Last week I talked about how dysfunctional breathing and sleep disturbances are linked and gave you a few exercises that may help with easing tension to facilitate a better night's sleep.  Using the breathing exercises as a way to access and then ease muscle tension helps to turn off the ever-active "flight or fight" response we have to our everyday stresses and allows our bodies to spend time in "rest and digest" mode for more restful sleep.  But for some, simple breathing exercises aren't enough.  This is when we start to introduce behaviour changes to encourage better sleep hygiene.  Described by Dr. Peter Hauri, sleep hygiene refers to "the habits, environmental factors, and practices that may influence the length and quality of one's sleep."  The concept of sleep hygiene is to allow for a smooth transition between the hectic demands of your day and sleep.  If you are dealing with stressors (work, family, etc) right up until the light's go off, it's unlikely you will have smooth transition to sleep.  You simply cannot flip a switch and drop into blissful sleep.  By establishing a pre-sleep ritual to break the connection between stress and sleep, we may limit the amount of time spent tossing and turning, waiting for sleep to come.  We all did this with our kids when they were younger, right?  Bath time, story time...everything meant to be done calmly and quietly to get them ready for bed.  Why not offer ourselves the same courtesy?  Here are a few tips to improve your sleep hygiene for a better night's sleep:

• Begin rituals that help you relax each night before bed.  This may include a warm bath (not hot), light reading, stretching or meditation.  You can even do some simple preparations for the next day (like making lunches or picking out clothing).
• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations. Set a bedtime that is early enough for you to get at least seven hours of sleep.
• Don’t go to bed unless you are sleepy. 
• If you don’t fall asleep after 20 minutes, get out of bed. 
• Use your bed only for sleep and sex. Do not read or watch TV or use a computer/tablet in bed.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature. 
• Limit exposure to light in the evenings. This includes the "blue" light emitted from personal electronic devices.  Studies have shown this light interferes with the release of melatonin.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack. 
• Exercise regularly, although avoid heavy exercise within 2 hours of bedtime
• Avoid consuming caffeine in the late afternoon or evening. 
• Avoid consuming alcohol before bedtime. 
• Reduce your fluid intake before bedtime.

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And don't forget to breathe!  A nice, relaxed belly breathing pattern with an effortless exhale helps to settle that busy brain as you rattle through your "to-do" list.  And if you struggle with finding that pattern, do try to find a physiotherapist with skills in treating dysfunctional breathing to help you find a pattern that works for you!

You're lying in bed, eyes squeezed shut, breathing maybe a bit too quickly; you can definitely feel your heart beating and in your mind you are thinking "go to sleep.  Big day tomorrow.  Need to feel rested.  Don't forget you have to pick up the kids early.  Oh, and don't forget to mention to your boss about that meeting.  Gosh, when will I fit a workout in do you think?  What's the weather supposed to be like?..."  And you open your eye, just a little bit, peek at the clock and realize you are STILL not asleep.  Sound familiar?  You're not alone.  A 2011 study, found that over 40% of a sample of 2,000 Canadians had at least one symptom of insomnia.  Insomnia is typically defined by the inability to fall asleep, stay asleep or the presence of "poor quality sleep."  So if you are lying in bed at night, waiting and waiting and waiting to fall asleep, or you wake up in the middle of the night and can't fall back to sleep, or if you just feel exhausted when the alarm goes off, you may be experiencing insomnia.
The consequences of chronic sleep deprivation are quite serious. Among the greatest health risk is the increase in the risk of accidents:  those with insomnia are 2.5 to 4.5 times more likely to have an accident.  Not enough sleep has been linked to impaired mood, memory and concentration and has even been shown to dampen immune systems.  Yet despite the frequency of insomnia and the severity of side effects, few people are seeking adequate treatment: in the same study mentioned above, the authors noted that only 13% sought help from a health professional and 10% had used medication. Perhaps it is because this is such a common problem, that we have just grown accustomed to this being the new reality (I know you new parents out there are thinking that!).  Among many of the treatment options out there, there is evidence to support both biofeedback and behavioural changes as an effective solution to insomnia.
In my practice, where people come to me for help with dysfunctional breathing, there is often an underlying component of poor sleep.  The story is almost always the same, in addition to breathing problems, there are issues with "busy brain" - those that think and worry all the time - and difficulties either falling asleep or staying asleep (or both).  And what I have found is that for these people, they haven't experienced true rest for a very long time.  Sure, they lay down, watch TV, read a book, maybe even meditate.  But they very rarely, "let go."  Tension in the jaw and neck, upper chest persists.  Breathing rates stay high.  The chest heaves up and down with each breath.  There is no way the body can relax and let go if this is the pattern that dominates.  I use a combination of biofeedback and breathing behaviour changes to try to restore what we call "physiological calm" - the true state of rest and relaxation.  And more often than not, one of the responses I will get from my patients is that they are experiencing better sleep.
The next time you find yourself lying in bed, mind chattering away at you, heart racing, try this simple exercise to bring your body back to a state of physiological calm:

• Lie on your back with your hands resting lightly on your belly
• Breathe in softly and quietly through your nose and feel your belly rise under your hands
• Breathe out gently - you should not hear your breath coming out, nor should you feel a "breeze" from it
• Feel yourself let go of any tension in your arms
• Repeat the inhale breath, and this time as you breathe out gently, feel the tension release in your shoulders - allow yourself to sink into your bed
• Repeat the inhale breath to the belly; this time breathe out and feel the tension melt from your jaw and face
• Continue to breathe in softly to the belly and out gently allowing yourself to release tension anywhere you feel it
• If thoughts come in to your mind, refocus to the sensations of your breathing

Sshhh!  Good night...