Sober Synthesis

Sleep Basics

• Quality sleep is essential for neuroplasticity (creating new neural pathways), mental and physical healing/recovery, memory consolidation, and overall health/wellness.
• Addiction severely disrupts restorative sleep, especially REM sleep, and restorative sleep often remains disrupted during early recovery.
• We generally have an average of 4-5 (90 minute) sleep cycles during healthy sleep. These include shallow sleep and slow wave sleep (non-Rem) earlier in our sleep cycle and rapid eye movement sleep (REM) later in our sleep cycle.

• Typically, the lowest body temperature occurs around 4:00 a.m., which is when people often experience their deepest sleep.
• Brain temperature falls in non-REM sleep and then rises in REM sleep that typically follows. 
• Changes in brain waves support the many restorative and consolidation activities that occur during sleep.

• Slow wave sleep 
  • Phase 1 is essential for optimal release of Human Growth Hormone (healthy metabolism).
  • Phase 2 (Sleep Spindle stage) is essential for optimal consolidation of new learning: memories stored in our hippocampus (jump drive) are transferred to our neocortex (hard drive of the brain).

• REM sleep occurs throughout our sleep cycle, but more frequently later in our sleep cycle. 
  • Schemas are built and rebuilt (opening folders and comparing documents).
  • We replay and consolidate spatial information (where we were and why) and form improved problem-solving approaches.
  • Discard irrelevant information and/or associations to maximize future learning.
  • Emotions and emotional memories are processed and stored.
• It is common and healthy to wake up around 4 hours after sleep onset.

Basic activities to maximize restorative sleep:

• Sleep Hygiene
  • Go to sleep around the same time. A consistent sleep schedule is more important than the amount of time slept. Sleeping later after going to sleep late does not compensate for the late start.
  • Safe exposure to sunlight for optimally 2 hours a day. Exposure within 2 hours of dawn and 2 hours of dusk is the “gold standard”.
  • Avoid arousal activities before sleep (action video games, intense movies or shows).
  • Avoid light, even briefly, including blue light (e.g. cell phones, ipads) after going to sleep (very important).
  • Regular exercise, preferably in the morning
  • Avoid caffeine after 2-3 PM
  • Regular eating times and avoid eating within 2 hours of sleep onset 
  • Keep bedroom cool (65-68 degrees Fahrenheit is optimal)
• Mindfulness/meditation can be helpful for sleep onset as well as falling back to sleep after waking. Effective practices include Non-Sleep Deep Rest (NSDR) and Yoga Nidra. 
• Supplements (e.g. melatonin, magnesium threonate) may be helpful. Melatonin is not recommended for long-term use. Important to inform your physician of any supplements and/or vitamins you are taking.
• Medications may be helpful for acute sleep disturbance.
• Group and/or individual therapy may be very helpful and needed for PTSD and/or co-occurring mental health conditions. 
• Ongoing sleep disturbance may be an indicator of a medical condition (e.g. sleep apnea). A sleep study may be helpful.

Proposed Questions for Thought/Sharing:

1. How has your sleep improved in recovery?
2. What changes in lifestyle have improved your sleep?
3. What changes do you plan to make to improve your sleep?

Disclaimer

This summary is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed.