Patients want to get better as quickly as possible but there’s often an overlooked part of the treatment plan that can speed up recovery. It is something we do every night and there are small changes that can be made to make it more beneficial—SLEEP.
What is sleep?
Sleep is a brain state in which our awareness and responsiveness to sights and sounds decrease. It should take somewhere between 10 and 15 minutes to fall asleep and consist of 5 to 6 sleep cycles, each of which lasts about 90 minutes. These cycles can be divided into two general phases: rapid eye movement (REM) and non-rapid eye movement (NREM) phases. NREM sleep has four stages of progressively deeper sleep. During REM sleep the body becomes paralyzed and the brain becomes active with electrical recordings of the brain (EEG) that are similar to when we are awake. This is also an important time for recovery and healing.
Why does this matter to you?
Sleep is important for healing! While we are in REM sleep the body releases a growth hormone that allows us to grow bone by signaling the liver to secrete insulin-like growth factor (IGF-I) and causes muscle growth by stimulating amino acid uptake and protein synthesis. Also, during this time, our bodies make more white blood cells to attack viruses and bacteria and regulates hormones that influence appetite control. In fact, a 2018 study in the Journal of Applied Physiology found that wound healing is delayed in sleep deprived individuals.
Poor sleep has also been linked to an increased risk for cardiovascular disorders, type II diabetes, memory and information processing difficulties, depression, decision making and impulse control.
How to Improve Your Sleep and Healing
One of the most important aspects of getting a good night’s sleep is sleep hygiene. Sleep hygiene consists of different habits and practices that improve sleep quality. I like to think of them in two different categories: actions and environmental factors.
There are many actions that you can take but some of the most important are:
- Setting a regular sleep schedule
- Avoiding alcohol, stimulants (caffeine, coffee, soft drinks) and heavy food at least 3 hours before bedtime
- Daily exercise (but not right before bed time)
- Getting natural light during the daytime to help regulate your sleep/wake cycles
- Avoiding daytime naps of longer than 30 minutes
- Establishing a relaxing night-time routine
The other aspect of sleep hygiene is setting up your environment. This involves avoiding exposure to bright light and electronics prior to bed (~90 minutes) and while you sleep. This can involve strategies such as using blackout shades and covering electronic clocks and lights in the room. This is important because our pineal gland, which produces melatonin, responds to changes in light– ask your health professional if melatonin supplementation would be appropriate if you are having trouble sleeping. Another step you can take is to make sure that your room is cool and comfortable. Most experts recommend a temperature of anywhere between 60 and 68 degrees.
It can also be helpful to make the bedroom, and more importantly the bed itself, a place for sleep by avoiding doing other activities in bed, such as watching television, using your computer or phone, or just hanging out. It allows your brain and body to be conditioned so that when you see your bed you know it is time to sleep.
Lastly, it is important to make sure that your bed is comfortable and allows your body to completely relax. One way to do this is to attempt to have your body in as much of a neutral position as possible and to “fill in space” wherever you have an unsupported segment. This can be as simple as making sure that your pillow is not under your shoulders but rather pulled snuggly into your neck or by putting a pillow between (side sleeping) or under (back sleeping) your legs and pulling it all the way up to your groin/butt. Also, sleeping on your stomach makes it very difficult to keep your neck in a neutral position and can close down your airway. As such it is recommended that you avoid this position unless you cannot sleep in any other position.
EXAMPLES OF APPROPRIATE SLEEP POSITIONS:
|Appropriate Sidelying||Appropriate Supine|
EXAMPLES OF INAPPROPRIATE SLEEP POSITIONS:
|Inappropriate Supine||Inappropriate Supine||Stomach Sleeping||Stomach Sleeping|
Now that you’ve fallen asleep, how long should you stay asleep?
Below are general guidelines for how long you should sleep each night. However during times of healing you may require more. If you are having trouble falling asleep, contact your health professional for further advice.
- School-aged children (6-13 y/o): 9-11 hours
- Teenagers (14-17 y/o): 8-10 hours
- Adults (18-64 y/o): 7-9 hours
- Older Adults (65+ y/o): 7-8 hours
Sweet (& healing )dreams,
Mike Plude, PT, DPT, CSCS