Is Sleep Affecting Your Rehabilitation?

We have all heard the famous saying of "I'll sleep when I'm dead." Many are very familiar with the feeling of needing to pull an all nighter to finish a deadline for school or work. When things get busy sleep seems to be one of the first things that gets neglected however, it's one of the most important things we can do for the overall health of our body.

 Some people choose not to sleep while others are unable to sleep because of stress, pain, or other health condition. So many people suffer from things like short term or chronic insomnia and sleep apnea that leave them feeling tired and fatigued throughout the day. Did you know that sleep deprivation is much more detrimental to health than just feeling tired? Not getting the sleep our bodies need consistently has been shown to increase an individual's risk for depression, cardiovascular disease, and potentially even Alzheimer's Disease. Obviously those are major concerns to overall health...but how could your sleep be affecting physical rehabilitation or your risk for needing physical rehab? One important aspect of sleep is that your body is able to grow and repair your body tissue while in the deep sleep stage so you can recover faster from any injury or damage to your body. While you are sleeping your body is able to send blood which delivers things your body tissue needs to heal and repair. This means that if you are not getting adequate sleep your body tissues are not getting what they need to repair which slows down the recovery process. General fatigue is also a problem for those that are not sleeping and going through some sort of physical rehabilitation. People are already busy plus they are working hard at their physical therapy appointments and they are being told that they need to do their home exercise program everyday to really get better. If someone is not sleeping they are lucky to have the energy to go see their physical therapist let alone do their exercises at home. Doing exercises at home along with being physically active is crucial to getting better following an injury and to preventing future problems. To have the energy to do those things an individual needs to get sleep so they are not constantly tired throughout the day. Sometimes sleep and pain can be a vicious cycle that is hard to overcome. Pain can keep people up or wake them up so they can't sleep and then decreased sleep has also been shown to increase pain perception so people who don't sleep hurt more than those that are rested. Even your body is not injured as bad, the increased pain perception will make it feel hurt so it will feel like a person is not getting better even if their body is. Another important health concern that decreased sleep contributes to is an increased weight gain. A substance that controls appetite is released while you are sleeping and so if you are not sleeping you are going to have an increased appetite resulting in eating more and that, combined with the lack of energy results in increased risk of gaining weight. Excess weight is correlated with a lot of major health conditions and also puts more stress on your body overall. So if you are having trouble sleeping, what can you do about it. There are good habits that can be established known as sleep hygiene that can help you sleep better. Some of these are things like trying to go to bed and get up at the same time each day, using the bed for sleep only, and avoiding caffeine later in the day. One of the best things people can do is avoid screen time before bed. Replacing screen time with better habits such as writing in a sleep journal, reading, or stretching will help relax your body to prepare it for sleeping.
Sleep is often an overlooked aspect of health by both health care providers and the general population. Sleep can interfere greatly with quality of life and limit how quickly an individual can rehabilitate following an injury. Sleep assessments are something that physical therapists need to start doing as part of their evaluations because the amount of sleep our patients are getting has a significant impact on their rehab prognosis.

Prescribing Exercise as Medicine

There is a medication that can be prescribed that can help prevent and treat many of the leading causes of death and disability in the United States such as heart disease, diabetes, obesity, and even cancer. Plus this medication has shown potential for reducing the risk of Alzheimer's disease and dementia along with helping individuals with depression and anxiety. This prescription is also extremely cheap and for most cases can even be free. This prescription exists yet it's severely underutilized in the health care system. So what is this magical medication? This amazing solution is exercise and physical activity. When we think of medicine we so often think of those orange bottles of pills prescribed by the doctor for individuals. Exercise however, could literally be considered medicine! Exercise has so many benefits fro an individual in terms of preventing disease and leading to a higher quality of life. Former Director at the National Institute on Aging Dr. Robert Butler has said, "If exercise could be packed in a pill, it would be the single most widely prescribed and beneficial medicine in the nation."

The evidence is clearly there that shows how beneficial exercise and physical activity is in preventing many of the chronic health problems in our country, so why is it not being prescribed more? For most people they are simply told that they need to exercise to improve their health and sent on their way. Could you imagine if that is how it worked with medications? You would just be told to go to the pharmacy and pick out any medication without your doctor even figuring out which is best for you or giving you help to pick something out that will help. When people are simply told that they need to be more physically active that is essentially what is happening. Exercise is literally medicine and just like other prescriptions it needs to be tailored to the individual based on what will benefit them most. The Exercise is Medicine initiative was coordinated by the American College of Sports Medicine in collaboration with the American Medical Association to help health care providers and patients understand the physical activity guidelines, assess if people are meeting those guidelines, and providing resources to help individuals use exercise as medicine. To learn some more about Exercise is Medicine and find advice on becoming more physically active check out more on their website http://www.exerciseismedicine.org/support_page.php/about/. 

Exercise is packed with benefits for so many health conditions and the side effects are significantly lower than other medications. The research shows how much exercise does in disease prevention, but since it's impossible to pack all those benefits in a pill we need to help health care providers and the population learn that exercise is medicine and needs to be prescribed like one. As movement specialists physical therapists can play a valuable role once the health care system starts recognizing the magical medicine of exercise. It's time we start assessing physical activity as a vital sign just like heart rate and blood pressure and then treat with the same urgency that we would treat anything else. Ask yourself this question...if there was a single medication out there that had the ability to prevent many debilitating diseases, would you want to get your hands on it? The good news is that you already have access to it and all it takes is finding some exercise you enjoy and start doing it.