Peak Performance

Sleep is essential for the brain and peak performance. There are many implications of poor sleep on the brain and cognition:

• Inattention and Hyperactivity: Concentration is vital to learning and academic success, but insufficient sleep reduces attention. Poor sleep can also mimic the symptoms of attention-deficit/hyperactivity disorder (ADHD).

• Memory Loss: Memory processing and consolidation occur during sleep. Without adequate sleep, you may not create memories or recall stored information.

• Confusion: Inadequate sleep can impair your ability to process information in an orderly manner, such as following step-by-step instructions in a manual.

• Reduced Creativity: Sleep fragmentation may impair your ability to connect diverse concepts necessary for thinking creatively.

• Sleepiness: Drowsiness can impact your academic and work performance. Dozing for seconds, known as microsleeps, can cause you to fall asleep at your desk and in meetings, reducing attention, learning, and processing.

• Risk Behaviour: Limited sleep can hinder the parts of the brain involved in making good decisions, increasing risk-taking behaviors.

• Irritability: Quality sleep is correlated with healthy emotional regulation, making individuals who fail to get enough sleep more likely to be irritable and aggressive.

• Depression and Anxiety: Sleep disruption co-exists with depression and anxiety.

• Cognitive Inflexiblity: Lack of sleep can hinder cognitive flexibility, reducing adaptation to uncertain or changing circumstances.

• Suboptimal Athletic Performance: Sleep deprivation impairs overall athletic speed, accuracy, endurance, reaction time, learning, and decision making, potentially resulting in loss and injury.

Although poor sleep can impair cognition, optimizing sleep can enhance cognitive performance.

What we offer at Sleep and Brain

At Sleep and Brain, we conduct a detailed clinical history and specialized physical examination to evaluate if a sleep disorder is impairing your cognitive and athletic performance. We prudently assess for sleep disorders as exampled below:

• Sleep-Disordered Breathing

  • The repetitive breathing interruptions cause sleepiness and cognitive issues related to attention, thinking, memory, and communication.

• Periodic Limb Movement Disorder

  • You or your child may unknowingly kick their legs intermittently during sleep. The limb movements can disrupt sleep and cause arousals which heighten inattention and hyperactivity.

• Insomnia

  • Insomnia, defined as difficulty falling asleep, staying asleep, awakening too early, or non-restorative sleep, can impair cognition.

• Sleep Deprivation

  • Sleep deprivation may worsen symptoms of anxiety and depression and make you prone to make errors, fail to learn new information, suffer deficits in memory, or have impaired decision-making.

Understanding the cause of you or your child's sleep problems is essential to customize a treatment regime for both the sleep disorder and cognition. Treating sleep problems may improve performance because, as mentioned, disordered sleep symptoms can fragment and reduce sleep. We direct treatment toward the sleep disorder as exampled below:

• Removing the tonsils, expanding the palate, and starting CPAP can help disordered sleep symptoms.

• Iron and dopamine deficiencies can cause RLS and PLMD. We treat RLS with iron supplements, medication, and non-medication therapies.

• Identifying and eliminating the cause of awakenings from sleep

• Utilizing light therapy to advance or delay your sleep cycle

In addition to treating an underlying sleep disorder, we institute robust sleep hygiene interventions, as partly described below, to make going to bed a pleasant experience and reduce anxiety:

• Ensuring your bedroom environment is conducive to sleep

• Eliminating sources of sleep interruption like light and noise

• Optimizing your diet as food can promote and hinder sleep

• Assessing your nighttime habits and rituals

For athletes, in particular, we recommend:

• Maintaining a consistent training schedule to avoid over-exertion

• Avoid early and late training sessions and competitions that can affect sleep quantity and quality

• Naps less than an hour and before 3 pm.

• Avoiding mental stressors that can affect sleep quality and impact performance.

A state of hyperarousal, frequently marked by worry, is a critical factor of insomnia. CBT-I reduces negative thoughts about going to bed, a type of anticipatory anxiety that challenges healthy sleep schedules. Even after falling asleep, you may awaken with anxiety in the middle of the night. CBT-I reorients negative thinking and helps you return to sleep when your mind races with worry. We also utilize relaxation techniques as part of our CBT-I to reduce anxiety and make it easier to fall asleep quickly and peacefully. Guided imagery, deep breathing, and mindfulness meditation are just a few approaches to putting your mind at ease and improving your sleep and performance.

Several medication classes to improve cognition, including anti-cholinesterase drugs and stimulants. However, these medications mitigate symptoms rather than cure the underlying cause. We judiciously use medications to treat an identified underlying cause.