Change Your Brain Every Day - The Link Between Sleep & Daytime Performance, with Dr. Shane Creado

Episode Date: June 24, 2020

Most of us are aware of the effect a bad night’s sleep can have on our day. But is there a way to hack your sleep patterns to optimize your work and athletic performance during the day? The short answer is yes. In this episode, Dr. Daniel and Tana Amen are once again joined by Dr. Shane Creado for a discussion on how to optimize performance through sleeping habits. For more on Dr. Creado's new book, "Peak Sleep Performance for Athletes" visit: https://www.amazon.com/Peak-Sleep-Performance-Athletes-Cutting-edge-ebook/dp/B085YFP9YW For more on Dr. Creado's online course, "Overcoming Insomnia", visit: https://brainmd.com/overcoming-insomnia-course

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 here with our friend and colleague, Dr. Shane Criotto, a psychiatrist, sleep medicine specialist. He and I consult on a number of our

high profile patients. So grateful for your help with Justin and his sleep issues, which was a major problem when he first came to see us. And in this episode, we're going to talk about performance, work performance, athletic performance, and the critical role of sleep. So before we get started, I would love to know from our listeners and our viewers, what did you learn in the last two episodes? And because I mean, I even I have just learned so much, we'd love to hear from you. We'd love to get your questions, your concerns, what's bothering you,

we love to answer them and base our podcasts on it. And if you wouldn't mind leaving us a review, we love that. It's very special to us. Brainwarriorswaypodcast.com, you can leave a review. And please post, tag us. And if you wouldn't mind taking a screenshot, that's really fun for us to see. And welcome, Dr. Criotto. Thank you so much for having me. Let's talk about performance. When you sleep, your brain cleans and washes itself, sort of takes out the trash from the day before. People who sleep less than six hours a night have lower overall blood flow to their brain, which means their brain's actually not taken out the beta amyloid trash, which is one of the proteins that builds up in people with dementia. And this one study just blew our mind. Do you remember the study on soldiers where

soldiers who got seven hours of sleep were 98% accurate on the range. Soldiers who only got six hours, one less hour, were 50% accurate on the range. Those who got five hours were 38% accurate. And those who only got four hours a night were dangerous. They were only 15% accurate on the range. So obviously sleep and performance go hand in hand. Definitely. And interesting, you mentioned reaction times. One night of sleep deprivation can reduce your reaction times by 300%. So there were actually studies comparing sleep loss to the equivalent of alcohol consumption. And they found that when you sleep four hours or less, it's like drinking four to five alcoholic beverages. You're legally drunk. How's that going to work for you when you're a sleep deprived

medical professional working at 36 hour shift, or when you're involved in a dangerous job, you're much more likely to get injured. Well, we need to talk about that because when we were interns and it was much worse when I was an intern than when you were an intern, right? Because they didn't care at all about our level of sleep. But I knew intuitively that I was dangerous, that if I hadn't slept for two days, and I remember I was on the oncology board and I had a patient that was bleeding and bleeding out, and I was just completely confused. And it's two o'clock in the morning, and I'm just like screaming, you guys have to help me because I'm confused. And it's two o'clock in the morning. And I'm just like screaming, you guys have to help me because I'm confused.

And it's still traumatic. We had two surgeons on our unit, so it was a trauma unit. Two of the surgeons that I saw when I was there that collapsed on the floor. One ended up triggering a seizure disorder. From that point on, he ended up having seizures. It was really crazy. Yeah, that can ruin your whole career.

And the thing is that there are studies done on medical interns, and some of those studies results show that if people have had one overnighter when they were working overnight on call, they commit 36% more serious medical errors. Yeah. 300% more medical errors in general that lead to death than those who work 16-hour shifts, although 16 hours is a lot. Compared to overnight shifts, they have so many more dangerous situations.

People can lose their lives. There's traffic accidents that occur as a result of sleep deprivation, over 6,500 fatal accidents in this country. There was another study that was done that was in the Harvard Business Review that showed if a medical professional works 24 consecutive hours, the risk of stabbing themselves with a needle or scalpel increased 61%. Yeah.

Corruption of the motor vehicle, there is- It's interesting you said that well that was so when i was an intern aids had just skyrocketed it was 1982 and i was sticking people with aids and i knew that if i stuck myself that i was in big trouble um And so I spent that year freaked out a lot. I actually stuck my, I did a double shift and was taking care of a guy who was known for doing a lot of drugs, dealing a lot of drugs. He was in for a gunshot wound and we, the guy had no original blood. I mean, we had basically had to transfuse so much blood because he almost

died. He coded several times. But I was sleep deprived. I did a double shift, and I stuck myself with a dirty needle, and the guy had hep C. So I had to go through a ton of testing. That's a scary moment. Yes. Very scary. And people can lose their lives. So you made the point that your performance will be better.

And I told you about being a consultant for the NBA. I worked with NBA referees for a year. And my first thought with these guys was these guys are all sleep deprived because they are forced by their contract to work a late night game and have to take the first flight out to the next city in the morning. So basically,

they're two, three hours of sleep at night. And then yes, they try to nap during the day. But it was my big issue with my friend Bob Delaney at the NBA. It's like, we need to work on their sleep. I completely agree. And in the book, Big Sleep Performance, I mention the NBA and the important job we have to improve people's lives, outcomes, the risk of injury. Everyone wins if you get more sleep. Less injury, longer playing careers, records will be broken, quicker reaction times, quicker recovery from concussions. So what are strategies? So I think we've made the point. If you don't sleep,

you're going to be less effective in sports, at work, probably in your relationships as well, everything with your health, right? Because if you don't sleep, and is it six hours or seven hours? What is the optimal sleep? I know it's probably different for different people. But what do you think based on the research? Well, it's anywhere between seven to nine hours if you're an adult. If you're a teenager, it's probably more around 10 to 14 hours, depending on how old you are. But each one's brain is different, as you said, in the absence of other complicated issues that impact your sleep. And if you're waking up feeling refreshed

and you're not feeling really sleepy and you need to take a nap during the day and you're not catching up on sleep in the weekends, if you're getting seven hours, that's probably good enough. If you're getting eight hours, that's good enough. If you're not feeling sleepy or dysfunctional during the day or catching up on the weekends. So on average, in 1900, Americans got nine hours of sleep at night. In 2018, on average, they get six hours and 40 minutes. And, you know, I think it's one of the reasons mental health problems are skyrocketing and health problems are skyrocketing because if you don't get good sleep, then everything else

in your life sucks. I have a question. How does age affect your tolerance for lack of sleep? Like I noticed when I was younger, I could do a double shift. Yeah, I'd feel awful the next day, but I could do it. But as I get older, I just don't have that reserve. And so I'm wondering if that's a me thing or an age thing. That is generally the older you get. There's so many other things that impact our functioning. It's not just, oh, we're young, we can do it. But there's inflammation, there's arthritis that kicks in this hormonal imbalances. And because even if you get less sleep, this less sleep impacts your hormone levels more, your inflammation more, your pain tolerance more, your mental health reserve more, and it's going to be more impactful in terms of your functioning. So what you're experiencing

is pretty consistent. Yeah. I need eight and a half hours and I know that. And if I don't get it, I just don't feel right. All right. So people are getting that if you're not sleeping seven to nine hours, it's a problem for so many different things, but let's give them as many practical tips as we have. And I always say brain health is three things. One, you have to have brain envy, you have to care about it, avoid anything that hurts it, do things that help it. I mean, that's ultimately, I can summarize my 40 years of work in three words, care, stop, do. Care, stop, do. And so I often think for sleep, it's the same thing. You have to have sleep envy, really care about it, avoid things that hurt it, caffeine, nicotine, exercise before bed, eating before bed, alcohol, benzos, opiates, marijuana, because they will fragment your sleep, and then do things that help it.

A cooler room, a dark room, a quiet room, prayer and meditation, put me to sleep can be very helpful. What am I missing in that? What would you add to that frame? What you can do as an individual is nap, but nap strategically. We always talk about napping being disruptive to your rhythms, but if you are partially sleep deprived, a nap at the same time every day can be potentially very helpful for your brain. When NASA studied pilots, they found that a 26-minute nap increases your alertness by 54% and performance by 34%.

Now, strategic napping means at the same time every afternoon, because there's a natural dip in melatonin, there's a dip in your functioning, there's a slight increase in melatonin. So if you're napping, same time every afternoon. Number two, it should be around 20 to 30 minutes, not longer. If it's longer, you'll be waking 20 to 30 minutes, not longer. If it's longer, you'll be waking up out of a deeper stage of sleep and you'll feel super groggy and tired. But if you're waking up within 25 minutes, that's half a sleep cycle. You wake up refreshed and energized. So either a 25 or 30-minute nap or a 90-minute nap.

But I'd avoid the 90 minutes because that can sabotage your nighttime sleep. That's so interesting. And you just said something really interesting to me. See, again, I learned something new. So I always hear people say, well, I have to have an afternoon cup of coffee because you hear so many people say it, right? And we know your food affects you. But what I heard you just say is that melatonin peaks for a short time in the afternoon. I didn't know that. That's fascinating. And if you want to block that, have no carbohydrates at lunch, if you want to block it.

Because what I've seen is if you have a sugar burst, that that's actually going to cause a lull in your blood sugar. So if you have a bowl of pasta or, you know, rice bowl at lunch, then that insulin is actually going to drive serotonin into the brain and you'd be happier, but also sleepier because serotonin then turns into melatonin. And so you have to be careful with carbohydrates at lunch. One of the other things I wanted to show people, we have a bright light. BrainMD has the Bright Minds bright light therapy lamp that 20 to 30 minutes in the morning helps to reset your circadian rhythm.

And for people who have trouble sleeping, I use this all the time for my patients. And I actually light the set because then I'm getting 20 to 30 minutes in the morning when I'm recording. And it's been shown to support mood, focus, energy, and healthy sleep. That is such a great device, Daniel. We have it in Chicago as well. And it causes your melatonin to be suppressed, so you'll be more energized in the morning. In the morning, if you combine that with deep breathing or jumping jacks,

get the blood flow going, get the melatonin to be suppressed, it's going to boost your energy levels and concentration and mood. Great. When we come back, we're going to talk about middle-aged people, hormones, and insomnia. Don't forget to post. And one secret on why 40-year-old women are irritable, drink more, and can't sleep. I already know the answer to that. But don't forget to post what you've learned.

I learned so much. I always thought that the carbohydrate issue was just a blood sugar issue. I didn't even think about the serotonin burning the melatonin. So interesting. 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.