Sleep is important for literally everyone. During our treatment plans, we put an extra emphasis on sleep with those recovering from a concussion. The following will include some brief questions to ask yourself, followed by a short video explanation. At the bottom of this post, there will be a full, and extensive, list of actionable tools you can use to improve your sleep.
When you are thinking about your sleep, it is important to consider a few questions.
- Are you getting enough hours? This is one of the easier questions to measure, are you sleeping closer to 7-9 or more on the 4-6 hours a night.
- When you wake up, are you alert or sleepy? This question is harder to answer, because you have to rely on your own feelings.
- Do you fall asleep and wake up at the same time during the week? This will be important to help set your internal clock.
Sleep is so important to us that we held a group meeting with our patients to share education points as well as some recommendations. If you’d like to learn more, please don’t hesitate to schedule an appointment to help improve your sleep quality.
The video above offers background information on sleep. We recommend watching the video if any of the following terms are new to you: REM, nREM, Sleep Cycles, Melatonin and Circadian Rhythm.
Light: using light is one of the biggest impactors for your circadian rhythm. It is important to see sunlight as early as possible after waking. This light should be direct sunlight, without staring at the sun directly. Avoiding sunglasses, windows and car windows is best. The light should be able to reach you, unobstructed.
Darkness: use darkness to help get yourself in the best possible scenario to fall asleep. In the evening, it is beneficial to avoid bright overhead lights. If possible, dim your environment and avoid blue light (from phones and screens) an hour before bed.
Sound: A sound bath can be described in different manners. One method of a sound bath is using Tibetan and crystal singing bowls, chimes, gongs, bells, tuning forks, didgeridoos, Ting-shas (small cymbals), and even the human voice, emit at a slow, steady pace to produce tones of varying frequencies, which then trail off. Often, these vibrations are placed near or on ones body to feel the vibrations (https://www.sleep.com/sleep-health/sound-bath).
Music improves sleep through calming parts of the autonomic nervous system, leading to slower breathing, lower heart rate, and reduced blood pressure. When designing a playlist to help you sleep, one factor to consider is the tempo. The tempo, or speed, at which music is played is often measured in the amount of beats per minute (BPM). Most studies have selected music that is around 60-80 BPM. Normal resting heart rates range from 60 to 100 BPM, it’s often hypothesized that the body may sync up with slower music (https://www.sleepfoundation.org//noise-and-sleep/music).
Some emerging evidence supports the use of binaural beats. Binaural beats are a perception of sound created by your brain. If you listen to two tones, each at a different frequency and each in a different ear, your brain creates an additional tone you can hear. This third tone is called a binaural beat. You hear it at the frequency difference between the two tones. Playing this sound at a delta frequency of 3 Hz may be beneficial to increasing the deep sleep stage. To summarize the previous paragraphs, the following three tools may benefit your sleep.
- Sound baths
- Comforting music
- Binaural Beats
Long term exposure to loud sounds can cause hearing loss, please consider what volume you are listening to and for how long you are listening to that volume level.
Smell: Smells aren’t simply detected and identified; they can produce both psychological and physiological response. When a pleasant smell makes you feel relaxed or a foul smell makes you queasy, you’re experiencing the diverse effects of your sense of smell. Scents can become part of emotional memory, recreating certain responses to smells when you encounter them again in the future.
Evidence suggests that aromatherapy may be able to help with sleep by creating a bedroom environment that is more conducive to falling asleep and staying asleep. Exposure to smells that are associated with a positive mood, calmness, and relaxation may be beneficial in the lead-up to bedtime and through the night. Stress and anxiety, forms of mental hyperarousal, frequently contribute to sleeping problems like insomnia. By promoting relaxation, certain essential oils may reduce this barrier to sleep.
- Indirect inhalation method: using a diffuser or applying scented oil to an absorbent material
- Direct inhalation method: breathing in air or vapor of a low concentration
- Skin Application method: gently rubbing a skin safe scented oil that may be infused with an essential oil
The information for how smell may be used to help you sleep was presented by link. Using any essential oils in any method should be guided by a trained professional with the right qualifications in your province or state.
Temperature: The body has to cool a couple degrees to fall asleep, and raise back up upon waking. If you have an environment that allows you to adjust the temperature automatically around bedtime and your waking time, it may be beneficial to experiment. Lowering your environmental temperature prior to sleep may help you fall into a sleep. Conversely, raising your body temperature in the morning can help signal to your internal clock that you are awake.
Exercise: Researchers don’t completely understand how physical activity improves sleep. “We may never be able to pinpoint the mechanism that explains how the two are related,” says Charlene Gamaldo, M.D. , medical director of Johns Hopkins Center for Sleep. While we may not pinpoint exact mechanisms, “We have solid evidence that exercise does, in fact, help you fall asleep more quickly and improves sleep quality” Dr. Gamaldo stated.
If you are completed an aerobic exercise bout (think more cardio related) trying it 1-2 hours prior to bedtime may be beneficial. With exercise, our body temperature raises, and it takes about 1-2 hours to fall. As it starts to fall, the temperature falling signals our internal clocks that it is bedtime.
How much exercises do you need? Dr. Gamaldo stated that even 30 minutes of exercise may improve your sleep, the same night! Full article available at https://www.hopkinsmedicine.org/health/wellness-and-prevention/exercising-for-better-sleep
Progressive Muscle Relaxation:
Progressive Muscle Relaxation (often called PMR) is a two-step process that follows many different variations. The two steps are very simple and are as follows:
Step 1: Tension. Feel the muscle, or muscle group, engage and get tighter. This can be referred to as a squeeze.
Step 2: Release Tension. All the tension you just built up, release it. Let your muscles soften.
Now the variations to this technique are infinite. What we often recommend is a systematic method, starting with your head, and moving stepwise down to your toes. Spending 1 breath cycle at each major joint is a good method to go head to toes. Timing your squeezes with your breath can be a great way to feel the tension release even better. Spend a slow 3-5 seconds inhale squeezing your muscles, then spend a slower 4-6 seconds exhale releasing all the tension. Remember there is not a wrong way to do this. If you do feel any pain, please lower tension. Full explanation available here.
Supplements:
Supplement information presented from this source, please refer to a family doctor or medical doctor before supplementing anything recommended here or in general.
- 145mg Magnesium Threonate or 200mg Magnesium Bisglycinate
- 50mg Apigenin
- 100-400mg Theanine
- (3-4 nights per week I also take 2g of Glycine and 100mg GABA.)
*I would start with one supplement (or none!) and then add one at a time as needed. Some people do not need any supplements, and some people like theanine but not magnesium, etc. so you have to determine what is best for you.
**Don’t take theanine if you have overly intense dreams, sleep-walk, or have night terrors.
***Also, some people (~5%), get an agitated stomach from magnesium supplementation, in which case, do not take it.
Additional Supplement information:
- Melatonin: the hormone of darkness and its secretion gradually reduce as we age; especially for people who need to adjust their circadian rhythm due to shift work or jet lags
- Passion Flower: can be used in tea or as an extract; for people with restless sleep and anxiety
- Chamomile: can be used in tea or as an extract; safe for children or elderly and helpful for those with restlessness and mild anxiety
- Broad Spectrum Minerals and Vitamins: not just for general wellbeing but also for less stress and better sleep quality; especially for those who do not have a balanced diet
We hope this provides a thorough and insightful list of possible cues that may benefit your sleep. We hope that some of these tips help you sleep faster, longer, and with better quality. Please wake up feeling refreshed, energized and ready to start the day.
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