Sleep and Recovery

Written by Dr. Mike Prebeg | Dec 7, 2023 11:29:09 PM

Getting these athletes ready for the season takes a lot of work, and recently I have spoken to a lot of them about recovery. One thing that always comes up and is highly overlooked is sleep quality on and off - season. I have always noticed that when I'm treating a patient and they fall asleep during the treatment, the results seem to be more profound.

The story is the same: I am just so tired, I don't get good sleep at night, I am stressed, and these sessions make me so relaxed. ESPECIALLY THE NEEDLES. Our regular patients AND athletes can both experience poor sleep quality, or not enough. It can be due to a lot of things, but most attribute it to stress, or more accurately sympathetic over load. Acupuncture is a peripheral nerve stimulant with specific effects on the autonomic nervous system.

Sleep must be of adequate quality in order for it to have a restorative effect on the body. This is particularly true for athletes whose physical and mental recovery needs are higher due to the high amounts of physiologic and psychologic stress.

Positive Effects of Sleep

Restorative effect on the immune system and endocrine system
Recovery of the nervous system
Role in learning, memory and synaptic plasticity

Negative Effects of Sleep Deprivation

Metabolic, immunologic and cardiovascular dysfunction
Impaired judgement and decision making
Associated with obesity and diabetes
Impedes muscle recovery
Increases pro-inflammatory cytokines
Alters pain perception

Most adults require 7-9 hours of sleep. Some recommend that athletes actually need more due to their intensive exercise regime and stress on their body. However, elite athletes are known to get less total sleep than non-athletes.

If the balance between training and recovery is inadequate then performance in subsequent training and even competition may be adversely affected. This is true for all types of recovery, not just sleep. Sleep disruption has been identified as the strongest predictor of injury in adolescent athletes, and athletes sleeping greater than 8 hours are less likely to suffer injury!

Sleep deprivation is associated with increased catabolic hormones and reduced anabolic hormones which results in impaired muscle protein synthesis reducing the optimization of training and recovery.

Inflammatory cytokines have been linked to disruption of normal sleep. Tumor necrosis factor (TNF) and other inflammatory cytokines like IL-6 are considered key in the regulation of sleep under normal conditions. In addition the autonomic nervous system plays an intimate role in the regulation of sleep, specifically the vagus nerve.

Not only is sleep regulation important for the performance of our athletes but also, the OVERALL HEALTH of ANY INDIVIDUAL or PATIENT! The literature shows that sleep disturbances is also a risk factor for inflammatory diseases.

How can we help?

Electroacupuncture is known to inhibit inflammatory cytokine release, including TNF and IL-6. In addition, along with auricular acupuncture, this method regulates the autonomic nervous system. In the images above you can see the intimate connection between auricular points and the vagus nerve. Combining these points with distal acupuncture points and spinal points is a great method to improve a patient's pain and overall recovery. Furthermore, acupuncture triggers a release in ADENOSINE. Adenosine is molecule that accumulates in the brain while we are awake which triggers sleep pressure. The more adenosine, the easier it is to fall asleep.

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