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On the last track we discussed behavioral interventions for breathing related sleep disorders. There are several types of breathing related sleep disorders for which exist a limited number of treatment options.
On this track we will discuss techniques for relaxation. For the purposes of sleep disorders, we will discuss three techniques for relaxation. The three techniques for relaxation that we will discuss are stretching, mind games, and autogenic training. As you listen to this track, you might consider the application of these techniques to your clinical setting. Could your client benefit from stretching, mind games, or autogenic training?
Technique #1 - Stretching
After I described these three stretches to Holly, she reiterated the specifics and degree of pain that kept her awake. Holly stated, "My shoulders and back hurt the most. Do you have any stretches that can help those muscles?" Clearly, I had been providing Holly with techniques that were not applicable to her specific problem.
-- Stretch # 4: I then stated, "Perhaps you should try the ‘shoulder stretch.’ Sit on the edge of a chair with your knees apart and your feet on the floor. Place your hands on your knees with your elbows slightly bent. Press your hands into your knees and lean forward. Rotate your shoulders and ribs to the left and then to the right."
-- Stretch # 5: To help Holly with her back pain, I then described the ‘back stretch’ to her. I stated, "Lie flat on your back in bed. Push your spine into the bed, flattening your back and pulling in your abdomen. Release, go limp in all muscles, and breathe deeply. Repeat several times. After the last time, remain limp and breathe deeply."
As I did with Holly, you may want to inform your client that before he or she begins any type of exercise, he or she should first consult a physician. After Holly’s physician cleared her for this type of exercise, Holly began a nightly stretching routine that began to benefit her. Could relaxation through stretching benefit your client?
Technique #2 - Mind Games
During one of our sessions, I asked Jackson to close his eyes and pay attention to the various patterns and colors on the inside of his eyelids. Jackson stated, "OK. I see them." I responded, "Good. Now, if you’d like, when you go to bed tonight close your eyes and focus on those colors and patterns. In a dark room, you might find that with enough thought you can not only see different patterns and hues, but you might also see them continually blending and changing. See if you can influence the changes in color or pattern through thought."
At a later session, Jackson stated, "I don’t know if my eyes are playing tricks on me or what, but there are definitely changing colors, even in the dark."
Jackson’s preoccupation with the ‘creating pictures’ technique began to help him get to sleep. What about your sleep disorder client? Could he or she benefit from these mind game techniques? Would trying these techniques yourself help you better apply them in your practice?
Technique #3 - Autogenic Training
Kahn, Baker, and Weiss taught 16 insomnia college students to use autogenic training. Each student began by thinking the phrase, "My right arm is heavy," repeating it several times. Students then focused on other areas of the body. Later, the students continued with "My arms are warm," "My legs are warm," "My entire body is warm."
At the end of the study, Kahn, Baker, and Weiss found that the students had cut their average time needed to fall asleep from 52 to 22 minutes. These same results were matched in a different study by Dr. Richard Bootzin, who found that a month’s daily practice of autogenic training produced 50 percent improvement in falling asleep.
If you are treating a client who suffers from insomnia or has trouble falling asleep, have you considered autogenic training? If not, you might consider implementing this technique, or perhaps some of the other techniques on this track. Perhaps you don’t currently have a sleep disorder client. Is a colleague currently treating a sleep disorder client? Could playing this track benefit him or her?
On this track we have discussed techniques for relaxation. For the purposes of sleep disorders, we discussed three techniques for relaxation. The three techniques for relaxation that we discussed were stretching, mind games, and autogenic training.
On the next track we will discuss taking control. We will examine worry time and reducing tension and coping with stress.
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