Good Night (slide share edition)

Good NightStaging Restful Sleep

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Enrique Saguil, M.D.

Grounding

Nutrition

Movement

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

First Health Associates

2010 S. Arlington Heights RdLL Suites

Arlington Heights, IL

Dr Ric

The First Health Approach

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Your Community of Care

Ric Saguil, MDJason Gruss, MD

Debbie Stamm, NPTom Jordan, RD

Katrina Christie, LCPCJennifer Green, NDJoe Musolino, DC

Emery Paredes, PTAimee Weber, EPYu Zhu, MD China

You

Stats

• 50-70 Million Americans suffer sleep or circ disrdr• 15% population affected by sleep disordered breathn• 1 in 20 RLS• 1 in 5 Chronic Insomnia• 20% population exposed to shift work schedule (> chance)

International Classification of Sleep Disorders 2nd ed Diagnostic and Statistical Manual of Mental Disorders

National Institute of Health

• Creation of - National Center of Sleep Disorders Research

-70% adults insufficient sleep/rest 1xm-11% adults insufficient sleep/rest daily-Short and Long sleep duration assoc w obesity, DM, HBP, Stroke, Depression, Subs Abuse (2 fold)

-Assoc 20% MVA Crash injuries

http://www.nhlbi.nih.gov/about/ncsdr/index.htm

Exxon Valdez

The Cycle

Evening Roller Coaster

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Circadian Rhythm Disorders

• Delayed Sleep Phase Syndrome• Advancement of Sleep Phase Syndrome• Irregular Sleep-Wake Pattern• Non-24Hour Sleep Phase Syndrome

• Shift Work Sleep Disorder• Jet Lag

Extrinsic

Intrinsic

Problems DX’d in Hospital

• Obstructive Sleep Apnea• Restless Leg Syndrome• Nocturnal Myoclonus(Periodic Limb Mvmt Dis)

Sleep lab

OSA

TX’d w/ Surgery or Appliance

Problems DX’d in Office

All other

Sleep Diary

TX’d with Pharmacy

• Lunesta• Sonata• Ambien• Rozerem• Halcion (BZ) • Lunesta

• Ambien CR• Restoril (BZ)

• Prosom (BZ)

• Doxepin (TCA)

To initiate Sleep

To Stay Asleep

Spokes in the “Wheel of Wholeness”

Sleep

One “Spoke of the Wheel”

that is easy to fix

Circadian Rhythm

The 5 sense rule

• Sight • Sound• Smell• Touch• Taste

5 Simple Ways to Effect a Change

• Close the curtains

• Block the indirect light

• Change the ipad to blue

• Let the sun shine in the morning not at night!We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Light

Fooling Nature’s Rhythm

• Illinois Coalition for Responsible Outdoor Lighting

• Chicago’s Department of Environment

Keep City Light Away from Nature

Keep Highway Light Away From Homes

Protect Migrating Birds

Sound• Create an environment starting 2 hours before sleep• White noise machine/fan/vapor• Sleep apnea machine (for him)• Ear plugs (for her)• Spare bedroom (sleep 1st Aid)

Mozart has a calming effect with the Brain

Metallica is good for Battle

Smell

• Aroma therapy to entrain RR• Herbalist blending• Get food away

Allergic Rhinitis

• Nasal irrigation• Hydrate • Vacuum and dust 2x week or more In season• Include curtains and use HEPA filters• Replace mattress (>5 years)• Cover mattress, pillows dust mite resistant case• Humidify or dehumidify P the area of house• Allergy shots? +/-• Benedryl/Claritin/Zyrtec

Touch

• Comfort feel• Loose feel• Textiles for temperature profile (ayurveda)

She= CoolHe = Hot

Temp and Season

• American Academy of Sleep Medicine• 68-72*(personal comfort)• Cool initiates sleep …but may freeze out others.

Like living in a cave

Going through the Change

Eat

• Timing• Reflux/cough• Hormonal stim (G.I.)• Ayurveda’s time clock

TX’s with Nature

• 5HTP Night• Melatonin• Valerian/hops• Passionflower• Skullcap• Ashwaganda• Breath (RR)

• Rhodiola Day• Caffeine • Light therapy• High protein day• High carb night• Exercise (ForF)

The B word

• MSW• LPC, LCPC• PsyD• PhD• APRN• MD, DO

(Behavioral Health)

Underlying Behavioral Conditions if not Addressed will Lead to Failure in Making a Change

The Saguil Approach

• Understand Rhythm Night

• Cut Caffeine/Decrease Fluids• Ritualize Bedtime for at least 21 days straight• Herbs (melatonin/valerian with hops)• Aromatherapy • Lights out/chill out• BAM• Journal 3 positives

• Light up the day Day

• Rhodiola• Music (Metallica)

QUESTIONS?

COMMENTS?CONCERNS?

Man YogaNorthwest Community Hospital Wellness Center

2010 South Arlington Heights RoadArlington Heights, IL

Phone: 847-593-3330www.FirstHealthAssociates.com