In a lecture given in 2013, Dr. Jacob Teitelbaum, author of From Fatigued to Fantastic (2007), expounded on his S.H.I.N.E. protocol approach to chronic fatigue and fibromyalgia syndromes. This holistic approach accounts for all aspects of the patient’s lifestyle, to include Sleep, Hormone regulation, Immunity rebuilding, Nutrition and Exercise. Over the coming weeks, we will examine each of these in turn, to begin with the foundation of health and well-being—a good night’s sleep!
Though we have been told from the time we were children that a solid eight hours is imperative to establish and maintain a baseline of health, when the going gets tough and our time becomes tight, our sleep is often the first thing we sacrifice. An estimated 70 million Americans are “problem sleepers,” with 30 percent of adults reporting “severe fatigue” lasting one month or more, and 6-24 million suffering from chronic fatigue or fibromyalgia syndrome (CFS/FMS). Dr. Teitelbaum describes the nature of such conditions as an “energy crisis” caused by the dysfunction of the hypothalamus—the body’s control center for sleep, hormone function, thermoregulation, and autonomic functions such as blood pressure and pulse. Dr. Teitelbaum states that 99 percent of FMS patients have trouble sleeping, and that the degree to which sleep is disturbed is predictive of the degree of pain, fatigue, and corresponding social dysfunction the patient experiences.
Our sleep is essentially divided into four stages, the first two consisting of light, REM or “dreaming sleep,” while stages three and four account for deep sleep. It is during the latter, deep sleep stages that the body performs its repair processes, to include muscle repair. These repair processes are initiated by the release of growth hormone (GH), which is consistently found to be depleted in patients with FMS. Dr. Teitelbaum theorizes that the disruption of sleep stages three and four robs the body of its ability to perform muscle repair functions, resulting in the widespread muscle pain characteristic of fibromyalgia. Hence, while sleep is important for anyone recovering from an illness, it is essential to solving the pain problem of FMS.
SLEEP HYGIENE BASICS
While there are many natural and prescription sleep aids, later discussed, the following sleep hygiene practices are important to establishing and maintaining quality sleep long-term:
1. Avoid alcohol before bed. It is wise to avoid alcohol altogether when battling an illness, and particularly within two hours of bedtime. While alcohol may help you to fall asleep initially, it disrupts the body’s fluid and hormone balance to the degree that cause you to wake again shortly afterwards, making it difficult to achieve deep sleep.
2. Limit caffeine consumption in the late afternoon, and consume no caffeine within 4-6 hours of bedtime.
3. Do not consume a heavy meal before bedtime; a light snack, however—high in protein a few simple carbs, such as from milk—will increase blood insulin levels, making it easier to fall asleep.
4. Do not work in bed. Make bed a place for sleeping, not doing homework or completing special projects.
5. Take a hot bath or a warm shower before bed, as this increase the temperature of tightened muscles and joints, helping them to relax.
6. Sleep in a cool room. While temperature extremes in either direction can disrupt sleep, studies show that most people slept best in a cooler—vs. warmer—environment.
7. If your mind races, set it to focus on one positive thought and stay with that thought until you sleep. If you are still awake 30 minutes later, get up and write down whatever thought(s) is keeping you awake. If it is a problem, write possible solutions down as well, read them through once and then return to bed with new resolve to sleep.
8. Limit beverage consumption before bed, and particularly diuretic beverages such as green tea and coffee.
9. Invest in a good pair of ear plugs and a sleeping mask.
10. Turn the clock around and place it out of arm’s reach, after setting your alarm. Continuously checking the clock only increases anxiety, making it more difficult to sleep and stay asleep.
11. Decrease the time you spend in bed to sleeping hours only. Go to bed when you plan to sleep, and set your alarm for the time you plan to get up. RESIST THE TEMPTATION OF THE SNOOZE BUTTON, as it sets you up to disrupt deep sleep prematurely.
12. Go bed at the same time every night, and get up at the same time every morning. This is the best way to establish and maintain the healthy circadian rhythm of sleep your body craves naturally, and most particularly when your immune system is compromised.
Aim for 8-9 hours of sleep every night, in addition to an afternoon nap of 90 minutes—the approximate duration of one light sleep cycle. Next time, we will examine the various sleep aid supplements and conducive therapies our clinic provides.