Change Your Brain Every Day - The Science Behind Why We Dream - Pt. 3 with Dr. Shane Creado

Episode Date: August 1, 2018

Most of us believe that our dreams are a collection of metaphors existing in our subconscious minds. So how are these thoughts and experiences created? In the third and final episode of a series on sleep with sleep physician, Dr. Shane Creado, Dr. Daniel Amen and Tana Amen discuss the role that past experiences, future events, and current stimuli play in shaping our dream experiences.

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. We're back with Dr. Criotto, and this is so interesting and so helpful. We're talking about sleep issues. And Dr. Criotto, before we jump into Restless Leg, I really liked something you talked about in the last segment with sleep apnea and how hard it is for people to get used to their masks.

But you know, it reminds me of something, it's about taking care of yourself and loving yourself. And you know, when I first met you, we just, we mentioned in the last segment that you lost weight and it helped your snoring. But when I first met you and we were getting serious and you know, engaged and like, it was hard for me because you snored

and I'm like, I can't sleep. This is really affecting my sleep. It's like, do you throw the relationship away because of something or do you figure out a way to fix it? Right? So I started wearing earplugs and you like to read at night. So I started wearing an eye mask and I did that because I love the relationship.

So why would you not figure out a way to wear a CPAP machine because you love yourself? Like I'm confused by that. I would have hated to have lost you over that. Right. I wouldn't like, I'm like, I'm about to have a panic attack. No, no. My point is it would have been silly. Like it would have been silly. We're going to have to use Dr. Criato's therapy techniques with us. No. All right. Cause we don't have a lot of time um three minutes on restless leg how do you know if you have it and what do you do about it and then i want to talk about dreams what's next tends to be a misnomer because people say oh my legs shake all the time while i'm in

class while i'm at work i must have restless legs no restless leg syndrome is a very specific disorder, and it's a clinical diagnosis. So, if someone has a weird sensation in their legs, maybe some people describe it as pulling, burning, pain, irritation, various terms to define how they feel about it, number one, that's worse at night or worse at rest, and relieved by movement, they may have restless leg syndrome. Now, it's not just the legs. As I said, it's a misnomer. So 21 to 54% of people also report some arm movements as well. It's under a group of conditions called sleep-related movement disorders in sleep medicine,

like periodic movements of sleep. They might be having sleep leg cramps or rhythmic movement disorder or myoclonus, which are little jerks when they're falling asleep. So it's very important to understand whether, in fact, it is restless legs or one of those conditions or neuropathy or nerve damage. Now, if someone has restless leg syndrome, the first thing we need to do is, again, with anything we do in medicine, look for the underlying cause. Don't just throw medications at this condition. Figure out why this is happening. One of the most common causes is iron deficiency or abnormal iron metabolism.

So I always want to make sure my patients have good iron levels, but not just iron levels, but also a storage form of iron called ferritin. And even if it's within normal limits, I want to see it above 75 and the normal limit, it might be at 50. That's not good enough for us because iron helps in producing dopamine. And one of the most common medication treatments for restless legs, for example, is a dopamine agonist like Mirapax or Requip, medications like that. So there is a growing body of evidence to suggest that dopamine abnormalities may result in restless leg syndrome. That's so fascinating. So which is why ADD children are hyperactive. And there is a correlation between ADD and restless leg syndrome. Oh, I'm so fascinated.

I always thought it was like magnesium. Which is often a deficiency of ferritin. So we often see kids who have low ferritin levels. Now, just so people who've heard me speak before, high ferritin is not great for you because it increases heart disease and dementia, causes internal rusting. It's about what's optimal, which is, you know, as Dr. Grado is saying, is around, you know, 80 to 100. If it gets above 300, I think you should actually get blood because... Don't go buy leeches, just go donate blood. Yeah, there's a whole thing between us. So I have a question.

So what qualifies as restless leg? If you obviously have an occasional episode of this does that yeah by as restless leg or does it have to be I mean it could be you just traveled right like you you slay dragons when you get home okay I always go with my patients goals so if it's causing them to have disrupted sleep or not being able to fall asleep or really troubling them for more than 15, 20 minutes most nights, let's treat that. Let's figure out the underlying cause. Is it low iron?

Is it caffeine? Alcohol? Women who are pregnant may develop restless legs, and it may subside once they've delivered the baby. Sleep deprivation can result in restless leg syndrome. Diabetes, antidepressants, anti-anxiety medications are notorious for this. Of course, the one exception may be Welbutrin because it doesn't act on serotonin. Antihistaminics, anti-allergy medications like Benadryl, hydroxyzine can also worsen it.

Antipsychotic medications can worsen or trigger restless legs. Dopamine-blocking anti-nausea medications can also worsen it. So we need to figure out what's causing it. In fact, people who have obstructive sleep apnea may have restless legs. And if the sleep apnea is corrected, the restless legs can resolve. What about a magnesium deficit? I mean, I heard 80% of the population is low in magnesium. Yes. Magnesium is important. And some studies have shown benefit for restless legs with magnesium supplementation. So if it's deficient, we should supplement. All right. Well, we promised

them. And I think this is what a lot of people are waiting on is talking about dreams. So interesting. Why do we dream and what the heck do they mean? Yeah. Well, this is one of the reasons I got into sleep medicine is because I did my psychiatry training and I studied one of my mentors, his written books. He's a psychoanalyst who trained in Harvard and he's written books in dream analysis. And so I worked with him processing patients' dreams. And dreams tend to occur in dream sleep or rapid eye movement sleep. If you look at the EEG on the polysomnogram, you know when someone is going to dream sleep. And in those times, people dream. But Freud once said that dreams are a combination of what you've experienced in the past, the stimuli you're experiencing while you're asleep, and anticipation

of future issues as well. The hippocampi primarily create the dreamscape. The right and left hippocampi map the topography of the dream and the timescape to create the dreamscape. And I've used dream analysis frequently with my patients in processing what they're experiencing and how it maps onto their current life situation. In fact, they've done experiments on rats where they've had rats with electrodes go through mazes, and then they look at the areas that are active in the brain, and then they record the rat's sleep. And dream sleep, the same areas of the rat's brain are active. So we're really cycling through what we're experiencing every day in our dreams. For example, a lot of our patients with anxiety disorders frequently have dreams of being chased or in dangerous situations

because that's what they're cycling through while they're awake. And no wonder they can't fall asleep. A lot of people suffer from middle of the night insomnia, where they're waking up in the middle of the night and cannot fall back asleep. They say, I don't know why I woke up. Well, dream sleep is more common in the later half of the night. That's when you start your dream cycles. And so they might be waking up in a panic their heart racing their blood pressure going up them waking up in sweats because you're reliving what you're experiencing every day and anticipating the next day so I have a question so when I was younger I had this sort of recurring these weird, I guess you'd call them nightmares,

that someone was chasing me, which you just described. And that right before I would get caught, I would take off flying and the flying was really hard. Initially I couldn't fly, but then all of a sudden I'd start flying and I was up above what was happening. And it was the coolest thing. I'd be like up above it. But it was always like this like really intense pressure, like about to be caught. And then I would fly. Do you hear a lot of people talking about flying in their dreams? I had no idea. Oh, yeah.

No, it was terrible. It was always like really scary. Sounds really cool. Yeah. Well, it is in the end. But the almost getting caught part was always terrible. So what would you do with that, Shane? But wait, do you hear a lot of people talk about flying in their dreams to get out of situations?

I do. And it's important to remember that we shouldn't go to Google or look at what they think dreams mean because it's really individualized. So I always dig in really deeper with my patients. I know what they've been going through through life. I know how it maps onto what they're currently experiencing. So in cases where people tend to escape from a dangerous situation, not necessarily flying, but escaping from a dangerous situation, it tends to be metaphors. The subconscious mind speaks to us through metaphors

and brings to our awareness what we need to be aware of, what we usually suppress with our conscious minds. So in this case, I would think it maps on to escapism, really. As kids, you may create these imaginary friends. Kids who have been traumatized may actually experience derealization or depersonalization, where they feel that their alternate realities and things like that. So in the dreamscape, it might represent a form of escapism where you're getting out of that scary situation by having powers you wouldn't otherwise have in the real world.

Interesting. I'll give you an example of a veteran I treated a few years ago who had severe PTSD. And his symptoms were all really well controlled with our treatment protocol. But one day he came to me and he said, oh, my PTSD has come back. I said, what happened? He said, well, I had a terrible nightmare. I dreamt I was back in Vietnam. I said, what happened? He said, well, I dreamt that I was in Vietnam. I had my gun ready. There were three Viet Cong approaching behind a wall, and I was ready for them. And then

I looked down and my gun is missing. I said, you do? He said, well, I panicked in my dream, but I waited for the first guy to come around. I tackled him and dealt with the other two. So he saved himself in the dream. And through understanding where it happened just before he went to sleep, it turned out that he had forgotten to take his nighttime medicine. Now, with the medications he was on, they would last in his body for a few days. So it wasn't like the symptoms would come roaring back. But the metaphor his subconscious used was, in Vietnam, his weapon was the gun. Now, his weapon is his medications to fight against these symptoms.

He was missing his medication or his weapon in Vietnam, but in spite of that, he could overcome his symptoms. He could overcome the situation and survive. So it's really fascinating what our dreams can tell us about our own resilience. Oh, that's so interesting. And I love the idea that you talked about dreams often will speak to us in metaphors. And if you can understand the metaphor, Louis Godchuk, who was the chairman of the department at UC Irvine and was my neighbor for a long time. So I loved his work. He was was really a pioneer he wrote a book about dreams and he said

to understand dreams you really need to understand three things so that each dream tends to contain a wish or a fear something from the past and a current event that triggers it does that fit with your experience yes that's what he called Jung would speak about with dream fulfillment, fears that have not been really faced, or accomplishments not yet achieved, or goals that you're reaching toward. It really maps well onto what Carl Jung spoke about and Freud spoke about, and what we know from modern neurobiology with the areas of the brain responsible for dreams well that would certainly fit with with what i like almost being caught

and then getting away so this is what so our niece who we talk about on this show um both our nieces were taken by child protective services um to foster care because their mom and dad, you know, were not right. They just said there was a situation. And so we really helped her mom get together. She got her kids back a year ago, Mother's Day. And but my 13-year-old niece, she had this recurrent dream of being in the red truck. And it always happened. She'd always wake up at 1.10 in the morning. And she was afraid. And so what I have my patients do whenever they have a recurrent dream is before they go to bed, finish it. So imagine it, but then put an ending on it that is safe and really go through it. And what is

really cool is it tends to then stop because they'll have a dream or two where they actually finish it in a more positive way and then it'll stop. I don't know. I mean, I don't have your education in this or experience, and so I would love to hear your feedback. And as somebody who just was doing what I knew how to do sort of intuitively to deal with stuff, something that helped me, one, was meditation and visualization. Really helped with just visualizing safety and whatever, going through my day and doing that on a daily basis, but also oddly enough, things like practicing karate. So doing

some things that for me felt empowering. Um, I don't know why, but those dreams went away. So, um, because you were finishing them in a more positive way. I felt empowered and I don't know if that had any connection, but it felt to me like I feel more empowered in my daily life. And somehow that went away. I didn't start karate for that reason. I just noticed that it tended to go away. Well, and what Shane's talking about is dreams as metaphors.

So you have developed other metaphors that are healthier. Shane, this was just great. We have to stop, but we have to do this again. You're going to come out and we're going to film a whole course. We should make dreams part of it because I think people are just so interested in it. Dr. Shane Criato, he is in our Chicago clinic until the fall when he's going to move to New York. If you have a sleep problem, you'd actually set up a phone consult with Dr. Criato. He's so helpful. I use him for many of my patients.

And I am just so grateful you're part of our Amen Clinics family. Thank you so much. I'm grateful to be with you guys. Yes, thank you. Thank you so much. So fascinating. Yes, thank you. Thank you so much. It's been a pleasure seeing you and talking to you guys today. Use the code PODCAST10 to get a 10% discount on a full evaluation at amenclinics.com or on our supplements at brainmdhealth.com.

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