Does anyone have a recommendation for a sleep expert or sports psychologist, ideally in the SF Bay area?
To be brief, my 25 year-old son is balancing medical school studies with competition at the national and world elite level (not in triathlon).
He has recurring problems with sleeping…which affect recovery…which affects performance…which creates anxiety…which affects sleep…You get the picture.
He has tried OTC and prescription sleep aids but these don’t treat the causes, only the symptoms, and of course they can create unhealthy “hangovers.”
I believe he has a healthy lifestyle, balanced nutrition (I think), and trains with discipline and intensity. He is possibly over-trained, which may be one of the root causes here.
I guess he should also try eliminating all caffeine, which he has not done yet.
Would very much appreciate any insights or recommendations.
I took a class as an undergrad from Dr. James Maas, who is a renowned sleep expert. Here is his website, your son might be able to find some good info here: https://jamesmaas.com/
Among the good tips that I have carried forward are:
take 20 minute power naps during the day… don’t make them any longer, or you risk falling too deeply asleep and you’ll wake up groggy
no caffeine after 4:00 pm
no screens (TV, phone) right before bed… this will probably be a tough one for him
get in the habit of sleeping and waking at the same time every day
Barring a physiological condition that is causing some form of apnea, docs and sleep docs typically steer patients to Cognitive Behavior Therapy (CBT). Google will return a lot of hits for CBTi (insomnia). I believe one of the main online programs originated at Stanford so there are probably a lot of resources available in the Bay area.
If he hasn’t tried a home sleep study that is probably where docs would start. For those that suffer sleep problems, these things are a special form of torture, but gives doc a baseline anyway.
Since he’s already been prescribed sleep meds he’s probably been told about CBTi, sleep studies and various methods for sleep hygiene, etc.
Other than the above tips about sleep hygiene, which are ofc vital, also address psychosocial factors. Consider emotional support from friends and family (talk to them about these issues), study technique (use podcasts/video training on distance rides), stress reduction techniques (mindfullness, meditation) and other things that is relevant, but not as obvious as sleeping aids.
And fwiw I think melatonin is a great sleeping aid. Gets me way more effective sleep time.
One of the world’s foremost authorities on sleep and sleep disorders is at stanford, but I doubt he still does individual counseling (but maybe he does):
One thing you should really explore:
How much time does your son spend on computers, laptops, tablets, or phones in the 4-6 hours before sleep? The light exposure from those devices severely curtails the natural release of melatonin, an essential regulator of deep and restful sleep. The science behind this is solid, here is a random article from the web about this:
Does anyone have a recommendation for a sleep expert or sports psychologist, ideally in the SF Bay area?
To be brief, my 25 year-old son is balancing medical school studies with competition at the national and world elite level (not in triathlon).
He has recurring problems with sleeping…which affect recovery…which affects performance…which creates anxiety…which affects sleep…You get the picture.
He has tried OTC and prescription sleep aids but these don’t treat the causes, only the symptoms, and of course they can create unhealthy “hangovers.”
I believe he has a healthy lifestyle, balanced nutrition (I think), and trains with discipline and intensity. He is possibly over-trained, which may be one of the root causes here.
I guess he should also try eliminating all caffeine, which he has not done yet.
Would very much appreciate any insights or recommendations.
Why on earth is he trying to do medical school and focus on sport at a world elite level. That is a huge red flag. I don’t care how “smart” or “athletically gifted” he is. Focus. To me it sounds like med school is a hedge. Kienle said it best when I was on the trainer last night watching 2015 kona nbc. “~I take a chance and maybe I have 10% chance of winning, I’m not racing for 5th.”
Why on earth is he trying to do medical school and focus on sport at a world elite level. That is a huge red flag. I don’t care how “smart” or “athletically gifted” he is. Focus. To me it sounds like med school is a hedge.
It is a lot, but a swimmer named Kurt someone did it … forgot the last name, but he’s one of the stories in Gold in the Water
Why on earth is he trying to do medical school and focus on sport at a world elite level. That is a huge red flag. I don’t care how “smart” or “athletically gifted” he is. Focus. To me it sounds like med school is a hedge.
It is a lot, but a swimmer named Kurt someone did it … forgot the last name, but he’s one of the stories in Gold in the Water
Sure it is doable, but unless you absolutely need to do it I would advise against it. Clearly the sleep thing is already a problem.
Why on earth is he trying to do medical school and focus on sport at a world elite level. That is a huge red flag. I don’t care how “smart” or “athletically gifted” he is. Focus…
+1 – Make a choice. Insomnia and anxiety are self induced…obviously.
Why on earth is he trying to do medical school and focus on sport at a world elite level. That is a huge red flag. I don’t care how “smart” or “athletically gifted” he is. Focus. To me it sounds like med school is a hedge. Kienle said it best when I was on the trainer last night watching 2015 kona nbc. “~I take a chance and maybe I have 10% chance of winning, I’m not racing for 5th.”
I think athletic pursuits at the top level do not need to be binary like you are suggesting. Triathlon is probably different because it takes so much time, but we don’t know what sport the OP’s son plays.
While in med school, my wife has won 2 trail running national championships and qualified for Team USA 3 times. Obviously n=1, but some can thrive with focus pointing in more than one direction.
The “panic attacks” I’d get in the middle of the night due to thinking that I wouldn’t have enough time to finish projects/study/etc. for my undergrad degree were enough to keep me awake most nights. And I didn’t do anything physically active at the time, have a job, or anything. Just knocking out my senior year in engineering. I could easily imagine that load on a person keeping them up at night. Constantly thinking about a test, training, and how little time you have to do it all.
Thank you for all the responses…all very helpful. Will certainly drill down on desert dude’s stuff.
Thomas, you are of course correct to emphasize the challenge…at some point there has to be a choice or at least a compromise of standards.
Will report back with an update in a month or so!
I’ve had a lot of trouble with insomnia over the years - high training volume easily exacerbates it. The things that have helped me most (none of them easy to put into place when work and life are demanding!)
daily mindfulness meditation (more valuable IMO than CBT, which focuses a bit too much on the “cognitive” - I can function on little sleep, I am not obsessing about it, it’s really just that my body and mind have no inclination to fall asleep!)
prioritizing “sleep efficiency” - same bedtime and rising time every day, get back up and read or similar if you can’t sleep and force yourself to get up at set time even if you only got a few hours (no naps longer than 20 mins, no naps after noon or wherever “your” noon is set)
no alcohol
minimize screen time in hours before bed (Kindle is OK b/c not backlit)
cold dark room
comfortable mattress and linens
avoid evening exercise where possible (apparently this is mostly because it increases core temperature, but there are also CNS activation issues - I find some forms of exercise disrupt sleep much more than others, evening masters swim is particularly pernicious!)
Why on earth is he trying to do medical school and focus on sport at a world elite level. That is a huge red flag. I don’t care how “smart” or “athletically gifted” he is. Focus. To me it sounds like med school is a hedge. Kienle said it best when I was on the trainer last night watching 2015 kona nbc. “~I take a chance and maybe I have 10% chance of winning, I’m not racing for 5th.”
I think athletic pursuits at the top level do not need to be binary like you are suggesting. Triathlon is probably different because it takes so much time, but we don’t know what sport the OP’s son plays.
While in med school, my wife has won 2 trail running national championships and qualified for Team USA 3 times. Obviously n=1, but some can thrive with focus pointing in more than one direction.
Absolutely right on having no idea on specific sport, but regardless anything at a world level requires all effort and attention. Sure it could be an up and coming sport with little competition but there will always be someone who is willing to go all in. One of my favorites quotes is “perfect is the enemy of great”. It takes a lot of sacrifice to be perfect and then a lot of luck. To be great is far less of a challenge.
Maybe he can compete at world class level on sheer talent, but in my view success is much more binary then people are lead to believe.