Change Your Brain Every Day - Is Lack of Sleep to Blame for Most of Your Problems? Pt. 1 with Dr. Shane Creado

Episode Date: July 30, 2018

Some of the biggest disasters of our time, such as the Exxon-Valdez spill, the Space Shuttle Challenger disaster, and the 3-Mile Island and Chernobyl incidents, were actually caused by sleep deprivation. In the first episode of a series on sleep issues, Dr. Daniel Amen and Tana Amen are joined by sleep physician Dr. Shane Creado for a discussion on the crucial importance of getting your sleep habits right.

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen. And I'm Tana Amen. Here we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain spec imaging to better target treatment and natural ways to heal the 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 nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com. Welcome to the Brain Warriors Way podcast. Hey, everybody. Welcome. Tan and I are so excited to welcome one of our own physicians, Dr. Shane Criotto, who is a board-certified psychiatrist, but also a sleep medicine specialist. He just completed his psychiatric residency and sleep medicine fellowship at the University of Wisconsin, where he was awarded the graduating resident award for academic achievement. He's also a sports psychologist

on the board of directors of the International Society for Sports Psychiatry. As its chairman of memberships, I love that because sleep is so important to peak performance, whether you're a mom, whether you're a CEO, or whether you're a professional athlete. I have a funny story we'll talk about. He also has experience with veterans, college mental health, with mindfulness, something called CBT or cognitive behavior therapy specifically of Behavior Therapy specifically for insomnia. He's just very special. He's in our Chicago clinic and in the fall going to move to our New York clinic. So Shane, welcome so much. Yes, welcome. This seems to be a topic really important, especially with a lot of women my age. So I think this is really good we're addressing this. So why do people need to sleep and why are you interested in it?

Well, thank you so much for this warm welcome, both of you, and I'm glad to be on today. Sleep is one of the most important things we know for brain health overall. We are supposed to spend one third of our lives sleeping and not many of us actually end up doing that. In fact, over 35% of the population gets less than their ideal sleep. And across the board, we're seeing loss of revenue, dips in performance, lost work performance, athletes being impaired. And so the major disasters of the world can be tracked back to sleep deprivation, from the Exxon Valdez oil spill to the Challenger disaster to the Three Mile Island disaster to Chernobyl, actually. So it's one of the most important things we need to get a handle on.

And just as we take care of brain health, we want to look at our regular checkups in terms of colon cancer and screening for those things. I think it's crucial we really dig in deep and figure out how to optimize our sleep. Not just quantity, but also the quality of the sleep we're getting. So what are we doing in our society that's messing us up? There's a lot of things we're doing wrong. We have our screens and our smartphones to begin with. Right. We have this situation where we think it's okay to sit and read in bed and watch TV in bed. Screens are everywhere.

They're in the bathrooms. They're everywhere we go. We're drinking alcohol in the evening, which can disrupt our sleep in the middle of the night. Our whole society is based on work performance and meeting deadlines, and everything is broken down to a checklist. What happens is we're just going from one stressful moment to the other, and in the end, our sleep is suffering. Because in modern sleep medicine, we don't look at insomnia as a lack of sleep, but a preponderance of wakefulness of the brain. If your brain is in danger mode, you're not going to be able to rest and get quality sleep. That's so interesting. I heard in 1900, Americans on average got about nine hours of sleep at night.

And now it's more like six hours and 45 minutes. And so can you imagine in such a short period of our life here on Earth, just 100 and some years to have that kind of radical shift has got to go with some pretty serious cognitive and mental health problems. So if people are not getting good sleep, what are the consequences of that? There are lots of consequences. I mean, poor sleep can make you fat. It's strongly linked to weight gain. When we look at this hormone leptin, if you're sleep-deprived four hours, your body thinks that you need 900 more calories, so you're going to feel hungrier. You're going to eat more. You're going to gain more weight. It's going to worsen your risk of sleep apnea.

That can also worsen your quality of sleep. So that's a fact. Weight gain is associated with lack of sleep. Now, good sleepers tend to eat fewer calories because they don't feel the calorie deficit. With less sleep, you're going to end up in a situation with more inflammation. Across the board, there's worse inflammation. A growth hormone won't be released the way it's supposed to. This is especially important in kids. It can affect their growth. Good sleep can improve concentration and productivity. You're going to feel more alert. You're not going to be chasing the day if you sleep well. The consequences of not getting good

sleep are that you're not going to be able to focus, your concentration, and they've done this in many studies. Your hit reaction times, your ability, in fact, to even perceive the fact that you're not performing well is going to be impaired. In the study that we saw, it shows that people are not even aware of the fact of how sleepy they are. It's going to result in workplace accidents. Sleep apnea alone, which is one of the causes of poor quality sleep, is going to cost our country every year over $150 billion. Wow. We're going to talk about sleep apnea in the next podcast.

This is just so important. And so, you know, you always hear me talk about brain envy, you know, that you have to care about your brain. But I've learned you also have to have sleep envy. Yes. That you need to like get serious about this because if you don't sleep, as you said, you can be overweight and unhappy. Yeah. I mean, in our house, this is something I seemed to have been able to get away with it a little easier when I was younger. I was a trauma nurse and there were times we worked 24-hour shifts. We worked double shifts. Usually ended up being about 20 to 22 hours, but that's a lot

of time on a trauma unit. They really had you work double 12-hour shifts? Yes. That's insane. Usually it turned out to be 20 hours minimum. That's when mistakes happen. And the funny thing is, on a trauma unit, you're taking in a lot of drunk driving cases and people who fell asleep at the wheel, okay,

who were not drunk but fell asleep at the wheel. And then we turn around and we do the exact same thing. And we had residents at that time who were working ungodly hours in the hospital. It was before the 80-hour law. Well, shame remembers this. Even 80 hours a week is a lot. No, and this was before that law was passed. Well, I remember. That's when I was a resident. Yeah, they would literally pass out on the floor. I'd be up 36 straight hours. Right. And I knew I was going to kill someone. I just knew I was going to kill someone

because I couldn't think. Right. I just knew I was going to kill someone because I couldn't think. Right. We saw this happen and we would turn around and do it to ourselves. Anyways, I used to be able to get away with it more, I thought, even though I hated it. But now everyone in my family knows I know I can't get away with it. If I am one hour short on my normal sleep, I am miserable. Like I feel miserable the next day. I feel like I'm walking through mud. I can't focus. Did you say you're miserable to me? I'm miserable to everybody. And you get less love. Like he knows, do not wake me up. There's

no love happening if you wake me up. Do not wake me up. So it's not happening because I don't feel good. I feel wonky, just weird. So for me, it's like eight to eight and a half hours. And I don't feel right if I'm not getting that. All right. So we have sleep envy, things to avoid. So screens, alcohol, which is odd because alcohol puts people to sleep, but then it then wakes you up as your brain rebounds. Exactly. It's going to make your brain more alert in the middle of the night when you need to sleep the most. Avoid nicotine, avoid caffeine close to bedtime, of course. If there are medications that you're on, those can worsen your sleep. People say, oh, I'm on this antidepressant. It's going to help me sleep

better, but it can worsen restless leg syndrome, and therefore you're going to be up more. Well, you and I just talked to someone who started an SSRI, and all of a sudden his jerking, you know, his movement disorder started, and that's not the first time I've heard that. So, you know, it doesn't mean you should throw away your antidepressant. You should talk to your doctor. But there are natural ways to boost your mood that you absolutely want to be engaging in those things. Like if you had diabetes or heart disease, please don't stop your medicine. But please put the lifestyle stuff into your life because you might be able to get off of it or need less of it. Well, and there's the one thing we can't forget about also is when you have a partner who either has sleep apnea or I always say you slay dragons when you travel. When Daniel travels, he doesn't have issues with all the other things, but for some reason when he travels and he comes home, I notice, I say he slays dragons in his

sleep. For whatever reason, he gets really restless. And that will keep me awake. I mean, so I hate doing it. But we've set it up to where I know if he's got this little like slaying dragon thing going on that night, I'll go sleep in the spare room because I'm not I'm just not a nice person the next day, if I don't sleep. So but it can affect your partner. Absolutely. And in fact, when people come to me because they cannot sleep, I always want to know what the bed environment is like, whether their partners are snoring or thrashing around, which is causing them to have a disrupted sleep. I'm not going to give somebody a medication if we can find the underlying cause of the sleep issue. And if it's their partner, for example, if the partner is snoring tell the partner sleep another room or use your plugs for example that's what i do yeah i use your plugs you hear yes and 12 pillows i'm not sure what the pillow thing is about we should spend some time with that um

energy drinks they're so common i'm just listening to Tony Hsieh's book, Delivering Happiness. And for some reason, he fell in love with Red Bull. And it's really irritating me because he felt like he could, you know, go on and on and on. And what do you think about energy drinks? I think they're best avoided. I mean, irrespective of whether it's near bedtime or far from bedtime, they have caffeine, they have taurine, they have all these other things that you add to the mix. And then you're going through a cycle where the brain is up and down with these in and out of your system. It's just, I would avoid it. I avoid energy drinks personally. When I was on those 20 hour, 26 hour shifts

in the hospital, I didn't touch caffeine. I'd take frequent naps in between when I could. Well, it becomes a vicious circle. It becomes a vicious circle because people do the caffeine to stay awake, then they don't sleep, and then they have to have the caffeine the next day, and it becomes this terrible vicious circle. But if you have problems, so say you begin to get your lifestyle right, that you're avoiding caffeine during the day, you're not drinking at night, you at least put blue light blockers on your phone, that your room is dark and a little bit cooler and quiet. So those are some of the lifestyle stuff, and people are still struggling,

what are the things you recommend to help people get better sleep? Okay, now that leads into what the underlying cause of their disrupted sleep is, right? So if they're taking care of the behaviors and all the substances they're consuming, then we look at sleep disorders that might be impacting them, whether it's sleep apnea, restless legs, narcolepsy, which causes fragmented sleep.

We look at psychiatric disorders like depression, PTSD, anxiety. We look at sleep disorders like delayed circadian rhythm. So, for example, if I'm the kind of person who's a night owl who can't fall asleep before 3 a.m. and I need to wake up at 12 p.m., that's my natural rhythm. How do I shift the rhythm properly using melatonin and light? Medications. I want to go through my entire patient's medical list to make sure that no medications are causing problems with their sleep. And once we've dealt with all those underlying factors, medications, drugs, health issues, psychiatric issues, then we talk about targeted approaches, natural approaches

first. The gold standard for disrupted sleep or insomnia is cognitive behavioral therapy for insomnia. It involves specific behaviors and strategies to optimize your sleep. Things like having a fixed wake-up time, not staying in bed too long. If you're only getting five hours of sleep but you're lying in bed for nine hours you're actually helping your brain think that it's okay to stay awake in the bed and think it's like Pavlov's dog the experiment with a salivation and the bell that's exactly what people are doing with their brains so I say if you can't fall asleep for more than 20 minutes get out of bed go to a comfortable chair read a book, not a screen,

but a book, then go back to the bed. Have a consistent schedule, whether it's a weekday or a weekend day, irrespective. Your sleep schedule has to be fixed. Avoid naps during the day. Avoid any stimuli like bright lights, dreams that will affect your ability to fall asleep. So there are behavioral strategies. How do we figure out if someone is worrying all the time? Busy day, go home, get to bed, that's when their worry time is. No, let's schedule a worry time earlier in the day so that when you're hitting the bed, the bed is just for sleep and sex, for nothing else. No reading in bed with your partner. You can read together on the couch if you'd like. No watching TV in bed. None of that. So being very strict with yourself. And patients think I'm crazy when I say, I know you're feeling sleepy,

but you're not going to nap at all during the day. And if you're only getting five hours of sleep every night, we'll only have you in bed for five and a half or six hours of sleep, six hours of sleep. They say, no, I'm going to not function the next day. But it's really important to be strict with your brain. Of course, when we restrict the time in bed, the two conditions I would say that's a bad idea is bipolar disorder and seizure disorder, because sleep deprivation can trigger episodes in those conditions. Otherwise, by not allowing yourself to nap during the day and by consolidating your sleep at night by reducing your time in bed, you're actually forcing your brain to get into rhythm once again. So those are some strategies called under the umbrella of cognitive behavioral therapy for insomnia, which I do.

And we will be having a video series on that as well. Oh, that's fantastic. What about, so one of my favorite techniques is we make a hypnosis audio that's on Brain Fit Life for sleep. And I have gotten letters from people all over the world saying they like to go to bed with me. Obviously, I'm at home with Tana. Because I find that so helpful. So hypnosis, meditation, it's just some practice to learn how to quiet your brain. Meditation has been so helpful for me. Oh, I agree with you guys. Absolutely. So meditation, progressive relaxation, which is a form of hypnotic induction. We talk about

guided imagery and visualization, all of the means to quieting the brain. So what works for one may not work for another, which is why it's so important to have a very individualized targeted approach to this issue i love that that's so important when we come back we're going to talk about sleep apnea also restless leg and their impact on marriages use the code PODCAST10 to get a 10% discount on a full Warriors Way and the Brain Warriors Way cookbook we give away every month.