but it throws off your sleep balance and takes time to get back into your natural sleep/awake rhythm.

Overall, you want to maintain a regular sleep routine as much as possible. Remember how important your sleep time is & plan AROUND it as much as possible. Your mind and body will be in a better state if you get enough sleep because it will be able to do all the repairing, healing, maintaining and building functions it needs to to function at its best. Bottom line, you will feel much better and have fewer health issues if you allow yourself enough sleep.

So, prioritize sleep and make sure you get enough. How can  you get enough? First, assess your sleep:

1. Add up 5 days’ worth of sleep hours. (I get the number of hours of sleep from my smartphone app). If it is 37.5 – 45 hours, you are fine. If you have LESS THAN 37.5 hours total over 5 days, you have not given yourself enough sleep time.

2. You can also figure out the average number of hours of sleep over 5 days.  It should be at least 7.5 hours daily on average. (I add up the number of hours over 5 days & divide by 5. That’s my average number of hours of sleep each night.) The average is nice to know so that you can see how much more time you have to add each night in the future (after you have made up your sleep debt).

3.  If your your total sleep time is less than 37.5 hours OR your average number of hours sleeping each night is less than 7.5 hours, you have a sleep debt you need to make up. 

Good news: If you have a sleep debt ( you are sleep deprived),  you CAN make it up over several subsequent nights.  

Here is how you can make up your sleep debt:

1. Figure out how many hours you need to make up & make them up over the next several days. For example: Total sleep was 32.5 hours. You are short 5 hours. You will have to make it up over the next several days (not all at once!). You may have a couple of weekend days when you can sleep in a little longer or you may want to go to bed earlier.

Note, that in the example of total sleep = 32.5 hours (there is a sleep debt of 5 hours total), also means on average, 6.5 hours of sleep per night. You would want to plan to make up the 5 hours over the next several days, such as sleeping 8.5 hours each night for 5 nights. But also note that in the future, you will need to find a way to add 1 hour of sleep per night to stay out of the sleep debt. Adequate sleep is important so that you don’t burn out your mind or body and you can maintain optimal functioning.

2. If your sleep debt is more than 9 hours, you may need to allow extra make up sleep to catch up, maybe 10 or 11 hours of make up sleep over the next week to make up a 9 hour sleep debt. So don’t let the sleep debt build up! It pays to pay off the sleep debt earlier, before it adds up to too many required make up hours where it becomes harder to catch up!

3. If you have insomnia or cannot sleep, that’s ok. You will still benefit if you allow yourself to lay quietly for the time you have planned. Whether you fall asleep or not is not as important as turning yourself off to the outside world for a period of time. You can still allow yourself much of the restorative functions of sleep by closing your eyes and meditating or relaxing so that you do not have to respond to anything. Laying quietly or with some soothing sounds will allow your body some time to perform some of the maintenance and repair functions that might have been skipped due to lost sleep hours.  With regular routine rest times, over time, your natural sleep/awake cycles will coordinate with your timing needs and allow you to sleep as your body and mind needs.

Sleep is important. It’s the time your body takes care of you and gets rejuvenated, healed, repaired, tuned up and restored. Protect your sleep time and work to respect your needs for sleep. Prioritize it. Take care of your body and mind & they will take care of you! Humans were designed to be healthy!

Photo by Jordan Whitt on Unsplash

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Posted in Habits & Behavior Change, Healthier Together, sleep

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Healthier Together Series: Cycle 1 C. Relaxation & Sleep — There’s an app for that…

Posted on February 28, 2014 | Leave a comment

Today’s Relaxation & Sleep Notes:

This group of notes will be geared towards how to relax, decompress, reduce stress and/or have more satisfying sleep. As a physician, I often have people come to me looking for a pill to help them relax or sleep or otherwise decrease their mental activity, quiet the mind. They are basically asking me for something to turn the brain’s conscious mind “off” or at least turn it down. Unfortunately, many of these pills are addictive or at least can cause a physical dependence. The media seems to promote these drugs as if everyone is taking it and it is “normal” almost to the point of making these pills trendy.

I am not a fan of pills if they are not necessary. And I am DEFINITELY not a fan of causing someone to become dependent on pills unnecessarily, and especially if there might be an alternative way to take care of them. Many of these pills, other than having dependence and addictive potential, can cause motor vehicle accidents, injuries at the workplace, allow misuse by “sharing or selling” it to others, and they take away your control of your own mind’s abilities to self regulate and calm itself. Also, over time, some of these meds require increasing doses as the body adjusts and needs more. They can have terrible withdrawal. In the worst cases, they can kill.

You can imagine, I wanted to learn other options for my patients–and initially, this search was prompted when I first started interacting with pediatric cancer patients and their family members. The children were scared, anxious or in pain or uncomfortable or dreading treatments. Also, their parents, siblings and close friends were having difficulties watching a loved one go through pain, procedures and fearing suffering and death. I wanted to be helpful.

I looked for options that would actually empower my patients and their families, improve their well-being, allow them to sleep, decrease their anxiety. I searched for options that would be able to be used on the road, at work, in the hospital, anywhere & whenever they needed it. I wanted tools that could be flexible – used for relaxation or for sleep, and that got more effective with time.

Fortunately, I went to a medical school that is progressive and understands the complexity of the human experience and appreciates an integrated model of providing health care. I had the opportunity over 3 years, to get advanced training in Medical Hypnosis. And guess what I found out? Using what I learned in my Medical Hypnosis training, I learned to teach my patients how to quiet their own minds. They learn how to train their own minds to relax, and if they want, to sleep!

Interestingly, there are apps for this also. The key is practice. How do you practice? Repetition.

I recommend finding a self hypnosis app or use Bud Winter’s sleep training or find a trained specialist who does medical hypnosis and chose a single method you like and use it regularly for a period of time. It will become more effective, and work faster, with practice. It’s a way of learning how to allow your conscious mind to talk to your subconscious mind. Once you learn the power of self hypnosis and develop the ability to control your own mind, you can accomplish anything. Relaxation and sleep will be within your mind’s control because you will have learned a way to quiet the mind.

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Posted in Habits & Behavior Change, Healthier Together, performance, relaxation, sleep

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The Freedom to Choose

Posted on July 4, 2013 | 2 comments

Today, on our nation’s birthday, I do not have to go to work. I appreciate my day is full of free choices. Every day, we make choices to move forward or to move backwards. Nothing ever stays the same. I choose today, to make choices that help me move forward.

I started my day choosing to wake up to my favorite alarm clock app. (It wakes me up when I am in my lighter sleep cycle in the 30 minutes prior to my goal wake up time. This makes wake up significantly much easier for me (as I am NOT traditionally a morning person).) Then, I threw on my workout gear & headed to the basement, my home gym. As I grabbed my water bottle, put on my heart rate monitor & started my music, I was already in such a good mood! I was awake to do something good for me and I have the ability to move my body. What a gift!

After warming up my muscles, I started lifting weights and enjoyed the quiet in the rest of the house while I was able to focus on my body and my health. I had time to notice how much easier some of the sets were, how my muscles were ever so slightly more defined; my mind felt clear and optimistic about the day and I thought of the many patients in the past few weeks who had talked to me about their health. Specifically, I thought of the patients who mentioned joint pain during their office visit. There were 3 groups of responses to joint pain.

Some patients stated they had joint pains and stated they could not exercise and were very limited in their lives because of it. Often, they had been told they had arthritis or some other joint issue that would never be fully better or would require an invasive intervention to “improve it.” They had somehow been convinced that it was never going to get any better. They were focused on the pain & had become a victim to the pain. Often, they would ask for a “band-aid”- like pain medication. They had given up on getting better, they just wanted to mask the pain, even if it meant creating new problems like constipation, nausea, dependence on medications, drowsiness, etc. Unintentionally, they were moving backwards, getting “worse.”

Several patients had joint pains and they were grateful that because they were doing some form of movement/exercise, it was not getting worse. They were grateful they COULD still move. They wanted to learn what else they could do.  They wanted their list of choices to move forward. They were focused on staying independent and working towards higher quality function from their bodies. They came for guidance & were eager to comply. If they were given a home exercise program, they would do it. If they were sent for physical therapy, they would do it. If they were sent to see a specialist, they would do it.  They knew they could make choices that could help them. They listened to their bodies and trusted they could make themselves better if they were given the right plan.

The third group of patients had joint pains and found that by choosing exercise (including yoga, home exercises, physical therapy, individual workout programs, working with a trainer, etc.), they had healed themselves or improved their pains. They felt grateful and powerful. They wanted to know what choices they could make, what they could do, to continue to stay healthy- how to improve their bodies even more. They were empowered and living life to their fullest.

As I moved onto my interval training, I considered it interesting that in my practice, these three different kinds of responses to joint pains were not correlated to the amount or duration of the pain. They were all about attitude and faith (or loss of faith) in their bodies. And of course, it’s about seeing they have choices and choosing to move forward, or backwards, every day.

As I increased and decreased the intensity of my interval training workout, I wondered how each of my patients would respond to the questions: Do you trust your body to take care of you? Do you listen to your body, understand the cues and respond appropriately? If not, do you just need to help learning? Do you believe your body knows how to repair itself and get better? Do you allow your body to recover, improve or heal by providing it what it needs- proper nourishment (what we put into our bodies), relaxation (such as meditation, journaling, emotional intimacy with another person(s))  and circulation of fluids (movement)? If not, do you want to learn what you don’t know?

If my patients have taught me anything, I have learned that we can make choices that move us forward or that cause us to slip backwards. I like forward movement better. I want that for my patients. My patients come to me because they know that, and they want help in seeing and making the choices to move forward.

In my practice, I show my patients their choices (if they do not already know them) and help them to see which ones will most likely allow them to move forward. I spend time teaching them ways to best nourish their bodies with nutrition and medication, if necessary. I have relaxation training sessions and I counsel on ways to safely circulate fluids and move our bodies. I try to give my patients more ways they can choose to move forward.

As I cooled down and stretched, I appreciated that we all have choices. We live in a country that cherishes our freedom to make choices and we have lots to choose from. Every day, we make choices about our health. We have the bodies we were given. Some were luckier than others. But we all can choose what to do with it at any moment. We can choose to trust our body will do the best that it can for us, if we give it what it asks for and needs. We have the freedom to choose every day.  As a physician, I recommend making choices that move you forward.

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