Why You Should Ask Clients About Sleep

I am a person who loves my “baby sleep” so it’s no surprise that I naturally ask my clients about their sleep. I’ve always maintained a good sleep habit (even through university!) because good sleep puts me in a better mood, gives me better memory, a stronger immune system, improved focus, and allows me to be more productive.

As I asked clients about their sleep, I noticed that many people experience problems with their sleep. In fact, statistics Canada reported, “short sleep duration and poor sleep quality are prevalent among Canadian adults. About one-third sleep fewer hours per night than recommended for optimal physical and mental health.”

From my work I've noticed a number of factors that commonly affect people’s sleep:

• Pain – trouble falling sleep because of pain, unable to find a comfortable sleeping position

• Stress – trouble falling asleep or staying asleep because of stressful or negative thoughts and emotions

• Fears or Anxiety – worries and fears about health effects from lack of sleep, looking at the clock and counting how many hours they are sleeping, feeling they have little control over sleep

• Fatigue during the day – leads to the habit of taking multiple (or long) naps during the day and consequently not feeling that tired at bed time

• Environmental factors – noise, light, temperature, etc. making it hard to fall asleep or stay asleep

As a physiotherapist, I aim to help my clients achieve their optimal physical and mental health. I can do all the manual therapy and teach clients all the exercises they need to do to facilitate their recovery, but if their bodies are not healing at the optimal rate, if they don’t have energy and motivation for physiotherapy or to do their exercises, and if other body systems are affecting their overall health and well being… it’s hard to help clients reach their optimal health. So why care or talk about sleep?

Much research has shown sleep to be important for:

• Healing and recovery of the body

• Reducing risk for chronic conditions such as heart disease, stroke, diabetes, obesity, etc.

• Removing metabolic waste products from the brain, i.e. sleep “detoxifies” the brain (Xie et al., 2013)

• Learning and memory consolidation (Rasch & Born, 2013)

• Attention and concentration

• A stronger immune system

• Better mood and motivation

• Growth and development

• Increased pain tolerance (Affleck, Urrows, Tennen, Higgins, & Abeles, 1996)

In other words, sleep is pivotal to our health, which is why I believe that as physiotherapists (or other primary health practitioners), we need to ask clients about their sleep. Once we know that sleep is a problem, we may provide clients with the appropriate sleep education and provide them with advice or resources to potentially help them improve their sleep. My next blog post coming up will offer 11 ways to help clients improve their sleep.

We may not always feel comfortable asking about or addressing the sleep concerns of our clients. Moreover, the cause(s) of sleep problems may be outside of our scope of practice (as there are multiple factors affecting sleep such as pre-existing health conditions, depression, hormones, sleep apnea, menopause, narcolepsy, medication side effects, etc.), but that’s okay! We should still ask about their sleep and refer clients to other resources and colleagues who may help them (e.g. a sleep specialist, cognitive behavioural therapist, psychotherapist, physician, and many other colleagues who may be able to help clients get a good night’s sleep). So the bottom-line is don’t forget to talk about sleep with clients! If you are a potential client reading this post, don’t be afraid to talk about your sleep concerns with your physiotherapist since she or he may be able to help you or direct you to the appropriate resources that may help you!

References:

Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M., ... & Takano, T. (2013). Sleep drives metabolite clearance from the adult brain. science, 342(6156), 373-377.

Affleck, G., Urrows, S., Tennen, H., Higgins, P., & Abeles, M. (1996). Sequential daily relations of sleep, pain intensity, and attention to pain among women with fibromyalgia. Pain, 68(2-3), 363-368.

Rasch, B., & Born, J. (2013). About sleep's role in memory. Physiological reviews, 93(2), 681-766.

https://www.statcan.gc.ca/pub/82-003-x/2017009/article/54857-eng.htm

https://sleepfoundation.org/

https://sleep.org/