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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
Mor
e Tot
al RE
M=B
rain
Res
t
Neve
r Con
tinuo
us R
EM fo
r
pred
ator
pro
tecti
on ?
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