EPISODES       SUBSCRIBE       REVIEWS       CONTACT

The Link Between Sleep & Daytime Performance, with Dr. Shane Creado

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

Most of us are aware of the effect a bad night’s sleep can have on our day. But is there a way to hack your sleep patterns to optimize your work and athletic performance during the day? The short answer is yes. In this episode, Dr. Daniel and Tana Amen are once again joined by Dr. Shane Creado for a discussion on how to optimize performance through sleeping habits.

For more on Dr. Creado’s new book, “Peak Sleep Performance for Athletes” visit: https://www.amazon.com/Peak-Sleep-Performance-Athletes-Cutting-edge-ebook/dp/B085YFP9YW

For more on Dr. Creado’s online course, “Overcoming Insomnia”, visit: https://brainmd.com/overcoming-insomnia-course

Read Full Transcript

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 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.

Daniel Amen, MD:

Welcome back. We are here with our friend and colleague, Dr. Shane Creado, a psychiatrist, sleep medicine specialist. He and I consult on a number of our high profile patients. So grateful for your help with Justin and his sleep issues, which was a major problem when he first came to see us. And in this episode, we’re going to talk about performance. Work performance, athletic performance, and the critical role of sleep.

Tana Amen, BSN RN:

So before we get started, I would love to know from our listeners and our viewers, what did you learn in the last two episodes? Because even I have just learned so much. We’d love to hear from you. We’d love to get your questions, your concerns, what’s bothering you. We love to answer them and base our podcasts on it. And if you wouldn’t mind leaving us a review, we love that. It’s very special to us. Brainwarriorswaypodcast.com. You can leave a review. And please tag us. And if you wouldn’t mind taking a screenshot, that’s really fun for us to see. And welcome, Dr. Creado.

Shane Creado, MD:

Thank you so much for having me.

Daniel Amen, MD:

So let’s talk about performance. When you sleep, your brain cleans and washes itself, takes out the trash from the day before. And people who sleep less than six hours a night have lower overall blood flow to their brain, which means their brain’s actually not taking out the beta amyloid trash, which is one of the proteins that builds up in people with dementia. And this one study just blew our mind. Do you remember the study on soldiers where soldiers who got seven hours of sleep were 98% accurate on the range. Soldiers who only got six hours-

Tana Amen, BSN RN:

One less hour.

Daniel Amen, MD:

… were 50% accurate on the range. Those who got five hours were 38% accurate. And those who only got four hours a night were dangerous. They were only 15% accurate on the range. So obviously, sleep and performance go hand in hand.

Shane Creado, MD:

Definitely. And interesting you mentioned reaction times. One night of sleep deprivation can reduce your reaction times by 300%. So there were actually studies comparing sleep loss to the equivalent of alcohol consumption. And they found that when you sleep four hours or less, it’s like drinking four to five alcoholic beverages. You’ll be drunk. How is that going to work for you when you’re a sleep deprived medical professional working a 36 hour shift? Or when you’re involved in a dangerous job, you’re much more likely to get injured. You’re much more likely to-

Daniel Amen, MD:

Well, I need to talk about that, because when we were interns, and it was much worse when I was an intern than when you were an intern. Because they didn’t care at all about our level of sleep. But I knew intuitively that I was dangerous. That if I hadn’t slept for two days, and I remember I was on the oncology board and I had a patient that was bleeding out and I was just completely confused. And it’s [2:00] in the morning and I’m just screaming, “You guys have to help me because I’m confused.” It’s still traumatic today.

Tana Amen, BSN RN:

We had two surgeries a night on the trauma unit. Two of the surgeons that I saw when I was there collapsed on the floor, one triggering a seizure disorder. From that point on, he ended up having seizures. It was really crazy. That can ruin your whole career if you’re a surgeon.

Shane Creado, MD:

The thing is that there were studies done on medical interns. And some of those studies results show that if people have had one overnighter, when they were working overnight on call, they commit 36% more serious medical errors. 300% more medical errors in general that lead to death than those who work 16 hour shifts. Although 16 hours is a lot compared to overnight shifts. They have so many more dangerous situations. People can lose their lives. There’s traffic accidents that occur as a result of sleep deprivation, over 6,500 fatal accidents in this country. There was another study that was done and that was in the Harvard Business Review that showed if medical a professional works 24 consecutive hours, their risk of stabbing themselves with a needle or scalpel increased 61%. Crashing a motor vehicle, there was [crosstalk [00:05:44].

Tana Amen, BSN RN:

It’s interesting you said that.

Daniel Amen, MD:

Well, that was… So when I was an intern, AIDS had just skyrocketed. It was 1982 and I was sticking people with AIDS, and I knew that if I stuck myself, that I was in big trouble. And so I spent that year freaked out a lot.

Tana Amen, BSN RN:

I actually stuck my… I did a double shift and was taking care of a guy who was known for doing a lot of drugs, dealing a lot of drugs. He was in for a gunshot wound. And the guy had no original blood. We basically had to transfuse so much blood because he almost died because he coded several times. But I was sleep deprived, I did a double shift, and I stuck myself with a dirty needle and the guy had Hep C. So I had to go through a ton of testing. That’s a scary moment.

Shane Creado, MD:

Yes. Very scary. And people can lose their lives.

Daniel Amen, MD:

Okay. So we’ve made the point that your performance will be better. And I told you about being a consultant for the NBA. I worked with NBA referees for a year. And my first thought with these guys was, these guys are all sleep deprived because they are forced by their contract to work a late night game and have to take the first flight out to the next city in the morning. So basically, there are two, three hours of sleep at night, and then yes, they try to nap during the day. But it was my big issue with my friend, Bob Delaney, at the NBA. It’s like, we need to work on their sleep.

Shane Creado, MD:

I completely agree. And in the book Peak Sleep Performance, I mentioned the NBA and the important job we have to improve people’s lives, outcomes, the risk of injury. Everyone wins if you get more sleep. Less injury, longer playing careers, records will be broken, quicker reaction times, quicker recovery from concussions.

Daniel Amen, MD:

So what are strategies? So I think we’ve made the point. If you don’t sleep, you’re going to be less effective in sports, at work, probably in your relationships as well. Everything with your health, because if you don’t sleep… And is it six hours or seven hours? What is the optimal sleep? I know it’s probably different for different people, but what do you think based on the research?

Shane Creado, MD:

Well, it’s anywhere between seven to nine hours if you’re an adult. If you’re a teenager, it’s probably more around 10 to 14 hours, depending on how old you are. But each one’s brain is different, as you said, and the absence of other complicated issues that impact your sleep. And if you’re waking up feeling refreshed and you’re not feeling really sleepy and you need to take a nap during the day, and you’re not catching up on sleep in the weekends, if you’re getting seven hours, that’s probably good enough. Getting eight hours, that’s good enough if you’re not feeling sleepy or dysfunctional during the day or catching up on the weekends.

Daniel Amen, MD:

So on average, in 1900, Americans got nine hours of sleep at night. In 2018, on average, they get six hours and 40 minutes. I think it’s one of the reasons mental health problems are skyrocketing and health problems are skyrocketing, because if you don’t get good sleep, then everything else in your life sucks.

Tana Amen, BSN RN:

I have a question. How does age affect your tolerance for lack of sleep? I noticed when I was younger, I could do a double shift. Yeah, I’d feel awful the next day, but I could do it. But as I get older, I just don’t have that reserve. And so I’m wondering if that’s a me thing or an age thing.

Shane Creado, MD:

That is generally the older you get. There’s so many other things that impact your functioning. It’s not just, oh, we’re young, we can do it. But there’s inflammation, there’s arthritis that kicks in, there’s hormonal imbalances. And because even if you get less sleep, the less sleep impacts your hormone levels more, your inflammation more, your pain tolerance more, your mental health reserve more. And it’s going to be more impactful in terms of your functioning. So what you’re experiencing is pretty consistent.

Tana Amen, BSN RN:

Yeah. I need eight and a half hours and I know that. And if I don’t get it, I just don’t feel right.

Daniel Amen, MD:

All right. So people are getting that if you’re not sleeping seven to nine hours, it’s a problem for so many different things. But let’s give them as many practical tips as we have. And I always say, brain health is three things. One, you have to have brain envy. You have to care about it. Avoid anything that hurts it, do things that help it. That’s ultimately, I can summarize my 40 years of work in three words. Care, stop, do. Care, stop, do. And so I obviously think for sleep, it’s the same thing. You have to have sleep envy, really care about it, avoid things that hurt it. Caffeine, nicotine, exercise before bed, eating before bed, alcohol, benzos, opiates, marijuana, because they will fragment your sleep. And then do things that help it. A cooler room, a dark room, a quiet room.

Tana Amen, BSN RN:

Prayer and meditation.

Daniel Amen, MD:

Prayer and meditation put me to sleep. Can be very helpful. What am I missing in that? What would you add to that frame?

Shane Creado, MD:

What you can do as an individual is nap, but nap strategically. We always talk about napping being disruptive to your rhythms. But if you are partially sleep deprived, a nap at the same time every day can be potentially very helpful for your brain. When NASA studied pilots, they found that a 26 minute nap increases your alertness by 54% and performance by 34%. Now, strategic napping means at the same time every afternoon, because there’s a natural dip in melatonin, there’s a dip in your functioning, there’s a slight increase in melatonin. So if you’re napping, same time every afternoon.

Number two, it should be around 20 to 30 minutes, not longer. If it’s longer, you’ll be waking up out of a deeper stage of sleep and you’ll feel super groggy and tired. But if you’re waking up within 25 minutes, that’s half a sleep cycle, you wake up refreshed and energized. So either 25 or 30 minute nap or a 90 minute nap. Avoid the 90 minutes because that can sabotage your nighttime sleep.

Tana Amen, BSN RN:

That’s so interesting. And you just said something really interesting to me. See, again, I learned something new. So I always hear people say, “Well, I have to have an afternoon cup of coffee.” You hear so many people say it. And we know your food affects you. But what I heard you just say is that melatonin peaks for a short time in the afternoon.

Shane Creado, MD:

Yes.

Tana Amen, BSN RN:

I didn’t know that. That’s fascinating.

Daniel Amen, MD:

And if you want to block it-

So it’s normal.

… have no carbohydrates at lunch if you want to block it. Because what I’ve seen is if you have a sugar burst, that that’s actually going to cause a lull in your blood sugar. So if you have a bowl of pasta or a rice bowl at lunch, then that insulin is actually going to drive serotonin into the brain and you’ll be happier, but also sleepier because serotonin then turns into melatonin. Right? And so you have to be careful with carbohydrates at lunch.

Tana Amen, BSN RN:

Light bulb moment.

Daniel Amen, MD:

One of the other things I wanted to show people, we have a bright light. BrainMD has the Bright Minds bright light therapy lamp that 20 to 30 minutes in the morning helps to reset your circadian rhythm. And for people that have trouble sleeping, I use this all the time for my patients. And actually light the set with, because then I’m getting 20 to 30 minutes in the morning when I’m recording. And it’s been shown to support mood, focus, energy, and healthy sleep.

Shane Creado, MD:

That is such a great device. Daniel. We have it in Chicago as well. And it causes your melatonin to be suppressed so you’ll be more energized in the morning. In the morning, if you could combine that with deep breathing or jumping jacks to get the blood flow going, get the melatonin to be suppressed, it’s going to boost your energy levels and concentration and mood.

Daniel Amen, MD:

Right. When we come back, we’re going to talk about middle-aged people, hormones, and insomnia.

Tana Amen, BSN RN:

Don’t forget to post-

Daniel Amen, MD:

And one secret on why 40 year old women are irritable, drink more, and can’t sleep.

Tana Amen, BSN RN:

I don’t know the answer to that. But don’t forget to post what you’ve learned. I’ve learned so much. I always thought that the carbohydrate issue was just a blood sugar issue. I didn’t even think about the serotonin converting to melatonin. So interesting.

Daniel Amen, MD:

Stay with us.

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.

Daniel Amen, MD:

If you’re considering coming to Amen Clinics or trying some of the brain healthy supplements from Brain MD, 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.