10/21/2019 Sheep Don’t Count Tips & Tricks for Better Sleep Jan McGilliard 1
10/21/2019 Introductions • Introduce yourself and a one ‐ liner about what brought you to this workshop • Set an intention • Make a lifeline/timeline about your sleep story/history • Name three things that keep you awake at night McGilliard, POAMN, Louisvile, 2019 2
10/21/2019 The Psalmist on Sleep “I will both lie down and sleep in peace; for you alone, O Lord, make me lie down in safety.” Ps. 4:8 McGilliard, POAMN, Louisvile, 2019 3
10/21/2019 The Psalmist on Sleep “He who keeps Israel will neither slumber nor sleep…The Lord is your keeper; the Lord is your shade at your right hand. The sun shall not strike you by day, nor the moon by night.” Ps. 121:4 ‐ 6 McGilliard, POAMN, Louisvile, 2019 4
10/21/2019 The Psalmist on Sleep “It is in vain that you rise up early and go late to rest, eating the bread of anxious toil; for he gives sleep to his beloved.” Ps. 127:2 McGilliard, POAMN, Louisvile, 2019 5
10/21/2019 A Fitful History of Sleep At Day’s Close: Night in Times Past Once Upon a Time Roger Ekirch, Professor of History Virginia Tech McGilliard, POAMN, Louisvile, 2019 6
10/21/2019 A Fitful History of Sleep • Sleep interruptions: lice, fleas, bed bugs, weather, illness, noise, smelly chamber pots McGilliard, POAMN, Louisvile, 2019 7
10/21/2019 Sleep deprivation • Several arousals in the night will lead to sleep deprivation • Napping during the day to compensate. Think Dagwood • Tossin and Turnin – Bobby Lewis, 1961 • https://www.youtube.com/watch?v=ghFBvBmXv4E McGilliard, POAMN, Louisvile, 2019 8
10/21/2019 We all need (yawn) better sleep • “Sleep is a miraculously curative way to help heal much of what ails us.” Liza Field, from Field Notes, Roanoke Times • Many consider sleep optional – a boring waste of consumer and spectator time. 1 of 2 adults gets by on 6 hrs./night, leading to • a “mangling” of the human genetic fabric, • switching off genes involved w/immune function, • triggering other genes associated w/inflammation, tumors, and cardiovascular disease …Matthew Walker, neuroscience professor McGilliard, POAMN, Louisvile, 2019 9
10/21/2019 Wired and tired Hours of Sleep per Night 2019 6.5 2013 6.8 1942 7.8 1910 9.0 0 1 2 3 4 5 6 7 8 9 10 • By the 1990s, every city was open for business round the clock • Now we have 24/7 sunbeams ‐ in ‐ the ‐ hand • Only 11% of U.S. teens get sufficient sleep • Grownups work 2 nd & 3 rd jobs, need down time, put off sleep McGilliard, POAMN, Louisvile, 2019 10
10/21/2019 Common symptoms of insomnia • Difficulty falling asleep at night • Waking up during the night • Waking up too early • Not feeling well ‐ rested after a night's sleep • Daytime tiredness or sleepiness • Irritability, depression or anxiety • Difficulty paying attention, focusing on tasks or remembering • Increased errors or accidents • Ongoing worries about sleep McGilliard, POAMN, Louisvile, 2019 11
10/21/2019 Common Causes of Insomnia • Stress. • Concerns about work, school, health, finances or family • Stressful life events or trauma — such as the death or illness of a loved one, divorce, or a job loss • Travel or work schedule. • Your circadian rhythms act as an internal clock • Guide your sleep ‐ wake cycle, metabolism and body temperature. • Disrupting your body's circadian rhythms can lead to insomnia. • Causes include jet lag, working a late or early, or frequent change in schedule. • Poor sleep habits. • Irregular bedtime schedule or naps • Stimulating activities before bed • Uncomfortable sleep environment, working, eating or watching screens in bed • Eating too much late in the evening. • A light snack before bedtime is OK, but eating too much is risky • Physical discomfort while lying down, heartburn, a backflow of acid from stomach to esophagus .. From Mayo Clinic McGilliard, POAMN, Louisvile, 2019 12
10/21/2019 Additional causes… • Mental health disorders. • Anxiety disorders, such as post ‐ traumatic stress disorder, may disrupt your sleep • Awakening too early can be a sign of depression. Insomnia often occurs with other mental health disorders as well. • Medications. • Many prescription drugs can interfere with sleep, such as antidepressants and medications for asthma or blood pressure. • Many over ‐ the ‐ counter medications — such as pain medications, allergy and cold medications, and weight ‐ loss products • Products that contain caffeine and other stimulants that can disrupt sleep. • Medical conditions. • Chronic pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease (GERD), overactive thyroid, • Parkinson's disease and Alzheimer's disease. • Sleep ‐ related disorders. • Sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. • Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them • Caffeine, nicotine and alcohol. • Coffee, tea, cola and other caffeinated drinks are stimulants • Nicotine in tobacco products is another stimulant that can interfere with sleep. • Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often causes awakening in the night. McGilliard, POAMN, Louisvile, 2019 13
10/21/2019 The aging factor • Changes in sleep patterns. • Noise or other changes in your environment are more likely to wake you. • Your internal clock often advances, so you get tired earlier and wake up earlier in the morning. • But older people generally still need the same amount of sleep as younger people do. • Changes in activity. • You may be less physically or socially active. • A lack of activity can interfere with a good night's sleep. • With less activity, the more likely a daily nap, interfering with sleep at night. • Changes in health. • Chronic pain from conditions such as arthritis or back problems • Depression or anxiety • Issues that increase the need to urinate during the night ― prostate or bladder • Sleep apnea and restless legs syndrome become more common with age. • More medications. Older people typically use more prescription drugs than younger people do, which increases the chance of insomnia associated with medications. McGilliard, POAMN, Louisvile, 2019 14
10/21/2019 Prevention • Keep your bedtime and wake time consistent from day to day, including weekends. • Stay active — regular activity helps promote a good night's sleep. • Check your medications to see if they may contribute to insomnia. • Avoid or limit naps. • Avoid or limit caffeine and alcohol, and don't use nicotine. • Avoid large meals and beverages before bedtime. • Make your bedroom comfortable for sleep and only use it for sex or sleep. • Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music. No screens or reading in bed. McGilliard, POAMN, Louisvile, 2019 15
10/21/2019 My Quest for Sleep • Many years of prescription sleep medication – then a firm decision to stop. Fear of later life changes in brain chemistry and potential loss of balance. • There are many things to try… McGilliard, POAMN, Louisvile, 2019 16
10/21/2019 Sleep Specialist • Goal setting • Mindfulness • The practice of paying attention to what is happening in your life from moment to moment. • It teaches us to slow down and notice things in the present. • Practice self ‐ acceptance, reduce self ‐ judgement. • Become an observer. Get curious. Practice describing what you observe. • Do one thing at a time, and while you do it, practice mindfulness. McGilliard, POAMN, Louisvile, 2019 17
10/21/2019 Mindfulness Meditation • Get comfortable • Begin by taking slow, deep breaths, focusing on your breathing • As you continue, focus on trying to relax your body • Visualize the tension leaving your body • If your thoughts start to wander, bring your attention back to your breath (no judgement!) • Continue for 10 ‐ 20 minutes • You can use a short mantra to help you stay focused McGilliard, POAMN, Louisvile, 2019 18
10/21/2019 Sleep Hygiene (habits) • Keep a regular sleep and wake schedule • Avoid daytime napping • Use bedroom for sleep and sex only • No reading or using electronics in bed • Avoid bright lights and screens at least one hour before bedtime • Bedroom should be comfy, dark, cool • Develop a relaxing bedtime routine (like a hot bath w/bath salts) • Avoid stressful conversations/thoughts before bedtime McGilliard, POAMN, Louisvile, 2019 19
10/21/2019 More habits! • No alcohol or tobacco products 4 ‐ 6 hours before bed • No caffeine after noon (coffee, tea, chocolate soda) • Avoid eating and drinking large quantities w/in 3 hours of bedtime • Expose yourself to natural light ASAP in the morning! Promotes healthy circadian rhythms. • Avoid heavy exercise up to 2 hours before bedtime • Stop clock watching! • Limit time in bed. If not asleep w/in 30 min., get up and go to another room. Relaxing/boring activity until sleepy again McGilliard, POAMN, Louisvile, 2019 20
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