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Stress Management

Re-establishing great health will rely on several factors; with stress reduction and stress management being among the most critical. Stress has been shown to initiate and contribute to many disease processes. Stress can worsen the effects of current diseases. Think in terms of restoring health without lowering stress being as effective as trying to stop an elephant by throwing ping pong balls at it.

A simple definition of stress might be the following: The demands of your life are outpacing your current resources or capabilities. When this is the case, the best long-term solution lies in the realm of your own personal effort. To an extent, your present and past way of life has contributed to this problem and lifestyle/attitude must be changed if lasting improvement is to occur.
Your first assignment is to examine your life and make concerted efforts to eliminate all habits that can add to stress.

Basically, you must decrease demands to a point below your current capability levels. This is the only way to begin to create the surplus energy needed for good health. With this in mind, the importance of adequate rest cannot be overstated. The only way for regeneration to occur is for less energy to be expended than can be regenerated. If you are not improving, you are doing too much and allowing too much stress in your life. In essence, if you are not improving, you are probably exceeding your current capabilities.

If stress is contributing to dysfunction, you are overextended. This means that there is more in your life than you can handle. The following factors will often act to add stress into your life. The cure is to consistently limit or eliminate exposure to as many of these situations as possible:

•  Crowds of people
•  Unproductive meetings
•  Financial concerns
•  Long telephone calls
•  Negative emotions
•  Anxiety for others
•  Cold or hot weather conditions
•  Sunbathing
•  Lack of sleep
•  Coffee (more than 1 cup)
•  Smoking
•  Dieting (low calories)
•  High carbohydrate breakfast
•  Too much sugar and starch
•  Violent movies
•  Chemicals
•  Strong smells of any type
•  Loud noise
•  Low quantity or quality sleep
•  Perfumes
•  Over extended in any area
•  Overwork
•  No exercise or too much exercise
•  Arguments

Long-term health habits that are essential for the management or lowering of stress include:
•  In bed no later than 11pm (although best sleep is between 9pm and 5am)
•  Rest periods (short breaks of 5-10 minutes) at least 2 daily
•  Cultivate positive feelings and experiences (find things to be happy and joyful about)
•  Practice deep, slow, abdominal breathing
•  Appropriate Exercise (Yoga, walking or moderate aerobic exercise, low intensity weight lifting)
•  Expose yourself to early morning sunlight immediately after waking (this is the most important time of the day to be outside so is a great time for a walk)
•  Music: Chants, Classical (especially Baroque)
•  Movies: Films that make you laugh or feel good
•  Eat a well-balanced breakfast with some form of protein (think dinner — a great breakfast should be just what you imagine a great dinner would be)
•  Limit dietary sugars, starches, caffeine, alcohol, drugs, and nicotine as much as possible.

Note: Depending on the state of your current health, building up a surplus of reserves can be a short or a long journey. Be careful about overextending your energy once you are starting to feel better. Your reserve supplies might still be low and will be exhausted readily. You may feel the effects of doing too much today, when in fact you over extended yourself several days ago.
 
CIRCADIAN RHYTHMS
•  On a daily basis, we should all be in tune with a 24-hour or circadian rhythm.
•  Twenty-four hour biological rhythms affect body temperature, alertness, performance, blood pressure, immunity,   hormones, bone turnover, neurotransmitter function, etc.
•  All of our rhythms are interconnected so if you strengthen one rhythm you positively affect the others.
•  But this is a double edge sword. If you allow one rhythm to be disrupted it will also take the others and wander off  with them as well.
•  A poison given to an animal at one time of the day can kill it but when given 12 hours later it will not.
•  When a medicine or supplement is given, it can have very different effects on health (best time to take most  medicines and supplements is not known).
•  Hormones: The right amount, at the right time, and in the correct sequence with other hormones is what really  matters.
•  We are completely dependent on consistent exposure to specific external cues in order to stay synchronised to a period of exactly 24 hours.
•  When you go to sleep is important in dictating rhythms but it pales in comparison to when you wake up and what you do when you wake up. This is the most important part of the day for providing the cues our biological watch needs to remain accurate.

PRIMARY CUES:
•  Light and dark (probably need a minimum of 3 hours exposure to quality sunlight to maximally entrain rhythms…   maybe more in some people)
•  Meal Timing (eating breakfast and lunch is most important)
•  Social Conditioning: A routine behaviour done at the same time everyday can and will have some influence as an external cue for keeping our biological clock accurate.

DISRUPTIVE FACTORS:
•  High stress
•  Night time artificial lights
•  TV and computer use (especially at night)
•  Electromagnetic fields
•  Sleep deprivation
•  Flying across time zones
•  Caffeine intake (excessive)
•  Alcohol intake (dose-dependent)
•  Medicines/Drugs
•  Supplements (possibly depending upon when given)
•  Hormones (depending upon when given)

Example: If we were to take very healthy young men and subject them to 5 days of military training that includes sleep deprivation, food deprivation, and intense physical activity, we will completely abolish their circadian rhythms. This is stress! Even 4-5 days of rest will not be sufficient at this point to re-establish the normal rhythmic order of our biological watch.
 
SLEEP
•  Shift Work will result in poor quality sleep for almost everyone.
•  Chronic Sleep Debt is estimated to affect millions and millions of people in the United States alone.
•  Research indicates that chronic sleep deprivation can hasten the onset of diabetes, high blood pressure, heart disease, cancer, memory loss, immune dysfunction, and can worsen all of these conditions.
•  With just a week of sleep deprivation we can take healthy young men, and if we simply reduce their sleep time to 4 hours per night for 1 week we will decrease insulin sensitivity tremendously, disrupt blood sugar handling, disrupt thyroid rhythm and function, and induce a night time surge in cortisol. These problems are rapidly corrected if we repay the debt.
•  Aging – disruptions in sleep patterns are a very common and a very unpleasant side effect of aging.
•  These disruptions might include increased need for daytime napping, early morning awakening, restless sleep, frequent nighttime waking, poor quality sleep, waking without feeling refreshed, and an inability to rigidly follow a controlled 24-hour sleep cycle (a free running biological clock).
•  Getting extra sleep matters. Even an hour more sleep makes sleepy people perform better. Even people who would describe themselves as well rested also are much sharper and perform much better when they get an hour of extra sleep.

Note: Insufficient quantity or quality of sleep can induce psychological and behavioural problems so always think of sleep and rhythm disorders as a
potential contributing factor when patients falling into these categories come to see you.

TYPES OF SLEEP
•  REM (active) and non-REM (quiet sleep)
•  Sleep follows a 90-120 minute cycle for most people
•  Early in sleep REM might be 10 minutes of this sleep cycle but by morning it might take up 1 hour)
•  Sleep is triggered by body temperate dropping.
•  IL-6, PGE2 and adenosine are all thought to trigger sleep
•  Sleep is like a bus that comes on a schedule. If you miss one chance you have to wait for the next bus (buses are thought to follow 90-120 minute schedules).

INSOMNIA
•  Generally speaking this is a disorder of entire sleep/wake cycle (so it is a 24-hour illness)
•  General categories
•  Sleep latency (too long to fall asleep)
•  Sleep waking (wakes during the night)
•  Delayed sleep phase syndrome
•  Advanced sleep phase syndrome

SLEEP THERAPIES:

•  Morning exposure to 45 minutes of quality daylight
•  Eating at regular times and no skipping meals (especially a well balanced breakfast everyday — NO EXCEPTIONS)
•  Avoidance of caffeine at least within 5 hours of bed
•  No alcohol (sedation is not the same as sleep)
•  Chamomile tea
•  Taking a warm bath (40°C) for 30 minutes starting about 90 minutes before you would like to fall asleep
•  Evening walk for 90-120 minutes before sleep
•  Consistent daytime exercise
•  Cold extremities and especially cold feet can prevent sleep
•  If you don’t fall asleep within 30 minutes after getting into bed…get out of bed. Sleep is like a train that comes on a schedule. If you miss this train you have to wait for the next one to arrive and it won’t get there any quicker by tossing and turning and getting frustrated. Wait till you feel tired and then try again.