Change Your Brain Every Day - The Science Behind Why You’re Not Sleeping! with Dr. Shane Creado

Episode Date: May 21, 2019

Although there are a multitude of factors as to why you’re not getting proper sleep, the standard treatment method is to just throw medication at the problem and hope it goes away, rather than look for the underlying cause. In the second episode of a series on sleep disorders, Dr. Amen and Tana Amen are again joined by sleep expert Dr. Shane Creado. In this episode, Dr. Creado discusses the common underlying factors to look for when assessing your own sleep issues.

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 back with Dr. Criotto. He's one of our Amen Clinics doctors who is a sleep specialist. So you must listen to the first podcast. We're

going to do two more on sleep. So welcome back, Dr. Criotto. We're going to talk about things. He's in our Chicago clinic. Yes. The polar vortex. We're so lucky. Yes. Yeah. It was crazy. I know. I survived. All my fingers and toes are intact, which is good. That was just insane. And then you came right into our rainy craziness here in California, which we rarely get. I guess that wasn't much. No. So let's talk a little bit more about sleep disruptors and what we can do. we'll get more into what we can do about that yeah yeah so your sleep can be disrupted by anything interestingly could be a medical health issue like chronic pain thyroid thyroid issues for sure adrenal adrenal problems hormonal imbalances it could be menopause menopause teenagers yes menopause and teenagersopause. Teenagers. Yes. Menopause and teenagers. Exactly.

So the older you get. Menopause is pausing from men. Right, yeah. Or putting men on pause. You know, men will suffer from drops in their testosterone levels and they can suffer the consequences too. Then we talk about mental health issues too. Look at any mental health disorder, PTSD, anxiety, depression, ADHD, there's always a sleep component there. There is sleep

disruption there too. Oh, people with ADHD, their cycles are often off. Yes. That they're not morning people. Trying to wake them is trying to wake the dead. Yeah. And it's like not fun and the restlessness causes them to have trouble settling down and going to sleep. Actually a number of my patients I've used stimulants at bedtime because it settles them down, which is like, that's totally weird. I agree with you completely. Um, and the thing is if they have sleep deprivation, they're going to have more concentration problems than what's going to happen in the dark is, if they have sleep deprivation, they're going to have more concentration problems. And what's going to happen?

The doctor is going to give them more stimulants. And it's a terrible, vicious cycle. So there are medical health issues we need to screen our patients for. There are mental health issues we need to screen our patients for when they have sleep disruptions. There's sleep disorders like sleep apnea, restless leg syndrome, circadian rhythm disorders. Are you a night owl or a morning bird? What medications are you taking? You might not really think of medicine may affect your sleep,

but beta blockers for hypertension can disrupt your sleep. There are antipsychotic medications that may be sedating for you. Great to go to bed, but they can also cause weight gain and worsen your sleep apnea if you do have sleep apnea as a cause for insomnia. Right. There are antidepressants that we prescribe to most of our patients with depression or anxiety. But those medications can worsen restless leg syndrome. So they may help you sleep better or help with the depression but not help with the restless leg syndrome.

Well, butrin is a really good medication for depression, especially the limbic sort of depression. But it's going to keep you alert and awake. And there's benzodiazepines like Valium, Ativan, Klonopin that a lot of people take. But they're only supposed to be used short term for sleep. Long term, there's concerns for dementia, frequent falls, confusional awakenings, especially in the elderly. Do I want an elderly patient to fall and break a hip or drive and forget about what happened, like is seen with some other medications too? So we look at the health issues, the medications.

We look at what their behaviors are. When I see a patient, I want to know exactly what they're doing prior to bedtime, around bedtime, how long it takes them to fall asleep, how many times they wake up, for how long, what time they actually wake up in the morning, how they feel, what happens during the course of the day as well. That influences how you're going to sleep at night. We talk about the drives to promote sleep, the circadian drive, the melatonin in your core body temperature, and the sleep need or the sleep depth that you build up during

the day, and how it's supposed to synchronize for you to fall asleep on time. Gosh, there's a lot. build up during the day and how it's supposed to synchronize for you to fall asleep. So given how complex it is, who, so I have this idea in my head that people are having trouble sleeping. So they go to their primary care doctor and they go, I have trouble sleeping and they often leave with a prescription for Ambien or Xanax, which just starts a nightmare for them. And it totally goes against first do no harm. So can you begin to tell our listeners what are the things to do before you take a sleeping pill? Absolutely. You're so right. If someone has fever, will they just take an ibuprofen? What

happens if they have other symptoms? What if that fever is because of meningitis? Right. Right? We're putting a bandaid over a bullet hole. Exactly. Exactly. It's not going to be effectiveaid over a bullet hole. Exactly. Yeah, exactly. It's not going to be effective. So that's one of the reasons I did sleep medicine too, because it was just shooting in the dark. I didn't like what was going on at all. Why just an Ambien or a Klonovan does help put somebody to sleep? What's the underlying cause of the sleep issue? That's

where we want to focus. So even before you resort to medication, it's really important to dig deeper. See if there's any mental health issues, any medical issues, any medications that are affecting your ability to sleep. What are your sleep behaviors? What are your thoughts regarding sleep? If you're not being able to sleep well for a certain amount of time, you'll have all these negative, these automatic negative thoughts. The ants eat away at you while you're trying to sleep. Can I say one thing about this? So this is really interesting because I went to a doctor when I was going through a divorce. It was really stressful for me. Um, and they gave me Ambien and what I noticed, I don't know if anyone else has

noticed this or if I'm just one of those weird people, but, um, the next, I didn't put it together at first. Next day I felt really depressed and I didn't, I didn't know it was the Ambien, like seriously depressed. I got really tearful for no reason. There was nothing triggering it. It just, I just got tearful for like no reason. And I didn't put it together. And then the next day I got like literally burst into tears and I'm like, Oh, this has to be the Ambien. I mean, I'm a nurse. I sort of put it together. I'm like, there's something wrong with this medication. It's definitely not affecting me in a positive way. Like, it was just like a crazy depressed type of feeling.

And so I took myself off the Ambien. It went away immediately. Wow. But I was seriously having trouble sleeping. I mean, partially the thyroid. So that's exactly my point. Right. You just go, I have trouble sleeping.

They give you a medicine that changes your brain to need it now in order to function. Yes. That has significant side effects. And part of my issue is I have thyroid on top of that. I have this thyroid condition where they keep my thyroid jacked up in order to suppress cancer. Right? So it's my metabolism is like amped all the time. So what I ended up doing was going to see a therapist.

And I was pretty anti-therapy at the time. In my head, I thought that it wasn't going to help. It helped so much. Going to therapy and then learning how to meditate. Yes. So those two things for me, critical. I mean, I did a whole bunch of other stuff because I'm one of those people, if I'm going to do it, I'm going to jump the canyon. Yeah.

But those two things were where I started. And it was just learning how to just like settle my own brain down was just critical for me. That's the key. In modern sleep medicine, we don't look at insomnia as a lack of sleep, but an excessive wakefulness of the brain. If your brain is in danger mode, fight or flight mode, there's no way you're going to be able to sleep properly. So one of the core aspects is not trying too hard because the more we try the more we try and control the situation the more alerting it is to try and fall asleep and then relaxing the brain through natural ways so what about a wind down period like a buffer zone i need an hour

i need an i know i need an hour so it might be a warm bar next two podcasts, we're going to talk about what to do. I want to know, so they can make an appointment with you. Yes. And you see people from all over the world and you do a lot of phone appointments. Yes. Even though you're in Chicago. Skype is probably a good way. That's a great way as well. Yeah.

Skype is a good way. So Skype would be good. You have a new sleep course that you just created. Yes. We're thrilled to partner with you on on that. So we'll give a link to the sleep course so people can take that. Because, you know, the reason I've written for so long and encourage you to do that is there's only so many patients we can see. Yes. But we have this information that is so critical. And as you said, this is one of the most important things you'll ever do. For sanity. Is get your sleep right so they can make a point with you. They can take the course. What are some other simple things that they need to do?

So what I've heard so far is they need to have their thyroid checked. Yes. That if they're not sleeping with anyone, then they probably need a sleep study. So that because if you're not sleeping with someone, you don't know that you're snoring or that you're not breathing. You stop breathing at night. So, and there are ways to do that. Even home tests that people can do. What are some of the other things people should do to assess it? Before we get into, here's the plan.

Yeah. In the sleep course that we've created, I have downloadable materials for patients as well. Just download a complete assessment form that screens and looks at everything from their complete bed routines to all the substances they may be using to all the medications they're on, screening them for sleep apnea, restless leg syndrome. Everything that we can screen them for is right there. One thing I heard, and I don't know if this is on your assessment because I heard this and maybe I'm sensitive to it. You mentioned if you are in flight or fight all the time, if you're feeling like you're in danger all the time, you're not going to go to sleep because you're alert. So

for those of us who grew up in sort of chaotic environments, he knows. I'm always looking over my shoulder. I'm always looking around. I'm always paying attention. He's always looking for the happy faces. She's looking. She has an FBI agent's brain. Right. And we actually have on Brain Fit Life,

we have a game that teaches people. Yeah, I hate this game. It's the dumbest game ever. Hang on, hang on. That teaches people to notice what's right rather than what's wrong.

So they look for the happy faces and ignore the bad faces. Yeah, that's never going to happen. The dangerous faces. than what's wrong. So they look for the happy faces and ignore the bad faces. Yeah, that's never going to happen. The dangerous faces. Dumbest game ever. I'm like, no, why do I care about happy people walking by me? I care about the terrorist or the gangbanger. I don't care about happy people.

They're fine. But that's why you're not sleeping. Okay, but that's not my world. Because the guy next to you is not a terrorist. Okay, I didn't grow up in that world. I've got cameras around my house. I've got alarm systems. Like, yeah, no.

Yes, chaotic environments can definitely disrupt your sleep. If your brain is in danger mode, obviously you're not going to be able to calm down and relax. A lot of people with anxiety have also experienced hypervigilance. And you need to protect yourself in some ways. A lot of people who face trauma might have faced trauma in the bedroom as well. Yeah, that's a big one. It's a big one. They also want to avoid nightmares if they try and delay sleep as long as possible. But the thing is, if you are sleep deprived, your brain will try and make up for it with more dream sleep, which will worsen the nightmares.

Yeah, more anxiety. So, absolutely. It's all discussed in the course as well and specific strategies how to address these issues depending on what you're dealing with. It's very precise. I love that. Keep it to each person. All right. We're going to talk more about it. Sounds good. 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.

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