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Practical Tips To Get Better Sleep At Night, with Dr. Shane Creado

Dr Daniel Amen and Tana Amen BSN RN On The Brain Warrior's Way Podcast

The coronavirus quarantine and working from home has caused many people to make shifts in their sleep schedules. Some are getting more sleep, and some less. In the third episode of a series with author and sleep expert Dr. Shane Creado, he and the Amens discuss some of Dr. Creado’s most effective strategies for planning and sticking to a healthy sleep schedule.

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Dr. Daniel Amen:
Welcome to the Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.
Tana Amen, BSN RN:
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, BSN RN:
The Brain Warrior's Way Podcast is also brought to you by Brain MD, 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:
Welcome back. We are here with Dr. Shane Creado, who is a psychiatrist, a sleep disorder specialist, the author of Peak Sleep Performance. Shane, where can they get your book?
Dr. Shane Creado:
Amazon and Kindle. If they just do a simple search on Amazon for Peak Sleep Performance for Athletes by Shane Creado, it'll pop up right away.
Dr. Daniel Amen:
Awesome. I highly recommend it. Dr. Credo also helped us create our supplement to support healthy sleep. Put Me To Sleep is the name of the supplement.
Tana Amen, BSN RN:
[inaudible 00:01:29] our 10 year old, she just loves it. She went through a really, really stressful time. And so to help her get back on track she used it, and she just loves that stuff.
Dr. Daniel Amen:
And it tastes great. It's actually a chewable. It's one to four chewables at night. All right.
I promised them practical tips, including for shift work. How can people get the best sleep?
Oh by the way, Dr. Creado also has a course on Amen University called Overcoming Insomnia. I actually recommended it to a patient yesterday.
Tana Amen, BSN RN:
It's so great.
Dr. Daniel Amen:
It's really great. So if you find this is an issue ...
My dad died a couple of weeks ago. I've been talking about grief and with grief, I always say fix sleep first. So if you're going through grief, fix sleep first. That's when a lot of people end up being hooked on Ambien or Restoral or Lunesta or Seroquel, the ones you talked about.
When people go through stressful times, whether it's you lose your dad or you're in the middle of a pandemic, what are the tips to really get people on track?
Dr. Shane Creado:
All right, first of all, I'm really sorry for your loss, Daniel. It was beautiful funeral analogy.
These times a lot of people are losing their loved ones and it can really disrupt your sleep because you're grieving. You're in danger mode. There's a survivor guilt component. I've always told my patients during this pandemic, use this opportunity to optimize your sleep. Use this to be a little selfish for yourself because you need to protect yourself and your brain health and your sleep, if you have to be a good relative and partner and be there for your kids and support your other loved ones in moments of need. We know that sleep deprivation will make you more irritable, make you more emotionally vulnerable. Even one night of sleep deprivation has triggered manic and hypomanic episodes in some patients.
So if you anchor your sleep, if you structure your days, you can schedule time to grieve and grieve well without causing you to end up in a danger zone. We do know that sleep deprivation is directly connected to increased suicide risk as well. 90% of people with depression report sleep problems. So yes, that is tied in with sleep. We can address the sleep without simply throwing Ambien or trazadone at people. We need to address it the way we do mental health; underlying factors, the right kinds of therapy, CBT for insomnia ... is the basis of overcoming insomnia.
What can we do right now? Structure our days and our nights. Have a fixed wake up time as much as we can, seven days a week. Now we may have more free time, so let's figure out how much sleep our brain really needs. Choose a wake up time seven days a week, and then lock it in. If you feel like you want to wake up at 6:00 AM every day, and you want to go to bed at 10:00 PM, do that. If you're still feeling sleepy during the day, if you feel you need catch up sleep or naps during the day, you might want to extend that sleep, maybe go to bed at 9:30 PM.
Have a nice wind down routine. Your brain constantly switch on and off like a light bulb, so a nice wind down routine of [inaudible 00:05:16], meditation, SONA is hyperbaric oxygen therapy. Have your supplements maybe 30 minutes before your desired bedtime. Avoid using the bed for anything other than sleep and sex. Once you have those routines and your brain is still busy, there are specific strategies to calm your busy brain down; your to-do list, your worry lists, relaxation, mindfulness, that's some really good apps there. A lot of people make the mistake of trying too hard to fall asleep. And that's really going to set you up for failure because trying involves waking your brain up.
So consider your sleep time at night, every night, to be your mini-vacation. "I'm going on vacation in half an hour. Let me wind down and calm down before I go on my sleep vacation." Those are some important skills to use. And of course there's other thought strategies based on whether you have PTSD associated busy brain, or whether you're catastrophist or an over-thinker. There's lots of amazing evidence based strategies to help you with those unhealthy thoughts.
Dr. Daniel Amen:
You brought up PTSD and there is a medicine that has been found to be useful for nightmares. I had a patient recently that I prescribed that for him; prazosin. Would you talk about that for a second, from a sleep doctor perspective? This is different. It's a blood pressure medicine. It's not addictive. It's not like Ambien or Restoral or Xanax things that you develop tolerance and get withdrawal from.
Dr. Shane Creado:
Prazosin was originally designed as a blood pressure medicine and it reduces the blood pressure because it works in the sympathetic nervous system, the danger response nervous system and calms it down. So it makes perfect sense that it could be helpful for nightmares. Now it's been used for nightmares related to specific traumas, but some people use it for people who just have nightmare disorder in general. Because it calms the sympathetic nervous system down, it makes sense that it would reduce the frequency and intensity of nightmares.
Other ways to reduce nightmares though, as I said, if your brain is deprived it's going to quickly drink as much dream sleep as it can get. So actually extending the amount of sleep you're getting and the quality of your sleep by dealing with things like restless legs or sleep apnea will actually cause you to have well-balanced non-dream and dream sleep rather than excessive dream sleep. That means less nightmares. Also calm and calming your brain down because your brain goes through the same cycles and dream sleep that it does when you're awake. So if you're calm or dealing with stress adequately during the course of the day, you're setting yourself up for success in terms of less nightmares.
I know that [inaudible 00:08:14] has been used for nightmares. I also use a medicine called clonidine for nightmares. It was used in kids who had been abused and traumatized during the Pol Pot regime in Cambodia. It also helps reduce the blood pressure, reduce sympathetic nervous system response. I've seen some really good benefits in people not just for the nightmares, but also the hyper-arousal, the danger mode, looking over your shoulder all the time. And it makes sense because if you calm down your nervous system during the day, your brain is less likely to repeat those negative reactions while you're asleep.
Dr. Daniel Amen:
That's so helpful. You've mentioned sleep apnea a couple of times. The common symptoms, you snore loudly, you stop breathing at night, you're chronically tired during the day, it increases the risk of obesity and depression. How would someone know if they had it? And then what's the best way to assess it?
Dr. Shane Creado:
So sleep apnea is extremely common, and I'm really glad you're bringing this up because there's many different kinds of sleep apnea. Te most common one we think of as obstructive sleep apnea, where airway closes off, your tongue falls back and there's less oxygen to the brain. So yes, it can result in more depression, tiredness, fatigue, or concentration problems, memory problems, dementia, heart attacks, strokes. It's a really deadly disease.
Now you may feel you're getting eight or nine hours of sleep but you still wake up really tired and sleepy, that may be a clue. A dry mouth may be a clue. Morning headaches, especially in the front part of your head may be a clue. Impotence, low testosterone levels, aches and pains in the daytime, more inflammation are all linked directly to sleep apnea.
We mentioned shift workers. Shift work has been designated a probable carcinogen by the WHO, because it's directly related to increase risk of heart attacks. With daylight saving time, after we lose that hour asleep, there's 21% more heart attacks the next day.
Tana Amen, BSN RN:
It's miserable.
Dr. Shane Creado:
People are dying, yeah.
So if you have any of the symptoms, just feeling sluggish, lethargic, and you try and get more sleep and you feel even worse, like you've been hit by a truck, it's time to get an evaluation for sleep apnea. It's quick, simple, easy. You can get a home study done. It's always covered by insurance and they tell you how many times you stop breathing at night and what position you were in.
It's not just everyone [inaudible 00:10:56] C-PAP; it depends on the severity of the sleep apnea and the position. So if you have really bad sleep apnea while you're on your back, but not while you're on your side, you may not need C-PAP. If you're morbidly obese, losing weight will improve your sleep apnea. There're mouth devices.
I know people are scared to get tested for sleep apnea because they don't want C-PAP, but there's lots of other strategies that we can use to help people with their sleep apnea.
Dr. Daniel Amen:
Great. When we come back, we're going to talk more about sleep, but specifically was Freud completely off base when he talked about the interpretation of dreams.
We're here with Dr. Shane Creado, psychiatrist, sleep disorder specialist, Amen Clinics physician, who we adore. He is the host of our course, Overcoming Insomnia at Amen University. Go to amenuniversity.com. And also the author of Peak Sleep Performance, the cutting edge sleep science that will guarantee a competitive advantage. Stay with us.
Tana Amen, BSN RN:
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Dr. Daniel Amen:
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