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Recent studies have shown that people who sleep less hours per night often develop health issues at a significantly higher rate than those that get the required amount. So how bad is it to try to get by on less sleep? In this series of The Brain Warrior’s Way Podcast, Dr. Daniel Amen and Tana Amen are joined by sleep specialist Dr. Shane Creado for an overview of common sleep issues, as well as practical advice to get you sleeping soundly through the night.
Dr. Daniel Amen: Welcome to The Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body.
Dr. Daniel Amen: The Brain Warrior's Way Podcast is brought to you by Amen Clinics where we have been transforming lives for 30 years using tools like brain SPECT imaging to personalize treatment to your brain. For more information, visit amenclinics.com.
Tana Amen: The Brain Warrior's Way Podcast is also brought to you by BrainMD, where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to brainmd.com.
Dr. Daniel Amen: Hey, everybody. Welcome to Sleep Week. We are here with one of our very special Amen Clinic doctors, Shane Creado.
Dr Shane Creado: Hello, everyone.
Dr. Daniel Amen: Dr. Creado is a psychiatrist, but he's also an expert in sleep medicine. He did a sleep medicine fellowship at the University of Wisconsin, and he is passionate about getting you to sleep.
Tana Amen: Which I am passionate about too so ... Our last podcast you did with us was so great, and it just did so well, so we're excited to have you back.
Dr Shane Creado: That's wonderful.
Dr. Daniel Amen: We have a new course-
Dr Shane Creado: We do.
Dr. Daniel Amen: ... that Dr. Creado has created. It's a 21-lesson course. Sleep is one of the most important things you do and-
Tana Amen: It's one of the hardest things for some people. I know I certainly struggled with it after my thyroid issues. After stressful things like a divorce, I mean people just really struggle with this. We hear from people all the time about this issue.
Dr Shane Creado: Oh, yes. Yeah.
Tana Amen: Yeah.
Dr. Daniel Amen: It was stressful last night as-
Tana Amen: Dear Lord. Sometimes it's not even your issue. Sometime it's your spouse, so ...
Dr Shane Creado: Very, very true.
Dr. Daniel Amen: I've not been feeling well. I've had sort of a sore throat and a little bit of a cough. Apparently, what she says-
Tana Amen: Sound like a freight train.
Dr. Daniel Amen: ... because I didn't know-
Tana Amen: Freight train.
Dr. Daniel Amen: ... is she's just beating me up in the middle of the night.
Tana Amen: I wasn't beating him up. I'm trying to get him to roll over and move his head, and all of a sudden, he's like, "Stop abusing me." I'm not abusing you.
Dr. Daniel Amen: I went and slept with the cat, but this is-
Tana Amen: Neither one of us got much sleep last night.
Dr. Daniel Amen: This is not uncommon. I actually was talking to a patient last night, and one of the big issues in their marriage-
Tana Amen: Is sleep.
Dr. Daniel Amen: ... is his snoring.
Tana Amen: Yes. No, I know a lot of couples who start sleeping separately because of snoring. Now, I wear earplugs because you often snore lightly, but there are times, so after you travel, this is my ... I already know the pattern.
Dr. Daniel Amen: We're doing a therapy session here, Shane.
Dr Shane Creado: Right.
Tana Amen: No, no. I'm actually bringing this up because of other people.
Dr Shane Creado: I'm observing in silence.
Tana Amen: Yeah, because other people bring this up to us. After he travels, his ... because I notice his circadian rhythm is a little off, and he's more tired. After he travels, he tends to snore very loudly.
Dr Shane Creado: Makes sense.
Tana Amen: It's harder to sort of roll him over. Normally, I can roll him over, and he stops. It's like he'll ... different positions will change that. After you travel, or when you're sick, or when you've got something very stressful and you're not sleeping like you normally do, that's when I notice it. Likewise-
Dr. Daniel Amen: It was actually in this ... It was stress last week. I had some stress which then made my immune system more vulnerable, because I hardly ever get sick, so stress, immune system vulnerability, snoring, wife abusing you.
Dr Shane Creado: More stress.
Dr. Daniel Amen: More stress.
Tana Amen: Then if you add that on to if you're having, like the spouse, if you're having any kind of stressful situation in your life where you're not sleeping quite as soundly, now you've got this combination, right? Am I wrong here?
Dr Shane Creado: Oh, you're absolutely right.
Tana Amen: Because you're the expert on this. I just am experiencing it, so-
Dr Shane Creado: That's exactly what we go for, right? It's always a person's experience that we go with. We start there. What's your subjective experience? I'm not going to tell a patient, "This is exactly what you need to do." It's what their goals are. That's how we connect with somebody and help them along their journey.
Tana Amen: Excellent, so I'm-
Dr. Daniel Amen: Why do we sleep?
Dr Shane Creado: Sleep is one of the most important things we need for survival. In fact, there's something called fatal familial hypersomnia and insomnias as well. If you don't get enough sleep, you will die. People say you need food, clothing, shelter. I say you need food, clothing, shelter, sleep.
Tana Amen: Isn't that why they do torture ... like sleep deprivation as a form of torture?
Dr Shane Creado: Absolutely. If you're sleep deprived-
Dr. Daniel Amen: Now, why is that the first thing you think of?
Tana Amen: Because I have a warrior mentality.
Dr Shane Creado: In fact, if you are sleep-deprived, no sensory stimulation as well, your brain will start making things up. You will hallucinate. You can go crazy.
Dr. Daniel Amen: I was the chief psychiatrist at Fort Irwin, which is in the middle of the Mojave Desert where we fought the soldiers, the tank divisions to fight the Russians in the desert. Their war games would go on for days. I would often see people get psychotic and come to me because they hadn't slept for two days. Now, the treatment for that is not an antipsychotic.
Tana Amen: It's sleep, yeah.
Dr. Daniel Amen: It's sleep.
Dr Shane Creado: Yes.
Tana Amen: We had ICU psychosis. When I worked in a trauma unit, ICU psychosis was when ... because all of the noise, and the beeping, and the helicopters coming in, and the patients didn't sleep, and so they literally would start hallucinating. They'd start screaming trying to rip stuff out of their arms. We had to give them medication to go to sleep so-
Dr Shane Creado: Exactly right. Same thing with Jerusalem syndrome where people travel to the Holy Land. They get off the airplane, and they're psychotic. With one night of sleep deprivation, you can go psychotic, and you're right, no antipsychotic medication there. They're sent on the next plane back home, and they're fine.
Tana Amen: Weird.
Dr. Daniel Amen: Oh, how interesting. Why do we sleep?
Dr Shane Creado: It's needed for most of your functioning, for your immunity, for proper blood flow, for restoration, for memory consolidation. If you've noticed even one night of sleep deprivation, you'll be more irritable, more cranky, especially if your spouse is disturbing you.
Tana Amen: Yes.
Dr. Daniel Amen: Now, there was some research a couple of years ago that showed, when we sleep, the brain washes itself, that it actually ... We didn't even think the brain had a lymphatic system, so they call it the glymphatic system. I watched these beautiful movies of this system actually doesn't open up to any significant degree until we go to sleep. When we sleep, the brain then washes itself, and so if you're not sleeping, trash builds up, especially beta amyloid, that it causes the plaques we think are partly responsible for Alzheimer's disease. Isn't it interesting Reagan, who didn't get a lot of sleep, ended up with Alzheimer's disease? Margaret Thatcher, who only slept four hours a night, ended up with Alzheimer's disease, Winston Churchill, who only slept four hours a night. I'm concerned about our current president who only sleeps four hours a night. Judgment goes down when-
Tana Amen: For sure.
Dr. Daniel Amen: ... sleep goes down as well.
Tana Amen: Well, and there's-
Dr Shane Creado: It really does, yeah.
Tana Amen: There's lots of studies on that.
Dr Shane Creado: There are many studies.
Tana Amen: Even losing one hour of sleep causes it.
Dr Shane Creado: Even losing one hour of sleep. In fact, they've looked at people who drive after being sleep-deprived. They drive as if they would if they were drunk.
Tana Amen: It's almost worse, right?
Dr Shane Creado: Yeah, yeah.
Tana Amen: Yeah. We used to get-
Dr Shane Creado: Same with athletes.
Tana Amen: In the trauma unit, we used to get almost as many people who got into near-fatal accidents because of sleep deprivation.
Dr Shane Creado: Yes.
Dr. Daniel Amen: I think that that kills as many people as alcohol.
Dr Shane Creado: It kills 6,400 accidents every year in the US, fatal accidents, because of drowsy driving.
Dr. Daniel Amen: Wow.
Tana Amen: Wow.
Dr Shane Creado: If you think about it, when you're nodding off, that takes three to five seconds. If you're driving at 65 miles per hour, you're traveling 95 feet per second, so the time you nod, you've driven around 300 feet asleep.
Tana Amen: That's how my sister got into the accident with me. She got into an accident driving 75 miles an hour and rolled the car two and a half times. I was a ICU nurse. I worked at night for a while, and it's when I ... I hated it because I had to like eat all night to try and stay awake because I'm not a night person at all.
Dr Shane Creado: Shift work is going to increase the risk of sudden death and heart attacks as well.
Tana Amen: Oh, it was terrible.
Dr Shane Creado: I'm glad you're not doing that anymore.
Tana Amen: The way I was eating was just terrible to try ... I was so afraid I was going to kill someone, so I was eating whatever I could to just stay awake and not make a mistake, but then I would get off work, and it was when I nodded off at the wheel that I quit. I quit right away.
Dr Shane Creado: Good.
Tana Amen: I'm like, "This is not ... this can't work. I'll find something else."
Dr Shane Creado: It's interesting you mention that because, when you are sleep-deprived, you will be hungrier. The hormone leptin that regulates your appetite can't work well enough. In fact, for every four hours of sleep deprivation you have, your body thinks you need 900 more calories, so you'll be eating more. You'll be gaining more weight. It'll cause you further sleep disruption, especially if you have sleep apnea.
Tana Amen: Maybe that's why nurses tend to gain a lot of weight.
Dr Shane Creado: Maybe.
Tana Amen: Interesting.
Dr. Daniel Amen: Right, because you go, "We're a healthcare organization. Why are we not healthy ourselves?"
Tana Amen: Your priority becomes-
Dr. Daniel Amen: Some of it can be the mechanism.
Tana Amen: Right.
Dr Shane Creado: Exactly.
Tana Amen: Some of it becomes caring ... You know you have to pay attention to what's going on with those patients. You can't afford to lose focus, right?
Dr. Daniel Amen: But we're not caring for the caregivers.
Dr Shane Creado: We're not caring for the caregivers. You know what they say on airplanes, right? Put a mask on yourself before helping the person next to you. If you're always vigilant, on guard, you want to do the best job you can as a healthcare practitioner.
Tana Amen: We can't afford to lose that.
Dr Shane Creado: You can't. There are lives at stake over there but, at the same time, you're actually training your brain to be hypervigilant around the time you're supposed to be sleeping. Same thing I've seen in our vet population, the people coming back from the wars. They're in danger mode all the time, and it's going to destroy your sleep.
Dr. Daniel Amen: What impairs sleep? What are the things that cause people to have problems sleeping?
Dr Shane Creado: Well, broadly, we can think about those as predisposing factors, genetically or the way your circadian rhythm, your internal biological clock works. There's precipitating factors, say a bad breakup, severe stress, or a certain medication that can disrupt and destroy your sleep. Not many people are aware of this, right?
Tana Amen: Mm-hmm (affirmative).
Dr Shane Creado: Almost every medication can have an impact on your sleep. Does it cause more dream sleep, less dream sleep, more deeper sleep, less deeper sleep? How does it cause your brain to function even in the next day? Then, of course, the perpetuating factors. Those are the learned behaviors. What are we doing on our part, as well, to perpetuate the insomnia? It could be things we think are good, like maybe if you can't fall back asleep, lying in bed, tossing and turning. That's one of the worst things you could do because then you're associating the brain with wakefulness in the bed.
Tana Amen: That makes sense.
Dr Shane Creado: Broadly, those are the predisposing factors, what makes you initially at risk, what triggers the sleep problems, and then what perpetuates them, and then-
Dr. Daniel Amen: We should probably have a couple of cocktails before bed too.
Dr Shane Creado: That's-
Dr. Daniel Amen: A lot of people do that, right? Some of the things-
Tana Amen: Well, because they have a hard time shutting their brain off.
Dr Shane Creado: Yeah.
Tana Amen: Yeah.
Dr. Daniel Amen: ... that a lot of people do, so they go to Ambien quickly ...
Tana Amen: Oh, terrible drug.
Dr. Daniel Amen: ... which is insidious because, once you start it, it's really hard to stop it.
Dr Shane Creado: Really hard to stop it.
Dr. Daniel Amen: Right? They use alcohol as a way to sort of settle themselves down, but three hours later when the alcohol's wearing off, it wakes them up. Plus, it's a diuretic, so they're going to have to go to the bathroom. Plus, it's hurting their brain, so they're more likely to continue to have sleep problems.
Dr Shane Creado: Yes.
Dr. Daniel Amen: What else do they do?
Dr Shane Creado: I don't like alcohol because-
Dr. Daniel Amen: They're on their phone.
Dr Shane Creado: Yeah, a lot of screen time. They're watching TV. They're reading in bed.
Dr. Daniel Amen: They're watching Fox or CNN, and they're throwing stuff at the television because they're so angry.
Tana Amen: Oh, yeah. No, I stopped watching the news. I can't. I just cannot. I'll get the headlines and I'm done because it's just too disruptive. Reading actually makes me sleepy, so if it makes you sleepy, it's okay. Correct?
Dr Shane Creado: Not necessarily. The way I go about thinking about this for my patients is if they don't have a sleep problem, they wouldn't really come to me unless they want to maintain their gains, and do what they're doing right, and know what they're doing right, and know what they're doing wrong. If you're sleeping well and you like reading at night in bed, that's okay. It's not ideal, but it's okay. If you have a sleep problem, reading in bed is associated with keeping you up as well, so you need to break that cycle. Get a little comfortable cubby. Create your own space separate from the bed, could be a nice comforter, a little couch.
Tana Amen: I see, so maybe near your bed but not in your bed.
Dr Shane Creado: Exactly, because we need to break that cycle.
Dr. Daniel Amen: See, I always say read boring stuff that you think you should read but is boring. Biochemistry used to put me to sleep. It was two pages, and I was done, or if you read the book of Leviticus in the Old Testament, then you will like be out after the 17th he begot that person.
When we come back, we are going to talk about some of the other significant causes of sleep disruption. Then we're going to spend the last two podcasts in this week talking about how do you get a better night's sleep? Stay with us.
Tana Amen: If you are enjoying The Brain Warrior's Way Podcast, please don't forget to subscribe so you'll always know when there's a new episode. While you're at it, feel free to give us a review or five-star rating, as that helps others find the podcast.
Dr. Daniel Amen: If you're interested in coming to Amen Clinics, give us a call at 855-978-1363.