sleep medicine

Is Relaxation Training Hocus-Pocus?

I am frequently asked about the evidence for relaxation training. The concept of relaxation training has been around for many years and much research is available in the scientific and medical literature to support and recommend its use, not only for insomnia, anxiety, stress and depression but also for chronic painful conditions.

According to Wikipedia:

relaxation technique (also known as relaxation training) is any method, process, procedure, or activity that helps a person to relax; to attain a state of increased calmness; or otherwise reduce levels of anxietystress or anger. Relaxation techniques are often employed as one element of a wider stress management program and can decrease muscle tension, lower the blood pressure and slow heart and breath rates, among other health benefits.[1]

Read the whole article here:

Read the article from Helpguide, a non-profit resource:

See what people at the Mayo Clinic have to say about relaxation techniques:

Watch the Mayo Clinic video: Mayo Clinic Video on Yoga for Relaxation

Peer reviewed medical and scientific literature is cited here for those who are skeptical and think of relaxation training as hocus-pocus:

J Psychiatr Pract. 2008 Nov;14(6):403-7.

Sleeping without a pill: nonpharmacologic treatments for insomnia.

Source

UCLA Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine/Resnick Neuropsychiatric Hospital, Los Angeles, CA 90024, USA. lkierlin@mednet.ucla.edu

Abstract

Insomnia is a complaint of patients seen in many medical settings, but it is particularly prevalent in patients who present to mental health practitioners. When choosing an intervention for insomnia, physicians often turn to pharmacological management options as their primary strategy, with other modalities only considered secondarily, if at all. Medications for insomnia, which include benzodiazepines, nonbenzodiazepines, and antihistamines, have been found to have both varying degrees of efficacy as well as side-effect profiles that may limit their use. In recent years, the American Academy of Sleep Medicine has studied nonpharmacologic interventions for insomnia and found evidence to support their use in achieving sustained improvements in sleep parameters over time. Methods such as cognitive-behavioral therapy, stimulus-control therapy, relaxation, paradoxical intention, and sleep restriction are efficacious treatments that mental health practitioners can consider in the treatment of insomnia. Researchers are only beginning to review evidence concerning complementary and alternative medicine therapies (CAM); however, given the preponderance of patients who may be employing these techniques for insomnia, it is important that clinicians be familiar with these approaches, which merit further study. This article reviews nonpharmacologic treatments for insomnia that are available to mental health practitioners as well as primary care providers, either via direct application of the techniques or by referral. The evidence for each of these modalities is presented in an effort to expand the treating physician's armamentarium beyond sole use of the medications traditionally used to treat insomnia.

J Psychiatr Res. 2012 Nov;46(11):1456-63. doi: 10.1016/j.jpsychires.2012.08.007. Epub 2012 Aug 30.

Comparison of relaxation training with a cognitive-behavioural intervention for indicated prevention of depression in university students: A randomized controlled trial.

Source

Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain. Electronic address: fernandolino.vazquez@usc.es.

Abstract

Although cognitive-behavioural programmes for preventing depression have produced promising findings, their administration requires extensive training. Relaxation techniques are more straightforward psychological strategies, but they have not been investigated in the prevention of depression. This trial aimed to compare the results of relaxation training (RT) with that of a cognitive-behavioural programme (CBT) for prevention of depression in university students with elevated depressive symptoms. The 133 participants (mean age 23.3 years, 82% women) were randomly assigned to CBT or RT. Both programmes were administered to groups of 5 or 6 participants in eight weekly 90-min sessions. Participants were evaluated by independent raters before, immediately after, and 3 and 6 months after taking part in the programmes. By itself, intervention type had no significant effect on either depression or anxiety scores. The scores were lower at the follow-up time points with respect to pre-intervention scores. Effect size was greatest between pre- and immediately post-intervention scores for CBT, d = 1.32, 95% CI [1.00, 1.64], and between pre- and 6-month post-intervention scores for RT, d = 0.75, 95% CI [0.47, 1.03]. Anxiety symptoms were significantly improved by both interventions at 3-month follow-up, and by CBT at 6-month follow-up also. In the medium term (3-6 months), relaxation training produced similar reductions in depressive and anxiety symptoms as a more complex cognitive-behavioural programme.

Copyright © 2012 Elsevier Ltd. All rights reserved.

PMID:

 22939979

[PubMed - in process]

 Am J Health Promot. 2012 Jul-Aug;26(6):e149-58. doi: 10.4278/ajhp.110516-QUAL-199.

Psychological and physiological response of students to different types of stress management programs.

Source

Cátedra de Química Analítica Instrumental, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina. siglesia@ffyb.uba.ar

Abstract

PURPOSE:

To design, implement, and examine the psychoneuroendocrine responses of three different types of stress management programs.

DESIGN:

Randomly assigned. A pre/post experimental design comparing variables between three different programs and a control group. The first program included training in deep breathing, relaxation response, meditation, and guided imagery techniques (RRGI). The second program included training in cognitive behavioral techniques (CB). The third program included both RRGI and CB (RRGICB).

SETTING:

The study was conducted at Buenos Aires University.

SUBJECTS:

Participants (N  = 52) were undergraduate students.

MEASURES:

Anxiety, anger, hopelessness, neuroticism, respiration rate, and salivary cortisol levels were assessed.

ANALYSIS:

Wilcoxon signed rank test was used to investigate differences in pre and post variables.

RESULTS:

Subjects in the RRGI group showed significantly lower levels of anxiety (p < .011), anger (p < .012), neuroticism (p < .01), respiratory rate (p < .002), hopelessness (p < .01), and salivary cortisol (p < .002) after the treatment. Subjects in the CB group showed significantly lower levels of anxiety (p < .018), anger (p < .037), and neuroticism (p < .03) after the treatment. Subjects in the RRGICB group showed significantly lower levels of anxiety (p < .001), anger (p < .001), neuroticism (p < .008), hopelessness (p < .01), respiratory rate (p < .001), and salivary cortisol (p < .002) after the treatment. Subjects in the control group showed only one variable modification, a significant increase in cortisol levels (p < .004).

CONCLUSIONS:

The combination of deep breathing, relaxation response, meditation, and guided imagery techniques with CB seems to be effective at helping people to deal with stress.

PMID:

 22747323

[PubMed - indexed for MEDLINE]

Sehatu Sleep Granite Bay CADeep Relaxation Training at Sehatu Sleep, designed with sleep medicine and psychology principles, empowers people by giving them skills to turn the mind switch on and off on command and to relax when needed. Classes can be attended via Skype.

Sehatu Sleep and Yoga Studio, located in Granite Bay, CA,  also provides a variety of Yoga classes, including Yin, Gentle and Restorative Yoga, as well as Meditation classes, for individuals who are interested in practicing a healthy lifestyle at any age, starting at any time in their life at any skill level. 

Case Studies In The "I Don't Have A Sleep Problem But I Am Always Tired Syndrome"

" I had my eyes open but it seems I was just dazed while driving. When I hit the curb it startled me. I really don't want to have a bad accident like this. What's happening to me? I searched on the internet. Could I be having seizures?

" I get dizzy sometimes when I stand up suddenly. I also get a lot of headaches. Could I have a brain tumor? I crave food all day long but I don't like eating breakfast except for a can of Coke, and then I have a Rockstar at lunch. I have a mean teacher in school. The class is so boring I keep falling asleep. My grades are dropping but that's because of my teacher."

" I doze off at work and can't help it. My supervisor is mad at me. I have no idea why that happens. I try my best to stay alert at work. Please help me. I don't want to lose my job."

" I operate heavy machinery. I drink energy drinks every hour to stay alert. When I go home I have lots of chores to do. By that time I feel I am completely spent. It seems that my body is just falling apart. I used to have so much energy.

" I don't need much sleep. I wake up on my own at 3 am. My mind is ready to go. I do my problem solving at that time. But my mind stops working later in the day. I don't know what's wrong with me. My blood sugar levels keep fluctuating and my blood pressure has been high. It never used to be like this. Whats happening to me?"

" I nurse my baby twice at night, and in between I sleep really soundly. But I am really tired with no energy all day. I have not even gone back to work yet but I get so tired just doing the small chores at home with my baby during the day. I try to nap when she is sleeping but it is so hard to turn off the mind just any time.  Could I be depressed?"

" I have no time for fun in a day. I go to school, then sports, then I do home work. I am so tired. Life is a drag. All I can do to socialize is be on facebook and text my friends when I am in bed. They are all up till 2 am. They don't have any problems, and it takes me a long time to fall asleep any way. Why am I having problems?"

" I drink half a pot of coffee in the morning and a couple of cans of soda in the afternoon. I like the taste of these drinks. I have put on 20 pounds in the last year. I think I need to exercise more. I sleep just fine. I need to have the TV on all night to sleep well and I wake up to go to the bathroom a couple times. No big deal, right?"

" I just crave chocolate. I love desserts. I have put on a lot of weight and I feel tired all the time. I sleep just fine but I am not a morning person. Everyone in my family is that way. Our minds work best at night."

" My whole family is feeling a lack of energy. We are all a tired, sickly bunch. Could it be something toxic in our house, like black mold? My wife snores so loudly she keeps waking me up. She says I snore even louder. My son snores too. Its so funny our house sounds like a train station at night. It's hilarious. "

" I am under a lot of stress. I am having trouble at my job because I can't finish my projects in time ever. My girlfriend is not happy with me because I have completely lost interest in sex. I am so tired all the time. I sleep fine. It just takes me a couple hours to fall asleep so I watch TV in bed. Is that a problem?"

" My husband is the one with the sleep problem not me. He works on his computer all night. I have started sleeping in a separate room because I have to go to work the next morning. I let my cat crawl into bed with me. I don't like to be alone in bed. What I don't get is why I feel I have no energy? I can't enjoy anything any more. My regular doctor prescribed an antidepressant but it has not helped so far. Could I have some bad disease?"

Sleep is the glue that holds the body and mind together. They did not realize it until they saw a sleep doctor who could put two and two together for them.

Its time to wake up from the slumber! Pun intended.

Deep Relaxation Training at Sehatu Sleep, designed with sleep medicine and psychology principles, empowers people by giving them skills to turn the mind switch on and off on command and to relax when needed. Classes can be attended via Skype.

Sehatu Sleep Granite Bay CASehatu Sleep and Yoga Studio, located in Granite Bay, CA,  also provides a variety of Yoga classes, including Yin, Gentle and Restorative Yoga, as well as Meditation classes, for individuals who are interested in practicing a healthy lifestyle at any age, starting at any time in their life at any skill level. 

 

 

On The Subject of The Active Mind Syndrome - Do You Have It Too?

To be very frank there is no such condition identified in the Diagnostics and Statistics Manual that mental health providers use, at least not so far. Could it be that the prevalence of this problem is so high it is considered kind of normal to suffer with it?

Society has been hard at work to train our children and adults alike, to work hard, be responsible, worry about the consequences of our actions and be held accountable. Nothing wrong with any of that but there are ramifications to this training that we never see coming.

In going through the process of developing these necessary traits in our personalities, we de-train ourselves from how were were as young children, happy go lucky, taking a day at a time, relaxed and unhurried. Some of us can cope with the change simply because they have been blessed with a calm demeanor implanted genetically into their minds. The rest of us suffer. We worry about getting to places on time, paying bills, caring for loved ones, making money, spending money, socializing, networking, entertaining, being entertained, even sleeping. We take our busy minds to bed with us and rise with these busy multi tasking, active minds. Our minds keep busy problem solving, thinking, recalling what happened and planning ahead for what might happen, even when we are supposed to be resting.

Rest doesn't come easy, sleep doesn't come, and if it comes it is not restful. We keep tossing and turning in bed trying to fall asleep. We wake up within 2-3 hours of falling asleep often staring in the dark, counting sheep, checking text messages and emails, turning the TV on and off and finally giving in to the temptation to take some sort of sleeping pill. Some will keep going to the bathroom or get up and eat. Then comes the dreaded morning and back to the race to finish tasks, be on time, finish the work, on and on and on.

I see these people every day in my sleep medicine practice. Nice, responsible, good people. Suffering people. Distressed people. "Doctor, the more I try to sleep the harder it is to fall asleep. My mind just races and doesn't stop, even when there is nothing stressful happening. What should I do? Can you help me?" And I find myself thinking, here is another patient with the undiagnosed and so far unnamed Active Mind Syndrome.

There are many ways to treat it should you be one of those people who have experienced the ill effects of this condition. Its important to know two facts first though. Firstly, there is no use asking the doctor since most doctors don't know what it is (and likely they have it too) and they wouldn't know how to treat it. Secondly, the answer is not in a pill.

What is your motivation? How strong is it? How bad is your suffering?

We at Sehatu Sleep think we have the answer. We call it Deep Relaxation Training (www.sehatusleep.com). We feel it requires re-training the mind to make the best of both worlds. People can learn to be productive, efficient, high achieving, and at the same time able to let go, relax, and loosen up on demand; able to sleep like a baby. It does require hard work, commitment and consistency but is very do-able. It is very powerful and gives you the capability to deal with life as it happens.

It is certainly not the only answer. Many paths can lead you to the same goal. We think ours is the most comprehensive. If not us, there are many wise people around you wherever you are. It just takes recognizing the problem and then seeking help. Its around the corner. Waiting for you. Wherever you are.

Happy dreams!