Gearing Clients up for 2020: Sleep & Exercise for Improved Mental Health

sleep and exercise

Get wellness clients back on track in the new year with healthy sleep and exercise habits that promote better mental health

January is commonly when people take stock of their overall wellbeing and think about what
changes they’d like to make in the new year–which makes it an excellent opportunity for you to
suggest fundamental shifts that can truly impact your clients’ health, both mentally and
physically. It’s also a chance for you to help them avoid jumping into trendy, unresearched
health fads that will likely fizzle out before the New Year’s confetti settles.
Two areas that have been getting a lot of research attention are healthy sleep and exercise
habits, and how improving both can positively affect mental health. Most people already know
how important both are for physical health, but there are encouraging studies documenting the
benefits that both have on mental wellbeing. If you have clients complaining about high levels
of stress, anxiety or depression, resetting healthy sleep and exercise habits is an easy place to

Part 1: Optimizing Sleep
When people get busy, sleep is one of the first things they deprioritize. In our culture of busy-
ness, it’s not unusual to hear people actually bragging about how little sleep they get. In a peer
review of several studies titled “Optimizing Sleep to Maximize Performance: Implications and
Recommendations for Elite Athletes,” published in the Scandinavian Journal of Medicine,
Science and Sports in 2016, the general findings were that surprisingly, even elite athletes
experience inadequate sleep, in both amount and quality. Most were getting less than 6 to 6.7
hours of sleep per night.
While this study focused on athletes, you can easily extrapolate the findings for clients in other
walks of life: high-end executives, emergency room technicians, stay-at-home moms, anyone
who pushes their schedule to the extreme trying to fit more into each day. Ask clients how
much sleep they get on average, and you’ll likely hear similar results to the athletes in the
What most people don’t realize is that any deficit in sleep is actually hurting them. One of the
reviewed studies found that a person’s subjective assessments of their own sleep typically level
off after a while, so that as a person continues to deplete sleep over several nights, the body’s
understanding of that depletion levels off and it doesn’t realize it’s operating in dysfunction.
That can be dangerous over long periods of time. Think about something your client is
struggling with–physical performance, mental clarity, quality of relationships, etc. Is your client
desperate to keep it all together, but isn’t sure why? Ask about sleep.

Here’s a sobering statistic to consider: 28 hours of straight wakefulness is equivalent to having
0.10 percent blood alcohol content, which is legally intoxicated. (Anything over 0.08 percent is
considered legally impaired in the United States.) Thus, people who skip an entire night’s sleep
are basically functioning as if they are inebriated.

Main Impacts of Poor Sleep:

  • Neurocognitive performance goes down (attention, executive functioning and decision-
    making skills)
  • Learning abilities are compromised
  • Mood and personal relationships suffer
  • Increased risk of physical injury
  • More susceptible to illness
  • Negative impacts on weight management

Getting Clients to Eight Hours of Zzzzzs:
The general goal is to get clients sleeping eight quality hours each night. First, you’ll need to set
the baseline by having them log the following for a week:

  • Amount of sleep
  • Quality of sleep (do they feel rested in the morning or is it hard to wake?)
  • Temperature of the room
  • Amount of light in the room
  • Activities 2-3 hours before bedtime

Once you have a sense of how much sleep your client is getting, if it’s quality sleep, and what
the environment is like, you can help them re-establish a healthier sleep routine. “Sleep
opportunity” is a phrase you can use to underscore the concept that they are giving themselves
the chance to sleep. They are doing something positive for themselves. It’s also important to
help them understand that a sleep deficit cannot be made up in one night. You can’t get six
hours of sleep for four nights and then nine or ten hours the next and expect to “catch up.”
You’re helping them reset their baseline. Getting eight hours each night should be the norm.
There’s a wealth of healthy sleep advice out there, but here are some basics you can provide
your clients to get started with:

  • Environment should be cool, dark and quiet (consider blackout shades if street lights are
    a problem, and lower the thermostat)
  • Eliminate or minimize ambient noise
  • Eliminate caffeine, or at the very least, no caffeine after 10AM. Explain the half-life of
    caffeine– that it stays in the body three to seven hours after ingestion.
  • Avoid afternoon naps
  • Avoid alcohol three to four hours before sleep
  • Get exposure to sunlight during the day to reinforce the day to night visual cues
  • Exercise during the day (though not two hours before bedtime)
  • Avoid digital screens two hours before bed. Read paper books instead of e-readers, and
    avoid computers and phones, as blue light is disruptive to melatonin release
  • Be consistent with sleep and wake times, even on the weekends

Part 2: Elevate Mood with Exercise
Everyone knows the physical benefits of exercise, and it’s a major component of most people’s
New Year’s resolutions. But there are mental benefits from exercise too. Exercising makes you
feel good, vital and strong. When you’re working with clients on improving their sleep quality,
exercise is a handy tool to have in your arsenal.
In the study “Association Between Physical Exercise and Mental Health in 1-2 Million Individuals
in the USA Between 2011 and 2015: A Cross-Sectional Study,” published in Lancet Psychiatry in
2018, the main findings pointed to a positive connection between regular physical exercise and
a decreased mental health burden. In plain terms, working out makes people feel better

When you’re analyzing your clients’ problem areas, after tackling their sleep needs, exercise is
the next fundamental area to assess. How often are they really exercising and for how long? If
your clients are dealing with stress, depression and anxiety, getting sleep and exercise in line
can be a major step forward.

Get the baseline
Ask your client to think back over the past 30 days and chart what they can remember of their
overall mood. What stood out as overly good or bad? How many days would they say were
optimal? How many days were just okay? Then, over the same period of time, have them plot
out when they exercised and for how long. See if you can make any connections. Exercise can
be anything physical outside of their jobs, anything “extra” that gets them outdoors or active,
whether it’s traditional exercise like running and biking, or something considered more of a
hobby like golf or kayaking. Try to find the patterns.

In the study, researchers found the sweet spot of optimal exercise to be between 30 and 60
minutes, with 45 minutes being a good middle ground, three to five days per week. Keep in
mind that the goal was improved mood and emotional wellbeing, not physical results like lower
BMI or strength gains (although these could coincide with increased activity). They also found
that excessive exercise, say three hours in one day, produced the opposite effect on mental
health burden, becoming stress-inducing.

Get them active
Once you establish the baseline of your client’s current activity levels, the goal is to get them to
that sweet spot of exercising for 45 minutes, three to five times per week. For busy clients, you
may have to get creative, especially if you’re working with someone who’s trying to incorporate
more “sleep opportunities” into their schedule. Try suggesting a schedule for very busy people,
picking an ideal time they can stick with and have them put it on their calendars and set
reminders. Remind them that this is a long-term goal, not a short-term resolution. Improving
their sleep and exercise habits are part of a life-long approach to better mental health, and a
better overall quality of life.

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