Change Your Brain Every Day - The Connection Between REM Sleep and the Brain, with Dr. Michael Breus

Episode Date: October 21, 2020

Whether you’re an early bird, night owl, or somewhere in between, at some point during our sleep all of us experience the phenomenon of REM (rapid eye movement) sleep. Most of us are aware that our dream state is associated with REM sleep, but what exactly is the brain doing at this time? In this episode, Dr. Daniel and Tana Amen are once again joined by Dr. Michael Breus for a discussion on the effects of REM sleep on the brain. For more information on Dr. Michael Breus, visit https://thesleepdoctor.com/  

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, everyone. We are introducing Dr. Michael Bruce to the brain warrior community. All brain warriors know sleep is essential if you want to be armed, prepared, and aware to win the fight of your

life for the health of your brain. Sleep forever has been one of the major pillars of brain health. We're bringing you one of the world's experts who's not only knowledgeable, but he's fun and funny and practical. One of the tools he has that a whole bunch of people have taken is chrono quiz. And so while we were talking, I took it and I'm a bear. So Michael, can you talk about the different types of sleepers and what that means to people? Absolutely. So the chrono quiz actually taps into your genetic sleep schedule. Now, you may not have heard of a chronotype before,

but you probably actually heard of the concept. If anybody's ever called you an early bird or a night owl, those are chronotypes. Back in the 70s, the research was done there and they discovered there's early people, there's late people. Then about 10 years later, they're like, well, I think there's also somebody in the middle. We're going to call them hummingbirds. All right. So you had early birds, you had hummingbirds, and you had night owls for a while. My contribution to the literature was I actually added a fourth chronotype, which is an insomniac. And so there's a genetic form of insomnia that has a lot to do with your circadian rhythms. And so I added that as a fourth category. Now, what was I going to call it? How

was it going to work within everything? Well, you know, that's not the easiest thing to figure out. So I was writing a book about it and the power of when, and we were all sitting around the table on the marketing side, trying to figure out what do we call each one of these types of people. And I decided I wanted to use animals that actually had the same chronotype that we were talking about. To be clear, we discovered very early on that nobody wants to be a porcupine. I'm just saying nobody wanted to be a porcupine. So we chose lions were the early birds. And it turns out that lions kill before dawn. So that made a lot of sense. Bears, which is what you are actually the best. Bears have a medium sleep drive. They're super knowledgeable. They get a lot of stuff done. And they're extroverts.

They have a tendency to work with people more. Turns out we've had almost 2 million people take the quiz. And we have some early bears who have a tendency to want to get up early, like our lions who like to get up at like 5.45 in the morning. And then we've got some later bears who would rather get up at like 7, 7.30, 8 o'clock, things like that. Then we move into our night owls and I renamed them the wolves. I am a wolf by trade. I have been a night owl my entire life.

Both my wife and I are night owls. And it was kind of funny because when we were dating, I would say, you know, when do you want me to pick you up? And she's like, oh, I don't know, 8, 8.30. And then we'd get to dinner and we'd have dinner from 9 to 10. And then maybe we'd go to a movie. And our date wouldn't end until two o'clock in the morning. And we were both completely fine with that because we were both night owls. It can be a little wonky if you're married to a night owl and you happen to be an early bird. And then we came up with dolphin as the one to represent the insomniacs. And we did

that because, yes, I know, because I picked you off very early in the conversation as a dolphin, don't worry. I never thought of myself as an insomnia. Well, what we can, we can talk about it later. Right. But yeah, take the test. I'm pretty sure you're a dolphin. Um, but, but what we know, I'm a dolphin. Yeah, exactly. Um, so, but what's fascinating about dolphins, the reason I chose dolphins by the way, as an animal is they sleep uni hemispherically. So half of their brain is asleep while the other half is awake and looking for predators. And I was like, right, the busy brain. Right. And that's really what I'm trying to get at is we've got a lot of people out there

with busy, busy brains. And that sometimes can prevent them from sleeping. It can cause excess anxiety, obsessive compulsive disorder, things of that nature. And so those were the four categories that we were able to figure out. And then once somebody falls into that category, it gets really interesting because I can actually, with very high degree of reliability, be able to predict the best time of day for you to have sex, eat a cheeseburger, ask your boss for a raise, talk to your children. It's unbelievable because once you start tracking somebody's hormones and you know what the, and you can predict and know what that schedule looks like, you know exactly when cortisol is going to be high, when adrenaline is going to be high, serotonin, dopamine,

and then you can tell people, Hey, this is the time to do that activity. That's so, so interesting. So chronoquiz.com, bear hanging out with the dolphin, I think is really interesting. When we first dated, I had season tickets to the Lakers. And so I could stay up to- Laker Nation, go Lakers. Way to go, guys. I like to get up at like four or five, or at least I used to. I've sort of adjusted because of him. Go to bed early, get up early. He would stay up till midnight. I almost broke up with him because of it. I'm like, I can't do this. This is just- Right. So if your chronotypes don't match-

What do you do? And you could have relationship issues, which I find so interesting. But in this episode, I want to talk about nightmares and dreams. And I read one study where nightmares went up during the pandemic. So talk to us. Why do people have nightmares? And, you know, obviously, as a psychiatrist, I treat a lot of people who have PTSD and nightmares. The only effective treatment, well, two that I use is actually have them write down the nightmares and then I give them a different ending. I said, you have to like, think of

yourself as a creator. Your brain created the trouble, the horror movie, and let's give it a different ending before you go to sleep. And I found that to be very helpful for some of my patients. And then there's actually a nightmare treatment by Dr. Barry Krakow at the university of New Mexico. And it actually follows that guideline. It does a couple of other things on top of that, which is very interesting. But what we do is we have them write out their entire nightmare in exquisite detail, every single thing they can think about.

And then they change the ending at the end, which is exactly what you were recommending. The other difference though, is that we ask them to read that three or four times right before bed. Oh, interesting. So we start to get that narrative going with the new ending. Within three to five days, the dream actually changes. Wow. And he studied that and published on that? Exactly.

It's been published. It's a well-known treatment for nightmares in particular, which in and of itself is quite interesting. And when you talk about nightmares and you're wondering, we're talking about COVID, one of the things that's really fascinating is because people are no longer waking up at their normal wake-up time, They're extending their sleep schedule. Many people don't know this, but the last third of the night is mostly made up of REM sleep, which is where 80% of the time you're going to be dreaming. So one of the easiest ways to stop having Quarren dreams, right? Because that's what they're calling them now.

Now, all the kids in our house have been saying they're having these weird, wacky, vivid dreams. Exactly. So number one, that's a stress reaction. But number two, they're oversleeping. They're getting more REM sleep. So they have more opportunity to have those dreams. If they just woke up at their normal wake up time, the dreams would almost stop because there's no more place for them to go.

Okay. What about, are you, I'm sure you are, familiar with prazosin and its impact on- On PTSD and nightmares? Yeah, absolutely. So prazosin is a really interesting medication. It was used in PTSD, and it has actually found to be quite effective for many of those people in terms of their nightmare frequency being to decrease. I will also tell you that there have been not formal studies, but cannabis is something that I have found with many of my veterans has been extremely helpful for PTSD nightmares in particular. And I'll tell you why is because one of the effects of cannabis is has a tendency to

start to lower REM sleep, which means it will lower the amount of timing when those people might be having some of those nightmares. And it was really interesting. On my podcast, Sleep Success, I actually interviewed a dream therapist. And I was very skeptical, okay? Because I'm like, come on, what's going on here? When you have a dream and you're swimming in water, it doesn't mean that you hate your mother or something stupid like that. And she was like, I'm not a dream interpreter. I'm a dream therapist. And I was like, okay, now I'm interested. So what she does is she has her clients write down their dreams. And then she brings those dreams in session and she uses the content of the dreams to help further their

emotional process. It's fascinating. So for people who have traumatic dreams, right? Who've been through traumas and things like that, what she'll do is she'll make sure number one, that they're safe about talking about that particular issue, because there are a lot of traumas that you really have to be very, very safe before you can really start to let that information out. So she creates set and setting, right? And then she says, okay, I want you to, in your mind, close your eyes and bring up the scene of the dream and tell me about what's going on. Tell me about what you see in the surroundings. Tell me about who you are in the dream, what you're feeling in the dream, things of that nature, right? And then she turns to her clients and she says, push play. And I was like, what? And she was like,

your brain doesn't remember dreams. It doesn't hit record when it's dreaming, it's playing. And nightmares by definition are dreams that awaken you. Guess what? The player just stopped. Your dream is on pause. Your nightmare is on pause, which is why you continue to have it and it wakes you up. But if you push play in a safe environment, you push through the emotional baggage of it, working with a therapist, and guess what? You stop having the nightmares. It was one of the most fascinating conversations, honestly, I've ever had. And she's a Jungian-trained psychoanalyst, like real degrees, really gets it, understands it. And I'm really interested. I'm considering actually doing some training with her so that I can

actually, you know, use this with some of my clients. Interesting. Well, I mean, Fred talked about dreams as the Royal road to the unconscious. I often say that dreams contain three things generally. And if you can understand those, that you really can be helpful. So a wish or fear, and nightmares obviously are fears, a current event that triggers it, and something from the past. And so if you can get those three things, it can really help inform. But, you know, you wonder why people have nightmares. Do you have, as a sleep doctor, have you, you know, why do we dream? Why do we have nightmares?

So there's a couple of different theories about their dream theory, right? So one theory of dreams is that it helps us emotionally process things that we may or may not be able to do during the day, either because our brains are just too full of other stuff going on, like driving our car and working and things like that. Or we're just, we are avoidant of these because they're so emotionally, you know, hot, if you will. And so a lot of this, we think comes out in the dream and allows our brain to start processing it when it's not having to do all these other things.

We also know that during REM sleep is when we move information from our short-term memory to our long-term memory. And so that process of memorializing and defining the data that you want to stay plugged into your brain has some sort of weird, fantastical vision in your head. And so that process of kind of basically finding a filing cabinet with the right file drawer with the right file to deposit that information is how your brain interprets dreaming. And so that process is sort of very odd and fantastical. And to be fair, it doesn't always work that well. Like if you have, so as an example, if you had a dream where you walk downstairs and your dog is eating a bowl of spaghetti with your second grade teacher and you don't know why, the likelihood is you had Italian for dinner, your dog jumped on your bed, and your second grader was talking about school,

which reminded you of your past, which was your second grade teacher. And so all of that information, for whatever reason you wanted to keep it, kind of got combobulated and landed in maybe not the best spot. And so that's really what we think dreaming is, is this movement of data into a more formalized area. And again, this is how our brain has a tendency to interpret it. Also, there's emotional processing that goes on as well. So dreams really do seem to be multifactorial in terms of their function. Wow. So interesting. I'm not like all these things. We could probably do a whole podcast just on dreams. Like what do certain things mean when you can't run and then you fly or people talk about getting their feet stuck in mud or they talk about. So that's actually a very well-known that's believe it or not, that's very well-known. And so what's interesting about that,

when people say they feel like they're running through the sand or in quicksand, that's, believe it or not, that's very well known. And so what's interesting about that, when people say they feel like they're running through the sand or in quicksand, that's actually them dreaming in REM sleep and interpreting the fact that their body is paralyzed during REM. Oh, interesting. Right. So that way you don't act out your dreams, right? Because otherwise you would actually act out your dream. If you didn't have this paralytic mechanism during REM sleep, you'd be all over the place. You'd probably get hurt. you'd be all over the place. You'd probably get hurt. There'd be all kinds of problems. And believe it or not, there's actually a sleep disorder called REM behavior disorder. And REM behavior disorder is where this paralytic mechanism doesn't work. I had a patient almost kill his wife, literally almost kill his wife

in the middle of a dream because he had REM behavior disorder. Also, interestingly, 35% of people with REM behavior disorder, it's a precursor for Parkinson's syndrome. So there's a lot of interest there in trying to understand kind of the Parkinsonian sleep relationship. And then also, Daniel, you were talking about early on, early on in our conversations, you were talking about the glymphatic system and how our brain cleans out that waste removal system that has to happen just before REM sleep, because that way all the data that we don't want goes away. Also along with proteins like tau and things like that. So we can avoid things like Alzheimer's and all that good stuff. And then what's left is what goes on into REM sleep and then becomes more permanent. Interesting.

That's so fascinating. So important. All right. When we come back, we are going to answer some of your questions on best supplements for sleep, sleep routine, suggestions for a restless mind. So stay with us. We're with Dr. Michael Bruce, go to the sleep doctor.com or chrono quiz.com. And you'll learn if you're a dolphin there. Oh, you know, I want

to say one thing before we go off to the next one. I read the book why we sleep which matt walker awesome and he said we actually discriminate in our society against night owls and and i've never thought about that oh yeah we have three children here and one of them is a lark um two of them are larks and the other one is a night owl. And you just see if you're not like up and at it at eight o'clock, I know it's going to be harder for you to perform at work or in school when society really has developed to support larks. And what's a lark in your lion a lion so if you're a lion you get a lot of societal praise oh yeah but if you're a wolf like me a wolf or a dolphin then well no i'm up early so yeah yeah you're always so number one we're gonna fix you don't worry um but you know when we but you're right.

And I can personally attest to that because I was told throughout high school that I was lazy. The very first class of the day, I slept through almost every day of high school. Why? Because I was 17 years old and my circadian rhythms had shifted. It changes. As all circadian rhythms shift in those kids, you want to stay up later and sleep later. This is one of the reasons why we're pushing for school start times to change so that they can be later so that way kids can do this. But Daniel, you really hit on an interesting point, which is I was told that I was a lazy, good for nothing kid.

Even though it's biology. Yeah. I mean, I can't count the number of times that my dad might've come into my room and it's like, you're sleeping the day away. What are you doing? And, you know, he didn't understand the biology. I mean, my dad has no medical training whatsoever. He's an insurance salesman, you know? And so he was just doing what he had been taught, you know, from his dad and from his mom is, you know, rise and shine. The early bird gets the worm and all of those kinds of things. Honestly, some of the most creative people in the world are night owls. They're wolves. I've had some, I mean, the most creative people that you know of, like we're talking artists, we're talking actors, we're talking musicians. Oh no, we know a lot of them and they're working at like, you'll get an email

at three o'clock in the morning. Why are you up? That's right. And, and, and they're up because they're wolves. And that's the, that's the creative night owl that's out there. We don't want to suppress that. We want to support that. We want those people to be creative because that's where we get our innovations. And that's where we get all our great ideas. So I feel the pain personally, as well as professionally as well. Yeah.

So many people, I think, have been shamed when it's nothing but their biology. So we often say it's easy to call people bad. It's much harder to go, why? What is going on? And that's where this sort of sleep neuroscience is so important. Asleepdoctor.com, pronoquiz.com.

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