How This Sleep Specialist Establishes Limitations, Sleeps Well, and Maintains Her Health

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When Dr. Saundra Dalton-Smith started experiencing burnout, about 10 years ago, she assumed she just needed to get better sleep.

So, the internal medicine physician set out to understand it better, learning about sleep technology, the process of how we get to deeper levels of sleep, and more.

“I got to a place where I really felt like, I can’t sleep any better…[and] I was still tired,” she says. “Honestly, it really was depressing, because it’s like, OK, I’m doing what everybody says I should do to feel energized, and I simply do not.”

Dalton-Smith, who is based near Birmingham, Alabama, started seeing the same pattern with her patients as well, fueling her investigation further.

“I had so many people coming in saying the same thing: ‘I’m doing all of these things that people are telling me should help me feel more rested, but I’m not,’” she says.

“That’s when I started really kind of looking at, OK, so if sleep is not solving my fatigue, then what kind of fatigue do I have? There’s something else that’s not being identified.”

Seven types of rest
This breakthrough in her research is what led Dalton-Smith to arrive at the seven types of rest, which she writes about in her book “Sacred Rest: Recover Your Life, Renew Your Energy, Renew Your Sanity,” and is perhaps what she’s most known for.

According to Dalton-Smith, sleep and rest are not the same thing. In fact, humans need seven different types of rest in order to flourish: physical, mental, social, creative, emotional, spiritual, and sensory.

Initially, the list was much longer, but after practicing with hundreds of patients “from every type of background you can imagine,” Dalton-Smith narrowed it down to these seven types, which she found lacking in most of her patients across the board.

Once she had identified the types of rest people needed, she could focus on solutions for how they could get it. It’s not the same for everyone, of course. Knowing that, Dalton-Smith offers her patients and readers many options along the way.

For instance, a mindfulness technique like journaling or meditation may work for one person trying to achieve mental rest, while a complete information detox may be the key for someone else.

“There’s a kind of self-discovery portion of understanding your rest needs,” she says.

The first step for everyone, though, is identifying where the deficits are in the first place.

One way to do this is by taking Dalton-Smith’s free rest quiz, which she believes “gives the quickest look into what [one’s] issues are.” The quiz only takes about 10 minutes to complete, and I found the results to be pretty spot on.

The types of rest I scored the highest on were emotional and mental, signaling that these are the primary types I’m missing in my life and should focus on.

Being emotionally rested, according to Dalton-Smith, means being able to freely express your feelings and cut back on people-pleasing. As a person who doesn’t like confrontation and always wants everything to be OK, this rings true. Some suggestions on how to get better emotional rest are to risk vulnerability and identify people who drain you.

To be mentally rested is to be able to quiet cerebral chatter and focus on what’s important. Welp! Rather than sleeping, I spent half of last night replaying a text conversation in my head that I wish I’d handled differently and analyzing the poor choices made by characters on “Euphoria.” So, that one really hit home.

Among Dalton-Smith’s recommendations to help with a mental rest deficit are to schedule short breaks throughout the day to remind you to slow down, and to keep a notebook by the bed to write down nagging thoughts that keep you awake at night.

Another way to identify your deficits, Dalton-Smith says, is by thinking about where you’re expending the most energy in your day and whether you’re doing enough to replenish those areas.

If it sounds overwhelming to make sure you’re getting the right kind of rest in seven different areas, Dalton-Smith’s advice is to start by focusing on one.

“Usually for most of us, there’s one or two rest deficits that are the greatest, so we focus on those specifically,” she says. “You start seeing the benefit without getting overwhelmed.”

I asked Dalton-Smith to share how she gets the right amount — and kind — of rest herself. Here’s what she said.

1. She starts small
Dalton-Smith wants to make one thing clear. When discussing getting the rest you need, she’s not necessarily talking about taking a major sabbatical or epic vacation.

“It’s really looking at, how do I incorporate…these restorative, restful activities in the middle of a busy day?” she says.

She does this in her own life, looking to fit rest in wherever she can so she never gets to a place of feeling totally depleted. If she feels like she’s holding stress in her neck, for instance, she’ll squeeze a couple of shoulder shrugs in while walking from room to room in the hospital.

“It’s those little things that we do to keep pushing us back to a place of restoration, and a place of feeling better in our bodies,” she says.

2. She sets boundaries
As you can probably imagine, an important part of making sure you get the rest you need is by having good boundaries.

“I always say, ‘Rest is not for the weak,’” Dalton-Smith states. “It takes a courageous person to own their boundaries, because a lot of us, we have this fear of confrontation.”

She believes it’s this fear — along with the guilt that comes with disappointing others — that has us often engaging in people-pleasing behaviors and saying yes to things we know we don’t have the time or energy for. As someone with a high emotional rest deficit, Dalton-Smith relates to this.

She has managed to instill boundaries by setting priorities for herself during each season of her life and sticking to them. Whereas in some seasons she’s focused her energy on her career, right now with two sons in high school, her family — their birthdays, ball games, and more — comes first.

“When an opportunity comes up that’s going to take my time or my energy, my first question to myself is, ‘Does this align with my priorities in this season?’ If the answer to that is no, and…it’s not something that I really feel passionate about,” she says, “chances are I’m going to say no.”

Even with a plan in place, it’s not always easy, of course. Dalton-Smith loves to help people, so saying no often means giving up something that would actually bring her joy — but at what cost?

“I had to learn that I can’t sacrifice myself to the point that I’m actually not giving you my best,” she says. Whether it’s with her family or patients, giving a yes for the wrong reasons is not helpful to anyone. “I think I just had to get very truthful about that.”

3. She assesses her energy at the start of each day
When Dalton-Smith gets out of bed in the morning, the very first thing she does is evaluate her energy level.

“I do that immediately at rising because unless I start treating it and being aware of it [right away],” she says, “the day’s just going to go down from that point forward.”

Nine out of 10 mornings, she wakes up feeling raring to go — but when she doesn’t, she thinks back to what she might have done the previous day that’s leaving her drained.

Usually, she’s overbooked herself. She has a tendency to work a lot, she says, and she’ll often schedule a bunch of things without remembering to leave space for self-care.

Dalton-Smith is not ritualistic in that sense, keeping a set schedule of when to go for walks and exercise — she likes to be a bit more intuitive. This is precisely why she runs out of time if she’s not careful, paying for it the next day.

“It’s honestly a good reminder for myself that I can’t do that,” she says.

4. She winds down gradually
While self-care activities might not be appointed on her calendar, Dalton-Smith tends to stick pretty closely to a sleep schedule. She tries to go to bed between 10 p.m. and 11 p.m. (though sometimes it gets pushed a bit later due to the kids’ extracurriculars) and wakes up between 6:30 and 7:30 in the morning.

Before she climbs into bed, she practices what she calls a sensory downgrade by dimming the lights on her computer, phone, and even the lamps in her house.

“A lot of times, people try to flip their brain and body off like a light switch, and just try to go to sleep,” she says. “I find that doesn’t work.”

She tries to avoid consuming anything overly graphic or stimulating before bed, even books, as she prefers mysteries and thrillers, which she finds highly mentally engaging. It’s all about clearing her head and her senses to make room for rest, (hence, sensory rest, one of the seven).

Once she’s in bed, she takes stock, similarly to the way she does in the morning, asking herself if anything hurts, is tight, tense, if she needs to stretch.

“There’ve been many times I’ve hopped out of the bed to stretch because,” she says, “the moment I hit the bed, I can tell, OK, I’m not going to get past this until I get up and stretch.”

5. She’s found the exercise and diet routine that works for her
In addition to stretching, Dalton-Smith goes on walks regularly and likes running half marathons. She enjoys spending time outside, hiking and appreciating nature, often with her husband — this is how they get their creative rest in, and it’s a nice way to stay connected, too.

Dalton-Smith tends to follow the keto diet for long stretches of time, mixed with periods of low carb eating, since she has a family history of diabetes.

She might have a glass of wine if she’s out to dinner, but it’s not something she does regularly. Most of the time, she doesn’t wake up feeling refreshed after drinking, and she thinks it disrupts the sleep cycle some, so alcohol isn’t a huge part of her life.

Committing to rest
As Dalton-Smith says in her TEDxAtlanta talk in 2019, “Sleep alone could never restore us to the point where we feel rested.”

Now that we have an understanding of the seven types of rest, “it’s time we begin to focus on getting the right type of rest,” she says. “It’s time for a rest revolution.”

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