Change Your Brain Every Day - What is the Single Most Effective (and Free!) Treatment for Insomnia? with Dr. Shane Creado

Episode Date: May 22, 2019

You may be surprised to learn that the gold standard for treatment of insomnia doesn’t cost a thing. So what is CBT for insomnia? In this episode of The Brain Warrior’s Way Podcast, Dr. Daniel Amen and Tana Amen are again joined by Dr. Shane Creado for an extended look into this treatment modality, and what makes it so effective.

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 in the middle of sleep week, and we've talked about a number of the causes of trouble with sleep. We talked about how critical

it is to the success of your life, but now let's talk about how to get and stay asleep. So what are some of the highlights? What are some of the most effective things you've seen to help your patients? Well, the most effective strategy to help with insomnia is something we call cognitive behavioral therapy for insomnia. Not many people are even aware of this. I would have never thought of that. Exactly. Not many people are aware of this, but this is the therapy that's the gold standard. It's approved by major international sleep organizations. Not Ambien, not Trazodone, Agabapentin, not Klonopin, but cognitive behavioral therapy for insomnia. And that's the cornerstone of the course that we've just created for all our patients and friends and

family. So how does it work? And I know, you know, we would love for them to take the course, but what's the short story? The short story is that it addresses everything, starting with an understanding of why we sleep, the rhythms that are associated with sleep functioning, circadian and homostatic drives. We talk about everything from understanding why those therapies or strategies are useful based on our knowledge of sleep, natural supplements and ways to deal with effective sleep, and then dive right into the meat of things. Everything from behaviors and thoughts surrounding the sleep or lack thereof, as well as ways in which we can regulate our rhythms. If you're in bed for nine hours,

only getting six hours of sleep, we need to reduce the time in bed because you're lying in bed, associating the bed with wakefulness, tossing, turning, worry. And then your brain thinks that's your worry time. So first of all, if you can't fall asleep within 20 minutes, get out of bed, comfortable chair, do a meditation, do something relaxing, no screen times, because you need to break that cycle between wakeful worry and the bed, then get back into bed. If you're awake for nine hours, only getting six hours of sleep, reduce your time in bed to six hours. People think I'm crazy for saying that, but they say, I'm not going to be able to sleep. Well, are you sleeping anyway? If we do a sleep diary that are available with the materials in the course,

you can actually track and see how much sleep you're getting. So if you're sleeping for six hours, but only in bed for nine hours, reduce that time. You're allowing your brain to get the same amount of sleep you get anyway. Keeping your wake up time fixed is really crucial because we're trying to entrain the inner rhythms to align themselves in the brain so if you're waking up at 6 a.m one night one day in the weekend wake up at 9 a.m it's going to throw your inner biological clock off every time you're basically making your brain go through jet lag every week if you think about it so always having a fixed wake-up time calculating how many hours you need and going to bed at

the appropriate time. Wind down before bedtime. If you wake up in the middle of the night, get out of bed, get comfortable, get back to bed when you're sleepy. Most people don't know the difference between sleepiness and fatigue. This is so interesting. So I've heard a lot of stuff on sleep and most of it is sort of repetitive. It's the stuff we think about darken your room, make it cool, all that stuff,

which is important, but you're addressing things I've never heard of. Like, like if you've been traumatized in the bedroom or, I mean, just some of the stuff you're talking about is really deep. So it's just so important that these things are addressed and it's, I just am loving what I'm hearing. Especially some of the things, not just women, everybody, but it's just, it's just such a thing that I've never heard someone address these topics for sleep. So I just am fascinated by this. And one thing I want to throw in there, my sister actually went to the doctor for, cause she went through a highly traumatic experience. They gave her gabapentin. She fell asleep on the toilet, fell off the toilet and hit her head on the bathtub.

So just throwing that out there. Right. And that's another point you raised. A medication may be okay, but is it the right medicine and the right dose at the right time for the right patient? Gabapentin is great for restless legs, can help you sleep better. But if it's too much or you're too sensitive to certain medicine at a certain dose, that's what's going to happen. Yeah. Would you rather have a head injury or break a hip or would you rather sleep better through natural ways? Right. So it just seems to me like it's at least, at least where you should start is working on your thoughts and clearing up.

So we need to get the ants out of bed. So a lot of people have an ant infestation in their bed, under their sheets, the automatic negative thoughts that steal your happiness. So learning how to not believe every stupid thing you think is really critical. I mean, it's important. But also, because I know you, it's a routine. If your routine has been one that is sleep harming, let's put you in a routine because your brain can then begin to associate sleep with the right

routine. Is that what we call sleep hygiene? Exactly. It's a component of sleep hygiene and also another concept in CBT for insomnia called stimulus control. Let's make sure that they didn't hear what I heard the first time I heard CBD. So let's make sure we're hearing this correctly. CBT, cognitive behavioral therapy for insomnia. Well, but why you brought that up. So what's the deal with CBD and sleep? Everybody's taking it.

It's a big thing now. So that's why I thought I heard it. They're giving it to their granny. They're giving it to their dog who's got arthritis. I mean, I know a minister taking it. It's a big thing now, so that's why I thought I heard it. They're giving it to their granny. They're giving it to their dog who's got arthritis. I mean, I know a minister taking it. What about CBD and marijuana for sleep? Well, we all know the bad effects in terms of marijuana, right, in terms of your increased risk for schizophrenia

to low blood flow in the brain and the scans. We've seen that every single time. CBD oil, there's more research that needs to come out. But from what I've seen that every single time. CBD oil, there's more research that needs to come out. But from what I've seen thus far in terms of insomnia, CBD oil may be helpful for insomnia, but in very high doses. So it might be more expensive for people. And depending on your brain sensitivity, I don't know what kinds of side effects you'll have. So until more evidence is out there in support of CBD oil, it's definitely not my first, second, third, or even 15th step in terms of a person with insomnia.

Okay. Isn't that interesting? I'm working on a new book called The End of Mental Illness, and I'm in a chapter called Mind Meds versus Nutraceuticals. What does the science say? Right. And for example, if I look at depression, the Prozac is 13th on the list, right? Where things that are much higher up are cognitive behavior therapy and omega-3 fatty acids, maybe SAMe. So rather than what most people do, go to the primary care doctor and get a drug, there's so many other things to do first. And that's what you talk about in the course and it's what we're talking about today. So let's go through the steps. So before I get to Ambien, and quite frankly, I don't think I've prescribed it in the last five years

because it's not really even on my list because my mom took it forever and then she couldn't stop taking it. And I wasn't the one giving it to her, trust me. So give us the top ten. What would you do? What would you start with if someone has got erratic sleep? If someone has an issue with insomnia or disrupted sleep, the first thing is you look at is a bed environment.

Is it comfortable? Is it conducive to better sleep? You look at what they're doing during the day. Is it something activating closer to bedtime? Caffeine, for example. Some people may feel that caffeine is okay for them to take in the afternoon, but if their brain is more sensitive, then avoid caffeine during the day, even if it's in the afternoon. If you're taking caffeine with an SSRI, an antidepressant, or with hormone replacement therapy, or with an

oral contraceptive, caffeine is going to last longer in your system. Oh, interesting. It's going to activate you, right? If you're taking alcohol too close to bedtime, it's going to wake you up in the middle of the night. If you're exercising, which is a great thing to do in the morning, too close to bedtime, it's going to make you more activated. Yeah, I have that problem too. Exactly. Can't settle down. So a few of those basic concepts, your behaviors first need to be taken care of. Screen time, reading, watching TV in bed, all gone. You need to have that barrier there. We

talk about blue light and white noise as well. Once those are taken care of, you can look into the medications you've already been prescribed. There's lots of information on the internet. See which ones may be sleep disrupting for you. Look at any thyroid issues you might have or any other health issues. Chronic pain is a big one too. And by doing that, you can actually eliminate or deal with those initial things way before you resort to medication like Ambien. There are medications that can knock you out

like antipsychotics, but they're dirty medicines. They cause a lot of side effects as well. Dirty medicines, I like that. Dirty medicines. You can't fish in. Dirty medicines. I like that. Dirty medicines. You can't fish in muddy water, right? I like that. Okay. So sleep hygiene.

One of my favorite things has been hypnosis. Yes. And I actually have a hypnotic on Brain Fit Life. I have a hypnotic thing for sleep. I think my first three published papers was, I mean, they were like miraculous things using hypnosis for sleep. I think my first three published papers was, I mean, they were like miraculous things using hypnosis for sleep. Parkinsonian tremor went away when I put a person in a trance for sleep, even before he went to sleep. A heart arrhythmia normalized under hypnosis for sleep. So that can be positive. In your course, you have a meditation that people can do. And I

know Tana has meditations on her site. I'm not a meditation expert. I just found that it really works for me. It's retraining your brain to a calmer state. And then when we come back, we're going to talk about supplements. And okay, if you have to use medicine, what are some of the ones that won't get you into trouble? Okay. 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 interested in coming to Amen Clinics, use the code PODCAST10 to get a 10% discount on a full evaluation at amenclinics.com. For more information, give us a call at 855-978-1363.