Sleep Hygiene

SLEEP

 

If there is one thing I could say to our community right now in order to stay or get healthy is to prioritise SLEEP. The World Health Organisation deems sleep the foundational of the three pillars of health, with diet and exercise being the other two. Studies show that between a third and two thirds of the Western World do not get enough hours of sleep per night.

Sleep has a significant impact on the reduction of both illness and injury and is one of the few interventions that can help prevent both contact and non-contact injuries. Performance research shows us that adequate sleep improves our accuracy, sprint and reaction times as well as the perception of strength and effort. It also has a huge impact on mental health. The brain recalibrates during sleep. It is no surprise then to find out that mood swings, paranoia, depression, anxiety and dementia are all linked to poor sleep.

 

Now back to current times and COVID 19 where prioritizing sleep is important in strengthening our immune system in order to fight off illness particularly when our body is under stress – which currently is more likely to be mental than physical but the body doesn’t have the ability to alter its responses to this.

 

In order to ensure you have a good night’s sleep both sleep rhythm and sleep drive is needed. Sleep drive is the need for sleep ie how tired you are. This can be challenging in the current situation if you aren’t getting as much physical exertion into your day as normal but for many this drive is increased simply from the mental stress of the lockdown and the uncertainties surrounding this. Sleep rhythm is ensuring you have regular sleep and wake times. This is why when you have a night out or stay up late to watch that extra movie even though you feel exhausted you don’t sleep as well.

In an ideal world the majority of adults get around 7.5 hours sleep as a minimum as each sleep cycle is approximately 90 minutes and we need 5 of them for a full night’s sleep. This does vary with age. Our children should be getting more as their requirements are greater, given they are growing and the elderly may need less.

Genetics play a part. Early birds or lions make up only 15% of the population. Usually those that are list makers, many CEO’s and those in management make up the large proportion of this group. They are asleep early and up early.

Wolves or night owls on the other hand are categorised as generally being creative personalities, high risk takers, often introverted even if they are extroverted in public life i.e. actors’ musicians authors. Ideally sleep to your rhythm, this gives you the best chance to achieve a good night’s sleep.

 

 

But its not all about quantity.

Sleep is about quantity and quality. Poor sleep is linked with a large number of physical conditions and diseases including increased blood pressure, heart disease, reduced immune function, diabetes, ncreased intensity of pain when pain is felt, weight gain, poor decision making, lower testosterone and lower libido in females.

Most likely it is the relationship between sleep and decision making and reaction times that are likely where the link to injury prevention comes in – more sleep better reaction time and decision making.

 

Food, Vitamins and sleep

Metabolism is affected negatively by sleep deprivation as metabolism slows down. Increased stress results in increased cortisol release which results in increased appetite BUT slower metabolism and therefore fat deposition. We are also more likely to overeat when we are sleep deprived as leptin decreases and this is hormone that tells us we are full.

 

People who are sleep deprived lack vitamin C and Selenium which affects immune function. Things you can try and do to help with this are to put citrus in your water and eat mushrooms or Brazil nuts to boost these vitamins.  B vitamins are essential for good sleep and serotonin levels so eat food rich in B vitamins such as broccoli.

Magnesium helps boost the quality of sleep as it helps regulate your circadian rhythm.. Ensure meals and snacks contain greens, nuts, brown rice and other grains. Bananas are loaded with magnesium so are awesome for sleep.

A lack of vitamin D can cause poor sleep quality. Getting out and about in the sunshine particularly at this time of the year when the sun isn’t too hot(whilst staying within your bubble!) is the most useful way of ensuring adequate Vitamin D.

Salmon is one of the best foods for sleep as it helps melatonin production.

For those that suffer with restless legs – ensure iron intake is sufficient as this is often a cause or part of the picture– eat plenty of spinach, red meat and other iron sources at the same time as consuming vitamin C (ie orange juice) as this increases your iron absorption. Ensure you don’t consume tea or coffee near these meals as these both affect your body’s ability to absorb iron.

 

Supplements and sleep

Melatonin is not good for insomnia; it is for jet lag. It affects the rhythm. It’s a sleep regulator not initiator so really useful for shifting sleep rhythm where appropriate. A lack of melatonin causes shallow sleep, insomnia or regular awakenings so is the other time where it is useful. 1-1.5mg is ideal amount – many are taking far too much/too higher dose. It takes 90 minutes to work so needs to be taken 90 minutes before sleep or blood plasma levels aren’t sufficient to work. Take for right reason, at right time in right amount!

 

On return to normal life

If post lockdown you continue to struggle with sleep go see your GP for an assessment of this. You may require some blood tests to check your levels of Vitamin D, melatonin, iron and magnesium. If this doesn’t give you any answers we can help. Learning strategies to deal with poor sleep can be really useful and one of the most effective with this is correct breathing patterns and breathing exercises to ensure your parasympathetic nervous system is engaged and your body and mind is therefore able to wind down and sleep.

 

 

For those who struggle with sleep if you are going to stress about sleep and your lack of it you aren’t likely to get a good night’s sleep so it’s somewhat of a “catch 22”. So where do you start?

Number 1 – PRIORITISE SLEEP – do you really need to watch that movie? Watch one more episode on tv? Play around on your phone when it’s just before bed time?

Know that one nights poor sleep won’t cause you significant issues in the long term. Changing your sleep patterns is a process like any other aspect of improving health and wellness. It takes a plan and the implementation of it.

Sleep hygiene is where to start! If you have any questions on this please send us an email on reception@buretaphysio.co.nz or give us a call on 5761860.

 

IN THE MEANTIME SORT OUT TONIGHTS PLAN!!

Improve your sleep

Strategies to Improve quality and/or quantity of sleep

Inadequate sleep and/or poor- quality sleep affects the non-athletic and athletic population. Consequently, adequate sleep is a critical component for post exercise recovery thus effecting performance. Therefore, below we have listed strategies you can implement to enhance your sleep quality to optimise your health, work/sport performance and recovery.

Nutrition do’s and don’ts
Do’s

Consume tryptophan containing foods such as milk, meat, fish, chicken, eggs, beans, peanuts, cheese and leafy green vegetables in the evening meal to increase melatonin production.

Try including carbohydrate foods at dinner to assist with Serotonin production, e.g. potatoes, rice, pasta… this may not be ideal if overweight or working on losing fat.

Try consuming 30ml tart cherry juice in the evening to increase exogenous melatonin intake (also decreases DOMS -Delayed Onset Muscle soreness). Use in a periodised way, e.g. around high volume training or to get sleep sorted initially if in a rut or during competition.

Consume a balanced, healthy diet, including adequate wholegrains, low fat dairy foods, fruits and vegetables for magnesium and B vitamins.

Try 300-400mg Magnesium supplement prior to bed.
Don’ts

Alcohol intake prior to bedtime (fragments sleep later in the night)

Caffeine and nicotine stimulants intake prior to bedtime (individual tolerances do exist). This includes coffee, tea, energy drinks, cola, chocolate.

To be cautious of
Be conscious of food portions before bed (eating large portions of food can raise core body temperature and make it difficult to fall asleep) and fluid intake prior to bed (to minimise need to go to the bathroom).

Consume fluids with evening meal to increase absorption, then taper off;
i.e. individual fluid prescriptions may be necessary following late- night training/competition to ensure rehydration.

Aim for no more than one visit to the bathroom during the night to minimise sleep fragmentation.

Combating Stress
Use a journal to write down worries/thoughts before bed

Write a ‘to do’ list for the next day to help clear the mind

Body Temperature
Lowering core body temperature in the evening to induce drowsiness and sleep:

Skin-warming (for cool environmental conditions) – achieved through warm baths/shower/spa, hot foot baths, warm blankets or dressing gowns, wearing warm socks and woollen boots/slippers

Skin cooling (for warm environmental conditions) –achieved through cool showers, cold water immersion, appropriate use of air conditioning, light bed covers

Keep a Routine
It is critical to maintain a pre- bed routine to prime the body for sleep. This is crucial for proper sleep hygiene.

Allow 1 hour ‘the de-power hour’ to unwind before bed

Maintain a regular bed and waking time each day (entrains our internal body rhythm -circadian rhythm)

Avoid computer screens, texting, bright lights for 1-2 hours before bed (stimulates the eye). Some people may find a dimmer TV screen from a distance helps them relax.

Creating a sleep friendly environment
Keep the TV out of the bedroom.

Keep the bedroom for sleep activities only, and ensure it is quiet, dark and comfortable.

If you cannot sleep within 15 minutes of going to bed, get up again and try a different strategy. Eliminate the bedroom clock (avoids stress of ‘losing valuable sleep time/clock watching’).
Napping
Napping can be a valuable way of increasing total sleep hours. Experimenting with a 90 minute nap mid-afternoon (one full sleep cycle). Recommended for individuals during heavy training prior to competition or who are having short nights.

If insomnia is a problem, do not nap in the day. Otherwise time naps for 8 hours after rising time (2-3pm) and keep these no longer than 30 minutes.

Naps times between 30-90 minutes or longer than 90 minutes may result in temporary sleep inertia and performance impairments.

Napping 10-12 hours after morning waking time will likely disturb nocturnal sleep. Set an alarm to wake at the right time post nap.

Don’t forget your exercise recovery is just important as the training you do

Screen-Shot-2014-09-07-at-8.50.38-pm-272x300

So many times in the Physiotherapy practice we get our clients asking how to improve performance, but commonly recovery is hugely overlooked. Marcel Gyde – Physiotherapist @ Bureta Physio takes you through some of the basics of exercise recovery to making sure you get the most out of your training.

You put the hard work in so now reap the rewards and recover well

Successful exercise and sport has a basis of quality training set around duration, frequency and intensity, with an important ingredient of recovery, as a means to adapt, improve and capitalise on training. All to often in physiotherapy we see many athletes suffering conditions related to fatigue, conditions of strain that can be avoided through successful exercise recovery programmes and tips.

HYDRATION – recovery and hydration begins before sport and exercise takes place, temperature and intensity are important aspects to consider, 1% loss of body water effects VO2 max output, increases heart rate and decreases alertness. For 20 minutes of exercise 300 ml of fluid needs to be consumed pre-event. Post event 1 litre of fluid for every kilogram of weight lost during event, measuring pre and post event can help with this equation. Electrolytes and recovery drinks can form important nutrient recoveries for the body, which is best 30 minutes post event, when muscles uptake of glycogen is at its optimum. A 4:1 carbohydrate to protein ratio is best for replenishment of glycogen stores and muscle repair, many recovery drinks fit this bill, as does low fat chocolate milk as a cheaper easy option.

FOOD – High quality carbohydrates are essential in optimal recovery, 7-12grams per kilogram of body weight is necessary to replenish muscle glycogen stores. An easy snack that contains 50 grams of carbs is 2 slices of toast with banana and 1 tablespoon of peanut butter. High quality protein is essential for muscle repair, 15-25 grams of protein should be consumed one hour post event. A favourite meal post exercise is pasta with chicken and vegetables which covers all the essential carbs, proteins and fat.

MUSCLE RECOVERY – Compression garments can aid in minimising tissue swelling, promote blood flow back to the heart and help with lactic acid recovery. There are several clothing brands now on the market but make sure the garment is tight but not constricting.
Static stretching post event can increase blood flow to muscles, improve range of motion and speed up recovery and promote injury prevention. It’s important to only stretch warm muscles, and the muscles you have used in your exercise or sport. Stretch slowly with no bouncing, and breath through stretches not holding breath, current time frames of 45 seconds to a minute for each stretch, re potions dependant on tightness and previous effort.
Ice baths are beneficial, they cause blood vessels to constrict, forcing out blood with waste products, such as lactic acid, from the muscles. No more than 10minutes of ice bath, I usually use a cold pool and for 5-10 minutes, followed by a warm shower to further promote circulation, but usually only on the heavier training days.
Massage can aid in flushing blood in and out of muscles and joints, aiding in reducing waste product stagnation, improving circulation, helping injury prevention and reducing muscle tightness and imbalances. Oboe rollers are becoming very popular and can be performed by yourself, which saves the cost of massage therapists, as well as not burdening partners with this arduous chore.
Active recovery can be another solution to good recovery, Low Intensity activity boosts circulation which removes lactic acids and promotes faster recovery, a talking pace with minimal exertion is paramount to this modality of recovery.

SLEEP – a good nights sleep, plus little nana naps are essential to good recovery, the body releases growth hormones and testosterone which aid in muscle repair and weight loss, as well as boosting immune system. It’s also a time for your brain to rest, your body to heal and repair post exercise. If it’s a nana nap on the cards, 45 minutes of sleep is optimal for physiological benefits to take place.

So there is the exercise recovery plan, hopefully a few good ideas in there to help your body into its next great sporting effort. Marcel Gyde

.