In the May 2017 Physical Therapy Journal, a recent article entitled: Sleep Health Promotion: Practical Information for Physical Therapists, nicely demonstrates the role physical therapists play with sleep health in prevention, health promotion, and wellness interventions. Sleep disturbances occur in one third of the US population, and the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control has deemed insufficient sleep to be a public health problem. Sleep has an important role in the proper functioning of most, if not all, body systems. Sleep is critical for immune function, tissue healing, pain modulation, cardiovascular health, cognitive function, and learning and memory. Without adequate sleep, people can experience increased pain perception, loss of function and reduced quality of life, depression, increased anxiety, attention deficits, information processing disruption, impaired memory, and reduced ability to learn new motor skills, and are at an increased risk for accidents, injuries, and falls. So, I am trusting you get how important sleep is for everyone, especially if you suffer from any chronic pain situations, TMJ issues, headaches, etc.
One of the reasons I feel we are so successful at Freedom Physical Therapy is because we place so much importance on doing a thorough evaluation of the whole person from head to toe. One component to our evaluations is assessing sleep, how much, how deep, when you wake do you feel rested, etc. In future blogs I will discuss the critical importance of assessing sleep in kids, especially those with TMD issues, headaches, neck pain. Also the importance as a PT, to assess the airway space and tease out possible sleep disordered breathing that can effect normal craniofacial development and contribute to orofacial pain. The key point here is as a profession, physical therapists should be advocates for their patients and at Freedom we take that very seriously. As a PT, I might not be able to directly treat sleep related issues, but I can certainly screen for sleep problems and then make the necessary referral or recommendation to the appropriate health care provider for evaluation and treatment.
In the article I mentioned above, the authors provide a simple list of questions you can include in your evaluations and if you are a patient reading this, answer these questions and see if you need to have your sleep quality assessed:
Patient Interview: General Questions
1. How much sleep do you typically get?
Healthy individuals (age range 30–70 years) who sleep less than 6 hours or more than 8 hours each night had a higher risk for mortality compared with those with adequate sleep (6–8 hours)
2. Do you feel well rested when you wake up?
3. Is your condition impacting your sleep? If so how?
4. How would you rate your sleep quality?
5. Does being sleepy during the day interfere with your daily function?
6.Do you have difficulty falling asleep, difficulty returning to sleep if you wake up in the middle of the night, or difficulty with waking up too early? (possible indicator of insomnia if last longer than three months)
8. Do you snore loudly or frequently? Has anyone observed you stop breathing while you sleep? (possible indicator of obstructive sleep apnea)
9. Do you have a strong urge to continually move your legs while you were trying to sleep? (Possible indicator of restless leg syndrome)
To integrate sleep health in prevention, health promotion, and wellness interventions, therapists should:
1. Assess overall sleep health and screen for risk of sleep disorders. Based on the responses to the questions above a therapist may need to include other screening tools like the Insomnia Severity Index, the Stop-Bang Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the
2. Epworth Sleepiness Scale (ESS).Refer for additional assessment if individual is identified as at increased risk for a sleep disorder.
3. Provide sleep hygiene education. Click this link to access the PDF on my TreatingTMJ Website.
4. Provide an appropriate exercise program.
5. Consider positioning to promote sleep quality.
6. Address bed mobility issues.
I hope you have found this blog helpful regarding your sleep, and the benefits you stand to reap from great sleep!!
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