1. Tips and Resources for Stress Management Cheryl Hawk, DC, PhD, CHES

2. Assessment of stress Numeric rating scales  “On a scale of zero to 10, where zero is no stress and 10 is unbearable stress, how would you rate your current stress level?”  OR put in positive terms: “On a scale of zero to 10, where zero is no confidence and 10 is complete confidence, how confident are you that you can successfully manage your current stress level? That is, manage it without negatively affecting your health and well-being?”

3. Stress MANAGEMENT is the key We can’t control outside events which cause stress We CAN control our reaction to these events This provides a feeling of control and empowerment

4. Interactive quizzes Holmes and Rahe stress inventory  Social Readjustment Rating Scale  http://www.actsweb.org/stress_test.php http://www.actsweb.org/stress_test.php How stressed are you?  http://www.arc.sbc.edu/stress.html http://www.arc.sbc.edu/stress.html

5. Sleep Poor sleep can be caused by stress and also contributes to stress—a vicious cycle  Sleep quality score: http://rozerem.com/en/tools_for_sleep/sleep_quality_score/ http://rozerem.com/en/tools_for_sleep/sleep_quality_score/  Caffeine can contribute to sleep AND stress Recommended amount: < 300mg/day Caffeine stays in system up to 10 hrs

6. Improving sleep quality Avoid caffeine 10 hrs before sleep Avoid alcohol and nicotine before sleep Avoid heavy meals 1-2 hrs before sleep Avoid exercise 4 hrs before sleep Go to bed and get up at same time

7. Ways to relax/manage stress Techniques  Visualization  Meditation/Relaxation Response  Progressive muscle relaxation  Self-hypnosis  Yoga, especially breathing Self management resources  General relaxation http://www.mindtools.com/stress/RelaxationTechniques/IntroPage. htm http://www.mindtools.com/stress/RelaxationTechniques/IntroPage. htm  Chronic pain http://www.med.umich.edu/painresearch/patients/self.htm http://www.med.umich.edu/painresearch/patients/self.htm  From ACA http://www.acatoday.org/content_css.cfm?CID=2203 http://www.acatoday.org/content_css.cfm?CID=2203

8. Autonomic nervous system balance Activating sympathetic nervous system: stress response Activating parasympathetic nervous system: relaxation response Parasympathetic ns activated by deep, slow breathing  http://www.amsa.org/healingthehealer/breathing.cfm http://www.amsa.org/healingthehealer/breathing.cfm  5-6 breaths per min (10-12 sec/breath)  Start with 5 minutes/day, gradually increase to 15-20 min/day