Archive for the ‘Seattle’ category

Reducing Night Nurse Fatigue

March 30, 2014

Lately it’s been a pleasure to provide an intervention program for night-shift nurses to help them sleep well during the day, and thereby improve their alertness at night. For many nurses working nights a typical shift is 12 hours, often from 7pm to 7:30am. This requires them to function well during the hours that human beings are designed for sleep. Many of these employees like to sleep during the night on a similar schedule to their loved ones when not working, which keeps them in a perpetual state of circadian misalignment, making it even more difficult to function well at night.

In December 2011 the Joint Commission issued Sentinel Event Alert #48 on the effect of extended work hours and cumulative work hours on patient safety and nurse health. They summarize the extensive research on the performance effects of working at night. Some of the results of fatigue include:
– impaired information processing and judgement
– inability to focus attention
– reduced motivation
– loss of empathy
Fatigue among healthcare workers increases the risk of adverse events, decreases patient safety, and negatively impacts the health of the night shift workers.

The Commission report goes on to suggest steps organizations take to improve employee alertness and thereby improve patient safety. Fatigue management typically includes steps for both individual employees and the administration. Sleep training for employees so they can sleep well during the day, and entrain their circadian rhythm to the schedule, is one step. Another is fatigue reducing strategies such as precisely-timed caffeine and light to increase alertness on the job. Administrations can optimize their scheduling practices, and provide an alerting work environment. You can see the full Sentinel Event Report of the Joint Commission here: http://www.jointcommission.org/sea_issue_48/

Over the next 6 months I hope to continue this work for Seattle-area hospitals, and expand to help other public safety organizations that are providing 24/7 service, including the police and fire departments. Around the clock service is a must for public safety, and helping these night-shift staff to sleep well during the day, so they can be alert and healthy during the night is extremely rewarding!

“Sleep Deprived in Seattle” in Seattle magazine

July 14, 2012

It was a pleasure to talk with journalist Sheila Cain about my approach to treating sleep disorders. The article is now published in Seattle magazine’s Top Doc issue (July).

My favorite excerpt is: “My primary care doctor gave me a printout of things to try, then told me to go home and do them,” Crocker said. “With Dr. Darley, we worked on a very individualized plan that was specific to me.”

The thing I love most is the way in which each person’s sleepless story is unique, even if each one is coming in for what appears to be the same ‘insomnia’ complaint.  Taking the time in the first appointment to really understand how the sleep problem developed, how it impacts their quality of life, and the individual lifestyle makes all the difference in making an individual treatment plan that works.

Sometimes in an appointment a patient and I will have moments where we are communicating so clearly, heart to heart, and getting to the root of the sleeplessness. Those times I imagine if someone took a picture there’d be a big light bulb over both of us. Those break through moments make this work worth every effort.

You can read the full article here: http://www.seattlemag.com/article/sleep-deprived-seattle

Sleep Class for New Families

May 26, 2011

With a new child in the family, sleep becomes a major issue, both for babies and for parents! If you are one of the many parents who need more good information about sleep, this is the perfect class for you.

In this interactive class you will learn:
– about normal sleep and naps in infants and toddlers up to 3 years
– how sleep impacts babies’ development and growth
– the strategies to help your child learn to sleep on his / her own, from ‘cry it out’ to the ‘no cry sleep solution’ and everything in between
– how to set your lifestyle, and bedroom, for good sleep
– how parents can still get the sleep they need despite parenting in the night

Most importantly, each family will develop their own custom sleep plan over the course of the class, a plan they will benefit from immediately.

Here are the details:
Instructor: Dr. Catherine Darley, naturopathic sleep specialist
Two Dates: Friday June 17th or Saturday June 18th, 10a to 1p
Location: 1904 3rd Ave, Seattle WA, 98101, 2rd floor
(next to Bed, Bath & Beyond in downtown Seattle)
Cost: $65
Register: http://www.naturalsleepmedicine.net

Cognitive Behavioral Therapy for Insomnia (CBT-I)

August 11, 2010

The Cognitive-Behavioral Therapy for Insomnia that we offer is based upon the program developed and researched originally at Stanford University Sleep Disorders Center. In this systematic program participants first learn some basics about sleep and to re-associate their bed with sleep. Next we reframe any sleep misconceptions or worries that actually interfere with sleep. An example is “If I don’t get to sleep right now I’ll never be able to get through my meeting tomorrow.” Realistically, the person who struggles with chronic insomnia has probably gotten through demanding days in the past after a disrupted night. While doing this cognitive work to reduce worries, we also teach relaxation techniques to relieve body tension that can contribute to insomnia. Another key component of our program is sleep restriction therapy. The client’s sleep diary is analyzed, and a agreeable bedtime and waketime set. As the client’s sleep improves, and they no longer have much (if any) time lying awake in bed, the bedtime is incrementally advanced each week. This process continues until the person reaches the goal – feeling well rested each day, and having consolidated sleep each night!

What makes our approach to Cognitive-Behavioral Treatment for Insomnia naturopathic is that we know the person’s health is an entire system, that their sleep can not be separated from the entirety. In addition to factors that conventional sleep specialists evaluate, we will also assess food allergies / intolerance, neurotransmitter levels, and overall wellness. Therefore we begin the program with an extensive intake interview. During this initial intake we review the clients’ health in all areas that have relevance on their sleep. This includes neurological, endocrine, psychological, and lifestyle, among others. We may also order lab tests to evaluate organ function. Our goal is to first identify the underlying cause of the sleep disorder, then to treat. Wherever the original cause lies, chronic insomnia has developed over time as an interplay of predisposing, precipitating and perpetuating factors, which will take time to tease apart and heal.

A Consistent Bedtime Routine Helps Baby Sleep

May 26, 2010

A consistent bedtime routine is a powerful tool to help infants consolidate their sleep into longer periods at night.  And when baby sleeps, parents can too!

Researchers had parents implement a 3-step bedtime routine.  The steps were a bath, a massage, and a quiet activity like cuddling or singing a lullaby, in that order.  Lights out was within 30 minutes of finishing the bath.  Nothing else was changed, the parents continued to put their child to bed they way they had been.

After just two weeks of this bedtime routine, the babies woke up fewer times in the night, and were awake for shorter periods.  Their mothers were less likely to perceive the babies sleep as a problem.  Not only that, but the mothers’ mood improved, so they were less tense, less depressed and less angry.

This gives hope to new parents, that they can help their child sleep better in just a few weeks, and that this improves the well-being of the family too!

Dr. Darley will be speaking on ‘Help your baby ‘Sleep Like a Baby'” on Tues, June 1st, in Mukilteo Wa.  This program is sponsored by Program for Early Parenting Support.

Teaching Babies to Sleep

May 24, 2010

There’s lots of discussion of what is the best way to help babies learn to sleep through the night. Use the ‘cry it out’ method, or use the ‘no cry’ method?

Sleep researchers have compared these methods, and here’s what they concluded:

1) The strongest support is for ‘Unmodified Extinction’ and ‘Preventive Parental Education.’
2) Research also supports the use of ‘Graduated Extinction,’ ‘Bedtime fading / positive routines,’ and ‘Scheduled awakenings’
3) Most children respond well to these behavioral techniques, and there is an improvement in the child’s daytime behavior, and parent’s wellbeing.

Here are those techniques briefly defined:
Unmodified Extinction: Parents put the child to bed at bedtime, and leave the child to sleep until the morning. Parents only monitor the child for safety and illness.
Preventive Parent Education: Parent ed aimed at preventing the development of sleep problems, and includes these behavioral interventions.
Graduated Extinction: Parents put child to bed at bedtime, and briefly check on the child on a pre-determined schedule.
Bedtime fading / positive routines: Parents establish an enjoyable bedtime routine, and put the child to bed when they usually fall asleep. Then the bedtime is gradually moved earlier once the child is able to fall asleep easily.
Scheduled awakenings: Parents first track when their child usually wakes up, then wake the child before that time, doing the same back to sleep routine as when the child wakes on his own.

Choose which method fits with your parenting values and your child, then stick with it and be consistent. In most studies only a few weeks were needed to help infants sleep through more of the night, and for parents to feel better.

Dr. Darley will be speaking on this topic for PEPS in Mukilteo, Wa. on June 1st. Please join us!

Sleep Health Education in Seattle

December 14, 2009

Talking with people about sleep health, giving them the facts, and the knowledge of how to promote healthy sleep for themselves and their families, is one of the things I love to do.  Just last week we put excerpts from a recent PTA talk on YouTube.  You can view it here http://www.youtube.com/watch?v=syxCF12fWdM.  Watch it and let me know what you think!

The calendar for 2010 is growing, please let me know if you’d like me to come talk to your PTA, civic group, or corporation.  Here’s a sample of what’s going on so far.

“Optimizing Work Performance – The Sleep Connection”

Vulcan Inc.
January 26, 2010, 12:30-1:30pm
Open to employees

Join Dr. Darley to learn about how good sleep health can improve your job performance.   Objectives for this one hour “Lunch and Learn” are:

  • Understand the ways poor sleep interferes with mental, physical and emotional performance
  • Understand the most prevalent sleep disorders, including insufficient sleep
  • Learn ways to improve sleep

“Sleeping Like a Baby”

PEPS (Program for Early Parent Support)
Good Shepherd Center, Seattle
January 26, 2010, 6:30-8:00pm
Open to PEPS participants

Many new parents struggle to help their infant get into a regular sleep routine, and get enough sleep themselves.   Dr. Darley will discuss questions parents frequently ask about how to get their baby to sleep, the safety of co-sleeping, nap routines and sleep schedules.   There will be 30 minutes for questions and discussion after her presentation.

“Sleep and Mental Health: A Dynamic Interplay”

Continuing Education event for the Seattle Counselors Association (SCA)
February 19, 2010
Open to SCA members and visitors

Dr. Darley will discuss the dynamic interplay between sleep and mental health.   We’ll look in depth at a few conditions, including ADHD, anxiety, and depression.   The second half of the presentation will include screening questions for counselors to use in assessing whether sleep may be a contributing factor.   We’ll also discuss the effects of pharmaceuticals, over the counter medications, and supplements.   There will be ample time for questions and discussion.

“Sleep Well, and Succeed in School”

Loyal Height Elementary, Seattle Washington
April 29, 2010, 7:00p to 8:30p
Open to school parents

Many children have sleep problems, and their mood and performance suffers.   Come learn about common pediatric sleep problems, how they influence your child, and what you can do to ensure your child gets healthy sleep.

Join Dr. Catherine Darley, ND from The Institute of Naturopathic Sleep Medicine as she discusses:

  • normal sleep in children
  • the effects of insufficient sleep, the most common sleep problem
  • sleep disordered breathing in children
  • Learn steps to take at home to improve your child’s sleep

Follow

Get every new post delivered to your Inbox.

Join 34 other followers