Health & Exercise Forum

Guest Columnist: Janet M. Caputo, PT, OCS

Last week this column discussed “The Top Ten Tips for Better Sleep.” One tip, relaxation, visualization and breathing techniques has great value as a natural sleep aid and warrants further discussion. Dozens of scientific studies have proven that relaxation is an effective treatment for insomnia. Relaxation techniques practiced during the day can counter daily stress responses and reduce the likelihood that stress hormones will be elevated at night. Since relaxation techniques elicit a brain-wave pattern similar to Stage I sleep, the transition state between waking and sleeping, they make it easier to eventually move into deeper sleep stages. When practiced at bedtime or after a nighttime awakening, relaxation techniques help turn off negative sleep thoughts, quiet the mind, and relax the body.

The key to relaxation is becoming aware of tension and its corresponding state, relaxation, in each of the body’s muscles. Once aware of the difference, you can learn to relax muscles one at a time until gradually your whole body is ready to drift into a restful sleep. Lying down or sitting comfortably, begin with the muscles in your feet. Contract the muscles with gentle force for three to five seconds and then relax. Don’t stop breathing while you tense the muscles. Repeat a few times and continue upwards to your calves, thighs, buttocks, and abdomen. Then, move onto your fingers, arms, neck, and face. Repeat this exercise two more times for a total of about forty-five minutes of relaxation time. Each time, you begin by tensing the muscles, holding the tension, and then relaxing.

Directing your attention from everyday problems by using a mental focusing device can help promote relaxation. You can choose a word or phrase that has special meaning to you, for example, sunset and repeat it, silently or out loud, until you feel relaxed. You can also choose a visual image of an enjoyable, relaxing place for example, walking on the beach. While you are in your favorite, peaceful place, imagine what you may be seeing, hearing, feeling, and smelling. When using your mental focusing device, let relaxation happen at its own pace. If distracting thoughts occur, disregard them and return your attention to your mental focusing device.

Diaphragmatic breathing can also promote relaxation using deep breathing techniques because it uses less effort and energy to breathe. When relaxed or sleeping, we breathe with the abdomen. When we feel stressed, our breathing pattern changes to short, shallow, irregular chest breaths, or we hold our breath. This type of breathing is not effective and further stresses the body. Since waste products were not removed during exhalation, they build up in the bloodstream and we feel more anxious. Practice the following steps to learn diaphragmatic breathing:

• Lying on your back or sitting comfortably, place one hand on your upper chest and the other just below your rib cage.
• Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.
• Tighten your stomach muscles, letting them fall inwards as you exhale through pursed lips.

Breathing exercises that utilize diaphragmatic breathing can calm our bodies and promote sleep. The following are two examples of breathing exercises that are recommended to bring on drowsiness and reduce insomnia:

• Lie on your back or side, eyes closed, and begin with a few very deep inhalations, filling your lungs as much as possible. Exhale fully, drawing your abdomen in to expel as much air as possible. Repeat this three times and at the end of the third exhalation hold your breath as long as you can. Repeat this procedure two or three times or until you feel drowsy.
• Exhale completely through your mouth. Inhale through your nose to a count of four. Hold your breath for a count of seven. Exhale slowly through your mouth for a count of eight. Repeat this cycle three times.

People who practice relaxation techniques fall back to sleep faster, sleep longer, have a better quality of sleep, and are more rested in the morning. Gradually they develop a greater sense of control over their mind and sleep. Although relaxation by itself is not a cure for insomnia, it has a significant positive effect on sleep for most insomniacs, especially when used in combination with the other tips discussed in last week’s column, which outlined 10 tips for better sleep.

Janet M. Caputo, PT, OCS, is clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC in Scranton, PA where she specializes in orthopedic, sports, and neurological physical therapy. She is a doctor of physical therapy student at the University of Scranton.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of  Scranton, PT Dept.