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Simple Sleep Assessment
Ben Mooney • Aug 09, 2023
Having trouble sleeping? Please consider taking 2-3 minutes to answer the following seven questions. This assessment is from Bastien et al. Insomnia Severity Index, Copyright 2001.
Rate the current SEVERITY of any sleep issues, based on your last two weeks of sleep.
None Mild Moderate Severe Very
1. Difficulty falling asleep 0 1 2 3 4
2. Difficulty staying asleep 0 1 2 3 4
3. Problem waking up too early 0 1 2 3 4
4. How satisfied/dissatisfied are you with your current sleep patterns?
Very Satisfied Very Dissatisfied
0 1 2 3 4
5. To what extent do you consider any potential sleep problems to INTERFERE with your daily functioning (e.g. daytime fatigue, ability to function at work/daily chores, concentration, memory, mood, etc.).
Not at all A little Somewhat Much Very Much
0 1 2 3 4
6. How NOTICEABLE to others do you think any potential sleeping issues are in terms of impairing your quality of life?
Not at all A little Somewhat Much Very Much
0 1 2 3 4
I have grown to love The Huberman Lab Podcast and Breathwork. I had such profound experiences with breathwork that I decided to take the training to become a breathwork facilitator. I believe breath is such a powerful tool to regulate our nervous systems; perhaps one of the most powerful ones we possess. The Physiological Sigh is something that everyone can use in real time. It works, and there is a great biological explanation. Andrew Huberman PhD. talks extensively about the Physiological Sigh in The Huberman Lab, and I am so excited to share this information! If you are stressed, it’s great to get a massage, soak in hot springs, go for a run, or go to yoga, but in reality, you often experience emotional turmoil in the moment. Which is why it's so important to have a tool for that moment. It is very hard to control your mind when you are in intense states of stress. Good luck being intentional or channeling inner wisdom of mindfulness at the exact moment something is driving you crazy. What do you do? Perhaps you have just enough mental capacity to temporarily think about your response before you react. You need a real time tool. I will try not to get too geeky, but there is a great biological component to this. First, a simple explanation: If you want to slow down your heart, lengthen your exhales in relation to the inhales. Calming your nervous system can happen quickly through a long exhale. Priming the exhale with an oxygenated inhale will help deliver oxygen to your blood and eliminate carbon dioxide. Finally, using the skeletal muscles of the diaphragm is a tool to fast-track this process. If this information is good enough, feel free to skip the next three paragraphs, and jump ahead to learn how to incorporate the Physiological Sigh as a reaction to in-the-moment stress. Breath controls heart rate through reactions between sympathetic and parasympathetic nervous systems. When you inhale, your diaphragm moves down as your lungs and heart temporarily expand. As a result, the blood in your heart is at a lower volume than prior to your inhale (in relation to the space in the heart), and your heart moves more slowly. The SA (sinoatrial) node in your heart registers the rate of blood flow, and acts as the pacemaker for your heartbeat. The SA node is constantly trying to achieve a balance of pressure and optimal oxygen distribution of blood throughout your body. A longer inhale causes the SA node to send a signal to your brain that blood is moving more slowly to your heart. The brain sends a return signal to the heart to speed up the heart rate to produce more oxygenated blood flow to muscles throughout your body. Therefore, if you want your heart to beat faster, inhale more vigorously than your exhales. Additionally, if inhales are completed over longer time periods than your exhales, you speed up heart rate. This creates a sympathetic activation response and is a great tool if you need to increase your attention or if you are tired (Journal of General Physiology, 9/13/10 136(3) 237-241, H. Peter Larson). The opposite is also true. If you want to slow down your heart rate and calm yourself, capitalize on the relationship between heart rate, diaphragm, and brain. When you exhale, the diaphragm moves up and gets smaller. The blood volume of the heart is flowing faster through the heart, and the SA node recognizes the faster flow of blood. The SA node sends a message to the brain to slow the heart rate. The parasympathetic nervous system is activated in your brain, via the vagus nerve and baroreceptors in the arteries as well as its relational connection to the diaphragm, and it sends a return signal to slow your heart down. Take a long exhale to calm yourself. Now, let's focus on your lungs for a moment. Think about how you breathe when you experience stress - often it is shallow. You have tiny sacks in your lungs called alveoli. The job of alveoli is to expand and contract as oxygen is inhaled and circulated into your blood. When you are stressed, the alveoli tend to collapse and are not as efficient. Meanwhile, carbon dioxide builds up in your bloodstream, increasing agitation. Your body will want to replenish the blood with rich oxygen and clear out the carbon dioxide at this time. Finally, the diaphragm is unique because it has the ability to be subconsciously controlled through natural processes similar to your spleen, pancreas, intestines, or stomach, AND as mentioned earlier, you can also voluntarily expand and contract your diaphragm with skeletal muscle control. You don't need to think about breathing, but you have the choice to override and manipulate your breath. As a result, you can do double or triple inhales and control the timing of your breathing for speed, capacity, and duration. Through a double inhale, you can efficiently re-inflate the alveoli, and cue your nervous system to focus on intentionally moving out of the shallow breathing pattern. The Physiological Sigh: Double inhale - first for one second, with your second inhale shortly after for ½ to ¾ of a second - to sneak in more air. Hold for several seconds, then perform a long exhale. Through my breathwork training, I learned if you combine your long exhale with a hum or audible sound, and you recruit the superpowers of the vagus nerve (your 10th cranial nerve and the longest and most complex of all cranial nerves) for a deeper calming effect - but this may not be appropriate in the middle of a staff meeting. Repeat this 1-3 times, or more until you gain your desired result or at least enough to find mental clarity to calm your reaction. The double inhale reinflates the alveoli fully in your lungs and the long exhale rids your body of the carbon dioxide, modulating your stress response through slowing your heart rate and calming your nervous system. This is a fast, hard-wired way to lower your internal reaction to stress the moment you experience it. I would recommend practicing it so it becomes immediate. Think of moments where you find yourself to be stressed and imagine using your physiological sigh as you proceed through that moment. Rehearse, rehearse, rehearse so it becomes more instinctual. This can be applied during weight lifting, at times of the day when you intentionally want to relax, as part of a calming routine before sleep, and certainly if you are triggered in the moment of a life stressor.
This exercise is designed to amplify your awareness of your internal thought stream. There are two primary goals for this exercise. The first is to transition from being so immersed in internal thoughts that your nervous system reacts. For example, if you are thinking about a work meeting tomorrow, not being prepared, and feeling nervous about presenting to a large group, even though the meeting is tomorrow, you are producing a stress response in your nervous system the moment you are thinking the thoughts. This triggers sympathetic nervous system reaction to produce cortisol, adrenaline/epinephrine, speed up your heart rate, etc. Your body is reacting like there is a danger in your environment even though the meeting is tomorrow. With this exercise, you will practice observing your thoughts, but not allowing a physiological reaction. Example: Move from “Thinker”: I am Frank. I am involved in a stream of thoughts about work responsibilities, preparation, communication, entertaining others, representing my business, demonstrating my value for employment, my desire to be liked, my desire to be smart, etc. Into the mindset of “Observer”: I am watching as Frank’s mind jumps in a stream of thoughts about work, responsibility, presenting, and intrinsic and extrinsic self-worth. As an observer, you are separating the thoughts from the self that is thinking the thoughts. From this perspective, Frank’s thinking does not follow a logical sequence, but rather jumps from one topic to another, and sometimes back. This is how thoughts work. Thoughts are typically not just around one theme. Here is a more realistic thought observation process for Frank might look like: I am watching as Frank’s mind jumps in a stream of thoughts about work, a recent news headline, overwhelming work responsibility, presenting for the meeting tomorrow. And how terrible the last one went, and the sad news from a co-worker earlier this week, a disagreement with a loved one, intrinsic and extrinsic self-worth, and a social media post. You have a mind that is constantly active with subconscious thought loops. This is a natural process in human brains. There is a term called “highway hypnosis” that describes how a driver can safely operate a vehicle, react to the changing environment, with no mental recall of making those decisions, while their mind is focused on other thoughts. This happens with all rote, basic activities of daily life. It’s also commonly referred to as “daydreaming.” The thought loops serve you in so many incredible ways. You can remember past events, predict the future, and consciously decipher complex feelings and emotions, all while keeping a steady heart rate, digesting your food, regulating your internal temperature, and sensing data from the environment for smell, taste, touch, sound, and vision. Meanwhile, you are driving to the grocery store; operating a 3000 lb car, and singing to the song on the radio with precise rhythm and pitch (or so I tell myself). As stated earlier, the first goal of this exercise is to just witness your thoughts as an observer. Through witnessing, you can regulate your internal chemistry. The second goal is to observe themes. We so often ruminate over the same themes throughout our day. I invite you to record these themes. Find a blank piece of paper and write down the topics you find yourself thinking about. It might feel silly to initiate this, but it reveals so much information. It is common to spend a significant quantity of energy immersed in thought about the same themes for weeks, years, and even decades, without questioning why or addressing the root cause of these concepts. You can just start with writing everything that comes to your mind, then placing those thoughts into common categories like connection/relationships, respect/recognition, success/failure, health and wellness, identity, control, and time. All individuals are unique, and the themes you have will likely be different from others, though there are often common similarities. Exercise: Practice observing your thoughts. Set a timer for one minute and observe your mind at work. You will likely have a period of time in the beginning where nothing happens, as you acutely pay attention to the space. Soon, thoughts will visit. Sit with the silence and focus on the stream of thoughts you have. Repeat this exercise several times and note what you observe. Application: First of all, if you are struggling to sleep, and are finally in a silent environment with less stimulation: A) This is not the time to solve your stress. Allocate a scheduled time during the day for this. If you are stuck on a few themes, I have so many tools to help find inner clarity. B) There is a physiological impact of switching from a “thinking” perspective to “observing.” Through thought observation, you are less likely to stimulate the sympathetic reaction of fight of flight. This is an exercise, like a muscle, that you can grow strength from with repetition.
