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Good Night Staging Restful Sleep We didn’t invent the practice of medicine…. we’re just changing the way it’s provided. Enrique Saguil, M.D.

Good Night (slide share edition)

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Page 1: 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.

Page 2: Good Night (slide share edition)

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

Page 3: Good Night (slide share edition)

The First Health Approach

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

Page 4: Good Night (slide share edition)

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

Page 5: Good Night (slide share edition)

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

Page 6: Good Night (slide share edition)

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

Page 7: Good Night (slide share edition)

The Cycle

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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 ?

Page 9: Good Night (slide share edition)

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

Page 10: Good Night (slide share edition)

Problems DX’d in Hospital

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

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Sleep lab

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OSA

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TX’d w/ Surgery or Appliance

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Problems DX’d in Office

All other

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Sleep Diary

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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

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Spokes in the “Wheel of Wholeness”

Page 20: Good Night (slide share edition)

Sleep

One “Spoke of the Wheel”

that is easy to fix

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Circadian Rhythm

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The 5 sense rule

• Sight • Sound• Smell• Touch• Taste

5 Simple Ways to Effect a Change

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• 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

Page 24: Good Night (slide share edition)

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

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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

Page 26: Good Night (slide share edition)

Smell

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

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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

Page 28: Good Night (slide share edition)

Touch

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

She= CoolHe = Hot

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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

Page 30: Good Night (slide share edition)

Eat

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

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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)

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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

Page 33: Good Night (slide share edition)

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)

Page 34: Good Night (slide share edition)

QUESTIONS?

COMMENTS?CONCERNS?

Man YogaNorthwest Community Hospital Wellness Center

2010 South Arlington Heights RoadArlington Heights, IL

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