Change Your Brain Every Day - How Do You Know if You Have a Sleeping Problem? With Dr. Shane Creado

Episode Date: June 2, 2020

Self-diagnosing issues with your sleep can be tricky. Observing your sleep patterns can be difficult because, well, you’re asleep! In this episode of the podcast, Dr. Daniel and Tana Amen are again joined by “Peak Sleep Performance for Athletes” author Dr. Shane Creado for a discussion on how to track your sleep patterns and make adjustments to get a better night’s sleep.

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel 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. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we have been transforming lives for 30 years using tools like brain spec imaging to personalize treatment to your brain. For more information, visit amenclinics.com. The Brain Warriors 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. Welcome back. We are still here with Dr. Shane Criotto, psychiatrist, sleep expert, and also sports medicine expert, which I did not realize.

That's so awesome. And he works in our Chicago clinic. And I just have to say, Dr. Criotto, you're one of my favorites because I love this topic and I love your new book. So Peak Sleep Performance, the cutting edge sleep science that will guarantee a competitive advantage. And that's your new book. And I'm super excited about it because this is such a major topic for so many people. I know for women, because I get bombarded by questions about this constantly, and I direct them to things we've done with you. But I think probably for a lot of people, it's just a major problem, and especially right now during a pandemic. So I love this. So I'm happy we're talking about this. So what about, how do people know if they're having trouble sleeping? I mean, people can go to sleep or they wake up in the middle of the night, they know. But what about, I wear Fitbit, and what about sleep trackers and sleep testing? So people may not think they have a sleep problem. They say,

I go to sleep okay, I wake up okay, maybe I'll sleep a little longer on the weekends. But if I had to tell them that your work performance could improve 50%, your concentration can be boosted by 10% to 30%, that your speed, your power output if you're working out at the gym could improve, if you can slash your risk of relapse from inflammation by half, if you can do all those things with more sleep, then that's the way to go. So how do you know? Well, you need to track your sleep.

As you said, there's various sleep trackers. I always trust the good old-fashioned sleep diary. They're free to download paper versions on the American Academy of Sleep Medicine website. There are several apps that have good sleep diaries you could fill out. The sleep diary simply means that you fill it out in the morning, not in the middle of the night, to be accurate, but fill out what time you went to sleep or you think you went to sleep versus what time you actually got into bed, how many times you woke up, how long you think you

woke up for, what time you woke up, what time you took your meds and supplements, and if you nap during the day. And that'll give us a really good measure in terms of how much sleep you're getting, whether you're having trouble falling asleep or staying asleep or waking up too early. Now, if you do have a fitness tracker, like the Apple Watch or Fitbit or Whoop, then sure, you can combine that data with your sleep diaries because it really depends on how those devices are calibrated, how sensitive they are. And the manufacturer determines how sensitive each device is. So they're not the most sensitive. And I would go with a combination of sleep diaries and your fitness tracker if you want to use it. But if you're the kind of person to lie in bed

with very light sleep, like the twilight zone some people experience, the device may say you're asleep, but you feel miserable when you wake up and say, I only got two hours of sleep, but it says I got six hours. Or if you have restless legs or you act out your dreams occasionally, the device might

think you're awake. So it might underestimate or overestimate the amount of sleep you get. And of course, during the day, you can use something like the Stanford Sleepiness Scale. It's downloaded. You basically write out how sleepy you are every three hours or so during the day, maybe at 9 a.m., 12 p.m., 3 p.m., 6 p.m., and 9 p.m. So during the night's time, you have a good sense of how you slept. In the daytime, you know how sleepy you've been. And if you are sleepy during the day, you might want to extend your sleep maybe 30 minutes more at the beginning of the night. So getting to bed maybe 30 minutes earlier and keeping your wake-up time fixed so we can really synchronize our circadian rhythms and then monitor your sleepiness.

That's the quantity of sleep. But also there are qualitative issues. If your legs bounce around at night, if you act out your dreams, if your partner wants to suffocate you with their pillow because you sleep. So all these things. Why are you laughing i was just trying to protect you from covid i wasn't trying to i think you were trying to kill me so in the book i just worn out it was like let me just crack me up

those are qualitative things the sleep disorders medications chronic pain ptsd and mental health issues affect the quality of your sleep as well so if you have a good quantity of sleep if you've extended your sleep, but you're still feeling sleepy or tired during the day, then you probably need an evaluation at Aiman Clinics to screen you for other disorders that damage your sleep. But you know what happens, Shane, is especially now, you're doing telemedicine with your family doc, and you're like, I'm anxious, I'm worried, I can't sleep. And the first thing is you get a prescription for Ambien or Lunesta or Restoril or whatever, you know, they're sleep or marijuana. Yeah.

And no one's done a proper assessment and they put you on something you cannot stop. So when my mom had trouble sleeping, I don't know, 20 years ago, one of her family doctors gave her Ambien and she became attached to it, which just horrifies me. But, you know, from Ambien to hemp gummies. And I've heard a number of people say and some people don't realize it's medication doing it to them they become extremely depressed they behave very differently during the day tearful I did that to me like it made me I couldn't figure out what was wrong I'm like oh my god I just started taking Ambien this was many years ago and so I was like I can't take it and that's when I that I learned. Yeah. But what's your take on it?

You're a sleep doctor and a psychiatrist. So good thing, not so good. I don't like medications for sleep unless it's the right medicine for the right duration, for the right person in the right context. So the gold standard for insomnia is figuring out the underlying factors, which is what we do at Amen Clinics every single day. Figure out what sabotages your sleep and then correct it. So medicines like Ambien and other sleep medicines have a black box warning because you can act out your, you can do things, you can sleepwalk, sleepwalk and get yourself in

a lot of trouble. There's medical legal issues in some cases when people do things that they were unaware of when they were asleep. Medications for anxiety like clonazepam, the benzodiazepines can worsen sleep apnea. So if you have sleep apnea, it's going to worsen the quality of your sleep and your brain basically suffocates every time you're asleep. If you're on an SSRI like Zoloft or Prozac, it can cause you to act out your dreams more. And it can also worsen restless leg syndrome. Medicines like Seroquel and other antipsychotic meds that are used to improve your sleep can cause weight gain and worsen sleep apnea. So unless it's a very specific medicine for a specific duration, I'm not a fan of medications for sleep. And they can be addictive.

And they can have really bad side effects, which is why we collaborated on designing a really quality sleep supplement. Even melatonin in very high doses, it can have an opposite effect and wake you up. Which is I've heard people say that. Which is why we use a low dose because it's more physiologically appropriate. What about things like Tylenol, PM, Benadryl? And now we know people who are taking medications like Benadryl have a higher incidence of dementia. I want to just throw this in there. You scanned me after I had surgery, which number one, the anesthesia,

but I was having trouble sleeping after the surgery because of pain and other things. I didn't want to take painkillers. So I'm thinking, Oh, Advil PM is fine. And then I also take it when we would travel. And when I got my scan, I was like, Whoa, what, what just happened to my skin? It was not good. So it freaked me out. So again, Advil PM, Tylenol PM, they basically are used for their side effect of sedation because it acts on histamine. But blocking your histamine receptors, also they end up blocking up acetylcholine, which results in increased risk of dementia,

but blocking histamine can again worsen restless leg syndrome. Again, I'm not a fan of those medicines because there are such good supplements available. There are such easy strategies to implement to calm your brain down, meditation, a nice winded down routine, a fixed wake up time. Those things can help you go a long way and improve in your sleep without using medicines that can have really bad effects in your brain in the long term. I love that. One question I have is how does dreaming, not so much nightmares, but like vivid, weird dreams, does that affect your sleep? Because I know a lot, I've heard so many people say that during this time, even in our own home, the kids, everybody, they're having these weird, wacky, vivid dreams during this time. And I'm just curious, does dreaming help your sleep because you're generated in the hippocampus, the same area of the brain we know, inspect imaging and neurobiology that helps you with new learning,

memory consolidation, emotional stability. Dream sleep is vital in terms of the normal sleep cycle. Nightmares occasionally are okay. It depends on how you interpret them. If you act out your dreams regularly, it's a problem called REM behavior disorder when your muscles are supposed to be paralyzed. But if you're waking up out of your dreams often, it might indicate an underlying anxiety disorder or PTSD disorder that needs to be handled adequately if you have to get better sleep. Because when your brain is in danger mode, you're not going to be able to fall asleep better when we're waking up tired we're gonna talk about tips for you to have better sleep we should also talk a little bit for our first responders about um people who have shift work and how to optimize sleep for that.

And then our last one, we're going to talk about what do your dreams mean? Stay with us. If you're enjoying the Brain Warriors 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. If you're considering coming to Amen Clinics or trying some of the brain-healthy supplements from BrainMD, you can use the code PODCAST10 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.