Category Archives: sleep

A Tool for High Performers: The Caffeine Nap

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

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

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

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

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

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.