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The Science Behind Why You’re Not Sleeping! with Dr. Shane Creado

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

Although there are a multitude of factors as to why you’re not getting proper sleep, the standard treatment method is to just throw medication at the problem and hope it goes away, rather than look for the underlying cause. In the second episode of a series on sleep disorders, Dr. Amen and Tana Amen are again joined by sleep expert Dr. Shane Creado. In this episode, Dr. Creado discusses the common underlying factors to look for when assessing your own sleep issues.

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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 personalized 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 hightest quality nutraceuticals to support the health of your brain and body. To learn more, go to BrainMD.com.
Welcome back. We are back with Dr. Creado. He is one of our Amen Clinics doctors who's a sleep specialist. So you must listen to the first podcast. We're gonna do two more on sleep.
Dr Shane Creado: Sounds good.
Tana Amen: Welcome back Dr. Creado. We're gonna talk about-
Dr. Daniel Amen: And he's in our Chicago clinic.
Tana Amen: Yes.
Dr. Daniel Amen: The polar vortex has left.
Tana Amen: We're so lucky. Yes. Yeah, that was crazy.
Dr Shane Creado: I know. I survived. All my fingers and toes are intact, which is good.
Tana Amen: That was just insane, and then you came right into our rainy craziness here in California, which we rarely get. For you I guess that wasn't much.
Dr Shane Creado: No.
Tana Amen: So let's talk a little bit more about sleep disruptors and what we can do. We'll get more into what we can do about that.
Dr Shane Creado: Yeah. Yeah. So your sleep can be disrupted by anything. Interestingly, it can be a medical health issue like chronic pain.
Tana Amen: Thyroid.
Dr Shane Creado: Thyroid issues for sure. Adrenal problems, hormonal imbalances. It could be-
Tana Amen: Menopause.
Dr Shane Creado: Menopause.
Tana Amen: Teenagers.
Dr Shane Creado: Yes.
Tana Amen: Menopause and teenagers.
Dr Shane Creado: Exactly. So the older you get-
Dr. Daniel Amen: You know menopause is pausing for men.
Tana Amen: Right. Yeah. Or putting men on pause.
Dr Shane Creado: Well, you know, men will suffer from drops in their testosterone levels, and they can suffer the consequences too. Then we talk about mental health issues too. You look at mental health disorder, PTSD, anxiety, depression, ADHD, there's always a sleep component there. There is sleep disruption there too.
Dr. Daniel Amen: Oh, people with ADHD, their cycles are often off.
Dr Shane Creado: Yes.
Dr. Daniel Amen: That they're not morning people. Trying to wake them is trying to wake the dead. I mean, it's like, not fun, and the restlessness causes them to have trouble settling down and going to sleep. Actually, a number of my patients I've used stimulants at bedtime because it settles them down, which is like, that's totally weird.
Dr Shane Creado: Oh, I agree with you completely. The thing is, if they have sleep deprivation, they can have more concentration problems. Then what's gonna happen? The doc is gonna give them more stimulants, and it's a terrible, vicious cycle. So there are medical health issues we need to screen our patients for. There are mental health issues we need to screen our patients for when there are sleep disruptions. There are sleep disorders like sleep apnea, restless leg syndrome, circadian rhythm disorders. Are you a night owl or a morning bird? What medications are you taking? You might not really think a medicine may effect your sleep, but beta blockers for hypertension can disrupt your sleep. There are anti-psychotic medications that may be sedating for you, great to go to bed, but they can also cause weight gain and worsen your sleep apnea if you do have sleep apnea as a cause for insomnia.
Tana Amen: Right.
Dr Shane Creado: There are anti-depressants that we prescribe to most of our patients with depression or anxiety, but those medications can worsen restless leg syndrome. So they may help you sleep better or help with the depression, but not help with the restless leg syndrome. Wellbutrin is a really good medication for depression, especially the limbic sort of depression, but it's gonna keep you alert and awake. There's benzodiazepines like Valium, Ativan, Klonopin that a lot of people take, but they're only supposed to be used short term for sleep. Long term, there's concerns for dementia, frequent falls, confusion on awakening, especially in the elderly. Do I want an elderly patient to fall and break their hip, or drive and forget about what happened, like we've seen with some other medications too?
So we look at the health issues, the medications. We look at what their behaviors are. When I see a patient, I wanna know exactly what they're doing prior to bed time, around bed time, how long it takes them to fall asleep, how many times they wake up, for how long, what time they actually wake up in the morning, how they feel. What happens during the course of the day as well? That influences how you're gonna sleep at night. We talk about the drives to promote sleep, that circadian drive with the melatonin and your core body temperature, and the sleep need or the sleep depth that you build up during the day. Now it's supposed to synchronize for you to fall asleep.
Tana Amen: Gosh, there's a lot.
Dr. Daniel Amen: So given how complex it is, who ... So I have this idea in my head that people are having trouble sleeping. So they go to their primary care doctor, and they go, "I have trouble sleeping." And they often leave with a prescription for Ambien or Xanax, which just starts a nightmare for them. It totally goes against first do no harm. So can you begin to tell our listeners what are the things to do before you take a sleeping pill?
Dr Shane Creado: Absolutely. You're so right. If someone has fever, will they just take an ibuprofen? What happens if they have other symptoms? What if that fever is because of meningitis?
Tana Amen: Right.
Dr Shane Creado: Right.
Tana Amen: We're putting a bandaid over a bullet hole.
Dr Shane Creado: Exactly.
Tana Amen: Yeah.
Dr Shane Creado: Exactly. It's not gonna be effective. So that's one of the reasons I did sleep medicine too because it was just shooting in the dark. I didn't like what was going on at all. Why just an Ambien or a Klonopin just help put somebody to sleep? What's the underlying cause of the sleep issue? That's where we wanna focus. So even before you resort to medication, it's really important to dig deeper. See if there's any mental health issues, any medical issues, any medications that are effecting your ability to sleep. What are your sleep behaviors? What are thoughts regarding sleep? If you're not being able to sleep well for a certain amount of time you'll have all these negative, these automatic negative thoughts, the ants eat away at you while you're trying to sleep.
Tana Amen: Can I say one thing about this? So this is really interesting 'cause I went to a doctor when I was going through a divorce. It was really stressful for me, and they gave me Ambien. And what I noticed, and I don't know if anyone else has noticed this or if I'm just one of those weird people, but the next ... I didn't put it together at first. The next day I felt really depressed, and I didn't know it was the Ambien, like seriously depressed. I got really tearful for no reason. There was nothing triggering it. I just got tearful for no reason.
Dr Shane Creado: Yeah.
Tana Amen: And I didn't put it together, and then the next day, I got literally, burst into tears. And I'm like, "Oh, this has to be the Ambien." I mean, I'm a nurse. I sort of put it together. I'm like, "There's something wrong with this medication. This is not, definitely not affecting me in a positive way." It was just a crazy, depressed type of feeling, and so I took myself off the Ambien. It went away immediately.
Dr Shane Creado: Wow.
Tana Amen: But I was seriously having trouble sleeping. I mean, partially the thyroid.
Dr. Daniel Amen: That's exactly my point. You just go, "I have trouble sleeping." They give you a medicine that changes your brain to need it now in order to function.
Dr Shane Creado: Yes.
Dr. Daniel Amen: It has significant side effects.
Tana Amen: And part of my issue is I have thyroid on top of that. I have this thyroid condition where they keep my thyroid jacked up in order to suppress cancer, right? So it's my metabolism's like amped all the time. So what I ended up doing was going to see a therapist, and I was pretty anti-therapy at the time. In my head I thought that it wasn't gonna help. It helped so much. Going to therapy and then learning how to meditate.
Dr Shane Creado: Yes.
Tana Amen: So those two things for me, critical. I mean, I did a whole bunch of other stuff 'cause I'm one of those people. If I'm gonna do it, I'm gonna jump the canyon.
Dr Shane Creado: Yeah.
Tana Amen: But those two things were where I started, and it was just learning how to just settle my own brain down was just critical for me.
Dr Shane Creado: That's the key. In modern sleep medicine, we don't look at insomnia as a lack of sleep, but an excessive wakefulness of the brain.
Tana Amen: Ah.
Dr Shane Creado: If your brain is in danger mode, fight or flight mode, there's no way you're gonna be able to sleep properly.
Tana Amen: Right.
Dr Shane Creado: So one of the core aspects is not trying too hard 'cause the more we try, the more we try and control the situation, the more alerting it is to try and fall asleep and then relaxing the brain through natural ways. So what about a wind down period, like a buffer zone prior to bed.
Tana Amen: See, I need an hour. I know I need an hour.
Dr Shane Creado: Exactly. It might be a warm bath.
Dr. Daniel Amen: So the next two podcasts we're gonna talk about what to do. I want to know ... So they can make an appointment with you, and you see people from all over the world. And you do a lot of phone appointments, even though you're in Chicago. What are some of the other things they should do?
Tana Amen: Just, Skype is probably the thing.
Dr Shane Creado: That's a great way to.
Tana Amen: Yeah, Skype is a good way.
Dr. Daniel Amen: So Skype would be good. You have a new sleep course that you've just created that we're thrilled to partner with you on that. So we'll give a link to this sleep course.
Dr Shane Creado: Perfect.
Dr. Daniel Amen: So people can take that because you know, the reason I've written for so long and encouraged you to do that, is there's only so many patients we can see.
Dr Shane Creado: Yes.
Dr. Daniel Amen: But we have this information.
Tana Amen: Right.
Dr. Daniel Amen: That is so critical, and as you said, this is one of the most important things you'll ever do.
Tana Amen: For sanity.
Dr. Daniel Amen: Is get your sleep right. So they can make an appointment with you. They can take the course. What are some other simple things that they need to do? So what I've heard so far is they need to have their thyroid checked.
Dr Shane Creado: Yes.
Dr. Daniel Amen: That-
Tana Amen: Hormones.
Dr Shane Creado: Hormones.
Dr. Daniel Amen: If they're not sleeping with anyone, then they probably need a sleep study so that ... 'Cause if you're not sleeping with someone, you don't know that you're snoring or that you're not breathing. You stop breathing at night, and there are ways to do that, even home tests that people can do. What are some of the other things people should do to access it before we get into here's the plan?
Dr Shane Creado: Yeah. In the sleep course that we've created, I have downloadable materials for patients as well, just download a complete assessment form that screens and looks at everything from their complete bed routine to all the substances they may be using, to all the medications they're on. Screening them for sleep apnea, restless leg syndrome. Everything that we can screen them for is right there.
Tana Amen: One thing I heard, and I don't know if this is on your assessment because I heard this and maybe I'm sensitive to it. You mentioned if you are in fight or flight all the time, if you're feeling like you're in danger all the time, you're not gonna go to sleep because you're alert. So for those of us who grew up in sort of chaotic environments, he knows, I'm always looking over my shoulder.
Dr Shane Creado: Yes.
Tana Amen: I'm always looking around. I'm always paying attention. He's always looking for the happy faces.
Dr. Daniel Amen: She's so funny. She's looking. She has an FBI agent's brain.
Dr Shane Creado: Right.
Dr. Daniel Amen: And we actually have on BrainFitLife, we have a game that teaches people-
Tana Amen: I hate this game. It's the dumbest game ever.
Dr. Daniel Amen: Hang on. Hang on, that teaches people to notice what's right rather than what's wrong. So they look for the happy faces and ignore the bad faces.
Tana Amen: Yeah, that's never gonna happen.
Dr. Daniel Amen: The dangerous faces, and she's-
Tana Amen: The dumbest game ever. I'm like no, why do I care about happy people walking by me? I care about the terrorist or the gang banger. I don't care about happy people. They're fine.
Dr. Daniel Amen: But that's why you're not sleeping.
Tana Amen: Oh, hey, but that's not my world. Like I didn't grow up in that world.
Dr. Daniel Amen: The guy next to you is not a terrorist.
Tana Amen: Okay, I didn't grow up in that world. I've got cameras around my house. I've got alarm systems. Like, yeah, no.
Dr Shane Creado: Yes, chaotic environments can definitely disrupt your sleep. If your brain in danger mode, obviously you're not gonna be able to calm down and relax. A lot of people with anxiety have also experienced hypervigilance, and you need to protect yourself in some ways. A lot of people who've faced trauma, might have faced trauma in the bedroom as well.
Tana Amen: Yeah, that's a big one.
Dr Shane Creado: It's a big one. They also want to avoid nightmares, so they try and delay sleep as long as possible, but the thing is, if you are sleep deprived, your brain will try and make up for it with more dream sleep, which will worsen the nightmares.
Tana Amen: Yeah, more anxiety.
Dr Shane Creado: So absolutely. It's all discussed in the course as well, and specific strategies how to address these issues depending on what you're dealing. It's very precise.
Tana Amen: I love that.
Dr Shane Creado: Catering to each person what they need.
Dr. Daniel Amen: Alright, we're gonna talk more about it.
Dr Shane Creado: Sounds good.
Dr. Daniel Amen: Stay with us.
Tana Amen: 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 why you're at it, feel free to give us a review or five star rating as that help others find the podcast.
Dr. Daniel Amen: If you're interested in coming to Amen Clinics, give us a call at 855-978-1363.