workbook - rightsleep® · is for transformation: what will happen to you once you have healthy...

Workbook

Name:

2

www.drgominak.com sgominak copyright 2017

Table of Contents

Introduction……………………………………………………………………………… 3

Your Baseline Data…………………………………………………………………….. 4-5

First D Level. Deciding on Your First Vitamin D dose…………… 6-7

Instructions for Grading Your Sleep…………………………………………..... 8-9

Recording Vitamin D Levels ………………………………………………………. 10

Graphing Your Sleep and your D levels………………………………………… 11

First Month………………………………………………………………………………… 12-16

Calculating Your D Dose for Month Two ……………………………………… 17-20

Month Two………………………………………………………………………………… 21-24

Month Three………………………………………………………………………………. 25-28

The 12 Week Mark……………………………………………………………………... 29

Month Four, Five and Six..……………………………………………………………. 30-41

The 6 Month Mark………………………………………………………………………. 42

How to Use Pantothenic Acid to Help Your Pain…………………………… 43

Month Seven, Eight, and Nine………………………………………………………. 44-55

The 9 Month Mark………………………………………………………………………. 56

Months Ten, Eleven and Twelve…………………………………………………… 57-68

Congratulations!!!! You’ve completed a year of RightSleep®…………… 69

RightSleep® Fundamentals…………………………………………………………… 70-77

http://www.drgominak.com/

3


Introduction:

If thousands of my patients can fix their sleep then so can you!!! The hardest

part is paying attention to your sleep for months. You have a life. You want to

sleep better so you can enjoy that life! Once you feel better you’ll forget to pay

attention because….. well, because that’s normal! In fact, I’m hoping you’ll just

lie down and go to sleep. But, keeping track of what you did when you were

better and then paying attention and making corrections when you get worse

again, that’s what will make a permanent difference in your life!

Once a week take a couple minutes to: Grade your sleep. Grade your pain level.

Record your vitamins. Record your exercise. Record changes in your diet, or your

medications. Record your sun exposure. This Workbook makes it easy!

RightSleep® will change your life!

R is for Respect:

Respect your sleep, it’s the most important thing you do every day!

I is for Information!!!

Listen to your body. Use this Workbook to write down what it tells you.

G is for Goal:

Remember your Goal: Wake up happy and healthy every single morning!

H is for Health:

Sleep is only one of 3: Healthy eating, Exercise daily, Sleep well. Do all three!

T is for Transformation:

What will happen to you once you have healthy sleep night after night.

RIGHT SLEEP will change your life. Stick to it and you’ll learn just

how wonderful you can feel every day!

Stasha Gominak, M.D.


4


(Please complete this page before your coaching session)( You will need to page

through the rest of the workbook and read carefully pages 15-18 and write down any

questions so we can review them during our session.)

Please make a list of things that have bothered you over the last several years.

You will use this list when you talk to me for your Virtual Coaching Session

but you’ll also keep it to remind you of how you felt before you started. You

may include your sleep but also include things such as headache, pain, energy

level, high blood pressure, irritable bowel symptoms, depression or anxiety.

List your medications taken daily or intermittently:

Before Starting RightSleep®


5


List the vitamins you are taking or have taken in the last two years:

Record your vitamin D levels done in the last two years: Date: Blood Level: Dose of Vitamin D

What do you remember about the last time you felt great?

How long do you think it will take you to feel better?

Let’s get Started!


6


Vitamin D3 25OH blood level: Date: (within the last month)

Recent B12 level? Date: (within the last two years)

If your B12 is greater than 500 pg/ml you do not need an extra B12 pill and you never will.

If B12 is below 500 pg/ml you need to take B12, 1,000 mcg pill every day, next 4-5 years.

Using the D level above, decide on your Vitamin D dose:

Your first month’s vitamin D dose is a guess. Start with whatever dose you feel comfortable

with, or use the chart below to use my 6 years of experience. But remember it’s still a guess.

We won’t know the right dose until we know your second D3 25OH level.

Suggested first month D dose using your vitamin D blood level: (not taking D supplement)

0-20 ng/ml: start with 15K/day for one month then 10K, 5K for summer.

20-30 ng/ml: start with 15K/day for one month then 5K for winter, 5K for summer.

30-40 ng/ml: start with 10K /day for one month then 5K /day winter , 2K summer.

40- 60 ng/ml: start with 5K/day for one month then 2K/day winter or summer.

For children under 12 start with half the dose given above for adults.

Warning: Most people need 15K/day to go from a blood level of 20 ng/ml to 40 ng/ml in a

month. But about 1/50 people need much smaller doses; 1/10th the normal dose, or 1,500

IU/day. If you’ve just started 10 times the dose your body wants, you will feel horrible in

about a week. If this happens drop the dose by 1/3 and recheck the vitamin D blood level

immediately!

Starting RightSleep®


7


You’ve made the first big step. You have your vitamin D dose:

My first month Vitamin D dose: Date started:

Here are the vitamins you will need to take daily:

D3: What you want is D3. DO NOT use the green pill of 50,000 IU of D2

that you might have gotten as a prescription, it is not the right

stuff. See page 75 and the website “See and Learn” section on

Vitamin D for more details.

B50 : B50 is all 8 B vitamins 50 mg(mcg) of each.

You will take B50 for THREE MONTHS ONLY.

Buy a bottle of 100 tablets or capsules. (GNC or health store)

(B12): 1000 mcg pills (only if blood level <500)

Multi- Generic is OK. All 8 B’s, about 100% min. daily recommended

Vitamin: dose of each B, and 10 mg or less of pantothenic acid.

Take a one minute inventory every morning:

If you have pain, grade it on a scale of 1-10 and record it.

Record what you noticed about your sleep and how you feel.

To help you grade your sleep see pages 8 and 9.

You can graph your sleep scale, your vitamin D levels and your pain levels on

page 11.


8


Grade Your Sleep

0 to 10 each category : 0 ……..…….....5 ………..….. 10

Are you tired in the morning? Very Tired Rested

Do you have trouble falling asleep at night? Yes No

Are you snoring Terribly No

Are you sleep walking, sleep talking, kicking Yes No

How energetic do you feel during the day No energy Great!

Waking with a headache or mentally slow Yes No

How many times are you waking during the night? Many None

How much pain do you have on awakening? I ache all over None

Are you falling asleep during the day inappropriately? Every day No

What time are you falling asleep? 4 am or later 9-10pm

Example

I’m tired three nights out of 7 5

I had trouble falling asleep 1-2 nights 9

My husband says I snored a little this week 9

I don’t sleep walk or talk or kick 10

I feel pretty energetic most days 10

I don’t have a headache or any trouble thinking 10

I woke up about twice per night this week 8

I have some back pain every morning 5

I don’t fall asleep during the day 10

I fell asleep about 10 pm every night 10

Total for this week 0-50 is poor sleep 100 is normal 86


9


Grade your Child’s Sleep

0 to 10 each category : 0 ………,,,,,,…….5………,,,,,…...10

How often did your child wake tired or cranky? Every morning None

How often did your child have trouble falling asleep? Every night None

Was your child restless, bedclothes in a mess, in the morning? Every night No

Sleep walking, talking or night terror this week? Every night No

How many times did your child wake during the night? (ask) Many None

Did your child have pain during the night or in the morning? Yes No

Did your child wet the bed this week? Yes No

Did your child (> 5year old) fall asleep on the way home? Every day No Did your child ( <5 years old) take a nap. No, I wish Daily Did your child come into your bed (ask to) this week Every night No

Was your child hyperactive, impulsive or distractible? Every day No

Example:

He woke up tired a couple of days, perky and smiling the rest 8

Trouble falling asleep two nights this week 7

Bedclothes on the floor every morning 0

No sleep walking and his brother did not report sleep talking 10

Says he didn’t wake up at all during the night 10

Complained of pain in his legs on two mornings 7

No bed wetting 10

He fell asleep on the way home from school one day 9

Didn’t try to come into our bed at all 10

Hit another kid 5

Total this week: 0-50 is poor sleep, 100 is normal 76


10


Vitamin D Doses and Blood Levels

Date Vitamin D Dose D3 25OH Level


11


Graph your D levels and your sleep. Document your 3 months of B50 also

Vitamin D levels

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan

10

9

8

7

6

5

4

3

2

1

0

100

90

80

70

60

50

40

30

20

10

Pain

Levels Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan

Sleep Rating

100

90

80

70

60

50

40

30

20

10

0


12


The following pages are to help you keep track of your vitamins, remind

you when to do your vitamin D levels, and to record your observations.

For the first two weeks, try to remember to grade your sleep and your

pain every day. After that you can grade your sleep and your pain

weekly. Graph them with your vitamin D blood levels on page 11 so you

learn how D levels and sleep are linked to one another


13


Week 1: Dates :

Vitamin D: IU’s /day

B50*

B12

Multivitamin

.

Grade your sleep every morning and your pain level (0-10) on awakening.:

Comments Sleep Score Pain Score

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

Exercise/Food:

Sun Exposure:

*If you have nausea when you start the vitamins stop the B50 for a week try to restart it with your biggest meal. If you still have nausea, even with just the multivitamin, stop the mvi also. Add back the mvi at week three with a big meal.

Then add back B50 at week 5 as ½ for a week, then B50 whole tablet. You will start counting the three months of B50 when you are able to start a whole B50


14


Week 2: Dates :


B50:*

B12

Multivitamin



Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

Record any other changes in your daily habits:

Changes in Medications/Food:

Exercise/Sun Exposure:

Job/Family stressors:

*If you are still waking every morning with significant pain try adding a second B50 at bedtime. If that additional amount makes your sleep or pain worse then try ½ of B50 at bedtime and compare.


15


Week 3: Dates :


B50:

B12

Multivitamin

This week’s sleep scale

This week’s pain scale


Comments: Sleep Score Pain Score

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Changes in diet:

Changes in medications :

Job/ Family Stressors:


16


Week 4: * Dates :


B50:

B12

Multivitamin



*You should be getting a Vitamin D3 25OH level at the end of this week!!

Grade your sleep every morning and your pain level (0-10) on awakening.: Comments: Sleep Score Pain Score

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Changes in Meds/Food:

Job/Family Stressors:


17


In next few pages I teach you how to calculate your next vitamin D

dose: This is how you will succeed with RightSleep®. You cannot

ignore this step. If you leave your D dose the same month after

month your D level will be too high and it will hurt you! This is

Important!!

Do not wait any longer than one month to check your D level! (No matter what anyone else

tells you.) Use your first two D levels to calculate your dose for the second month. Each

person changes at a different rate. If math is not your thing get a friend or a family member

to help you. Your doctor will not know this, and may not be interested in helping you.

Example 1:

First D: 20 ng/ml You took 15K/day for a month.

Second D: 40 ng/ml

Change in level in ng/ml Desired change for next month

Vitamin D dose/day X

The right D level for sleep is 60-80 ng/ml.

You want to go up another 20 points, from 40 to 60 ng/ml. 60-40 = 20

𝟒𝟎−𝟐𝟎

𝟏𝟓𝑲 𝑰𝑼/𝒅𝒂𝒚=

𝟔𝟎−𝟒𝟎=𝟐𝟎

𝑿 or

𝟐𝟎

𝟏𝟓 =

𝟐𝟎

𝑿 or 𝑋 =

(𝟐𝟎)(𝟏𝟓)

(𝟐𝟎)

X equals 15K/day. So stay on the same dose another month.

At the end of the second month you’ll be at about 60 ng/ml.

Now you will have to decrease to 5K/day TO STAY THE SAME.

Do a third D level a month after decreasing to 5K to be sure that 5K/day is keeping your

level between 60-80ng/ml.

Example 2:

First D: 22ng/ml You took 10K/day the first month.

Second D: 52 ng/ml difference 52-22=30 Level went up 30 points in one month.

What dose of D should you take for the second month?


18


Where do you want to be end of 2nd month? You’re already at 52, you want to be 60-80.

If you stay on 10K/day you’ll go up another thirty points and be too high!

Stay conservative, you want to be at about 62 in a month so the difference will be 62-52=10

Change in level in ng/ml Desired change for next month

Vitamin D dose/day X

𝟑𝟎

𝟏𝟎𝑲/𝑫𝑨𝒀=

𝟏𝟎

𝑿 or 𝑿 =

(𝟏𝟎) (𝟏𝟎)

𝟑𝟎 or 𝑿 =

𝟏𝟎𝟎

𝟑𝟎 3K to 4K

In the second month get as close as you can with the pills you already have. In this case you

could take 5K /day Monday through Friday and none on Saturday and Sunday, which

averages out to 4K/day. Once you run out of 5K pills go buy 2K pills. Your dosing will be

relatively small and you’ll end up going to 2K/day to stay the same.

So you’ll take 4K/day for one month to get to 62 ng/ml. Then decrease to 2K/day TO STAY

THE SAME

You’ll need to get a third D level about 6-8 weeks after the level of 52ng/ml.

Example 3.

First D is 15. You took 15K/day for the first month.

Second D is 29. Difference in level : 29-15 = 14 Wow, didn’t go up much.

DID YOU REALLY TAKE IT EVERY DAY?

ARE YOU REALLY TAKING 15 K? (Are the pills 5K and are you taking THREE per day?)

Yes to both. Then we decide if we want to take another 3-4 months to get to 60-80. If yes

then stay at 15,000/day for another two months and get another D level two months from

the second level of 29. You can increase to 20,000/day now that you know how slowly your

level is increasing. If you went up about 15 ng/ml on 15K you’ll go up about 20 points per

month on 20K/day so you take 20 for two months and go up by 20/ month or from 29 + 40

= 69, then you will need to decrease to 5-10K to stay the same.

Repeat a D level at the end of two months of 20K!

Do not dose any higher than 20K/day. 20 K is the maximum we make on our skin, entire

body exposed, in the summer so this is still in the range of our body’s normal.


19


What to do when the level is too high?

When D blood level goes over 80 I don’t stop it, I decrease by ½ to ¼ . Most people

experience significant depression at about day 5-7 if it’s stopped completely. The level

usually falls about 25 points per month when completely off D in the winter.

So lets say your level comes back at 97 and you were taking 20K/day, drop to 5K/day and

get another level done in no longer than 4 weeks.

If the level at the end of the month of 5K comes back at 77 that means that we need

somewhere between 20K/day which took you too high and 5K/day which led to a drop by

20ng/ml. Don’t just continue to take 5K/day or it will fall another 20 points in another

month and you’ll be too low! Go back to in between; 10K/day for the “stay the same” dose

and check the D again in a month to be sure you’re staying the same.

What if you have been taking D for years?

Example 4:

You have been on 2K/day for three years and had one D level done 3 years ago that was

22ng/ml, and another about 6 months ago that was 32ng/ml. These are the hardest to

figure out, but you’ll do the same routine as described above. Get a first D level then a

second D in a month.

Let’s say your first D is 28 now, (it’s fallen four points, from 32 to 28 in the last six months).

We still don’t know what your first dose should be but we do know that if you stay on 2K

your level will continue to fall in the winter. You can’t use the starting doses listed above

because your body has already been on D for many months! So for the first month’s dose:

Be Conservative, double your dose and start at 4K/day then get a second level and use it in

the same way as above.

Let’s say that you’ve been on 2K of D for years and your most recent D level comes back at

55ng/ml. If there are still several months of winter go up by about 1,000 from 2K to 3K and

then repeat a D level again in one month. If summer is coming or it is summer now you

should stay on 2K and check a D in the middle of summer. You may still need to establish

what your maintenance dose is over time but it might be close to 2K.


20


(Please record any questions you have for our virtual Coaching session.)

Notes and Calculations:


21


Week 5: Dates :

Second month Vitamin D dose: (You should be changing your dose based on your calculations from pages 15-18.)

B50:

B12

Multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Foods:

Job/family stressors :


22


Week 6: Dates :

Second month Vitamin D dose:

B50:

B12

Multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family stressors :


23


Week 7: Dates :


B50:

B12

Multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

You may not feel any better yet. Don’t get discouraged. Be patient, try to

sleep any time you can!

Exercise/Sun:

Meds/Food:

Job/Family :


24


Week 8: Dates :


B50:

B12

Multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food :

Job/family :

Week 9* Dates :


25


*You may need a vitamin D level this week depending on your calculations. Third month Vitamin D dose:

B50:

B12

Multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/family :

Week 10: Dates :


26


My third vitamin D 25OH level: Date:

third month Vitamin D dose:

B50:

B12

Multivitamin

Sleep scale

Pain scale


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

Your sleep will not get much better until your D level is over 60. Be sure

to do your levels frequently.

Exercise/Sun:

Meds/Food:

Job/family:

Week 11: Dates :


27



B50:

B12

Multivitamin

Sleep scale

Pain scale


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/family :

Week 12*: Dates :


28


*If you did not have a third D level done at 8 weeks you need one now!


B50:* Last week of this vitamin!Yay!

B12

Multivitamin

Sleep scale

Pain scale


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

If you still sleep better in the recliner, go ahead and stay in the recliner.

Exercise/Sun:

Meds/Food :

Job/Family:

Congratulations!!You’ve made it through 12 weeks of RightSleep®

I hope you are sleeping better, but don’t be discouraged if you are not.


29


About now we should be meeting for the three month coaching session

and I can share with you what has worked for other people.

Make sure you know when your coaching session is and list any

questions you have for that session below. Please review the

Fundamentals at the back of the Workbook to remind you of the process

and what may occur in the next six months so we can anticipate and

discuss that during your session.


30


Week 13: Dates :

4th month Vitamin D dose:

B50:

B12

Multivitamin

Sleep scale

Pain scale


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family :


31


Week 14: Dates :

4th month Vitamin D dose:

B50 You’ve stopped this!

B12

multivitamin

Sleep scale

Pain scale

Grade your sleep every week using the numerical scale at the front of the workbook .

Write down a brief list of symptoms every morning to help you remember.


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


32


Week 15: Dates :

My fourth month Vitamin D dose: IU’s /day

B12

multivitamin

Remember to document your sleep and pain and D levels on the graph on page 11


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

If you’re still having trouble falling asleep try some melatonin 5-25 mg, it

may help now even if it didn’t before.


Exercise/Sun:

Meds/Food:

Job/Family:


33


Week 16: Dates :

My fourth month Vitamin D dose: IU’s /day

B12

multivitamin


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:

Week 17: Dates :


34


My fifth month Vitamin D dose: IU’s /day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:

Week 18: Dates :



35


B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:

Week 19: Dates :


B12


36


multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

About now you may notice some pain or stiffness in the morning, if so go to page 43.


Exercise/Sun:

Meds/Food:

Job/Family:

Week 20: Dates :


B12


37


multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:



Exercise/Sun:

Meds/Food:

Job/Family:

Week 21: Dates :

My sixth month Vitamin D dose: IU’s /day


38


B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:



Exercise/Sun:

Meds/Food:

Job/Family:

Week 22: Dates :

My month Vitamin D dose: IU’s /day

B12


39


multivitamin


Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:



Exercise/Sun:

Meds/Food:

Job/Family:

Week 23: Dates :


B12


40


multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:

Week 24: * Dates :


B12

multivitamin


41





Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

Exercise/Sun:

Meds/Food:

Job/Family:

About now you may notice some pain or stiffness in the morning. If you have not had a D level in

more than a month, check your D it might be that your D is wrong. But the second possibility is that

there is not enough B5 in your multivitamin to supply the amount of extra sleep and extra repair

you are trying to do. Find the Pantothenic Acid handout (page 43 )and read it to see what to do

now.


42


Congratulations!!

You have made it through 6 months of RightSleep®.

Your sleep should be better or it was better and it might be getting worse

again.

There is one more thing to do to make your body sleep happily ever after.

You may need to adjust the amount of B vitamins until you wake without pain.

If you have no pain on awakening now then the dose in your mvi is perfect for

you and you will continue that dose for the next 6 months or so . You will

know when it’s time to stop your mvi because you will be stiff on awakening.

Then you’ll stop the mvi and never need it again. ( Still take vitamin C or fruit

juice )

It’s time for your six month coaching session. Please read page 42 if you

haven’t already and write down any questions you have for your session:


43


If you are reading this you are waking with muscle or joint pain. Your vitamin D level in the last month was 60-80 ng/ml, you completed three months of B50 or B100, and you are only on vitamin D and a mvi (multivitamin) (with 10 mg of B5 and all 8 B’s in small dose). The B vitamins are the building blocks of all body repairs. When you were not sleeping normally your brain didn’t finish your repairs. Luckily, it kept a list of all of the things that didn’t get done. Now that you are sleeping again your brain is trying to stay in “repair sleep” longer. More repairs need more B’s. We find out how much you need by paying attention to your morning pain. (B5 blood levels are not accurate, they do not measure body stores.) I know this sounds weird but it works, so just follow the instructions. B5 makes cortisol, the stuff we doctors give for arthritis, if you don’t have enough B5 you get arthritis. B5 also runs paralysis during sleep. Too little B5 you move in sleep and wake with pain. Too much B5 you also wake in pain. Just the right amount and you wake pain free! Six months from now, when you’ve finished the extra repairs you’ll have pain again and you’ll decrease again, slowly. Eventually all of your repairs will be up to date and yay, no more pills, you’ll stop the mvi. “B complex” with 5-10 mg of B5 and all 8 B’s are hard to find. If you can find one, use that to follow the instructions, if you can’t you’ll need to use the multivitamin you have. Do not buy health food store multivitamins that have large doses of B vitamins and do not buy B5 by itself. Those B50 pills that you may still have a few of have 50 mg of B5 so you can use them once your dose is at least 25 mg ( if it’s a tablet that you can cut in half.)

Increase B5 by 5 mg every two days until you wake pain free. Day mvi B5 Day mvi + B50 B5 1-2 1.5 15mg 17-18 0 + B50 50mg 3-4 2.0 20mg 19-20 0.5 + B50 55mg 5-6 2.5 25mg 21-22 1.0 + B50 60mg 7-8 3.0 30mg 23-24 1.5 + B50 65mg 9-10 3.5 35mg 25-26 2.0 + B50 70mg 11-12 4.0 40mg 27-28 2.5 + B50 75mg 13-14 4.5 45mg 29-30 3.0 + B50 80 mg 15-16 5.0 50 mg (now switch to B50) 31-32 3.5 + B50 85 mg If you go too high the pain will come back. Adjust up and down a little to find the right dose. You can take it am or pm or split the dose, whatever works best. Yes, you are duplicating a whole bunch of things but you won’t do that for long, you’re just doing it to find your perfect dose. When you wake pain free you’ve found the dose you will stay on for several months. Go to the store and buy a multivitamin with that much B5. If you get to 40 mg B5, go find a mvi with 20mg of B5 and take two, or find one with 40 mg of B5. If you end up higher at 60, take a combination of one B50 plus one mvi with 10 mg. After about 5-6 months your pain will return again, you will need to start reducing B5, usually by about 5 mg per month until you are completely off the mvi, and you will never need it again!

How to Use Pantothenic Acid to Help Your Pain


44


Week 25: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


45


Week 26: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


46


Week 27: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


47


Week 28: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


48


Week 29: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


49


Week 30: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


50


Week 31: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


51


Week 32: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


52


Week 33: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


53


Week 34: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


54


Week 35: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


55


Week 36: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


56


Congratulations!!!!

You’ve made it through 9 months of Right Sleep®. Your 9 month session of

coaching should be coming up. You should hopefully be sleeping well and

waking pain free. Please think about how you’re doing, write down what

problems you still have and check through your Workbook. Write down any

questions you have for your session:


57


Week 37: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


58


Week 38: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


59


Week 39: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


60


Week 40: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


61


Week 41: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


62


Week 42: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


63


Week 43: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


64


Week 44: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


65


Week 45: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


66


Week 46: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


67


Week 47: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


68


Week 48: Dates :


My B5 dose per day

B12

multivitamin




Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:


Exercise/Sun:

Meds/Food:

Job/Family:


69


Congratulations!!!!

You’ve made it through a whole year of Right Sleep®. Your one year session of

coaching should be coming up. You should be sleeping better and waking pain

free. Please evaluate how you’re feeling. Write down any problems or

questions you have for your session:


70


RightSleep® Fundamentals

A B12 blood level done within the last year

A vitamin D3 25OH level within the last month

Vitamin D 5,000 IU pills

A multivitamin: cheap, generic with all 8 B vitamins (thiamine, riboflavin, niacin, pantothenic acid,

pyridoxine, biotin, folate, cyanocobalamin approximately 100% minimum daily recommended

doses and10 mg of pantothenic acid or less.)

B50 :a bottle of 100. You will take this for THREE MONTHS ONLY.

(If your B12 level was less than 500 you will continue B12 pills for the rest of your life.) B12 1000

mcg

You will need to have 4 vitamin D3 25OH levels performed in the first year

This RightSleep® Workbook to record daily observations, your vitamin doses and blood levels.

A year dedicated to improving your sleep and therefore, your life!

Your personalized vitamin D dose Your personalized vitamin D dose for month 2

B50 or B50 twice a day B50 or B50 twice a day

B12 if your B12 level was less than 500 B12 if your B12 level was less than 500

Multivitamin as above Multivitamin as above

Most people notice no difference in how they feel when they start the vitamins. If you have more

body pain or nausea on starting the RightSleep® regimen it could be that the dose B 50 is too

strong for you. Try off the B 50 and compare. If you have less pain or nausea off B50 then reduce to

½ the dose or B25. Then wait a week or so and try adding B25 again or slowly increase it a little

each week and take it with food. (You cannot take the B’s every other day to average out, it will be

too much one day and too little the next.)

Warning: Most people need 10K -15K/day of vitamin D on starting RightSleep®. But about 1/50

people need a much smaller dose,1,500 IU/day ( 1/10th the dose) . There’s no way to know what

dose you will need at the beginning but if you’ve just started 10 times the dose your body wants,

you will feel horrible in about a week. If you feel much worse in a week, drop the dose by 1/3 and

recheck the vitamin D blood level immediately!

What You Will Need to Succeed

Month One Daily Vitamins Month Two Daily Vitamins


71


Your personalized vitamin D dose for month three

B50 or B50 twice a day

(B12)

Multivitamin as above

Remember to STOP B50 after three months

Your daily maintenance vitamin D dose Your daily maintenance vitamin D dose

Multivitamin Multivitamin

(B12) (B12)

At approximately month six if you have pain on awakening go to the Pantothenic Acid Handout

(page 43) and adjust the B5 dose using those instructions.

We start on the left with light sleep at 10:00pm. Then at about 10:30p comes the first stage of deep

slow sleep, or Slow Wave Sleep (SWS). We do deep sleep in blocks of time, usually no more than an

hour, because we’re paralyzed in deep sleep. Then we switch to light sleep, (not paralyzed) change

position, and go back into deep sleep again. We do more SWS at the beginning of the night and more

REM sleep toward the end of the night. Most of the REM sleep happens between 3-6 am. Usually if

you wake in a dream you were in REM sleep. Deep Sleep is either SWS or REM sleep. REM = Rapid

Eye Movement.

Month Three

Four through Six Seven through Twelve

Sleep Basics

REM

Slow Wave Sleep


72


.

Incorrect popular beliefs: Bad sleep comes from: Fat neck, fat tongue, too fat!!! Insomnia is your

own fault. You’re not doing it right. You’re on your computer/phone too much. You drink too many

caffeinated drinks. You don’t exercise enough. You think too much. Your bedroom isn’t right. You’re

not a morning person, you’re lazy. We can do better than all that blaming, and it’s really not true!

Sleep is not something we have any control over. You can’t “do it wrong”, so it can’t be “your fault”.

If you have normal brain function you will fall asleep despite the television, telephone or your

partner’s snoring.

People with insomnia get bored lying in the bed and get up . Watching television will not prevent

you from getting better. When your brain is better it will fall asleep despite the television.

A sleep study is not the only way to get information about your sleep. Your observations about your

bedclothes and what happened during the night are very valuable.

If you get up from bed, take off your CPAP and go to the recliner it means you need to move the

CPAP next to the recliner and sleep in the chair.

Each person is unique. Any treatment that allows you to fall asleep, stay asleep and feel better on

awakening is valid for you at that time.

Bed partners should report changes in snoring, talking or kicking during sleep. Notice how messy

the bedclothes are. “I was always a restless sleeper” is still not normal. Many people with sleep

disorders have not slept normally since childhood

Actigraphic sleep measurement (actigraph; “measures movement”) with “fitbit” or a phone

application is a good measure of the amount of deep sleep, we are normally completely paralyzed in

deep sleep. If you’re moving a lot between 3 am and 6 am you’re not getting normal REM sleep.

The Real Truth About Sleep

RightSleep® is a Way of Thinking About Sleep


73


People who sleep during the day are only doing what their body tells them. Sleeping during the day

means a very severe, long standing sleep disorder (and you may or may not have sleep apnea). It

does not mean you are a bad person, it means you need to be patient. You will only get better by

sleeping during the day. Just do what your body wants to do, and don’t listen to anyone who tells

you otherwise.

Don’t take your sleeping pills at 10 pm if you know you don’t fall asleep until 3am, the medications

won’t make your brain fall asleep until your brain is ready. Take the sleep medications a half hour

before you really fall asleep.

When the brain clock gets better you will start to fall asleep earlier. Pay attention to what your body

is doing, respond to that and start moving your sleep meds earlier .

Everyone eventually falls asleep at 9-10 pm and wakes up at 6-7am, but that happens slowly and

the sleep clocks only get fixed by sleeping.

Once you can sleep, sleep as much as you can, any time you can and don’t feel guilty! It’s what your

body needs to do.

If you work nights you are doomed to failure. Your sleep cannot be cured while you still work

nights, when you start to get better you will fall asleep on the job and in your car on the way home.

Take three months off and dedicate yourself to fixing your sleep then get a day job. Your life is

shortened a year for every year you work nights it is not worth it!!

Sleeping pills are not inherently bad. They just mimic the chemical that you don’t make enough of.

You’ll know that your doctor found the right one when you fall asleep and stay asleep and feel

better in the morning.

As you get better you will need less medication and you will get dopey from the dose you’ve been

taking for years. Pay attention to what your body is telling you and respond to it.

Other medications that interrupt or prevent normal sleep: clonidine, Beta blockers (atenolol,

labetalol, Inderal), SSRI’s (Prozac, celexa, Lexapro, paxil, Zoloft, Welbutrin etc) SNRI’s. (Effexor,

cymbalta, pristique, fetzima, savella) Try to take all of these in the morning.

It’s Not Normal to Sleep in the Day But it’s Not “Bad For You” Either!

Sleeping Pills


74


Apnea means “no breath”; breathing stops. Not because the neck is too fat, or the airway is wrong,

but because the brain has made the throat muscles “too paralyzed” during deep sleep. (There are

certain people who do have an anatomic throat problem that need a dentist’s intervention to

enlarge the palate. But I am not in favor of surgery to take out the uvula or the roof of the mouth.)

There are many types of sleep disorders but they’re all caused by the same brain problem. To

understand how and why the sleep problems happen we can organize the brain sleep control

centers into two basic “switches”: the time clock and the paralysis switch.

The “sleep clock” is run by nerve cells in the lowest part of the brain called the brainstem. Nearby

are other nerve cells responsible for paralysis. We get paralyzed during sleep to repair moving

parts.

Insomnia or sleeping at the wrong time is a clock problem. Sleep walking, sleep talking, chewing,

kicking and waking with knee pain are all paralysis problems. Many people have both. They get “too

paralyzed” ( stop breathing) and “not paralyzed enough” (kicking). Their paralysis switch is

wobbling instead of making them perfectly paralyzed.

When the RightSleep® vitamins arrive the clock and the paralysis cells start to make repairs, but

only during deep sleep.

The brain must supervise every repair that is made. Very sick patients have many repairs to make.

They will need months to years of perfect sleep to function normally again, even with CPAP, an oral

appliance, medications and the RightSleep® vitamins.

Your sleep won’t change much until the vitamin D level is 60-80ng/ml.

D levels above 80ng/ml can cause terrible sleep too.

Once your sleep is better, if it worsens again GET A D LEVEL immediately.

The best sleep occurs at a D level of 60-80 ng/ml. RightSleep® will be most successful for you when

you get good at listening to your body! When you start to recognize how your body tells you that

Vitamin D and Sleep

Sleep Apnea and Other Sleep Disorders

Sleep Disorders: Broken “Paralysis Switch” or a Broken “Clock”

A Little Repair Every Night Means Many Nights to Get Better


75


your D is too high or too low. Each person has their own set of symptoms, so you must have the D

blood level testing to learn this.

Warning: Some people need tiny doses of D, those people will feel worse in 1-2 weeks or sometimes

immediately on starting large dose vitamin D. Anyone who feels worse should lower the D dose and

get a D level immediately.

Vitamin D 2 made by fungus the oldest D form of D. BAD

Vitamin D3 made by all animals; GOOD.

D2 and D3 are not the same and despite the current recommendations to give D2 50,000 once a

week. D2 (green pill) is not what humans make or use, it is what rats use and should not be given to

humans. There are lots of scientific articles documenting this but your doctor may not know it!

www.vitamindcouncil.org is a very good reference for the discussion of nomenclature of vitamin D.

Refer your doctors there if they are inclined to argue with you or if you want to learn more about it.

There are many different chemicals all called vitamin D which makes this subject very confusing for

you and the doctors!

Option 1: Blood tests ordered by your doctor:

Medicare and most insurance will cover four tests per year if the ICD 10 code E55.9 is used. Try to

convince your doctor that it’s worth his (her) time to give you four undated lab slips to use

throughout the year. Insurance diagnostic codes: ICD 10: Vit D: E55.9

Vit B12: E 53.8 (needed once)

Types of vitamin D tests:

Dr. Order: D3 25OH blood level Not D1,25 OH blood level (wrong D)

Lab method: D3 25OH light chromatography, mass spectroscopy (LC MS) (good)

Not D25OH immunoassay. (not accurate enough above a level of 50)

The 3 in D325OH usually prompts the LCMS. Ask your doctor to always order D3 25OH.

Quest lab No. 91735 is called “Cardio IQ” it is the D3 25OH. Labcorp Test # 504115 is the LCMS.

Option 2: Blood draw without your doctor:

You can get a D level done directly ordering online. Here’s how:

Go to www.ultalabtests.com/vaxbeforetravel/Patient/Registration/NewAccount and make a new

account. After that it’s easy to order the Vitamin D that is called Quest “CardioIQ’’(LCMS) ($40-50).

What You Really Need to Know About Vitamin D

Vitamin D3 25OH Testing Options


http://www.ultalabtests.com/vaxbeforetravel/Patient/Registration/NewAccount

76


Using your zip code you can locate the lab draw station nearest you. They will send the results

directly to you. Ordering through ulta is easy if you make an account first.

The websites: www.vitamindcouncil.org and www.grassrootshealth.net will both do a vitamin D3

25OH level for you by ‘blood spot’ test at home, without a doctor’s order. It is important to note that

the results of blood spot tests are very reliable IF you follow the instructions carefully! You do not

need to fill all the little circles, just one single drop of blood, without touching the paper is enough.

The B vitamins were originally purified from the liquid concoction of yeast (and bacteria) that was

used for making bread and beer. This is what Pasteur used in the little petri dishes to start growing

bacteria back in the late 1800’s. The bacteria needed what was in that concoction to grow so they

were called “bacterial growth factors”. Later we figured out that humans needed these same

“factors” and when the individual chemicals were isolated they were called the B “vitamins”. There

were originally 12 B vitamins named, but B4, B8, B10 and B11 were eventually declared imposters,

(we can actually make them ourselves) so now there are only 8 B vitamins. (That’s why there is a

B12 even though there are only 8, confusing!)

Thiamine B1

Riboflavin B2

Niacin B3

Pantothenic Acid B5

Pyridoxine B6

Biotin B7

Folate B9

Cyanocobalamin B12

The listing of the vitamins on the back of the bottle usually starts with thiamine and ends with

cyanocobalamin, but there must always be all 8! Start at thiamine and count down 8. Always take

all 8 together. Do not take the B’s individually (except B12)

“B 50” is a form of “B complex”, it has all 8 B’s, 50 mg of each, that’s why it’s “B 50”!

B50 can be easily found at GNC (everything else is way too expensive, only buy B50).

CVS also has B50 easily available. Shop at the larger pharmacies and look for Two for One deals. Do

not buy expensive health food multivitamins. Expensive is not better.

B50 = ½ of B100. If you can only find tablets of B100 you can cut them in half to get B50.

B Vitamins are Bacterial Growth Factors


77


Most of the B vitamins are produced for us by our normal intestinal bacteria. There are some B

vitamins in food but if your bacteria are not right you can still be B vitamin deficient, despite your

good diet. You are taking D plus B50 for three months to bring back the healthy, happy bacteria.

Then the bacteria will take over your normal B vitamin supply. Once the normal bacteria grow back

if you are still taking the pills you will be on double the dose, and the B vitamins can hurt you if the

dose is too high! So you will take B50 for only 3 months.

Document changes in your RightSleep Workbook, graph your results, make a time line. Because

everything happens slowly you’ll forget to relate changes in sleep to what you are doing if you don’t

pay attention. Do a one minute inventory every morning: How did I sleep? how much pain do I have

now, how stiff am I getting out of bed? How do I feel mentally ?

Always document D blood levels and D doses you’re taking in writing or electronic form.

Normal people can be either awake or asleep but never both.

The brain uses multiple control centers and chemicals to be ABSOLUTELY SURE that we are in one

state or the other, but never both. But if the brain centers have not been repairing properly they

begin to malfunction and they can be both awake and asleep. It’s dangerous and embarrassing! The

sleep switches are only supposed to switch on while

we’re lying down in a safe place and we’re only supposed to get paralyzed when we’re asleep.

Imagine what would happen if that went wrong!

Awake and dreaming at the same time is called hypnogogic hallucinations.

Awake but still paralyzed is called sleep paralysis.

Falling to the ground paralyzed while awake: cataplexy “struck down by paralysis”.

Attacks of falling down flopping around like a fish (so-called “pseudo-seizures”) are the opposite of

cataplexy. I’ve called them “kineoplexy” “struck down by movement”.

Sleep attacks during the day are called narcolepsy “sleep attacks”.

All of the above represent sleep switches that are malfunctioning while we’re awake. No matter

what you call it, the people with these problems cannot live a normal life!!!

B Vitamins Are Made by the Gut Bacteria

Sleep disorders That Happen While We’re Awake!

Maximizing Your Success


workbook - rightsleep® · is for transformation: what will happen to you once you have healthy...

Documents