OVERVIEW OF SLEEP BENEFITS
In recent years of research, it has been determined that about ⅔ of the world’s population is not getting the recommended 8 hours of nightly sleep. This is a staggering statistic, particularly when one understands the many ways in which sleep contributes to a properly functioning body and mind. Sleep recharges the immune system, modulates blood sugar, clears coronary arteries, removes waste from the brain, and facilitates memory, creativity, problem-solving, and the acquisition of motor skills.
For people recovering from a stroke, traumatic brain injury (TBI), or concussion, sleep is even more important and should be prioritized because of its wide range of necessary functions.
From restoring the immune system to removing excess inflammation in the brain, sleep provides unique benefits that cannot be accessed otherwise and that are absolutely necessary when recovering from a neurological injury.
WASTE REMOVAL aka “BRAIN WASHING”
Recent discoveries in sleep research have shown us that the brain essentially washes itself during sleep, through means of the newly discovered glymphatic system. The glymphatic system operates in a similar way to the body’s lymphatic system, where fluid is sent to remove toxins and metabolic waste from an area, flushing them out and refreshing the area. However, instead of sending lymph, the glymphatic system uses cerebrospinal fluid (CSF) as its washing medium. Think of it as a microscopic sewer system for the brain that is only fully active during sleep.
When a person is not sleeping properly, the glymphatic system cannot perform its duties, and waste builds up in the brain over time. This leads to dementia, Alzheimer’s, and many neurological issues that are severely life-altering and extremely difficult to treat.
MEMORY & LEARNING
Research shows a significant increase in memory issues and attentional deficits in those who do not sleep the recommended 8 hours. This is for a few different reasons, again highlighting the importance of sleep for optimal quality of life.
During stage 2 of sleep, the brain is able to restore its capacity for learning by creating more “storage space” for new memories and information. This allows a person to fully receive and store new experiences, while removing that which is deemed unimportant. Another interesting component of sleep comes after learning something new. Sleep actually protects newly acquired information, reducing the likelihood that it will be forgotten. The deeper one can sleep, particularly in the deep non-REM stage of sleep, the more information they will retain the next day.
This improved retention of information and of learned skills, as you can imagine, are profoundly important when one is learning to walk or talk again after a stroke.
Sleep provides the patient’s brain with a chance to embed the progress made during the day and build on those successes the next day.
SLEEP FOR EMOTIONAL STABILITY & MENTAL HEALTH
Poor sleep and mental health conditions (such as PTSD, depression, and anxiety) are shown to have a bidirectional relationship, meaning that sleep problems are both a cause and consequence of mental health conditions.
According to research statistics, at least 90% of U.S. veterans with combat-related PTSD suffer from insomnia symptoms and poor sleep.
The traumatic events replaying in veterans’ minds, nightmares, and high state of alertness prevent them from sleeping soundly, and the consistent nights of poor sleep worsen their PTSD symptoms. This bidirectional relationship also occurs with depression, anxiety, and bipolar disorder, each in their own respective ways.
While this presents a challenging, seemingly never-ending cycle of intensifying symptoms and poor sleep, it also means that treatment for both issues can go hand-in-hand. There are ways to improve one’s sleep hygiene that can move the needle in a positive direction and give the person the best chance at improved natural sleep, which in turn can begin to relieve some symptoms of their mental health condition. This positive cascade compounds over time, and can be accelerated with some neurological therapies we offer at Resiliency.
How do you know if your sleep is sufficient? What are some ways to improve your sleep? We teach our patients all of these things during their treatment programs at Resiliency.
For more information about how to become a patient at Resiliency, please fill out this contact form.
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OVERVIEW
Bloodwork analysis is a crucial component of successful neurological recovery after a traumatic brain injury (TBI), stroke, or concussion. As we explain in this article, the entire body must be working in harmony for the brain to heal and for the positive changes to stick. Thorough blood tests are an important method of identifying imbalances in the different systems of the body, allowing a clear view of what’s happening.
However, not all doctors interpret these lab results the same way, and it’s important to know the differences between the conflicting approaches.
This article focuses on the differences between the standard model and the functional medicine model, identifying the causes and consequences of following outdated models. In short, interpreting blood work through a functional medicine lens differs significantly from the “standard” lens, and is entirely more effective in identifying and treating imbalances before they become disease.
THE STANDARD MODEL | STANDARD LAB RANGES
The standard model uses ranges that are far too wide, and thus only flags numbers when they’re outrageously off, meaning it’s often too late by the time the doctor says anything. This disempowers patients by making them dependent upon significant interventions, often including invasive procedures and pharmaceuticals that bring a whole slew of negative side effects.
This standard approach is problematic because it leads to higher levels of disease in our country, overwhelms hospital staff trying to accommodate patients whose disease has already wreaked havoc on their bodies, and makes millions of Americans dependent on pharmaceutical medications for the rest of their lives.
THE FUNCTIONAL MEDICINE MODEL | FUNCTIONAL LAB RANGES
Functional lab ranges, on the other hand, are much narrower, and therefore allow the patient to see the direction that their numbers are trending before it’s too late. This empowers the patient and the practitioner to catch imbalances before they escalate into disease, and treat them proactively with lifestyle changes rather than reactively with extreme methodology as mentioned above. This is a vastly superior approach in improving patients’ quality of life and reducing the likelihood that they will need to depend on prescription medications for the rest of their lives.
At Resiliency, we use this functional medicine perspective, looking at a smaller range of lab values and considering all potential factors when reviewing our patients' bloodwork. Understanding that the human body works as a complex set of system allows us to identify address issues further "upstream" (meaning root cause) rather than merely focusing on "downstream" symptoms.
EXAMPLE
An example often helps our patients understand this, so we will use testosterone levels in men. Through the standard medical lens, many doctors consider acceptable testosterone levels to be between 300-1,050 ng/dL, regardless of the man’s age, lifestyle, and other conditions. If an 85-year old man, for example, has a testosterone level of 900 ng/dL, this is certainly not “normal”, yet it is often not flagged as problematic because it still falls within the acceptable range. On the other end of the spectrum, if a young man 21 years of age has a testosterone level of only 350, this can be considered “normal” even though this is extremely low for a man his age.
In the above example of the elderly man with high testosterone levels, let’s imagine the doctor sends him home without addressing his high testosterone. The patient’s health declines, and a year later he goes back to the doctor. His testosterone level is now 1,100 (out of range), so his doctor finally runs some tests and they find he has advanced stage testicular cancer.
Something that could have been treated earlier with a high degree of success is now a life-threatening condition.
This type of experience happens in different contexts all the time, with patients experiencing kinds of symptoms that are often either dismissed because the lab values are within the acceptable range, or masked with a pharmaceutical medication without addressing the root cause. Thankfully, more and more practitioners are adopting a functional medicine approach and considering a wider range of factors when looking at blood work.
For more information about how to become a patient at Resiliency, fill out this contact form.
WHAT IS PERSEVERATION?
Practically everyone knows what it’s like to have a song stuck in their head, where no matter what they do, it won’t leave. This can be an irritating experience, but overall doesn’t have a big impact on day-to-day function. Perseveration is similar to this concept, though unlike having a song stuck in one’s head, it tends to be a thought or series of thoughts that stays stuck in the forefront of their mind, and can be detrimental to one’s well-being. These perseverative thoughts often involve negative self-talk and can even be as extreme as to involve suicidal ideation.
Perseveration, while potentially crippling, is actually quite common among patients who have suffered from traumatic brain injury (TBI), stroke, concussion, PTSD, or anxiety.
These perseverative thoughts are a symptom of an underfunctioning frontal lobe–as a result of a brain injury or chronic mental health condition–and can actually prevent a patient from recovering, due to the negative mindset that they perpetuate. By keeping the patient locked in a thought loop about the past or worrying about the future, perseveration prevents the patient from being fully present in the moment and engaging in their day-to-day activities. This blocks joy and contentment, creates intense anxiety and depression, prevents sleep, and can cause damage in relationships.
WHAT CAUSES PERSEVERATION?
Perseveration occurs when one’s frontal lobe, the inhibitory lobe of executive function and emotional regulation, is damaged and cannot fully inhibit the compulsive, repetitive thoughts. In a healthy brain, the frontal lobe will recognize when thoughts are running rampant, and can effectively shift awareness to something other than those same negative thoughts to keep the mind in check. It doesn’t necessarily suppress the negative thoughts, but it can recognize that they are not serving the person in a positive way and can move onto the next thought with little difficulty.
When the frontal lobe is struggling as a result of injury, however, it cannot “turn off” these negative thoughts.
Instead, they play on a loop endlessly and can spiral the patient into manic states, periods of severe depression, or harmful behavior when not kept in check. It is important for the patient to recognize that it is not their fault this is happening, and that it is in fact a neurological condition that can be treated successfully with the right effort.
CAN PERSEVERATION BE TREATED?
In addition to neurological treatments that target the frontal lobe, such as repetitive transcranial magnetic stimulation (rTMS) and certain eye exercises (ex: anti-saccades), an important step in getting rid of perseverative thoughts is creating awareness of these thoughts and beginning to recognize when one is caught in a perseverative loop.
When someone is stuck in these thoughts all day and night, he or she may not even recognize that it’s happening because the thoughts are all-consuming.
However, through awareness practices such as mindfulness meditation and journaling, one can begin to identify these perseverative thoughts and “come up for a breath of air,” so to speak. Through consistent awareness practice and the strengthening of the frontal lobe and its connections to the rest of the brain, one can notice the perseverative thoughts more quickly and use certain techniques to try to shift your thoughts toward something more positive.
It’s as if the person is swimming and they have been sucked into a whirlpool, and they’ve been spinning in circles for hours. All of a sudden, in a moment of clarity, they notice they’re stuck in a whirlpool, so they can begin to swim away. As awareness increases and the frontal lobe recovers over time, the person will notice they’ve been sucked into the whirlpool much more quickly, and swimming away is much easier. Continuing even further, they will eventually notice the tug of a whirlpool before it even pulls them in, allowing them to change course and swim freely without getting stuck in it. The moments of relief and clarity extend longer and longer until the whirlpool is simply a gentle wave in the water rather than a tumultuous, inescapable vortex.
If you or a loved one suffers from perseveration, please fill out this contact form.
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