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Some of the biggest disasters of our time, such as the Exxon-Valdez spill, the Space Shuttle Challenger disaster, and the 3-Mile Island and Chernobyl incidents, were actually caused by sleep deprivation. In the first episode of a series on sleep issues, Dr. Daniel Amen and Tana Amen are joined by sleep physician Dr. Shane Creado for a discussion on the crucial importance of getting your sleep habits right.
Dr. Daniel Amen: Welcome to The Brain Warrior's Way podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. Here, we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions.
Dr. Daniel Amen: The Brain Warrior's Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain SPECT imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.
Tana Amen: The Brain Warrior's Way podcast is also brought to you by Brain MD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information visit brainmdhealth.com. Welcome to The Brain Warrior's Way podcast.
Dr. Daniel Amen: Hey everybody, welcome. Tana and I are so excited to welcome one of our own physicians, Dr. Shane Creado, who is a board certified psychiatrist, but also a sleep medicine specialist. He just completed his psychiatric residency in sleep medicine fellowship at the University of Wisconsin, where he was awarded the graduating resident award for academic achievement. He's also a sports psychologist on the board of directors of the International Society for Sports Psychiatry as its chairman of memberships. I love that, because sleep is so important to peak performance, whether you're a mom, whether you're a CEO, or whether you're a professional athlete. I have a funny story we'll talk about.
He also has experience with veterans college mental health, with mindfulness, something called CBT or Cognitive Behavior Therapy specifically for insomnia. He's just very special. He's in our Chicago clinic, and in the fall going to move to our New York clinic. So, Shane, welcome so much.
Tana Amen: Yes, welcome. This seems to be a topic really important, especially with a lot of women my age. I think this is really good we're addressing this.
Dr. Daniel Amen: Why do people need to sleep and why are you interested in it?
Dr. Shane Creado: Well, thank you so much for this warm welcome, both of you. I'm glad to be on today. Sleep is one of the most important things we know for brain health, overall. We are supposed to spend one third of our lives sleeping, and not many of us actually end up doing that. In fact, over 35% of the population gets less than their ideal sleep. And across the board, we're seeing loss of revenue, dips in performance, lost work performance, athletes have been impaired. And so, the major disasters of the world can be tracked back to sleep deprivation. From the Exxon Valdez oil spill to the Challenger disaster, to the Three Mile Island disaster, to Chernobyl actually. So, it's one of the most important things we need to get a handle on.
Just as we take care of brain health, we want to look at our regular checkups in terms of colon cancer and screening for those things, I think it's crucial we really digging deep and figure out how to optimize our sleep. Not just quantity, but also the quality of the sleep we're getting.
Dr. Daniel Amen: What are we doing in our society that's messing us up?
Dr. Shane Creado: There's a lot of things we're doing wrong. We have our screens and our smartphones to begin with. We have the situation where we think it's okay to sit and read in bed and watch TV in bed. Screens are everywhere. They're in the bathrooms. They're everywhere we go. We're drinking alcohol in the evening, which can disrupt our sleep in the middle of the night. Our whole society is based on work performance and meeting deadlines, and everything is broken down to a checklist.
What happens is we're just going from one stressful moment to the other. And in the end, our sleep is suffering. Because in modern sleep medicine, we don't look at insomnia as a lack of sleep, but a preponderance of wakefulness in the brain. If your brain is in danger mode, you're not going to be able to rest and get quality sleep.
Dr. Daniel Amen: That's so interesting. I heard in 1900, Americans on average got about nine hours of sleep at night. And now it's more like six hours and 45 minutes. And so, can you imagine in such a short period of our life here on earth, just 100 and some years, to have that kind of radical shift, it's got to go with some pretty serious cognitive and mental health problems. If people are not getting good sleep, what are the consequences of that?
Dr. Shane Creado: There are lots of consequences. Poor sleep can make you fat. It's strongly linked to weight gain. When we look at this hormone leptin if you're sleep deprived for hours, your body thinks that you need 900 more calories. So, you're going to feel hungrier. You're going to eat more, you're going to gain more weight, it's going to worsen your risk of sleep apnea, that can also worse in your quality of sleep. So, that's affect. Weight gain is associated with lack of sleep.
Now, good sleepers tend to eat fewer calories, because they don't feel the calorie deficit. With less sleep, you're going to end up in a situation with more inflammation. Across the board, there's worse inflammation, a growth hormone won't be released the way it's supposed to. This is especially important in kids, it can affect their growth. Good sleep can improve concentration and productivity. You're going to feel more alert, you're not going to be chasing the day if you sleep well.
The consequences of not getting good sleep are that you're not going to be able to focus your concentration. And they've done this in many studies. Your hit reaction times, your ability, in fact, to even perceive the fact that you're not performing well is going to be impaired. In the study that we saw it, it shows that people are not even aware the fact of how sleepy they are. It's going to result in workplace accidents. Sleep apnea alone, which is one of the causes of poor quality sleep, is going to cost our country every year over $150 billion.
Tana Amen: Wow.
Dr. Daniel Amen: We're going to talk about sleep apnea in the next podcast.
Dr. Shane Creado: Okay.
Dr. Daniel Amen: This is just so important. You'll always hear me talk about brain envy. That you have to care about your brain. But I've learned, you also have to have sleep envy. You need to get serious about this. Because if you don't sleep, as you said, you can be overweight and unhappy.
Tana Amen: Yeah. In our house, sleep ... This is something I seemed to have been able to get away with it a little easier when I was younger. I was a trauma nurse, and there were times we worked 24-hour shifts, we worked double shifts. Usually ended up being about 20 to 22 hours, but that's a lot of time on a trauma unit.
Dr. Daniel Amen: They really had you work-
Tana Amen: 20 hours.
Dr. Daniel Amen: ... double 12-hour shifts?
Tana Amen: Yes.
Dr. Daniel Amen: That's insane.
Tana Amen: It usually turned out to be 20 hours minimum.
Dr. Daniel Amen: That's when mistakes happen.
Dr. Shane Creado: Exactly.
Tana Amen: The funny thing is, on a trauma unit, you're taking in a lot of drunk driving cases and people who fell asleep at the wheel, okay? Who were not drunk, but fell asleep at the wheel. And then we turn around and we do the exact same thing. And we had residents at that time who were working ungodly hours in the hospital. It was before the 80-hour working law.
Dr. Daniel Amen: Shane remembers this. Even 80 hours a week is a lot.
Tana Amen: No, and that was before that law was passed.
Dr. Daniel Amen: I remember. That's when I was a resident.
Tana Amen: Yeah. They would literally pass out on the floor.
Dr. Daniel Amen: I'd be up 36 straight hours, and I knew I was going to kill someone. I just knew I was going to kill someone, because I couldn't think.
Tana Amen: Right. We saw this happen and we would turn around and do it to ourselves. Anyways, I used to be able to get away with it more, I thought, even though I hated it. But now, everyone in my family knows I know I can't get away with it. If I am one hour short on my normal sleep, I am miserable. I feel miserable the next day. I feel like I'm walking through mud, I can't focus.
Dr. Daniel Amen: Did you say you're miserable to me?
Tana Amen: I'm miserable to everybody, and you get less loves. He knows. Do not wake me up. There's no love happening if you wake me up. Do not wake me up. It's not happening, because I don't feel good. I feel wonky, just weird. For me, it's like eight to eight and a half hours, and I don't feel right if I'm not getting that.
Dr. Daniel Amen: All right. We have sleep envy, things to avoid, so screens.
Dr. Shane Creado: Screens.
Dr. Daniel Amen: Alcohol, which is odd, because alcohol puts people to sleep. But it then wakes you up is your brain rebounds.
Dr. Shane Creado: Exactly. It's going to make your brain more alert in the middle of the night when you need the sleep the most. Avoid nicotine, avoid caffeine close to bedtime of course. If there are medications that you're on, those can worse in your sleep. People say, "Oh, I'm on this antidepressant, it's going to help me sleep better." But it can worsen restless leg syndrome, and therefore you're going to be up more. So, [crosstalk 00:09:47].
Dr. Daniel Amen: Well, you and I just talking to someone who started an SSRI, and all of a sudden, his jerking, his movement disorder started and that's not the first time I've heard that. So, doesn't mean you should throw away your antidepressant, you should talk to your doctor. But there are natural ways to boost your mood that you absolutely want to be engaging in those things. Like if you had diabetes or heart disease, please don't stop your medicine. But please, put the lifestyle stuff into your life, because you might be able to get off of it or need less of it.
Tana Amen: Well, and there's [crosstalk 00:10:23] the one thing we can't forget about also is when you have a partner who either has sleep apnea, or I always say you slay dragons, when you travel. When Daniel travels, he doesn't have issues with all the other things, but for some reason when he travels and he comes home, I say he's slays dragons in his sleep. For whatever reason, he gets really restless, and that will keep me awake. I hate doing it, but we've set it up to where I know if he's got this little slaying dragons thing going on, that night I'll of asleep in the spare room, because I'm just not a nice person the next day if I don't sleep. But it can affect your partner.
Dr. Shane Creado: Absolutely. In fact, when people come to me because they cannot sleep, I always want to know what the bed environment is like. Whether their partners are snoring or thrashing around, which is causing them to have a disrupted sleep. I'm not going to give somebody a medication if we can find the underlying cause of the sleep issue. And if it's their partner, for example their the partner is snoring, tell the partner to sleep in another room or use ear plugs for example.
Tana Amen: That's what I do. Yeah. I use ear plugs.
Dr. Daniel Amen: Yes. And 12 pillows. I'm not sure what the pillow thing is about. We should spend some time with that. Energy drinks. They're so common. I'm just listening to Tony Shay's book, Delivering Happiness. For some reason, he fell in love with Red Bull and it's really irritating me because he felt he could go on and on and on. What do you what do you think about energy drinks?
Dr. Shane Creado: I think they're best avoided. Irrespective of whether it's near bedtime or far from bedtime, they have caffeine, they have taurine, they have all these other things that you add to the mix. And then you're going through a cycle way or the brain is up and down with these in and out of your system. I would avoid it. I avoid energy drinks personally. When I was on those 20-hour, 26-hour shifts in the hospital, I didn't touch caffeine. I take frequent naps in between when I could. There are ways to deal with it.
Tana Amen: Well, it becomes a vicious circle. It becomes a vicious circle because people do the caffeine to stay awake and then they don't sleep, and then they have to have the caffeine the next day and it becomes this terrible vicious circle.
Dr. Daniel Amen: But if you have problems, so say you begin to get your lifestyle right. That you're avoiding caffeine during the day, you're not drinking it night, you at least put blue light blockers on your phone, that your room is dark and a little bit cooler and quiet. Those are some of the lifestyle stuff, and people are still struggling. What are the things you recommend to help people get better sleep?
Dr. Shane Creado: Okay. Now that leads into what the underlying cause of their disrupted sleep is, right? So, if you're thinking of the behaviors and all the substances they're consuming, then we look at sleep disorders that might be impacting them. Whether it's sleep apnea or restless legs, narcolepsy, which causes fragmented sleep. We look at psychiatric disorders like depression, PTSD, anxiety. We look at sleep disorders like delayed circadian rhythm. For example, if I'm the kind of person is a night owl who can't fall asleep before 3:00 a.m. and I need to wake up at 12:00 p.m. that's my natural rhythm. How do I shift the rhythm properly using melatonin and light?
Medications. I want to go through my entire patient's medical is to make sure that no medications are causing problems with their sleep. Once we've dealt with all those underlying factors, medications, drugs, health issues, psychiatric issues, then we talk about targeted approaches, natural approaches first. The gold standard for disrupted sleep or insomnia is cognitive behavioral therapy for insomnia. It involves specific behaviors and strategies to optimize your sleep. Things like having a fixed wake up time, not staying in bed too long. If you're only getting five hours of sleep, but you're lying in bed for nine hours, you're actually helping your brain think that it's okay to stay awake in the bed and think. It's like Pavlov's dog. The experiment with the salvation and the bell. That's exactly what people are doing with their brains.
So, I say, if you can't fall asleep for more than 20 minutes, get out of bed, go to a comfortable chair, read a book, not a screen, but a book, then go back to the bed. Have a consistent schedule, whether it's a week day or a weekend day, irrespective. Your sleep schedule has to be fixed. Avoid naps during the day. Avoid any stimuli like bright lights, screens that will affect your ability to fall asleep. So, there are behavioral strategies. How do we figure out if someone is worrying all the time? Busy day, go home, get to bed, that's when they're worry time is. No. Let's schedule a worry time earlier in the day so that when you're hitting the bed, the bed is just for sleep and sex. For nothing else.
No reading in bed with your partner. You can read together on the couch if you'd like. No watching TV in bed. None of that. So, being very strict with yourself. Patients think I'm crazy when I say, "I know you're feeling sleepy, but you're not going to nap at all during the day. And if you're only getting five hours of sleep every night, we'll only have you in bed for five and a half or six hours of sleep." They say, "No, I'm going to not function the next day." But it's really important to be strict with your brain.
Of course, when we restrict the time in bed, the two conditions I would say that's a bad idea is bipolar disorder and seizure disorder. Because sleep deprivation can trigger episodes in those conditions. Otherwise, by not allowing yourself to nap during the day, and by consolidating your sleep at night by reducing your time in bed, you're actually forcing your brain to get into rhythm once again. Those are some strategies under the umbrella of cognitive behavioral therapy for insomnia which I do, and we will be having a video series on that as well.
Tana Amen: Well, that's fantastic.
Dr. Daniel Amen: One of my favorite techniques is we make hypnosis audio that's on Brain Fit Life for sleep.
Dr. Shane Creado: That's right.
Dr. Daniel Amen: I have gotten letters from people all over the world saying they like to go to bed with me.
Tana Amen: They sleep with my husband.
Dr. Daniel Amen: Obviously, I'm at home with Tana. Because they find that so helpful. So, hypnosis, meditation, it's just some practice to learn how to quiet your brain.
Tana Amen: Meditation has been so helpful for me.
Dr. Shane Creado: Oh, I agree with you guys. Absolutely. Meditation, progressive relaxation, which is a form of hypnotic induction, we talk about guided imagery and visualization, all with the means to quieting the brain. So, what works for one may not work for another, which is why it's so important to have very individualized targeted approach to this issue.
Dr. Daniel Amen: I love that. That's so important. When we come back, we're going to talk about sleep apnea, also restless leg, and their impact on marriages.
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