Physical Therapy Info Health Tips

Physical Therapy Info Health Tips

Our Integrated Physical Therapy blog, your go-to source for physical therapy articles and holistic health information. We provide expert insights, practical physical therapy tips, and the latest developments in the field. Whether you're recovering from an injury, managing chronic pain, or looking to improve your overall well-being, our physical therapy blog covers a variety of helpful topics.

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Let's Talk About Sleep!

Sleep Better, Recover Faster, Move Better

Do you find yourself generally fatigued all the time? Maybe burned out with work or school? Not performing to your best level at work or in the gym or on the field, court, track or pool?

I’m raising my hand, are you?

Most people will answer uhhhh yeah, as chronic fatigue due to lack of sleep recovery is a becoming an enormous problem in today’s stressed out, high performing, fast paced and ever plugged-in society.

So, here’s today's questions, how’s your sleep?

Are you figuratively burning the candle at both ends and running your body and mind into the ground; daily?

It IS TIME to step back and look at the root cause of chronic fatigue and how to fix it.

Quick fix strategies like caffeine, or the latest and greatest supplements you saw on Instagram or even prescribed medications (not always) are only adding to the problem, and most likely landed us here in the first place.

The real solution is much simpler, and it’s available to us all!!!

If our goal is to beat back chronic fatigue, improve recovery and retake control of our lives, the answer is fixing our poor sleep patterns

SLEEP is the #1 most effective recovery strategy that is undervalued, overlooked and neglected.

What is Sleep and Why Do We Sleep?

Sleep is defined as a natural periodic state of rest for the mind and body, in which the eyes are closed, so that there is a decrease in bodily movement and responsiveness to external stimuli.

Sleep is an essential function that allows your body and mind to recharge, leaving you refreshed and alert when you wake up. Healthy sleep also helps the body remain healthy and stave off diseases. Without enough sleep, the brain cannot function properly. This can impair your abilities to concentrate, think clearly, and process memories.

Most adults require between seven and nine hours of nightly sleep. Children and teenagers need substantially more sleep, particularly if they are younger than five years of age. Work schedules, day-to-day stressors, a disruptive bedroom environment, and medical conditions can all prevent us from receiving enough sleep. A healthy diet and positive lifestyle habits can help ensure an adequate amount of sleep each night.

Sleep affects how we look, feel, and perform on a regular basis, and can have a significant impact on our overall quality of life.  If you go without this valuable necessity in your life, your healing process is interrupted.

To get the most out of your sleep, both quantity and quality are essential. This aim of this guide is to go over some key factors so you may reach a high-quality sleep and reap all the benefits.

(https://medlineplus.gov/ency/patientinstructions/000871.htm)

What Are The Stages of Sleep?

Once we fall asleep, our bodies follow a sleep cycle divided into four stages. The first three stages are known as non-rapid eye movement (NREM) sleep, and the final stage is known as rapid eye movement (REM) sleep.

Stage 1 NREM: This first stage marks the transition between wakefulness and sleep, and consists of light sleep. Muscles relax and your heart rate, breathing, and eye movements begin to slow down, as do your brain waves, which are more active when you are awake. Stage 1 typically lasts several minutes.

Stage 2 NREM: This second NREM sleep stage is characterized by deeper sleep as your heart rate and breathing rates continue slowing down and the muscles become more relaxed. Eye movements will cease and your body temperature will decrease. Apart from some brief moments of higher frequency electrical activity, brain waves also remain slow. Stage 2 is typically the longest of the four sleep stages.

Stage 3 NREM: This stage plays an important role in making you feel refreshed and alert the next day. Heartbeat, breathing, and brain wave activity all reach their lowest levels, and the muscles are as relaxed as they will be. This stage will be longer at first and decrease in duration throughout the night.

REM: The first REM stage will occur about 90 minutes after you fall asleep. As the name suggests, your eyes will move back and forth rather quickly under your eyelids. Breathing rate, heart rate, and blood pressure will begin to increase. Dreaming will typically occur during REM sleep, and your arms and legs will become paralyzed – it’s believed this is intended to prevent you from physically acting out on your dreams. The duration of each REM sleep cycle increases as the night progresses. Numerous studies have also linked REM sleep to memory consolidation, the process of converting recently learned experiences into long-term memories. The duration of the REM stage will decrease as you age, causing you to spend more time in the NREM stages.

These four stages will repeat cyclically throughout the night until you wake up. For most people, the duration of each cycle will last about 90-120 minutes. NREM sleep constitutes about 75% to 80% of each cycle. You may also wake up briefly during the night but not remember the next day. These episodes are known as “W” stages.

(https://www.sleepfoundation.org/stages-of-sleep) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768102/)

(https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/sleep-disorders/overview-of-sleep?query=sleep)

Benefits of Sleeping

Many people are neglectful about getting enough sleep because they genuinely don’t understand the benefits from it. So why is it so important?

Sleep is an elevated anabolic state, meaning that the body builds, or repairs, itself from damage in this state. It also fortifies your immune system, balances hormones, boosts the metabolism, increases physical energy, and improves the function of your brain. With all the essential benefits that sleep is giving you; it is also clinically proven that you cannot survive, or thrive, without it.

Top 20 Biohacks For A Perfect Night’s Sleep

Sleep Biohacks and their research are by Kevin Masson MS, CSCS, NSCA-CPT, USAW.

I have not listed them all, but here’s my favorites.

Start Your Day with a Morning Routine, Meditation and Success Planning

Waking up early, even just prior to sunrise, ironically, is one of the best things you can do to improve your sleep. This goes back to our ancestors having a specific pattern of waking up at sunrise and going to bed at sundown. We’ve only managed to override this pattern within the last hundred years with the invention of artificial light but we’ll come back to this point later.

By waking up early, you start the process of helping your Circadian rhythm, or internal clock, link up with the natural rhythms of the earth.  Get up when the sun rises.

You might have a challenging time at first, simply take it slow. Strive for 15 minutes earlier than what you used to. Typically, your body will adapt in under two weeks and have you feeling more rested and refreshed when you wake up, but also you will start the day with an instant win.

“The single most important factor in winning your mornings and owning the day is to get up 15 minutes earlier and work on your number one priority before anyone else is awake.”  – Craig Ballantyne

Build a success routine. I personally like to drink a big bottle of cold water than I take my dog for a walk, and while on my walk I go through some personal gratitude exercises thanking everything I have in my life which can turn into a meditation. Once I get home, I have a coffee and start writing or reading content for 45 minutes, then I cook breakfast and go along with the rest of my day. This is an example of what I do, and you should create a routine that will help you work towards your own goals.

Prioritize Getting Red Light From The Sunrise

These specific wavelengths pass through human tissue easier than other wavelengths.  Specifically, light in the mid-600 nm and mid-800 nm range has been shown to provide optimal biological responses. Red-light creates a biochemical effect in our cells that serves to increase mitochondrial function. This results in improving ATP (adenosine triphosphate) production in the body. Why is this important? ATP is the source of energy for every cell in the body. Without it, we don’t function at all. The more cellular energy production, the better the body functions as a whole.

To get the most out of red light obviously natural light at sunrise is better than artificial, but a lot of companies out there came out with products that create both infra-red and near infra-red wavelengths and could be use in the comfort of your own house.

Get More Sunlight During The Day

It is well known that sunlight is the only way for our body to produce vitamin-D but what is less known is the benefits of sunlight as on our sleeping pattern.

As diurnal creatures, we humans are programmed to be up and active while the sun is shining and sleeping at night, as opposed to nocturnal creatures like owls. This is why melatonin is produced during the dark hours and stops upon exposure to daylight. It is a hormone produced by the pineal gland in our brain and it sends a signal to regulate the sleep-wake cycle in your body.

When people are exposed to sunlight or very bright artificial light in the morning, their nocturnal melatonin production occurs sooner, and they enter into sleep more easily at night.  The melatonin rhythm phase advancement caused by exposure to bright morning light has been effective against insomnia.

The melatonin precursor, serotonin, is also affected by exposure to daylight. Generally produced during the day and commonly associated with positive mood, serotonin converts to melatonin while in darkness (after sunset).

With our modern-day penchant for indoor activity and staying up well past dusk, melatonin production is at its lowest. For this reason, it is imperative that people get outside as many times as possible during the day and attempt to limit the use of artificial light during evening hours. This can have a significant impact on melatonin production and can result in improvements in mood, energy, and sleep quality. (Mead 2008)

Be More Physically Active

Some studies have shown that morning exercise significantly improved time to fall asleep compared with evening exercises. More specifically, aerobic types of activity in the morning, when compared with say1 PM or 7 PM, was also found to diminish time to fall asleep. Meanwhile, strength training was found to decrease time in wakefulness and led to better sleep quality due to longer REM time. Therefore, practitioners should urge clients who struggle to fall asleep to work out earlier in the morning, whereas those who struggle to stay asleep may benefit more from evening strength training sessions. (Alley, 2018)

It is also worth mentioning that this study shows the best time to help people with a sleeping disorder. If athletic performance and putting on muscle mass is your goal, it’s been demonstrated that later in the day exercises are considerably more efficient than the morning. Overall as long as you give yourself 3 hours prior bed to calm your body down and get a decent amount of physical activity throughout the day, it will impact your sleep positively.

Don’t Eat Within 90 Minutes of Going to Bed

Do you tend to wake up every single night around 2 or 3 am? Research shows that this is actually a part of our ancestor DNA that cues a natural instinct for checking for threats. Nowadays the more likely reason behind this event is due to hypoglycemia, a crash in blood sugar.

First, don’t eat 90 mins before bed especially if you’re eating carbs because the inherent blood sugar spike will cause a sharp drop in blood sugar later and will wake you up. If this happens to you every night try to have a small snack before going to bed high in protein or carbs that contain the amino acid tryptophan. This amino acid increases serotonin which converts into melatonin. For instance, turkey meat has high levels of tryptophan and is why it is commonly associated with the “Thanksgiving coma.”

Cut Caffeine 5+ Hours Before Bed

Caffeine is the most popular drug in the world. Because it is a powerful stimulant, most people use it after waking up in the morning or to remain alert during the day. According to a survey done in 2017, 83% of Americans are very likely to use caffeinated beverages to combat daytime sleepiness. While it is important to note that caffeine cannot replace sleep, it can temporarily make us feel more alert by blocking sleep-inducing chemicals in the brain and increasing adrenaline production.

Such side effects definitely have its place during the day where we want to have our CNS lit up to promote higher performance in the gym or be more cognitively alert for cognitive tasks like writing an article (wink, wink).

The way caffeine work is by entering the bloodstream through the stomach and small intestine.  The stimulating effect can take hold in as little as 15 minutes after it is consumed. Once in the body, it takes on average 5 hours for our body to get rid of. For that reason, you should not drink coffee 5+ hours before bed. If you are very sensitive to caffeine, then you might want to have an even earlier curfew. I have a general rule of not drinking coffee past 4 pm. If your nervous system is lit up, you can forget about having quality sleep.

Limit Alcohol Consumption

If you booze, you lose. This may sound counterproductive but drinking alcohol is a terrible idea if you are looking for quality sleep. While studies show that you may fall asleep quicker after drinking alcohol, the quality is far from being the best.

Alcohol before bed is linked with more slow-wave sleep patterns called delta activity. That’s the kind of deep sleep that allows for memory formation and learning. At the same time, another type of brain pattern, alpha activity, is also turned on. Alpha activity doesn’t usually happen during sleep. Together alpha and delta activity in the brain after drinking may inhibit restorative sleep and memory processing. This is essentially inhibiting REM sleep and, therefore, you are not allowing short-term memories and experiences to convert into long-term memories.

Ever blacked out after partying too hard and don’t know what happened or how you got home? Yep, thank the few to many shots you had the night before. I am not going to tell you to get rid of alcohol altogether, but moderation is key and gives yourself a couple of hours to get it out of your system before going to bed.

Use Blue Light Blockers

Researchers found that blue light has the most potent effect on prohibiting the secretion of melatonin from the pineal gland. Unfortunately, in today society most of our lighting, computer screens, tablets, TV and cell phones fall into this blue zone of the light spectrum.

Harvard sleep researcher Lockley suggests a link between exposure to blue light at night, may contribute to not only lack of sleep but also some types of cancer, diabetes, cardiovascular diseases, obesity, and depression. (Sigurðardóttir,2013)

Another research program showed that the effects of blue light can be felt even for as short as 15 seconds. In that extremely short time frame it induces significant circadian phase shifts in humans. Such inadvertent phase resetting may be an unrecognized risk factor for insomnia, circadian rhythm sleep disorders, and a variety of adverse health effects associated with circadian rhythm disruption. (Rahman, 2017)

Therefore, blocking blue light should be a primary objective and one of the most beneficial quick fix that you can do to improve sleep quality.

Turn Your Bedroom Into a Cave

If you are serious about recovery and want a high-quality sleep, your bedroom should be only for sleeping and sex.

You need to create a neuro-association within your brain that once you step into the bedroom its sleep time and not watch five episodes on Netflix. You should make it as dark as possible, the science behind this is that light is a stimulus, no matter if you close your eyes because your skin reflects that stimulus back to your brain and during that time you should not have any stimulus or at least keep it as low as possible.

Sleep In A Cold Environment

Studies show that optimal room temperature should be between 60F – 67F (15C – 19C) to get the highest sleep quality. Many benefits come from sleeping in cooler temperatures. Check out THIS cold thermogenesis article.

I live in South Florida and I remember that one day when the power went off, there was no air conditioning and all the sudden the room goes up to 90F (32C) what a nightmare. There was no way I could fall asleep. I am sure you have had an experience similar to this one and have had to attempt to sleep in a hot environment, which isn’t at all easy or comfortable if it is even possible.

When we fall asleep our body drops in temperature to initiate the sleep cycle, if the temperature of our environment is too high then it can take a longer time to start the cycle.

Have Sex

Oh yeah, we going to have “the talk.” Like I stated above there are only two things you should do in your bedroom, sleep and sex.

This should be a no-brainer but having an orgasm has a huge sedative effect on most people. This is because during the act there’s a rush of endorphins and other hormones towards the same part of your brain that regulates your arousal and your sleep-wake cycle. Endorphins are hormones that make you feel great and drop your cortisol level usually related to stress.

So, there you have it, having trouble sleeping? Ask your partner for some help.

Incorporate Breathing & Meditation Exercises

This is an excellent tool I learned not too long ago and I am still very new to the practice of meditation, but it really works. Ex-Navy SEAL and founder of SEALFit Mark Divine has hailed box breathing as a great tool as well and I now use this breathing technique daily to unwind before bed or in bed. Here is how you can apply it:

  • Step 1 – Mark recommend that you sit upright for this, but I like to be comfortable laying down in bed, it also helps me with diaphragm breathing instead of chest breathing, so choose what is more conformable for you. Slowly exhale, getting all the oxygen out of your lungs. Focus on this intention and be conscious of what you’re doing, the all idea is to be mindful of the breathing.
  • Step 2 – Inhale slowly and deeply through your nose to the count of five. In this step, count to five very slowly in your head. Feel the air fill your lungs, one section at a time until your lungs are full and the air moves into your abdomen.
  • Step 3 – Hold your breath for another slow count of five.
  • Step 4 – Exhale through your mouth for the same slow count of five, expelling the air from your lungs and abdomen. Be conscious of the feeling of the air leaving your lungs.
  • Step 5 – Hold your breath for the same slow count of five before repeating this process.

Go To Bed Earlier

This is key to get better quality sleep, now that you are waking up earlier you need to get to bed earlier. If you aim to wake up around 5 am and according to the national sleep foundation the recommendation for adults is to sleep between 7 to 9 hours, you should be in bed by 9-10 pm.

Not only you will get in better sync with your circadian rhythm, but you can eventually switch to being a morning person, and achieve a lot more in life. If your friends are making fun of you with the common adage: “you are so old, you go to bed by 10,” take into consideration there is nothing “normal” about being up so late, we as humans are not nocturnal creatures, we are up when the sun rises and we sleep when the sun goes down. Also, you can tell your friends some of the most successful and greatest minds in history wake up in the early morning from Mozart, Arnold Schwarzenegger, Bill Gates, Tony Robbins, Warren Buffet, Richard Branson to Tom Brady and the list goes on

The National Sleep Foundation recommends the following amount of sleep for varying age groups:

  • Newborns: 14–17 hours
  • Infants: 12–15 hours
  • Toddlers: 11–14 hours
  • Preschoolers: 10–13 hours
  • School-aged children: 9–11 hours
  • Teens: 8–10 hours
  • Adults: 7–9 hours
  • Older adults: 7–8 hour

The idea of this article and the Sleep Biohacks and their research are by Kevin Masson MS, CSCS, NSCA-CPT, USAW

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