Sleep: Is it possible to get more rest?

I appreciate the positive feedback about our recent blog (if you missed it, click here) and wanted to follow up on tools you can use to improve your sleep.  I heard from patients this week that "I want to sleep more, but how do I get more rest?"

As we prepare for great rest, we want to look at the three focus points for Sleep Hygiene: (1) Diet, (2) Environment, & (3) Habits.

DIET-- You'll want to ponder beverages and food.

• Beverages: caffeine is a great starting point.  How late are you drinking coffee, hot tea, energy drinks, pop, or sweet tea?  Move it back before 2pm for all caffeine.
• Alcohol: Research is very strong that adult beverages are a health benefit (we can cover this in a future blog).  Obvious caveats would be complications of medications, chronic diseases, addiction, or other psycho-spiritual factors--*talk to your physician.  For entire body health, women are likely to benefit from 1-3 servings, and men from 1-5 servings daily.  BUT, if you're looking for healthy sleep, perhaps you should look for less than 2 servings in the evening, and cork that bottle within 2 hours of bedtime.
• Drink this, not that: look for chamomile tea or another soothing herbal tea 1 hour before bedtime.
• Food: is dinner after 7pm your largest meal of the day?  If so, make it 6pm or make lunch your largest meal.
• Late-night snack: avoid.  If you have trouble fighting cravings, look to your dinner to have more fiber (Read: vegetables and legumes) and you will feel less urges at 10pm.  Evening sugar (desserts) are a recipe for a blood sugar spike and crash, leaving you awake and hungry at 2am.

ENVIRONMENT-- Bedrooms are for two things...and both should be experienced in a healthy way.  Have you set your environment for successful rest?

• TV: Is there a television in your bedroom?  Why?  That's not one of the two things a bedroom is for.  Are you tempted to watch within 90 minutes of when you should be sleeping?
• Light: Is the room dark enough?  Would an additional window treatment add 2 hours to deeper rest?
• Sound: Could you benefit from a white noise machine?  There's a reason they work so well for newborns and toddlers.  A constant sound is a cue to sleep as well as drowning out the other noises (eg snoring) you may hear.  I love this one: http://amzn.to/127K0AD  A box fan can also move air and provide gentle noise.
• Temperature: Did you know you'll sleep better if your body temp drops overnight?  It's worth the A/C bill and a fan to get good rest.  Your health is worth the use of electricity.  For most of us, this means between 69-72 deg F at night.  Try one degree lower and see how you feel.

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We'll finish this list next week in our "Ask the Doc" feature on our blog.  I'll talk about habits that might prevent you from great rest.  In the meantime, stay connected to our facebook, twitter, or blog and share any of your tips or success stories.  You might write down 1 or 2 "action items" that you are ready to improve to feel awake all day.

Sleep: Are you getting enough?

Your household may not have a toddler keeping you up at night, but if you're with 80% of Americans, you're not getting enough sleep.  I've continued to struggle getting enough, and it's only going to be more difficult with one more on the way.  I welcome you to daydream as we highlight the value of regular, restful sleep.

American adults are currently averaging about 6.5 hours per night, while we should be getting between 7.5 - 9 hours.  More than 25% of adults are sleeping less than 6 hours.  Are you one of them?

Sleep helps to restore energy by balancing brain chemicals which control mood as well as provide an extended time of tissue repair.  Your mood and your muscles should improve with sleep.  Research has even shown wounds heal faster with appropriate sleep.

Reduced, irregular sleep can be dangerous to your health.  It is connected with sleep apnea, stroke, depression, and fibromyalgia--to name a few.  For many looking to return to a more optimal weight, sleep may be more important than any other activity you do in a day.

Sleep.  Regular, restful sleep.  How much are you getting?  It is hard to assess how much better your hormones, brain neurotransmitters and organs would function with more rest until you try it.  Why not make the next 4 weeks a diet of more sleep? 

The tarp goes down before the tent! --preparing a strong core

A patient came to the office this week with pain in her right hip.  After reviewing her experience--pain during running, pain walking up stairs, and soreness in her thigh--and a full examination, I recommended to her we begin some core rehab beginning with Transverse Abdominis (TA) recruitment.

We will refrain from a long academic tangent about the TA muscle.  She felt my analogy was more helpful: one way of thinking of the TA is like the tarp on a camping trip.  Just like the tarp, proper core control begins with the TA muscle.  Optimally, our TA is like a firm belt--supporting the spine, pelvis, torso, and other abdominal muscles.  Our TA is located about the same place a large belt buckle would be, firming and strengthening nearly every motion of the body.

When camping, you start with the tarp, and it will help prevent moisture from ruining a good night's sleep and protect your tent.  A tarp is often an afterthought yet regretted when forgotten.  Just like the TA--an afterthought until it's a problem.


As you are considering "core workouts" and resolution of back, hip, or knee pain.  It is a great idea to investigate whether you are able to engage and utilize the Transverse Abdominis.  It may be the answer to your symptoms.

At home test: touch the bony prominences in the front of your pelvis (6" to the side of a belly button and 3" down).  Now move to the center 1" and down 1".  While lying on your back, and holding 2 fingers at that spot, gently firm the muscle under your fingers.  Did you feel it?  Many of my patients have a tough time finding this, so do not dispair!  It is important to be able to hold that muscle firmly while still able to breathe deeply, letting your belly rise and fall.  Many patients bring their "six-pack" muscles into it, and this is not optimal.  Continue to contract and relax these muscles in a gentle rhythm.  You are now working the TA and helping your brain become more aware of this muscle!  If you have difficulty performing this contraction, or draw other muscles into it, it may be a sign of TA dysfunction leading to other symptoms.  Consider it as you seek to reach your pain-free goals!