Making Sleep Part of Your Practice: Practical Strategies to Incorporate Now
May 19, 2024
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Physical therapist and professor Brett Neilson discusses the crucial link between sleep and chronic pain management, highlighting a gap in research practices. The conversation covers the impact of sleep on pain, role of wearables, and practical advice for clinicians on incorporating sleep assessments. Emphasizing the importance of understanding individual sleep needs and using tools like the CBTI Coach app.
Initiating conversations about sleep with patients can improve overall well-being and incorporating tools like CBTI apps is valuable for promoting positive changes.
A scoping review revealed a significant gap in chronic low back pain trials regarding the inclusion of sleep measures, emphasizing the importance of addressing the relationship between sleep and pain in research.
Deep dives
Importance of Addressing Sleep in Clinical Practice
Addressing sleep habits with patients can greatly impact their overall well-being. Understanding that sleep quality is more important than quantity, clinicians should initiate conversations with patients about their sleep patterns and offer guidance on effective sleep hygiene practices. By incorporating tools such as CBTI apps, clinicians can assist patients in making positive changes.
Research Findings on Sleep and Chronic Low Back Pain Trials
A scoping review revealed that a minimal percentage of chronic low back pain trials incorporate sleep measures, despite guidelines recommending their inclusion. Less than 10% of trials examined included any measure of sleep, highlighting a significant gap in addressing the relationship between sleep and pain in research.
Role of Wearables and Understanding Sleep Efficiency
Wearable technology can provide valuable insights into sleep patterns but may not be suitable for everyone, as it can lead to anxiety. Clinicians should adapt a balanced approach in utilizing wearables, considering factors like sleep efficiency. Achieving an 80-85% sleep efficiency rate is considered ideal for optimal rest.
Education and Training in Sleep Management for Clinicians
Providing education on sleep hygiene practices and integrating sleep discussions in clinical training can enhance clinicians' ability to address sleep-related issues with patients. By understanding the importance of quality sleep, clinicians can tailor interventions to individual needs, promoting holistic patient care.
Episode Summary: In this episode of the Modern Pain Podcast, host Mark Kargela is joined by Brett Neilson, a physical therapist and professor at Hawaii Pacific University. Recorded live at the Pain Science in Motion conference in Las Vegas, the episode delves into the crucial intersection between sleep and chronic pain management. Brett shares insights from his scoping review on the integration of sleep measures in chronic low back pain research, highlighting a significant gap in current practices. The conversation covers the impact of sleep on pain, the role of wearables, and practical advice for clinicians on how to incorporate sleep assessments and interventions into their practice. Brett emphasizes the importance of understanding individual sleep needs and using tools like the CBTI Coach app to help patients improve their sleep quality.
TIMESTAMPS: 00:00:00 Episode begins 00:01:43 Interview Start 00:02:53 Brett's Work on Sleep 00:05:04 What did they find in their systematic reveiw? 00:08:25 Clinical pearls gained in pre-conference course 00:10:43 What apps or tools are out there for clinicians? 00:13:46 Can tracking sleep excessively become anxiety generating? 00:14:57 How do we determine the right amount of sleep for the individual? 00:19:47 Mindulness or meditation for sleep 00:23:12 How do we get this in curriculum? 00:26:20 How do we get this as every day practice? 00:31:59 Sleep as a part of the big picture in pain
Key Takeaways: Sleep and Chronic Pain Connection: There is a strong link between poor sleep and chronic pain. Addressing sleep issues can potentially alleviate pain symptoms.
Research Findings: A scoping review revealed that less than 10% of chronic low back pain trials include sleep measures, highlighting an area for improvement in research practices.
Role of Wearables: While wearables can provide useful sleep data, they should be used cautiously to avoid causing anxiety. It's best to view sleep data in the context of long-term trends rather than daily fluctuations.
Screening and Interventions: Simple questions about sleep quality can help identify patients who may benefit from further sleep assessment. Tools like the CBTI Coach app, developed by the VA, can assist clinicians in guiding patients through cognitive behavioral therapy for insomnia.
Individualized Approach: Quality of sleep is more important than quantity. Clinicians should tailor their recommendations based on the individual needs and experiences of their patients.
Practical Tips for Clinicians: Incorporate basic sleep questions into patient assessments, use validated sleep measures, and educate patients on sleep hygiene practices. Encourage patients to find relaxation strategies that work for them, whether it's mindfulness, reading, or other calming activities.
Educational Integration: Teaching about sleep and its impact on health should be integrated into PT education to better prepare future clinicians.
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