Disclaimer:
The following information is for educational purposes only and not intended to diagnose, prevent or treat any diseases or conditions. Please consult your doctor before incorporating any of this information into your care. The information presented on this podcast is not medical advice.
AI generated transcript of my audio
Sleep Overview & Evaluation – Bullet Summary 😴
Importance of Sleep
Sleep affects many aspects of health:
Mood
Inflammation
Metabolic health
Hormone balance
Overall wellbeing.
Initial Sleep Assessment
Key questions:
Difficulty falling asleep
Difficulty staying asleep
These patterns help guide treatment strategies.
Common Contributors to Sleep Problems
Psychological factors
Anxiety
PTSD
Nightmares
Hyperarousal of the nervous system.
Physiologic conditions
Sleep apnea
Pain
Itching
Hormonal changes affecting body temperature.
Stress & Hormone Rhythms
Cortisol rhythm should follow a daily pattern:
High in the morning
Low in the evening
Cortisol:
Anti-inflammatory hormone
Part of the fight-or-flight response
Chronic stress or hyperarousal can disrupt this rhythm and interfere with sleep.
Nervous System Balance
Daytime stress levels often influence nighttime sleep.
Hyperarousal occurs when the nervous system stays activated instead of calming down at night.
Helpful Data for Sleep Evaluation
Vital signs
Resting heart rate: 60–80 bpm
Respiratory rate: 12–20 breaths/min
Heart rate tracking
Wearable devices or manual pulse measurement can reveal patterns.
Persistent elevated heart rate may indicate stress or poor recovery.
Blood Pressure Patterns
Diastolic blood pressure (bottom number) reflects resting cardiovascular stress.
Elevated blood pressure after sleep may suggest poor nighttime recovery.
Blood Sugar & Sleep
Blood glucose instability can disrupt sleep.
Both high blood sugar and low blood sugar (<70) can trigger stress responses.
Low glucose episodes can activate fight-or-flight hormones for up to 24 hours.
Symptoms to Monitor
Clues to underlying sleep disruption:
Night sweats
Temperature dysregulation
Skin itching
Hormonal fluctuations
Frequent waking during the night.
Lifestyle Factors Affecting Sleep
Stimulants
Caffeine timing and dose
Stimulant medications.
Medications
Steroids can disrupt cortisol rhythm and sleep.
Inflammation & illness
Frequent illness or inflammation may affect sleep and body temperature regulation.
Substance Use
Substances that may disrupt sleep:
Cannabis
Psychoactive substances
Alcohol
Possible mechanisms:
Inflammation
Blood sugar disruption
Altered sleep cycles.
Tracking Sleep Patterns
Important observations:
Frequency of night waking
Nightmares or stress dreams
Depth of sleep.
Treatment Direction
CBT-I (Cognitive Behavioral Therapy for Insomnia) is the most effective evidence-based treatment for insomnia, outperforming medications.
Focus is on behavior change and sleep regulation strategies, which will be explored further.
