Making Sleep Part of Your Practice: Practical Strategies to Incorporate Now!

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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.

CBT-i Coach App - https://mobile.va.gov/app/cbt-i-coach
Scoping Review - https://pubmed.ncbi.nlm.nih.gov/37259...

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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