Dody E. Jordahl, CRT Certified Health Coach Health Coaching For
Better Sleep
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Objectives Describe the interaction between sleep and health,
and the lifestyle changes that can improve both. Discuss the
differences between intrinsic motivation and willpower and their
impact on coaching for long term success
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About Me
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How We View Sleep A luxury Stressful hours/night
shifts/multiple jobs Home obligations Fast paced lives Many things
to do other than sleep: internet TV time with friends/family
email
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Scary Statistics Some 70 million people in the United States
have a sleep problem. About 40 million adults suffer from a chronic
sleep disorder; an additional 20 - 30 million have intermittent
sleep-related problems. (National Heart, Lung and Blood Institute)
Effects of sleep loss on work performance may be costing U.S.
employers some $18 billion in lost productivity. (NSF 1997 poll on
Sleeplessness, Pain, and the Workplace) Americas adults average 6.9
hours of sleep each night, slightly less than the range of seven to
nine hours recommended by many sleep experts. (NSF 2005 Sleep in
America poll) One-quarter of Americas adults, 47 million people,
dont get the minimum amount of sleep they say they need to be alert
the next day. (NSF 2002 Sleep in America poll) One-quarter of
Americas adults say their sleep problems have some impact on their
daily lives. (NSF 2005 Sleep in America poll) More than one-half of
Americas adults nap at least once a week. (NSF 2005 Sleep in
America poll).
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Sleep and Health
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Sleep/Health Impact ObesitySeveral studies have linked
insufficient sleep and weight gain. 1 DiabetesStudies have shown
that people who reported sleeping fewer than five hours per night
had a greatly increased risk of having or developing type 2
diabetes. 2,3 Fortunately, studies have also found that improved
sleep can positively influence blood sugar control and reduce the
effects of type 2 diabetes. 4 Cardiovascular disease and
hypertensionA recent study found that even modestly reduced sleep
(six to seven hours per night) was associated with a greatly
increased the risk of coronary artery calcification, a predictor of
future myocardial infarction (heart attack) and death due to heart
disease. 5 There is also growing evidence of a connection between
sleep loss caused by obstructive sleep apnea and an increased risk
of cardiovascular diseases, including hypertension, stroke,
coronary heart disease, and irregular heartbeat. 6 Harvard
University http://healthysleep.med.harvard.edu
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Sleep/Health Impact Immune functionInteractions between sleep
and the immune system have been well documented. Sleep deprivation
increases the levels of many inflammatory mediators, and infections
in turn affect the amount and patterns of sleep. 7 While scientists
are just beginning to understand these interactions, early work
suggests that sleep deprivation may decrease the ability to resist
infection (see The Common Cold, below). Common Cold In a recent
study, people who averaged less than seven hours of sleep a night
were about three times more likely to develop cold symptoms than
study volunteers who got eight or more hours of sleep when exposed
to the cold-causing rhinovirus. In addition, those individuals who
got better quality sleep were the least likely to come down with a
cold. 8 Harvard University http://healthysleep.med.harvard.edu
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Sleep/Health Impact Not surprisingly, these potential adverse
health effects can add up to increased health care costs and
decreased productivity. More importantly, insufficient sleep can
ultimately affect life expectancy and day-to- day well-being. An
analysis of data from three separate studies suggests that sleeping
five or fewer hours per night may increase mortality risk by as
much as 15 percent. 9 Major restorative functions in the body such
as tissue repair, muscle growth, and protein synthesis occur almost
exclusively during sleep. Scientists have discovered that
insufficient sleep may cause health problems by altering levels of
the hormones involved in such processes as metabolism, appetite
regulation, and stress response. 10, 11, 12 Studies such as these
may one day lead to a better understanding of how insufficient
sleep increases disease risk. Harvard University
http://healthysleep.med.harvard.edu
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Why Lifestyle Change ? Many of the major diseases causing death
in the United States can be greatly improved by changing our habits
and behavior. some of these include Obstructive Sleep Apnea Getting
enough sleep Heart disease Cancer Diabetes Obesity Lung disease See
the connection?
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What Lifestyle Change ? Healthy Eating More movement Less
Stress And of course Make Sleep a priority
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How Do We Get There? If we can overcome the Psychological and
Logistical barriers in our way, we can create a healthy lifestyle
and weight in months. What does that mean? Working on the Stuff
between our ears!!! Danzinger JAMA 06
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Willpower VS. Intrinsic Motivation Danzinger JAMA 06 Willpower
- control of one's impulses and actions; self- control. Willpower
does not work long term
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Intrinsic Motivation It is Why We Do What We Do It is the
Process of Doing An Activity for Its Own Sake The Reward is
Inherent in the Activity Itself It Creates Feelings of: Excitement
Accomplishment Personal Satisfaction What is It?
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Intrinsic Motivation (IM) A Childs Curiosity Mastering the
Challenges of Life Motivation is Something People Do for Themselves
The Desire to Be the Originator of Ones Own Actions Rather than a
Pawn Manipulated by External Forces Rewards Turn the Act of Playing
into Being Controlled from the Outside
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Intrinsic Motivation (IM) Are We Better Off Now? (150 hours
more work/year) We Work for Extrinsic Measures House, Job Money and
Modern Life Controls and Creates Alienation Deadlines, Imposed
Goals, Surveillance, Evaluation Antagonistic to Autonomy FAILURE
SUCCESS?
Autonomy To Act in Accord with Ones Self Free and Volitional in
Ones Actions People Are Fully Willing to do What They Are Doing
Embrace the Activity with Interest and Desire Actions Emanate from
Their True Self They Are Being Authentic Organizing Your Life
Around What Matters Most
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Promotes Autonomy Fulfillment Depression Failure Success Rust
Out Depressed and Failure Abundance Fulfilled and Successful
Contentment Fulfilled but Failure Burnout Successful but
Depressed
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Controlled To Act Because One is Being Pressured People Act
without a Sense of Personal Endorsement Behavior is Not an
Expression of Self Self Has been Subjugated to the Control People
are Alienated
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2 Types of Controlled Behavior 1.Compliance (Conformity) Doing
what you are told to do 2.Defiance-(Rebellion) Doing the opposite
of what you are expected to do
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Competency Important for Intrinsic Motivation Person Takes on
and in Their View Meets Optimal Challenges Works Towards
Accomplishment and Mastery They Are Doing There Best
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Competency As People Gain Confidence in Dealing With Themselves
and Their World and As They Become More Autonomous in Doing That
They Will Perform More Effectively and Display a Greater Sense of
Well Being Edward L. Deci Ph.D. Professor of Psychology
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Relatedness People Do Not Only Need to Be Effective and Free
They Need to Be Connected The Need to Love and Be Loved The Need to
Care and Be Cared For To Be Free to Be Dependent!
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Your Role as a Coach Up One: Down One Parent/Child -
Teacher/Student - Health Coach/Patient In a Position to Give Advise
through Guidance Need to Fully Embrace The 3 Key Factors of
Intrinsic Motivation in Order to Move People Forward
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Your Role as a Coach Autonomy Supportive Help the Patient
Become Competent Connect the Patient to a Support Network
Relatedness : Healthy Peers Support Group Friends/Family Help With
Internalization of Our Health System
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Autonomy Supportive To Relate to Others as Human Beings not as
Objects to Be Manipulated for Our Own Needs See the World From
Their Eyes It is Not as Easy as Controlling But it is Our
Responsibility
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Autonomy Supportive Provide Rationale Understand Why
Acknowledge A Person May Not Want to Do It Minimize Pressure More
Like and Invitation than a Demand You Will Know Because Their
Subsequent Behavior: They Will Feel Free, Empowered, and Believe it
Was Personally Impactful Not Permissive but They Are Accountable to
Themselves Ask if the Have a Setback
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Autonomy Supportive Praise Can Be Non Controlling or
Controlling What Are Your Own Intentions? Minimize Controlling
Language Minimize Controlling Style
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Coach Competency Help Your Patients Gain Mastery Your Patient
Takes on and Meets Optimal Challenges Help them Work Towards
Accomplishment Do Their Best Praise Only as Non Contingent Not
Controlling You are Their Guide Increases Their Intrinsic
Motivation
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Relatedness Connect and Build Your Relationship Set Avenues of
Communication Help Your Patients Feel Comfortable Will Come When
They Feel Free and Effective Their Network is an Authentic
Community
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33 Friends Educational Materials Online Support Group Support
Healthy Peers Family Patient Support Network: Micro-Environment of
Health Coach Relatedness
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Internalization This is the process of our system becoming part
of the Individual It is Moving From It Being Something Being Done
to You to Being Inside of You This is Where True Coach Mastery
Occurs The Last Piece
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Internalization This is Where People Do it Because: They Feel
Free to Do It (Autonomous) They Feel Can Do It (Competent) They
Want To Be Connected and Involved With Others (Relatedness)
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Internalization Two Types Introjection vs. Integration
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Introjection This is Doing it Because You Should or Ought That
Some Controlling Force Says You Must Swallowing a Rule Whole View
it as Something that Pushes You Around Declares, Demands,
Demeans
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Introjection Voices in Our Head that Come From the Outside
Create Either Conformity, Half Hearted Adherence or Rebellion
Create stress, confusion, feelings of inadequacy lack of well being
Can not Live up to Them
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Integration True Sense of Choice You Do It Because it Supports
Your Autonomy It is a Secondary Choice which Creates Sustainable
Motivation. You Learn it and Adopt it as a Part of You Creates
Sense of Well Being Artistic Football Player Requires You To Relate
to Them as Human Beings
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Integration Worthy of Your Support Not Objects to Be
Manipulated for Your Own Needs Must Take Their Perspective See the
World from Their Point of View as We Relate to Them
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Integration You Do It Through: Rational-Acknowledge-Minimize
Pressure We Tie Them into The Community We Help Them Become
Successful
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Seems Like A Lot
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Your Role as A Coach Help Your Patients Find Their
Intrinsically Motivation
Decide Desire to Accomplish Because They Want To They
Understand and See Themselves Doing It The Feel Connected and
Desire to Relate to You! You Help Your Patients to:
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Building A Healthy New America
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References 1. Kohatsu ND, et al. Sleep Duration and Body Mass
Index in a Rural Population, Archives of Internal Medicine. 2006
Sep 18; 166(16): 1701.Sleep Duration and Body Mass Index in a Rural
Population 2. Taveras EM, et al. Short Sleep Duration in Infancy
and Risk of Childhood Overweight, Archives of Pediatrics &
Adolescent Medicine. 2008 Apr; 162(4): 305.Short Sleep Duration in
Infancy and Risk of Childhood Overweight 3. Knutson KL, et al. Role
of Sleep Duration and Quality in the Risk and Severity of Type 2
Diabetes Mellitus, Archives of Internal Medicine. 2006 Sep 18;
166(16):1768.Role of Sleep Duration and Quality in the Risk and
Severity of Type 2 Diabetes Mellitus 4. Gottlieb DJ, et al.
Association of Sleep Time with Diabetes Mellitus and Impaired
Glucose Tolerance, Archives of Internal Medicine. 2005 Apr 25;
165(8): 863.Association of Sleep Time with Diabetes Mellitus and
Impaired Glucose Tolerance 5. Nilsson PM, et al. Incidence of
Diabetes in Middle-Aged Men Is Related to Sleep Disturbances,
Diabetes Care. 2004; 27(10): 2464.Incidence of Diabetes in
Middle-Aged Men Is Related to Sleep Disturbances 6. King, CR et al.
Short Sleep Duration and Incident Coronary Artery Calcification,
JAMA, 2008: 300(24): 2859-2866.Short Sleep Duration and Incident
Coronary Artery Calcification 7. Kasasbeh E, et al. Inflammatory
Aspects of Sleep Apnea and Their Cardiovascular Consequences, South
Med J. 2006 Jan; 99(1): 58-67.Inflammatory Aspects of Sleep Apnea
and Their Cardiovascular Consequences 8. Opp, MR, et al.
Neural-Immune Interactions in the Regulation of Sleep, Front
Biosci. 2003 May 1;8:d768-79.Neural-Immune Interactions in the
Regulation of Sleep 9. Cohen S, et al. Sleep Habits and
Susceptibility to the Common Cold, Arch of Intern Med. 2009 Jan 12;
169 (1):62-67.Sleep Habits and Susceptibility to the Common Cold
10. Colten HR and Altevogt BM, eds. Sleep Disorders and Sleep
Deprivation: An Unmet Public Health Problem. Board on Health
Sciences Policy; National Academies Press. 2006.Sleep Disorders and
Sleep Deprivation: An Unmet Public Health Problem 11. Spiegel
K,Brief Communication: Sleep Curtailment in Healthy Young Men Is
Associated with Decreased Leptin Levels, Elevated Ghrelin Levels,
and Increased Hunger and Appetite, Annals of Internal Medicine.
2004 Dec 7; 141(11): 846-850.Brief Communication: Sleep Curtailment
in Healthy Young Men Is Associated with Decreased Leptin Levels,
Elevated Ghrelin Levels, and Increased Hunger and Appetite 12.
Spiegel K, et al. Impact of Sleep Debt on Metabolic and Endocrine
Function, Lancet. 1999 Oct 23: 354(9188): 1435-9.Impact of Sleep
Debt on Metabolic and Endocrine Function 13. Meier-Ewert HK, et al.
Effect of Sleep Loss on C-reactive Protein, an Inflammatory Marker
of Cardiovascular Risk, J Am Coll Cardiol. 2004 Feb 18; 43(4):
678-83.Effect of Sleep Loss on C-reactive Protein, an Inflammatory
Marker of Cardiovascular Risk