The Dirty Little Secret Stealing Your Gains, Stress
In today’s fast paced quick fix shiny object society, it safe to say that people are simply stressed the hell out. Between hours of aimlessly scrolling through social media feeds, main lining simulates and spiking caffeine to just “get through” the days, and punishing themselves in the gym with a “more is always better” mentality trying to make up for poor diet and lifestyle choices, it’s no surprise that we are sicker, fatter, and more chronically stressed out than ever before in human history.
Did I mention that the average person is also attempting to do ALL of this while chronically sleep deprived?
See, the thing about stress which makes it all too easy to sweep under the rug and act like it’s NOT a monumental problem cursing our physical, mental, psychological and emotional health is that other than having your doctor tell you that your blood pressure is sky high and you should start taking meds before your heart gives out, stress is somewhat silent.
Silent until that chronic stress filled powder keg finally explodes.
Stress comes in many forms, and the body doesn’t necessarily know how to differentiate between different sources of stress, creating a cumulative stress load on the system with additive properties that can not only become detrimental to performance, but also health and wellness.
If your goal is to live a high performance life where you look, feel and function your very best, you better get your stress load under control. But instead of just sitting around red lining your stress in hopes to make it to your next beach vacation without a catastrophic blowout (professionally, personally, physically…) it’s time you start making some simple daily steps in the positive direction for reducing your stress load and combating the ill effects of our now common chronically stressed out society.
This article will be your roadmap for down regulating your system, learning to utilize simple yet effective tools to manage stress, and do it on a daily basis in as little as a few minutes a day. But before I get into the top 20 most effective ways to reduce stress, we must appreciate why stress is such a big deal, because if you ask me, it’s the #1 thing plaguing our health and wellness today.
Why Stress Is So Detrimental To Our Health?
Contrary to popular belief, stress actually boosts calorie burning via constant low-level activation of fight-or-flight pathways. It is not at all uncommon for people to gain weight when chronically stressed, but this is generally due to stress-induced excess eating or water retention from stress hormones. Stress hormones (cortisol in particular) can serious hinder weight loss attempts.
Stress is a change in our physiological state in response to what our bodies deem to be a dangerous situation. Our body is regulated by the autonomic nervous system, and this system is always on. Its job is to balances our physiology between calm and stressful states of being.
We have two distinct branches of the autonomic nervous system:
- Parasympathetic State: This is when we are calm, at rest, and digesting and assimilating the nutrients from our food. This is where we recover and grow, and as you might have guessed, is the preferred state of being when it comes to fat loss.
- Sympathetic State: This is our fight or flight response, which is when we are in a state of high stress. Not all stress is bad. The problem is when we are in heightened states of stress for too long. Stress is crucial for our bodies to disrupt homeostasis, which is what allows us to adapt, grow muscle, and lose body fat. We do not want to live in a sympathetic state. We want to enter into it when we train, then immediately get out and return to a parasympathetic state post workout, as we begin the rest and recovery process.
In today’s world, the issue is we spend far too much time in a sympathetic state. Now what defines stress is – anything and everything – it all depends on you!
So, what could be causing you stress? Examples include:
- Lack of sleep
- Financial troubles
- High caffeine intakes and energy drinks
- Poor body image
- Social Media
- Relationship issues
- Work issues
- Poor quality food
- Smoking and alcohol
- Environmental pollutants
When we stress our body perceives it as danger. Now the human brain has not evolved too far from our days as hunters and gatherers. Back then, we may have been attacked by a tiger, entering us into a sympathetic state. We had a choice, fight or flight. Fight, or run as fast away as possible!
In the world we live in today our stress is vastly different. It’s less physical, and much more emotional. Every day we encounter small stresses from our partners, colleagues, boss, social media, environment, Dr. Rusin’s highly intense screams before an exercise, and every time, the body believes we are in danger.
Most people including myself use exercise as a stress reliever but it is quite the opposite actually while we exercise we are causing huge amount of stress to our body which is a good thing if we can properly recover and grow form it.
But what do we usually see going on? If we take a look at the trending hit intensity fitness classes (not naming names here) added to a highly stressed individual to a super high intensity one hour session. This individual will feel great after that workout because they think they got the crap kicked out of them, they are sweaty and feel good about themselves but watch this same individual, always be tired and never able to lose weight.
So, what can we do about it?
It makes it sound so easy, “Just get your body into a parasympathetic state” and you’ll reduce stress and better manage performance and recovery, right? Sure, the rest and recover parasympathetic side of the CNS is where we want to be living. This involves calming and stress mitigation activities and this is why I created this guide, to give you options to reach such state.
Two Sides of the CNS: Sympathetic and Parasympathetic
Let’s get a little geekier. Sympathetic and parasympathetic refer to your nervous system. Biologically speaking, your body runs on nerves. The nerves send signals throughout your body using the nervous system as a whole, which connects to the brain.
Biologists have studied the possibility of “hacking your brain” to gain better health. Some might call this mindfulness and others refer to it as neuroplasticity. Neuroplasticity is the technical term used to explain how you can retrain your brain to think more positively, even teach it new tricks. Someone who suffers a brain injury can help their mind create new neurons, which allows the creation of new pathways for messages to be sent from the brain to the rest of the body. If speech is interrupted, neuroplasticity techniques can be used to create new pathways to improve speech.
Hacking your brain is about the same thing. You are going to use your mind and your nervous system to help your body recover from training, stress from work, stress from relationships, and other stress issues.
As you already know, the sympathetic nervous system is an automatic response system we understand as our flight or fight response. The parasympathetic nervous system is the opposite, where your body is at rest and in the “digest” stage. While your sympathetic nervous system reacts to stress when there is a threat or injury, the parasympathetic nervous system helps control your body’s functions when at rest. Your muscles relax, and your heart rate goes to a resting phase.
Top 20 Ways To Reduce Stress and Enhance Recovery
The following 20 tools and methods can help your body return to a parasympathetic state, to overcome the flight or fight factors you experience during stress. While this is not an exhaustive list, these are the most instantly applicable ways to combat stress and recover and perform stronger than ever.
#1 Sleeping Is The Foundation of Recovery
To build a solid recovery process, you must start with the foundations. No matter how dialed in your training program and execution may be, or how structured your nutritional strategies are, each of these two factors become highly dependent on your lifestyle, especially as it pertains to the amount of stress in your life.
You cannot out train or out eat poor sleep habits coupled with a lifestyle of constant physical and emotional stress. These place a heavy strain on the CNS (Central Nervous System) over extended periods of time.
Sleep is defined as a natural periodic state of rest for the mind and body, in which the eyes are closed, and consciousness is lost so that there is a decrease in bodily movement and responsiveness to external stimuli. When we sleep well, we wake up feeling refreshed and alert for our daily activities.
Sleep affects how we look, feel and perform on a regular basis, and can have a significant impact on our overall quality of life. Also, it allows your body time to heal. If you go without this valuable necessity in your life, your healing process is interrupted. The body is designed in such a way that you will always heal from your wounds after a period of sleep.
To get the most out of your sleep, both quantity and quality are essential I highly recommend that you go over “the ultimate guide to biohacking the perfect night’s sleep” to learn more on the topic.
#2 Parasympathetic Breathing Post Workout
So how do we recover faster to train harder and more frequently? Sure, nutrition, hydration, and stress all play a role, but what about the time it takes us to shift from a sympathetic based CNS response in training to a parasympathetic based response that allows the recovery process to start doing its work?
That intermediary period between your last set and the time where your CNS comes down off the sympathetic bender it’s been on in the gym needs to be minimized. One of the most effective methods to do that is by using recovery breathing as the last “exercise” of the day before you leave the gym.
How To Do It
Recovery breathing is about the position and setup. The passive positioning of the arms and legs help with centralized drainage of lymphatic fluid. The spine remains in a relatively neutral position to reduce the threat-response to the body. You basically get your body as comfortable as possible for the goal of reversing the CNS response from training.
- Try to find a quiet area of the gym away from music or noise.
- Lay on your back with your head resting on the ground.
- Elevate your legs to above heart level with knees slightly bent.
- Elevate your arms overhead.
- Close your eyes and relax the body.
From this position, you should be able to relax every single muscle in your body to allow a fully passive response to take place. From here, focus on only one single movement: your breathe. Stay here for 5-10 minutes and walk out recharged.
Tempo of Breath
- Inhale 3-4 seconds
- Hold 2-3 seconds
- Exhale 6-8 seconds
#3 Sauna and Steam Room
Saunas and steam rooms offer similar detoxification and energy for your body. Steam rooms use heat and moisture, while some saunas are meant to be a dry heat. Both will help you relax and recover.
The use of ice has been debunked and does not help to recover faster from injuries but heat is well known to help with some physical conditions. Heat is also known to help relieve cramps and relax your muscles. To aid in your recovery after significant stress or extensive training, using a sauna or steam room will provide relaxed muscles, help with any cramping, and potentially reduce injury time. Although most studies done on sauna come from regular dry heat saunas but infra-red sauna that utilize red light is coming out with some tremendous benefits.
- Enhanced detoxification (particularly useful prior to a weight cut)
- Heat Shock Protein (HSP) Activation
- Reduced Protein Degradation
- Greater Muscle Regrowth following immobilization
- Greater Muscle Retention during immobilization
- Increased Growth Hormone
- Increased Insulin Sensitivity
- Anti-depression (Red light sauna)
#4 Massage Therapy
Massages target knots in your muscles and tight nerves. Like acupuncture, massage therapy is designed to open your body, to help it reduce the toxins in your system, by alleviating the pain you feel.
A massage therapist can work on trouble areas or your entire body by doing a technique called lymphatic drainage. The movements are meant to be circular with the pressure moving down from your head to your toes. Starting at your spine and working out from your shoulders down to your fingertips and down along your spine and out to your sides.
At first, you might feel a slight tensing in your muscles because they are reacting to the pressure of the therapist hands, but then the muscles will relax. At the end of the massage, your body is ready to let go of the toxins, and your muscles will feel more like jelly.
Recovery with massage is also about your mental state. On a massage table, you are there to relax, to let the therapist alleviate the pain, and to listen to calming music that lets your mind take a rest. As you enjoy the feeling of pain going away from your body, your brain can concentrate on soft music, often water-related, to help you stop thinking. If you allow a massage to work the way it is supposed to, you will go through an hour in a nearly sleepy state or even fall asleep.
E-Stim or TENS is an electronic stimulator. The pads of the machine are placed in areas where you have significant tension in your muscles. The electronic stimulators move in a circular pattern, vibrating your muscles, digging down like a massage therapist fingers, on those knots. You should use e-stim for ten to fifteen minutes per session. Some chiropractors will use the E-stim option combined with heat for ten to fifteen minutes, before adjusting your spine back into alignment. You can use the unit with a heating pad or hot towels.
The idea behind E-stim is to find the knots causing the most pain. You want a unit that will make direct contact with the central part of the knot, so it can spread the relief throughout the rest of your body. Units are made affordable for the average person, but you may want to pay for a visit to a chiropractor or other specialist that has one of the commercial units.
Before using E-stim on your own, you should have a specialist show you your main problem areas. You want the device to be the most effective it can be for you. E-stim are another tool for you to relax and put you back into a parasympathetic state after a tough workout
Meditation has been around since Buddha. Meditation is a technique designed to help you reduce your stress and pain. Too often, our minds focus on the negatives in our life, whether it is a pain from training or tension related. Meditation asks you to sit and let the focus of your mind go. Instead of dwelling on the thoughts you have, you are meant to breathe out those thoughts, until your mind is empty, and you feel lighter.
Meditation can be combined with massage, steam room and sauna.
For meditation, sit or take a repose position, in a quiet room. If you are the type of person who relaxes better with music or water sounds, turn on a fountain or relaxation music. Avoid radio or Pandora due to the commercial interruptions. The music should be something that will keep you in a constant state of relaxation and not pop you out of it because of an annoying commercial.
With the music going, water sounds, and a comfortable position start to concentrate on your breathing. On each exhalation, let a thought escape and bring in, only, a calming breath. Your mind might want to wander from thought to thought, even help you think of a story or a positive memory. Do not dwell on what your mind brings in or let’s go of, just enjoy the sensations you are experiencing. After fifteen to thirty minutes, start to wake your mind up. Focus on how you will remain stress-free, calm, and relaxed, and start on the essential tasks.
If you hate to meditate because you find it boring then you are probably the person that needs it the most. I was like this for a while and by learning to meditate even if it just 3 minutes or 5 minutes at a time I could truly feel the difference.
If you are a beginner you there are plenty of videos on Youtube or apps like Headspace that will guide you through it.
Each time you feel stressed or after you finish training, you will want to use meditation to relax your mind and body. You will notice the stress and pain gone from relaxing your entire body, you have more energy to complete the critical tasks.
Yoga is used for strengthening, relaxation, and core training. Yoga can be a helpful recovery tool for after your main training session or on an active recovery day. Several types of yoga positions exist from those that require you to be on your hands to others that work strictly on your core, without too many positions on your limbs.
For those who have arthritis or tendinitis in their joints, putting pressure on individual arms can be painful. One suggestion is abdominal yoga positions or Bikram Yoga. Where the position and the heat wont affect your joints as much. You gain relaxation in these poses, more strength, and learn how to use your body to breath properly.
Yoga is often conducted to relaxing music with the beginning and end of the sessions focusing on your breathing and relaxation techniques to bring your body and mind to a parasympathetic state of calm and serenity.
Pilates is also about core strength. Pilates like Yoga has several poses you are meant to use to stretch your body. One expert says Yoga is meant for improved flexibility, while Pilates is intended to focus on relaxing your muscles and strengthening those muscles. However, you could say that both help you relax your muscles while strengthening your body.
The poses are different from Pilates, but also in many ways, similar. You will find yourself on your back lifting your back from the ground, with one leg on its tiptoes and the other straight in the air, for one pose. Others might have you stretching your entire back, with one leg straight in the air, and the other being held in your hand, with your arm stretched out along the ground. Pilates spends less time on the hands, with many poses starting on your back and stretching your spine as much as possible.
A chiropractor straightens the spine, making sure your vertebrae are not pinching your nerves and causing you pain. During training, it is possible to knock your spine out of alignment. You may also have muscles that tense up due to tightness in your joints. Chiropractic care targets the tight joints and spine to ensure nothing is being pinched and causing you pain.
Additionally, some people may sit or work in jobs that cause hips to be out of alignment or one shoulder to be higher than another. With the alignment of your spine and joints, your body goes back to being centered. Stress can even be the cause behind your sore muscles, tensing up and pushing your spine out of alignment due to improper sitting positions and disinterest in proper posture.
A chiropractor will get things back where the spine is happy, but you must do the training and workouts to keep your vertebrae and joints in the right place. Like massage therapy, chiropractor techniques can also release toxins from the body, and cause dehydration. You will need to drink plenty of water after your alignment.
#10 Foam Rolling
Foam rolling is a technique designed to provide self-massage. Nowadays, there a new foam roller coming out every year, with new guns, to electric vibration roller the science is the same. Like massage techniques, you are helping increase the circulation in your body, removing toxins, and alleviating pain. You will gain improved movements, including a better range of motion, and decrease your risk of injury and recovery time during your regular training sessions if you use foam rolling post workout.
Another popular time you will see coaches recommending their clients and athletes get on the foam roller and address soft-tissues is in the pre-training routine. I can already hear you say yea but why would I want to get into a parasympathetic state pre-workout? Granted yes this will put you in a parasympathetic state but if your warm-up is well thought off, then the foam rolling will be followed by activation and CNS stimulation techniques. A reliable system such as Dr. John Rusin 6-Phase Dynamic Warm Up Sequence in the Pain-Free Performance Specialist Certification will go over the right way to warm-up.
#11 Color Therapy
Color therapy or chromotherapy is best used for emotional healing over physical problems. The goal is to help you relax and address psychological imbalances, like stress. Depression is one illness that has shown improvement with color therapy. Color therapy is thought to be as old as Ancient Egypt. Eastern medicine added the concept of chakras, where you are supposed to ground your body with the earth to help with overall wellbeing.
We do know that some colors are found to relax a person more than others. Surrounding yourself with colors that help relax you is one way to use color therapy. Color therapists have specialized equipment they use to show you pictures and colors to help you relax. The colored light projections help your mind focus on the color and how it pleases you versus on your thoughts. Green and blue tend to be the most relaxing colors. By surrounding yourself with greens and blues, you can feel love, joy, and peace versus depression and hopelessness. Darker colors and reds are often associated with more energetic higher intensity feeling. Which is not a bad thing but being excited and pumped up will not put us back in a parasympathetic state.
#12 Light Therapy
Light therapy was devised to treat seasonal affective disorder (SAD), a stressful disorder brought on by winter darkness. Those that live higher north tend to not see a lot of light during the day in the winter months which as been attributed to depression and higher suicidal tendencies.
Light therapy is designed to mimic natural light. You can use a regular light bulb, a light box, and other lights intended to help with seasonal affective disorder to help combat sleep issues, depression, and other stress conditions. Those who train in the early morning hours when it is still dark out can also suffer from SAD, and benefit from light therapy.
Even thought blue light is having a bad rep recently with all the anti-blue light glasses, you still need it during the day to have a normal circadian rhythm. Natural blue light (sun) has been shown to trigger serotonin, which is part of what makes us happy. Serotonin is also converted to melatonin in darkness which helps us fall asleep a night.
#13 Trigger Point Therapy
Trigger point therapy can be conducted with massage, chiropractic care, or foam rolling. The idea behind trigger point therapy is to target the area producing the pain, which is then referred throughout the rest of your body.
The therapist or yourself would target the knot, working intensely to alleviate the tight muscles, which then allows your entire body to feel better. The technique itself may not be relaxing, as trigger point therapy is actually quite painful but it is the after-effect of the therapy that will relax the muscle and puts us into a parasympathetic state.
Acupuncture is a form of Chinese medicine. The Chinese believe in a balance of the body, where you need equal parts of Yin and Yang to have proper energy or Qi. Acupuncture works on the meridian (your energy channel) to detox your body and relieve the pain. Acupuncture helps with anxiety, chronic pain, arthritis, migraines, insomnia, depression, sciatica, sinus congestion, stress, and training related pain. It has also been associated with weight loss, through the reduction of mental factors like depression that can hinder your diet.
Acupuncture uses needles, strategically placed to alleviate known pain sites. Often, the pain you feel is stimulated by a muscle higher up in your body or near your spine that is contracting and not releasing, with the right needle placement, you can feel the muscles relax, and your entire body begins to feel better.
You can use acupuncture at home by purchasing a Shakti Mat. Shakti mats are like the Indian bed of nails, where spikes apply pressure to the skin, helping to alleviate pain and support better circulation. There isn’t a lot of science to back up this claim but I always fall asleep on it, therefore from a case study point of view, it does help to get back to a parasympathetic state.
Earthing is a technique to help you relax through meditation. In fact, you are meant to walk outside, without shoes, and let your bare feet touch the ground, while you relax and soak up the sun. We never used to have such a fancy word for it people just used to go outside and enjoy nature, getting vitamin D from the sun, and relaxing from the sheer pleasure of being outside with fresh air. If you are close to a park or the beach that is one of the best ways to get away from the stress and feel less anxious.
There is also a great study from the journal of environmental and public health shows that earthing does indeed reconnect our body to the earths natural electron and sessions of 30 to 40 minutes daily can alleviate pain and reduce chronic stress. Another reason why earthing would be important in this day and age is the amount of Electromagnetic field (EMF) our body is bombarded with on a daily basis. From computer, phones, tv, radio, 5G internet, so on and so forth. Earthing provides a way for our body to ground itself naturally from those constant threats.
#16 Salt Room
Salt has long been considered a healing mineral. Salt pools and natural salt springs are said to help alleviate pain, reduce toxins, and help with other physical ailments. Wounds tend to heal faster with a salt soak. Using a salt room can help you improve your skin, reduce pain, and even help with allergies. Salt rooms are becoming popular in the USA, but you can also create your own with a salt based pool or hot tub in your home.
#17 Binaural Beats
Binaural beats use sounds or tones to help your brain respond and relax. Each ear is given a different tone to help increase brain activity. The rhythmic sound is designed to help you relax, to avoid thinking of pain, and to feel energized. Binaural beats have been around for centuries. You simply sit with the binaural music, with headphones on, and allow the tones to relax you.
To appreciate the importance of the binaural beat and how it can influence your brainwaves, let’s take a look at how different brainwave levels can influence specific behaviors and emotions. By knowing how brainwaves work, you can practically craft specific moods and experiences for yourself, including deep sleep.
Based on the table above, you can use binaural beats with specific frequencies to induce specific states, emotions, or behaviors. Since we’re talking about deep sleep here, you should use a binaural beat track with a maximum frequency of 4.00, which is considered to be within the Delta Wave range that’s optimal for a deep and slow wave sleep.
Aromatherapy is the use of different fragrances to help you relax and to alleviate pain. Valerian root is meant to reduce anxiety and stress. Lavender helps you relax and sleep. Peppermint can soak up inappropriate scents and return a room to a fresh scent. Various natural plants are turned into essential oils, which are used in diffusers to spread the fragrance throughout the room. Since these are plant-based, make sure you are not allergic to the scent.
It has been more than 40 years since Norman Cousins published an article in the New England Journal of Medicine extolling the potential medicinal benefits of laughter and humor. Whether you’re watching a video on facebook or quietly giggling at a cartoon, laughing does you good. Laughter is a great form of stress relief, and that’s no joke.
If you haven’t seen the movie patch adams with the late Robin Williams, you should and then go check out the real Dr. Adams work on laughter medicine.
A good sense of humor can’t cure all ailments, but data is mounting about the positive things laughter can do.
“Laughter is the tonic, the relief, the surcease for pain.”
A good laugh has great short-term effects. When you start to laugh, it doesn’t just lighten your load mentally, it actually induces physical changes in your body. Laughter can:
- Stimulate many organs. Laughter enhances your intake of oxygen-rich air, stimulates your heart, lungs and muscles, and increases the endorphins that are released by your brain.
- Activate and relieve your stress response. A rollicking laugh fires up and then cools down your stress response, and it can increase and then decrease your heart rate and blood pressure. The result? A good, relaxed feeling.
- Improve your immune system. Negative thoughts manifest into chemical reactions that can affect your body by bringing more stress into your system and decreasing your immunity. By contrast, positive thoughts can actually release neuropeptides that help fight stress and potentially more-serious illnesses.
- Relieve pain. Laughter may ease pain by causing the body to produce its own natural painkillers.
- Improve your mood. Many people experience depression, sometimes due to chronic illnesses. Laughter can help lessen your depression and anxiety and may make you feel happier.
Go ahead and give it a try. Turn the corners of your mouth up into a smile and then give a laugh, even if it feels a little forced. Once you’ve had your chuckle, take stock of how you’re feeling. Are your muscles a little less tense? Do you feel more relaxed or buoyant? That’s the natural wonder of laughing at work.
#20 Praying / Gratitude
Praying or practicing gratitude for the atheist can also be a very powerful tool of mindfulness and stress relief. Study shows being grateful for the things you have in life and not “sweat” for the bad things that have or may happen does relieve anxiety. Have you ever noticed those people that always have a positive attitude? That always see the good in everyone and if shit happens they are just ok with it? They get up and get on with their lives like nothing happened?
This is a very broad topic to be talking about on a fitness related article but my point is cultivating gratitude builds an emotional resilience and optimism which can help in maintaining a positive attitude in your daily life. By paying more attention to what is good in your life, and less to the things that don’t matter or that you cannot change, will drastically cut a huge amount of stress out of your life.
Obviously this won’t happen overnight but I wanted to put in the top 20 hacks because in the long term this is probably one of the most important.
BONUS #20.5 Chewing Gum
Chewing gum has the ability to trigger the parasympathetic nervous system. As you may already know by now, the parasympathetic get triggered only when the body needs to relax, heal, sleep and in this case digest.
Think of it as tricking your brain, chewing is part of digestion, and chewing gum will trigger the parasympathetic nervous system to up its efforts and counterbalance the stress being induced by your sympathetic nervous system. The idea is that the body cannot be in danger if it is eating, so it is able to relax.
About The Author
- The Ultimate Guide To Biohacking The Perfect Night’s Sleep. (2019). Retrieved from https://drjohnrusin.com/the-ultimate-guide-to-biohacking-the-perfect-nights-sleep/
- The 12 Most Effective Ways To Spark The Recovery Process. (2019). Retrieved from https://drjohnrusin.com/spark-the-recovery-process/
- Bodhi B. What does mindfulness really mean? A canonical perspective. Contemporary Buddhism. 2011;12(1):19–39. doi: 10.1080/14639947.2011.564813
- Wallace R. K., Benson H. The physiology of meditation. Scientific American. 1972;226(2):84–90.
- Coclivo A. Coloured light therapy: overview of its history, theory, recent developments and clinical applications combined with acupuncture. Am J Acupunct. 1999;27:71–83.
- Klotsche C. Colour Medicine. Arizona: Light Technology Publishing; 1993.
- Murray JM, Sletten TL, Magee M, Gordon C, Lovato N, Bartlett DJ, Kennaway DJ, Lack LC, Grunstein RR, Lockley SW, Rajaratnam SMW. Delayed Sleep on Melatonin (DelSoM) Study Group. Prevalence of circadian misalignment and its association with depressive symptoms in delayed sleep phase disorder. Sleep 2017; 40(1). [PMID: 28364473]
- Graham, C., & Cook, M. R. (2016). Human sleep in 60 Hz magnetic fields. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10407512/
- Ilch, D. (1969). Prescription: Laughter. AORN Journal, 10(3), 101. doi: 10.1016/s0001-2092(08)70655-0