Change Your Brain Every Day - How Does Sleep Deprivation Affect Your Brain? with Dr. Shane Creado

Episode Date: May 20, 2019

Recent studies have shown that people who sleep less hours per night often develop health issues at a significantly higher rate than those that get the required amount. So how bad is it to try to get by on less sleep? In this series of The Brain Warrior’s Way Podcast, Dr. Daniel Amen and Tana Amen are joined by sleep specialist Dr. Shane Creado for an overview of common sleep issues, as well as practical advice to get you sleeping soundly through the night.

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. Hey everybody, welcome to Sleep Week. We are here with one of our very special Amen Clinic doctors, Shane Criotto. Dr. Criotto is a psychiatrist, but he's also an expert in sleep medicine.

He did a sleep medicine fellowship at the University of Wisconsin, and he is passionate about getting you to sleep. Which I'm passionate about too. In our last podcast, you did with us was so great, and it just did so well. So we're excited to have you back. And we have a new course. We do. That Dr. Criotto has created.

It's a 21-lesson course. Sleep is one of the most important things you do. And it's one of the hardest things for some people. I know I certainly struggled with it after my thyroid issues. And after stressful things like a divorce, I mean, people just really struggle with this. We hear from people all the time about this issue. Yeah. So, yeah.

And it was stressful last night. Dear Lord. So sometimes it's not even your issue. Sometimes it's your spouse. So I've not been feeling well. I've had sort of a sore throat and a little bit of a cough. And apparently what she says, because I didn't know, is she's just beating me up.

I wasn't beating him up. I'm trying to get him to roll over and move his head and all of a sudden he's like, stop abusing me. So I went and slept with a cat. So neither one of us got much sleep last night. But this is not uncommon. I actually was talking to a patient last night, and one of the big issues in their marriage is his snoring.

Yes. No, I know a lot of couples who start sleeping separately because of snoring. Now, I wear earplugs because you often snore lightly. But there are times, so after you travel, this is my, I already know the pattern. We're doing a therapy session here. No, no, I'm actually bringing this up because of other people. Yeah. Because, because other people bring this up to us.

So after he travels his, cause I noticed his circadian rhythm is a little off and he's more tired. He, after he travels, he tends to snore very loudly and it's harder to sort of roll him over. Yep. Normally I can roll him over and he stops. It was like he'll, he'll different positions will, um, we'll change that. So,

but after you travel or when you're sick or when you've got something very stressful and you're not sleeping like you normally do, that's when I notice it. So, and it was actually in this, it was stress last week. I had some stress, which then made my immune system more vulnerable.

Cause I like hardly ever get sick. So stress, immune system, vulnerability, snoring, wife abusing you. More stress. And then if you add that on to, if you're having like the spouse, if you're having any kind of stressful situation in your life where you're not sleeping quite as soundly, now you've got this combination, right? Am I wrong here?

Oh, you're absolutely right. Because you're the expert on this. I just am experiencing it. That's exactly what we go for, right? It's always a person's experience that we go with. We start there. What's your subjective experience? I'm not going to tell a patient this is exactly what you need to do.

It's what their goals are, and that's how we connect with somebody and help them along their journey. Excellent. So why do we sleep? Sleep is one of the most important things we need for survival. In fact, there's something called fatal familial hypersomnia and insomnia as well. If you don't get enough sleep, you will die. So people say you need food, clothing, shelter. I say you need food, clothing, shelter, sleep. Isn't that why they do sleep deprivation as a form of torture? Absolutely. Now why is that the first thing you think of? Because I have a warrior mentality.

In fact, if you are sleep deprived, no sensory stimulation as well, your brain will start making things up. You will hallucinate. You can go crazy. You know, I was the chief psychiatrist at Fort Irwin, which is in the middle of the Mojave Desert, where we fought the soldiers, the tank divisions to fight the Russians in the desert. And their war games would go on for days. And I would often see people get psychotic and come to me because they hadn't slept for two days. Now, the treatment for that is not an antipsychotic. It's sleep. Yeah. We had ICU psychosis.

So when I worked in a trauma unit, ICU psychosis was when, because all of the noise and the beeping and the helicopters coming in and the patients didn't sleep. And so they literally would start hallucinating. They'd start screaming, trying to rip stuff out of their arms. We had to give them medication to go to sleep. Exactly right. Same thing with Jerusalem syndrome, where people travel to the Holy Land. They get off the airplane and they're psychotic. With one night of sleep deprivation, you can go psychotic.

And you're right. No antipsychotic medication there. They're sent on the next plane back home and they're fine. Weird. Oh, how interesting. So why do we sleep? It's needed for most of your functioning, for your immunity, for proper blood flow, for restoration, for memory consolidation. If you've noticed even one night of sleep deprivation, you'll be more irritable, more cranky, especially if your spouse is disturbing you.

Now, there was some research a couple of years ago that showed when we sleep, the brain washes itself. Actually, we didn't even think the brain had a lymphatic system. They call it the glymphatic system. And I watched these beautiful movies of this system actually doesn't open up to any significant degree until we go to sleep. And when we sleep, the brain then washes itself. And so if you're not sleeping, trash builds up,

especially beta amyloid, that it causes the plaques, we think are partly responsible for Alzheimer's disease and so is it an interesting Reagan who didn't get a lot of sleep ended up with Alzheimer's disease Margaret Thatcher who only slept four hours a night ended up with Alzheimer's disease Winston Churchill who only slept four hours a night. I'm concerned about our current president who only sleeps four hours a night and judgment goes down when sleep goes down as well. It really does.

There's lots of studies on that. There are many studies. Even losing one hour of sleep. Even losing one hour of sleep. In fact, they've looked at people who drive after being sleep deprived, they drive as if they would if they were drunk. It's almost worse, right? Yeah. Yeah. We used to get in the trauma unit, we used to get almost as many people who got into near fatal accidents because of sleep deprivation. Yes. I think that that kills as many people as alcohol. It kills 6,400 accidents every year in the U.S., fatal accidents because of drowsy

driving. Wow. If you think about it, when you're nodding off, that takes three to five seconds. If you're driving at 65 miles per hour, you're traveling 95 feet per second. So by the time you nod, you've driven around 300 feet. That's how my sister got into the accident with me. She got into an accident driving 75 miles an hour and rolled the car two and a half times. And I was an ICU nurse and I worked at night for a while. And it's when I, and I hated it because I had to like eat all night to try and stay awake. Because I'm not a night person. Shift work is going to increase the risk of sudden death and heart attacks as well.

Oh, it's terrible. I'm glad you're not doing that. And the way I was eating was just terrible. I'm like, I was so afraid I was going to kill someone, so I was eating whatever I could to just stay awake and not make a mistake. But then I would get off work, and it was when I nodded off at the wheel that I quit. I quit, like, right away.

I'm like, this is not, this can't work. I'll find something else. It's interesting you mention that, because when you are sleep-deprived, you will be hungrier. The hormone leptin that regulates your appetite can't work well enough. In fact, for every four hours of sleep deprivation you have, your body thinks you need 900 more calories. So you'll be eating more, you'll be gaining more weight. It'll cause you further sleep disruption, especially if you have sleep apnea. Maybe that's why nurses tend to gain

a lot of weight. Maybe. Interesting. Right. Because you go, you know, we're a healthcare organization. Why are we not helping ourselves? But your priority becomes. And some of it can be the mechanism. Right. Some of it becomes caring. Like, you know you have to pay attention to what's going on with those patients.

You can't afford to lose focus. But we're not caring for the caregivers. We're not caring for the caregivers. You know what they say on airplanes, right? Put a mask on yourself before helping the person next to you. But if you're always vigilant and guard, you want to do the best job you can as a practitioner. But you can't afford to lose that. You can't.

There are lives at stake over there. But at the same time, you're actually training your brain to be hypervigilant around the time you're supposed to be sleeping. Same thing I've seen in our vet population, the people coming back from the wars. They're in danger mode all the time. And it's going to destroy your sleep. So what impairs sleep? What are the things that cause people to have problems sleeping? Well, broadly, we can think about those as predisposing factors.

Genetically, or the way your circadian rhythm, your internal biological clock works. There's precipitating factors, say a bad breakup, severe stress, or a certain medication that can disrupt and destroy your sleep. Not many people are aware of this, right? Almost every medication can have an impact on your sleep. Does it cause more dream sleep, less dream sleep, more deeper sleep, less deeper sleep? How does that cause your brain to function even in the next day? And then, of course, the perpetuating factors.

Those are the learned behaviors. What are we doing in our part as well to perpetuate the insomnia? It could be things we think are good, like maybe if you can't fall back asleep, lying in bed, tossing and turning. That's one of the worst things you could do. Because then you're associating the brain with wakefulness in the bed. Makes sense. Broadly, those are the predisposing factors, what makes you initially at risk, what triggers the sleep problems, and then what perpetuates them.

So we should probably have a couple of cocktails before bed too. A lot of people do that, right? Because they have a hard time shutting their brain off. before bed to... A lot of people do that, right? So some of the things that a lot of people do, so they go to Ambien quickly, which is insidious, because once you start it, it's really hard to stop it. Right?

They use alcohol as a way to sort of settle themselves down, but three hours later when the alcohol is wearing off, it wakes them up, plus it's a diuretic, so they're going to have to go to the bathroom. Plus it's hurting their brain, so they're more likely to continue to have sleep problems. Yes. So what else do they do?

I don't like alcohol because... They're on their phone. Yeah, a lot of screen time. They're watching TV. They're reading screen time. They're watching TV. They're reading in bed. Um, they're watching Fox or CNN and they're throwing stuff at the television cause they're so angry. Oh yeah, no, I stopped watching the news.

Um, I can't, I just cannot. Um, it just, I'll get the headlines. I'm done because it's just too disruptive. Um, but reading actually makes me sleepy. So if it makes you sleepy, it's okay. Correct? Not necessarily. So the way I go about thinking about this with my patients is if they don't have a sleep problem, they wouldn't really come to me unless they want to maintain their gains and do what they're doing right and know what they're doing right and know what they're

doing wrong. If you're sleeping well and you like reading at night in bed, that's okay. It's not ideal, but it's okay. But if you have a sleep problem, reading in bed is associated with keeping you up as well. So you need to break that cycle. Get a little comfortable cubby, create your own space separate from the bed. It could be a nice comfort or a little couch. So maybe near your bed, but not in your bed.

Exactly. Because you need to break that cycle. I always say read boring stuff that you think you should read, but it's boring. So biochemistry used to put me to sleep. Like it was two pages and I was done. Or if you read the book of Leviticus in the Old Testament, you'll like be out, you know, after the 17th, he begot that person. When we come back, we are going to talk about some of the other significant causes of sleep disruption. And then we're going to spend the last two podcasts in this week talking about how do you get a better night's sleep. 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 interested in coming to Amen Clinics, use the code PODCAST10 to get a 10% discount on a full evaluation

at amenclinics.com. For more information, give us a call at 855-978-1363.