This is a presentation on strategies to deal with stress and sleep problems

1. Sleep & Stress Management
Dr Jason Drivere
Doctor of Chiropractic
M.S. in Human Anatomy & Physiology Instruction
Contact Information:
driverechiropractic@yahoo.com
www.driverechirowellness.com

2. Legal Disclaimer
The following presentation is intended for
educational purposes only and is not a substitute
for medical advice. Please consult a physician or
a health professional if you have any questions
regarding treatment of medical conditions.
The statements in this presentation have not been
evaluated by the FDA. The products and
ingredients listed herein are not intended to
diagnose, treat, prevent, or cure any disease.

3. Got Stress?
Take a number. One thing that binds us together in
society is that most if not all of us have to deal with
stress on a daily basis.

4. What is stress?
Stress is defined as state of mental or emotional strain or
tension resulting from adverse or very demanding
circumstances..

5. What is stress?
Stress in general are things in your social environment
which are taxing on you mentally, physically, and spiritually.

6. What are the physical
symptoms of stress?
•Low energy & fatigue
•Headaches
•Upset stomach, including diarrhea, constipation and
nausea
•Aches, pains, and tense muscles
•Chest pain and rapid heartbeat
•Insomnia
•Frequent colds and infections
•Loss of sexual desire and/or ability.
.

7. What can you do about it?
Stress is a part of life and you have to develop strategies to
adapt to it and manage it…or typically it simply manages
you.

8. Strategies to help reduce
stress
•Exercise Regularly- exercise has been proven to have
a beneficial effect on a person's mental and physical
state. For many people exercise is an extremely
effective stress buster.
•Division of labor - try to delegate your responsibilities
at work, or share them. If you make yourself
indispensable the likelihood of your feeling highly
stressed is significantly greater.

9. Strategies to help reduce
stress
• Assertiveness - don't say yes to everything. If you can't
do something well, or if something is not your
responsibility, try to seek ways of not agreeing to do
them.
• Alcohol and drugs - alcohol and drugs should not be
the first choices to help you manage your stress better.
Consider stopping consuming them completely, or cut
down. ** If you are on medications for stress,
depression, or anxiety always consult with a physician
before altering medication dosage.**
• Caffeine - if your consumption of coffee and other
drinks which contain caffeine is excessive, cut down.

10. Strategies to help reduce
stress
• Nutrition - eat plenty of fruit and vegetables. Make
sure you have a healthy and balanced diet.
• Time - make sure you set aside some time each day
just for yourself. Use that time to organize your life,
relax, and pursue your own interests.
• Breathing - there are some effective breathing
techniques which will slow down your system and
help you relax.

11. Strategies to help reduce
stress
• Communication - talk to you family, friends, work
colleagues and your boss. Express your thoughts
and worries.
• Seek professional help - if the stress is affecting the
way you function; go and see your doctor.
Heightened stress for prolonged periods can be bad
for your physical and mental health.
• Relaxation techniques - meditation, yoga,
chiropractic, or massage have been known to greatly
help people with stress.

12. Vitamin & Supplement
Support for Stress & Sleep
When necessary one should consider science-
based nutritional support to help increase the
effectiveness of stress relief strategies.
Supplements also are an easy, cost-effective and
logical method for helping to manage symptoms of
stress or sleep problems.
Many times people are often confused about what
supplements to take. I typically help them to
develop a supplement plan based on their
symptoms.

13. Vitamin & Supplement
Support for Stress & Sleep
Don’t simply trust your health to a salesperson in a retail
store. Also, be cautious when considering products
because recent studies show that store bought
supplements/herbs may not contain the listed ingredients.
Seek out the advice of a trusted nutritional health
professional to develop a treatment plan using quality
ingredients based on your individual needs.
The following slides include information including the
ingredients of a few supplements we have found to be
helpful for people suffering from stress or sleep problems.

14. Powerful Natural Solutions for
Sleep and Stress
Management
America’s #1 Health Problem

15. Stressed &Tired
Stressed & Wired
Stressed & Hot
Stressed & Cold
Stressed & Depleted
Disturbed Sleep & Mood
Stress
Has Many Faces

16. CALM DAY
• Formulated to support production of the
neurotransmitters serotonin, and
dopamine.*
• Designed to improve problems with stress,
sleep, anxiety, cognitive function, mental
focus, ADD & OCD
• Typical dosage is 1-2 capsules, once or
twice a day.

17. CALM DAY Ingredients
Amount per 2 vegetarian capsules:
• 4-amino- 3-phenylbutyric acid 500 mg
• L-Taurine 500 mg
• Glycine 500 mg
• Vitamin B-5 pantothenic acid (as d-calcium
pantothenate) 10 mg
• Vitamin B-6 (as pyridoxal 5-phosphate) 10 mg
• Other ingredients: vegetable cellulose (capsule),
vegetarian leucine

18. Focus on the Ingredients
4-amino- 3-phenylbutyric acid (also called
phenibut or fenibut)
◦ anxiety-reducing & cognition-enhancing
◦ similar to the brain chemical GABA (gamma-
aminobutyric acid) except it crossed the blood/brain
barrier (GABA does not) and can be absorbed more
efficiently.
◦ extensively researched in Russia
◦ studied for its ability to prevent the negative effects of
sleep deprivation, namely protecting the adrenal
glands and reducing cognitive and emotional disorders
caused by lack of sleep.
◦ researched for its ability to reduce anxiety. Phenibut is
commonly used in Russia to improve anxiety, sleep
disorders, depression, post-traumatic stress disorders,
and more.

19. Focus on the Ingredients
Glycine:
– a non-essential amino acid.
– has been used to protect brain cells after ischemic
stroke.
– used to promote a sense of well-being and reduce
anxiety.
– Research has shown that glycine can subjectively
and objectively improve sleep quality.
– In a study where people’s sleep was restricted,
glycine also reduced daytime sleepiness.

20. Focus on the Ingredients
L-taurine:
– An amino acid that’s a GABA-receptor agonist,
meaning it produces a GABA-like effect in the body.
• GABA is a sedating, inhibitory neurotransmitter.
– In animal studies, application of taurine with GABA,
or taurine with glycine produced stronger effects than
taking either glycine or GABA alone.
– Taurine is sometimes used to enhance sleep quality.

21. Focus on the Ingredients
B vitamins are involved in nerve transmission,
nerve regeneration, neurotransmitter synthesis.
Vitamin B5-a water-soluble B vitamin with
numerous biological roles.
Used by the body to manufacture, among other
things, coenzyme A which is an important
compound for energy metabolism and the
production of fatty acids, cholesterol, and the
neurotransmitter acetylcholine.

22. Focus on the Ingredients
B6 is another water-soluble B vitamin. Many
functions in the body, including as a co-factor
in several reactions of amino acid metabolism.
– Used in conversion of tryptophan to serotonin
– Biosynthesis of neurotransmitters GABA, dopamine,
serotonin, epinephrine, and norepinephrine.
– Pyridoxal 5-phosphate is the preferred, metabolically
active form of B-6 used in higher quality nutritional
supplements.

23. Calm Day
• Start with 1 cap in the morning and 1 cap
in the evening on empty stomach.
• Patient should “feel it “ within a few days
(usually 1 or 2 days); if they don’t within a
week double the dosage.
• It comes in 60 or 120 cap size

24. • Difficulty falling asleep
• Difficulty waking up
• Daytime drowsiness
• Waking up frequently
during the night with difficulty
returning to sleep
• “Zoning out” in the middle
of a conversation or task
• Difficulty concentrating
• Clumsy and/or slower
reactions times
• Feeling emotional
• Altered memory &
judgment
Some of the expressions of sleep
disturbances are the following:
http://www.cdc.gov/niosh/stresswk.html

25. Today, the practice of “burning the candle at both ends”
has created so much sleep deprivation that what is really
abnormal sleep is now almost the norm
http://www.stress.org/problem.htm
http://www.ninds.nih.gov
Disturbed Sleep & Mood

26. • Benzodiazpines (Valium)
• Flurazepam (Dalmane)
• Zolpidem tartrate (Ambien)
• Temazepam (Restoril)
• Triazolam (Halcion)
FDA Warning:
Commonly used Rx for sleep disorders can disrupt
performance and be addictive. Some recent studies show
that they could significantly increase the risk of dementia
and Alzheimer’s disease.

27. Deep Refreshing Sleep and Relaxation
Can Be Achieved Naturally and Safely By:
• Supporting a natural sleep cycle through
balancing neurotransmitter (serotonin,
dopamine and GABA) levels in the brain without
producing side effects or grogginess
• Stimulating alpha brain waves, which are
associated with an awake, yet relaxed, state
• Promoting healthy serotonin levels to
encourage falling asleep and deep sleep
http://www.ninds.nih.gov

28. What Are
Neurotransmitters?
• Neurotransmitters serve as
messengers, transmitting
information from one nerve
cell to another
• Deficits in specific neurotransmitters disrupt
the sleep cycle
• It is important to support healthy
neurotransmitter function when addressing
sleep disturbance
http://www.ninds.nih.gov

29. Neurotransmitters,
Brain Wave, Sleep
Connection
• Serotonin – influences mood,
appetite and sleep
• Dopamine – influences mood – possible depletion
during REM cycle
• GABA (gamma-aminobutyric acid) – mood,
cognition and sleep disorders – possible depletion
during REM cycle
http://www.brainsync.com/about/4states.asp
Beta
Theta
Alpha & Theta
Delta & Theta{
Beta

30. Stage 1 Stage 1
↓SEROTONIN
Stage 2
Stage 3 & 4
↓SEROTONIN
Stage 5
↓GABA
↓Dopamine

31. Sleep Time
• Same exact ingredients, as Calm Day except we added 5HTP
(trytophan) and melatonin for sleep issues to further enhance
any sleep issues
• Start with 2 caps 30-60 minutes before bed and increase
dosage by 1 cap until desired effect!
• Do not use if on anti-depressants (Prozac)!!
• Youtube “60 minutes the placebo effect” and you also may
have an increased risk of Alzheimer’s disease and dementia
with regular consumption of antidepressants.
http://www.medscape.com/viewarticle/838788

32. Tryptophan
• Effective Serotonin Precursor for Balancing
Mood, Appetite, Sleep, Sexual Behavior and
Pain Sensation
• Excellent safety profile: Readily crosses the
blood-brain barrier
• Well-tolerated

33. Tryptophan
Helps Regulate Sleep
• improves sleep quality
during stages 1, 4 and REM
sleep
• increases in REM sleep
• When using for sleep, 200
mg per day may be
preferable to higher dosages
Soulairac A, et al. Ann Med Psychol 1977;1:792-98. (French)
Guilleminault C, et al. Electroenceophalogr Clin Neurophysiol 1973;34:177-84.
Wyatt RJ, et al. Electroenceophalogr Clin Neurophysiol 1971;30:505-09.

34. Calm Day & Sleep Time
• Do not use if you are taking any
Benzo’s! (Valium/diazepam,
Clonazepin, Xanax) medications!
• Calm Day could be a natural
alternative to these medications.
• ***As always consult your
physician if you are considering
altering medication dosage.***

35. Other Key Natural Ingredients To
Safely Balance Neurotransmitters
Super B Complete:
• 5-methyl tetrahydrofolate (5-MTHF)
• Methylcobalamin (active B12)
• Pyridoxal 5-Phosphate (active Vitamin B6)

36. 5-MTHF ● Methylcobalamin ● Vitamin B6
Supports Neurotransmitter Synthesis ● Promotes Rest
• 5-methyl tetrahydrofolate (5-MTHF) and methylcobalamin,
neuroactive forms for folic acid and vitamin B12, are helpful
with depression and restless leg syndrome.
• 5-MTHF at levels as low as 200 mcg per day may exhibit
anti-depressive effects
• Methylcobalamin influences melatonin levels – a sleep
enhancing neurotransmitter, and may improve alertness
• Vitamin B6 is required for the creation of neurotransmitters -
serotonin, melatonin, epinephrine, norepinephrine, and
GABA
Am J Physiol 1975;229(3):777-82.
Ikeda M, et al. Methylcobalamin amplifies melatonin-induced circadian phase shifts by facilitation of melatonin
synthesis in the rat pineal gland. Brain Research 1998;795(1-2):98-104.
OkawaM, et al. Vitamin B12 treatment for delayed sleep phase syndrome: a multi-center double-blind study.
Psychiatry Clin Neurosci. 1997;51(5):275-79.

37. Other Key Natural Ingredients To
Safely Balance Neurotransmitters
Melatonin
• Melatonin 1mg ( for children under 12 years)
• Melatonin 3mg sublingual (adults)
• Melatonin SR3 ( staying asleep)

38. Safety
Potential side-effects associated with 5-HTP are
– Occasional GI disturbance, heartburn, stomach pain, belching,
flatulence, nausea, vomiting, diarrhea
– Anecdotal reports regarding sleep: 400-600 mg doses taken one
hour prior to bedtime may be linked to vivid dreams and/or
nightmares
– Taking 100 mg 5-HTP between meals or one hour before sleep,
reduces chance of any digestive upset; titrate upward as needed
Potential herb interactions
– Do not use with botanicals known to significantly influence
serotonin balance, such as St. John’s Wort, unless under
supervision of the prescribing physician
Potential drug interactions
– Carbidopa (Lodosyn) (Parkinson’s)
– Serotonin agonists (Prozac, Zoloft), antagonists (Sansert), MAO
inhibitors, tricyclic and atypical antidepressants (Elavil)

39. Legal Disclaimer
U.S. law states that any substance which is claimed to
treat, cure, or prevent any disease is under the control of
the FDA and is “legally characterized as a drug” as a result
all non-drug products(vitamins, herbs, minerals, foods)
have to say the following:
The statements in this presentation have not been
evaluated by the FDA. The products and ingredients listed
herein are not intended to diagnose, treat, prevent, or cure
any disease.

40. References
 * This statement has not been evaluated by the Food and Drug Administration. This product is not
intended to diagnose, treat, cure, or prevent any disease.
 Tiurenkov IN. Bagmetova W. Borodkina LE. et al. [Fenibut and its citrate
prevent psychoneurological disorders caused by chronic stress (paradoxical
sleep deprivation)]. Eksp Klin Farmakol. 2012;75(6):8-13.
 Ziablintseva EA. Pavlova IV. [Influence of GABA agonist phenibut on the
neuronal activity and interaction in hippocampus and neocortex in
emotionally negative situations]. Ross Fiziol Zh Im I M Sechenova. 2009
Sep;95(9):907-18.
 Zyablitseva EA. Pavlova IV. Effects of the GABA receptor agonist phenibut
on behavior and respiration in rabbits in emotionally negative situations.
Neurosci Behav Physiol. 2008 Jul;38(6):555-62.
 Lapin I. Phenibut (beta-phenyl-GABA): a tranquilizer and nootropic drug.
CNS Drug Rev. 2001 Winter;7(4):471-81.
 Song NY. Shi HB. Li CY. et al. Interaction between taurine and
GABA(A)/glycine receptors in neurons of the rat anteroventral cochlear
nucleus. Brain Res. 2012 Sep 7;1472:1-10.
 Lin FJ. Pierce MM. Sehgal A. et al. Effect of caffeine and taurine on sleep-
wake activity in Drosophila melanogaster. Nat Sci Sleep. 2010 Sep
24;2:221-31.

41. References
Bannai M. Kawai N. New therapeutic strategy for amino
acid medicine: glycine improves quality of sleep. J
Pharmacol Sci. 2012;118(2):145-8.
Bannai M. Kawai N. Ono K. et al. The effects of glycine
on subjective daytime performance in partially sleep-
restricted healthy volunteers. Front Neurol. 2012;3:61.
doi: 10.3389/fneur.2012.00061.
Nordqvist, C. (2014, September 5). "What is stress? How
to deal with stress." Medical News Today. Retrieved from