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The Connection Between REM Sleep & The Brain, with Dr. Michael Breus

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

Whether you’re an early bird, night owl, or somewhere in between, at some point during our sleep all of us experience the phenomenon of REM (rapid eye movement) sleep. Most of us are aware that our dream state is associated with REM sleep, but what exactly is the brain doing at this time? In this episode, Dr. Daniel and Tana Amen are once again joined by Dr. Michael Breus for a discussion on the effects of REM sleep on the brain.

For more information on Dr. Michael Breus, visit https://thesleepdoctor.com/

Daniel Amen, MD:

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.

Daniel Amen, MD:

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 BrainMD, where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to brainmd.com.

Daniel Amen, MD:

Welcome back everyone. We are introducing Dr. Michael Breus to the brain warrior community. All brain warriors know sleep is essential if you want to be armed, prepared, and aware to win the fight of your life for the health of your brain. Sleep forever has been one of the major pillars of brain health. And we’re bringing you one of the world’s experts. Who’s not only knowledgeable, but he’s fun and funny and practical.

And one of the tools he has that a whole bunch of people have taken is Chrono Quiz. And so while we were talking, I took it and I’m a bear. So, Michael, can you talk about the different types of sleepers and what that means to people?

Michael Breus, PhD:

Absolutely. So, so the Chrono Quiz actually taps into your genetic sleep schedule. Now you may not have heard of a chronotype before, but you probably actually heard of the concept. If anybody’s ever called you an early bird or a night owl, those are chronotypes. Back in the 70s, the research was done there and they discovered there’s early people, there’s late people. Then about 10 years later, they’re like, well, I think there’s also somebody in the middle. We’re going to call them hummingbirds. All right. So you had early birds, you had hummingbirds and you had night owls for a while.

My contribution to the literature was I actually added a fourth chronotype, which is an insomniac. And so there’s a genetic form of insomnia that has a lot to do with your circadian rhythms. And so I added that as a fourth category. Now, what was I going to call it? How was it going to work within everything? Well, that’s not the easiest thing to figure out. So I was writing a book about it, The Power of When, and we were all sitting around the table on the marketing side, trying to figure out, what do we call each one of these types of people?

I decided I wanted to use animals that actually had the same chronotype that we were talking about. To be clear, we discovered very early on that nobody wants to be a porcupine. I’m just saying, nobody wanted to be a porcupine. So we chose lions were the early birds, and it turns out that lions kill before dawn. So that made a lot of sense. Bears, which is what you are, are actually the best. Bears have a medium sleep drive. They’re super knowledgeable. They get a lot of stuff done. And they’re extroverts. They have a tendency to work with people more.

Turns out we’ve had almost 2 million people take the quiz. And we have some early bears, who have a tendency to want to get up early. Like our lions who like to get up at like [5:45] in the morning. And then we’ve got some later bears who would rather get up at like seven, [7:30], [8:00], things like that.

Then we move into our night owls, and I renamed them the wolves. I am a wolf by trade. I have been a night owl my entire life. Both my wife and I are night owls. And it was kind of funny because when we were dating, I would say, when do you want me to pick you up? And she’s like, oh, I don’t know, eight, [8:30]. And then we’d get to dinner and we’d have dinner from nine to 10. And then maybe we’d go to a movie. And our date wouldn’t end until [2:00] in the morning. And we were both completely fine with that because we were both night owls. It can be a little wonky if you’re married to a night owl and you happen to be an early bird.

And then we came up with dolphin as the ones who represent the insomniacs. And we did that because … Yes, I know. I picked you off very early in the conversation as a dolphin, don’t worry. It is that-

Tana Amen, BSN RN:

I never thought of myself as an insomniac.

Michael Breus, PhD:

We can talk about it later.

Daniel Amen, MD:

Take the test.

Michael Breus, PhD:

Right. Take the test. I’m pretty sure you’re a dolphin.

Tana Amen, BSN RN:

I did. I’m a dolphin.

Michael Breus, PhD:

Yeah, exactly. So, but what’s fascinating about dolphins … The reason I chose dolphins, by the way, as an animal is they sleep uni-hemispherically. So half of their brain is asleep while the other half is awake and looking for predators.

Tana Amen, BSN RN:

Busy, right.

Michael Breus, PhD:

Right. The busy brain. Right. And that’s really what I’m trying to get at is we’ve got a lot of people out there with busy, busy brains, and that sometimes can prevent them from sleeping. It can cause excess anxiety, obsessive compulsive disorder, things of that nature. And so those were the four categories that we were able to figure out.

And then once somebody falls into that category, it gets really interesting. Because I can actually, with a very high degree of reliability, be able to predict the best time of day for you to have sex, eat a cheeseburger, ask your boss for a raise, talk to your children. It’s unbelievable. Because once you start tracking somebody’s hormones, and you can predict and know what that schedule looks like, you know exactly when cortisol is going to be high, when adrenaline is going to be high. Serotonin, dopamine. And then you can tell people, hey, this is the time to do that activity.

Daniel Amen, MD:

That’s so, so interesting. So chronoquiz.com. Bear hanging out with the dolphin. I think it’s really interesting. When we first dated, I had season tickets to the Lakers.

Tana Amen, BSN RN:

Oh, it drove me crazy.

Daniel Amen, MD:

And so I could stay up-

Michael Breus, PhD:

Laker Nation. Go Lakers. Way to go, guys.

Tana Amen, BSN RN:

I like to get up at like, four or five, or at least I used to. I’ve sort of adjusted because of him. Go to bed early, get up early. He would stay up until midnight. I almost broke up with him because of it. I’m like, I can’t do this. This is just-

Daniel Amen, MD:

Right. So if your chronotypes don’t match-

Michael Breus, PhD:

What do you do?

Daniel Amen, MD:

… then you could have relationship issues, which I find so interesting. But in this episode, I want to talk about nightmares and dreams. And I read one study where nightmares went up during the pandemic. So talk to us. Why do people have nightmares? And obviously as a psychiatrist, I treat a lot of people who have PTSD and nightmares. The only effective treatment … well, two that I use, is I actually have them write down the nightmares and then I give them a different ending.

I said, you have to like, think of yourself as a creator. Your brain created the trouble, the horror movie, and let’s give it a different ending before you go to sleep. And I found that to be very helpful for some of my patients. And then there’s-

Michael Breus, PhD:

So there’s actually a nightmare treatment by Dr. Barry Krakow at the University of New Mexico, and it actually follows that guideline. It does a couple of other things on top of that, which is very interesting. But what we do is we have them write out their entire nightmare in exquisite detail, every single thing they can think about. And then they change the ending at the end, which is exactly what you were recommending. The other difference though, is that we ask them to read that three or four times right before bed.

Tana Amen, BSN RN:

Oh, interesting.

Michael Breus, PhD:

So we start to get that narrative going with the new ending. Within three to five days, the dream actually changes.

Daniel Amen, MD:

Wow. And he studied that and published on that?

Michael Breus, PhD:

Exactly. It’s been published. It’s a well-known treatment for nightmares in particular, which in and of itself is quite interesting. And when you talk about nightmares and you’re wondering … We’re talking about COVID. One of the things that’s really fascinating is because people are no longer waking up at their normal wake up time, they’re extending their sleep schedule.

Many people don’t know this, but the last third of the night is mostly made up of REM sleep, which is where 80% of the time you’re going to be dreaming. So one of the easiest ways to stop having quaran-dreams … right? Because that’s what they’re calling them now.

Tana Amen, BSN RN:

All the kids in our house had been saying they’re having these weird, wacky, vivid dreams.

Michael Breus, PhD:

Exactly. So number one, that’s a stress reaction, but number two, they’re oversleeping. They’re getting more REM sleep so they have more opportunity to have those dreams. If they just woke up at their normal wake up time, the dreams would almost stop because there’s no more place for them to go.

Tana Amen, BSN RN:

Okay.

Daniel Amen, MD:

Are you … I’m sure you are familiar with prazosin and its impact on-

Michael Breus, PhD:

On PTSD and nightmares? Yeah, absolutely. So prazosin is a really interesting medication. It was used in PTSD and it was actually found to be quite effective for many of those people in terms of their nightmare frequency beginning to decrease. I will also tell you that there have been not formal studies, but cannabis is something that I have found with many of my veterans has been extremely helpful for PTSD nightmares in particular. And I’ll tell you why, is because one of the effects of cannabis is it has a tendency to start to lower REM sleep. Which means it will lower the amount of timing when those people would might be having some of those nightmares.

And it was really interesting on my podcast, Sleep Success, I actually interviewed a dream therapist. And I was very skeptical, okay? Because I’m like, come on, what’s going on here? Like, when you have a dream and you’re swimming in water, it doesn’t mean that you hate your mother or something stupid like that. And she was like, I’m not a dream interpreter. I’m a dream therapist. And I was like, okay, now I’m interested. So what she does is she has her clients write down their dreams and then she brings those dreams in session and she uses the content of the dreams to help further their emotional process. It’s fascinating.

So for people who have traumatic dreams, who’ve been through traumas and things like that, what she’ll do is she’ll make sure number one, that they’re safe about talking about that particular issue, because there are a lot of traumas that you really have to be very, very safe before you can really start to let that information out. So she creates set and setting, and then she says, okay, I want you to, in your mind, close your eyes and bring up the scene of the dream and tell me about what’s going on. Tell me about what you see in the surroundings. Tell me about who you are in the dream, what you’re feeling in the dream, things of that nature.

And then she turns to her clients and she says, push play. And I was like, what? And she was like, your brain doesn’t remember dreams. It doesn’t hit record when it’s dreaming, it’s playing. And nightmares, by definition, are dreams that awaken you. Guess what? The player just stopped. Your dream is on pause. Your nightmare is on pause, which is why you continue to have it and it wakes you up. But if you push play in a safe environment, you push through the emotional baggage of it working with a therapist, and guess what? You stop having the nightmares.

It was one of the most fascinating conversations honestly I’ve ever had. And she’s a Jungian trained psychoanalyst, real degrees really gets it, understands it. And I’m really interested. I’m considering actually doing some training with her so that I can actually use this with some of my clients.

Tana Amen, BSN RN:

Interesting.

Daniel Amen, MD:

Well, I mean, Freud talked about dreams as the royal road to the unconscious. Freud would often say that dreams contain three things, generally. And if you can understand those that you … really can be helpful. So a wish or a fear, and nightmares obviously are fears. A current event that triggers it, and something from the past. And usually you can get those three things, it can really help inform. But you wonder why people have nightmares. Do you have, as a sleep doctor … why do we dream? Why do we have nightmares?

Michael Breus, PhD:

So there’s a couple of different theories about their dream theory, right? So one theory of dreams is that it helps us emotionally process things that we may or may not be able to do during the day. Either because our brains are just too full of other stuff going on, like driving our car and working and things like that. Or we are avoidant of these because they’re so emotionally hot, if you will. And so a lot of this we think comes out in the dream and allows our brain to start processing it when it’s not having to do all these other things.

We also know that during REM sleep is when we move information from our short-term memory to our long-term memory. And so that process of memorializing and defining the data that you want to stay plugged into your brain, has some sort of weird fantastical vision in your head. And so that process of kind of basically finding a filing cabinet with the right file drawer, with the right file to deposit that information is how your brain interprets dreaming. And so that process is sort of very odd and fantastical, and to be fair, it doesn’t always work that well.

So as an example, if you had a dream where you walk downstairs and your dog is eating a bowl of spaghetti with your second grade teacher and you don’t know why, right? The likelihood is you had Italian for dinner, your dog jumped on your bed, and your second grader was talking about school, which reminded you of your past, which was your second grade teacher. And so all of that information, for whatever reason you wanted to keep it, kind of got combobulated and landed in maybe not the best spot.

And so that’s really what we think dreaming is, is this movement of data into a more formalized area. And again, this is how our brain has a tendency to interpret it. Also, there’s emotional processing that goes on as well. So dreams really do seem to be multifactorial in terms of their function.

Tana Amen, BSN RN:

Wow. So interesting. All these things, we could probably do a whole podcast just on dreams. Like what do certain things mean when you can’t run and then you fly? Or people talk about getting their feet stuck in mud or they talk about-

Michael Breus, PhD:

So that’s actually a very well known … Believe it or not, that’s very well known. And so what’s interesting about that, when people say they feel like they’re running through the sand or in quicksand, that’s actually them dreaming in REM sleep and interpreting the fact that their body is paralyzed during REM.

Tana Amen, BSN RN:

Oh, interesting.

Michael Breus, PhD:

Right. So that way you don’t act out your dreams. Because otherwise you would actually act out your dream. If you didn’t have this paralytic mechanism during REM sleep, you’d be all over the place. You’d probably get hurt. There’d be all kinds of problems. And believe it or not, there’s actually a sleep disorder called REM Behavior Disorder. And REM Behavior Disorder is where this paralytic mechanism doesn’t work. I had a patient almost kill his wife, literally almost kill his wife in the middle of a dream, because he had REM Behavior Disorder. Also, interestingly, 35% of people with REM Behavior Disorder, it’s a precursor for Parkinson’s syndrome. So there’s a lot of interest there in trying to understand kind of the Parkinsonian sleep relationship.

And then also Daniel, you were talking about, early on in our conversations, you were talking about the glymphatic system and how our brain cleans out that waste removal system. That has to happen just before REM sleep, because that way, all the data that we don’t want goes away. Also along with proteins, like tau and things like that so we can avoid things like Alzheimer’s and all that good stuff. And then what’s left is what goes on into REM sleep and then becomes more permanent.

Tana Amen, BSN RN:

Interesting. That’s so fascinating.

Daniel Amen, MD:

So important. All right. When we come back, we are going to answer some of your questions on best supplements for sleep, sleep routine, suggestions for a restless mind. So stay with us, we’re with Dr. Michael Breus. Go to thesleepdoctor.com or chronoquiz.com. And you’ll learn if you’re a dolphin or if you’re a bear.

I wanted to say one thing before we go off to the next one. I read the book, Why We Sleep [crosstalk [00:16:21]. Awesome. And he said we actually discriminate in our society against night owls. And I’d never thought about that. We have three children here. And one of them is a Lark.

Tana Amen, BSN RN:

Two of them are larks.

Daniel Amen, MD:

The other one is a night owl. And you just see, if you’re not like up and at it at eight o’clock, it’s going to be harder for you to perform at work or in school when society really has developed to support larks. And what’s a Lark in your-

Michael Breus, PhD:

Lion.

Tana Amen, BSN RN:

Lion.

Daniel Amen, MD:

So if you’re a lion, you get a lot of societal praise. But if you’re-

Michael Breus, PhD:

A wolf, like me.

Daniel Amen, MD:

… a wolf or a dolphin-

Tana Amen, BSN RN:

Well no, I’m up early. [crosstalk [00:17:20]

Michael Breus, PhD:

So number one, we’re going to fix you, don’t worry. But you’re right. And I can personally attest to that because I was told throughout high school that I was lazy. The very first class of the day, I slept through, almost every day of high school. Why? Because I was 17 years old and my circadian rhythms had shifted, as all circadian rhythm shift in most kids, to want to stay up later and sleep later. This is one of the reasons why we’re pushing for school start times to change. So that they can be later so that way kids can do this.

But Daniel, you really hit on an interesting point, which is, I was told that I was a lazy, good for nothing kid.

Tana Amen, BSN RN:

Even though it’s biology.

Michael Breus, PhD:

Yeah. I mean, I can’t count the number of times that my dad might’ve come into my room and was like, you’re sleeping the day away. What are you doing? And he didn’t understand the biology. I mean, my dad has no medical training whatsoever. He was an insurance salesman. And so he was just doing what he had been taught from his dad and from his mom, is rise and shine. The early bird gets the worm. And all of those kinds of things.

Honestly, some of the most creative people in the world are night owls, they’re wolves. I mean, the most creative people that you know of, we’re talking artists, we’re talking actors, we’re talking musicians.

Tana Amen, BSN RN:

Oh, no. We know a lot of them. And they’re working at … You’ll get an email at three o’clock in the morning. And I’m like, why are you up?

Michael Breus, PhD:

That’s right. And they’re up because they’re wolves and that’s the creative night owl that’s out there. We don’t want to suppress that. We want to support that. We want those people to be creative because that’s where we get our innovations. And that’s where we get all our great ideas. So I feel the pain, personally, as well as professionally as well.

Daniel Amen, MD:

Yeah. So many people I think have been shamed when it’s nothing but their biology. We often say, it’s easy to call people bad. It’s much harder to go, why? What is going on? That’s where this sort of sleep neuroscience is so important. thesleepdoctor.com, chronoquiz.com. Stay with us. We’ll answer your questions when we come back.

Tana Amen, BSN RN:

If you’re enjoying The Brain Warrior’s Way podcast, please don’t forget to subscribe so you’ll always know when there’s a new episode. And 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 considering coming to Amen Clinics or trying some of the brain healthy supplements from BrainMD, you can use the code podcast 10 to get a 10% discount on a full evaluation at amenclinics.com or a 10% discount on all supplements at brainmdhealth.com. For more information, give us a call at 855-978-1363.

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