Search for tag: "insomnia"

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Scot: Welcome to the "Sideshow" on "Who Cares About Men's Health." We're going to talk about an article that I found about sleep. This is kind of interesting. But the first question I have for you guys, Troy and Mitch, is would you like a sleep consultant? Would you like to have somebody in your life that would help you make sure that you're getting the optimal amount of sleep?

Mitch: Are they sitting and watching me sleep or . . . Because that's the first thing I thought of. I don't know if that's accurate, but just what do you mean?

Troy: Yes. There are people who do that.

Mitch: I know. But it just sounds . . .

Troy: They're also called stalkers, but yeah.

Mitch: Just pull up a chair and watch me toss and turn.

Scot: That's right. Maybe you should lay on your left side, Mitch, for a little bit. I notice you seem uncomfortable on your right side.

Mitch: Right.

Scot: "Thanks, sleep consultant."

Troy: I'm going to say no, I would not want that just, because it would just make me more frustrated than I already am. I know my sleep is not good.

Scot: So this is kind of interesting. In the Olympics, Olympic teams, a lot of times they have coaches and trainers and physical therapists and massage therapists and all that so they can perform at the height of their abilities. In Tokyo, the U.S. weightlifting team had another person on the team to help athletes perform at the top of their game. It was a sleep performance director. They're the only Olympic team to have such a thing on their staff. And this person's job essentially . . . He said, "I'm a sleep doper, is what I am. I just try to manipulate using people's natural rhythms and sleep to make sure that they get the maximum amount of sleep and recovery."

Troy: Sorry, which team was this?

Scot: The U.S. weightlifting team.

Troy: Oh, wow. And only the weightlifting team. It wasn't like the soccer team or anyone else?

Scot: Yeah. This year, it was just the weightlifting team. So Jeffrey Durmer, Dr. Jeffrey Durmer, he's a neuroscientist who specializes in sleep, and he's been doing this since 2013. He's been a sleep consultant that helps optimize athletes' performance through sleep programs and just using natural physiology and science to improve the sleep.

I thought this was an interesting thing. He said, "What we found is the concept of overtraining syndrome really is not about overtraining. It's about under-recovery." And when we talk about the core four, we talk about activity, nutrition, emotional health, and sleep as important components to your health. And I think that really underlines how important sleep is, first of all, that Olympic team had a sleep consultant, and then this notion of under-recovery.

Something else that the doctor said that I really, really liked was this notion of, "Don't think of going to sleep as ending your day. Think about it as getting ready for tomorrow." You guys like that?

Troy: I like it. Here's my thought on sleep. And it's funny, I was just thinking about this today. Sleep is the new smoking. I feel like we're going to look back . . . honestly, I think we're going to look back in 30 years and be like, "What were we thinking?" in terms of our approach to sleep, in terms of often disregarding it. Obviously, we're seeing changes there, but we feel like, "Oh, anyone who sleeps eight hours a night is weak. I admire people who sleep five hours a night and look how productive they are."

And I think in 30 years, we're going to look back and be . . . kind of how we look at smoking in the 1950s and '60s now. You look back at the doctors who would smoke and appear in ads and be like, "Smoking is healthy." It's funny. Maybe I thought about that because I'm actually listening to a book on the history of tobacco right now.

Yeah, I feel like sleep is the new smoking. And in 30 years, we're going to be like, "Wow, we were stupid."

Scot: The doctor said that the most important part of his job as a sleep performance director is first educating the athletes about the benefits and necessity of sleep. So there's this mentality, like you referenced, Troy, "I'll sleep when I'm dead," or when you're an athlete, you've got to use all those waking hours to train.

Troy: Yeah.

Scot: So that's the first thing. And then the second thing is to actually help the athletes and the individuals sleep better. And we've talked about some of this stuff before, but I think it's worth repeating. I would like to have a sleep expert on and talk about this notion of, out of the three of us, maybe one of us does better going to sleep at 3:00 in the morning and sleeping their eight hours until whenever they get up. This notion of you have to get up at 6:00 in the morning or 5:00 in the morning, that doesn't necessarily work because everybody has their own kind of natural sleep rhythms, if you will.

Troy: Yeah. But it's fascinating to me too, and I think we talked to Kelly Baron about that, the idea that there are short sleepers out there. People who function just fine on three, maybe four hours a night. And her response was that, "No, they don't. These people don't exist. They just have learned to be tired." They've learned to be tired, and that's how they function.

We all need sleep. We're not superhuman. And it's so prevalent in the medical profession. That's what's so hard for me. It's just this idea that it's crazy how . . . As medical professionals, sure, I'm going to tell patients who need sleep, but among our profession, how we disregard that. And we even look at people who prioritize that as weak or unfit.

I think in our society, larger society, it's in so many areas people disregard it. And certainly in the tech industry, I think there's a lot of that there where it's like, "Yeah, you can work all day and party all night, or work all night too and get by on four hours of sleep," and that's the definition of success. So, hopefully, that'll change.

Scot: Yeah, the short sleeper notion that Dr. Baron talked about, I think about that a lot. The notion that they've done research. There are still these people in the world that say, "I only need four hours of sleep, and I work great. I actually do better than if I sleep too much."

But what their research found that I wanted to also throw out there is they do things to really keep themselves awake. They drink a lot of caffeine beverages, or a lot of sugar beverages, or they really amp up their excitement level and their intensity to try to push through it.

So it's not necessarily they don't need fewer hours of sleep. It's just they found strategies to get around that and cheat sleep a little bit, which, as you said, cheating sleep, not a good idea.

Troy: Yeah. And I think as they studied those people, too, they found that they engage in multiple what they referred to as microsleeps during the day, where essentially, their brain is turned off. Their eyes are open, but their brain is off, which is a little scary if you're driving. That happens and they may try napping or just . . . essentially, involuntarily napping, just doze off for 10, 15 minutes just to try and . . . Their body is trying to compensate.

Mitch: Well, for me, when I'm hearing Troy talk about the social impact of how it's cool not to sleep, etc., I think the one that I get tripped up on a lot is, "Am I sleeping right?" And for sleep to be such a standard biological process, there's a part of me that's like, "Oh, I have to have the most perfect sleep hygiene. Am I sleeping right? How do I optimize whatever?"

And so I guess what I wonder is, does the consultant help you figure out how to do that? Because that would be great, especially if you're trying to personalize and figure out what works best for you, rather than just what works for everyone.

Scot: This consultant in this article did give some suggestions, so I'll go ahead and go through those. We have heard some of them. There's a couple of them that I hadn't heard before.

So wind down before bed. Slow down 30 to 45 minutes before you go to sleep. This individual suggested setting an alarm even to remind yourself to do that. How many times have you been like, "Oh, geez. I've got to go to bed now"? You don't get that 30 to 45 minutes to wind down. So meditation, reading, stretching, anything that helps you settle.

The second suggestion is to cool your core. So take a warm shower or a bath and then rapidly cool your body in the air.

Troy: Oh, interesting.

Scot: And that helps you fall asleep faster. Also, belly breathing will help with that as well.

Troy: Haven't heard those before.

Scot: Treat the bedroom as a recovery sanctuary. So the technology stays out. We've heard that, right?

Troy: No TV.

Scot: You can't be reading that stuff. Yeah, not only the light of the technology, but sometimes the content when you're scrolling and looking through the comments of Facebook or social media

Troy: Yeah, it gets your blood pressure up.

Scot: Don't add anything until you've eliminated stuff. So light, noise, heat, bed discomfort, or objects that stimulate wakefulness.

Include sleep as part of your training. This was the notion that sleep is your basis for your performance the next day. So think of your sleep as the beginning of tomorrow, instead of the end of today.

And then be mindful of your own sleep habits and patterns. Are you giving yourself enough time to sleep with a regular routine?

And if you still are doing all these things, you're winding down, you're trying to get the eight hours, and you're getting to bed on a consistent time, you're getting up at a consistent time, and you still don't feel rested, then they suggest you get professional advice from a sleep physician.

So there are a couple extra tips for how to make your sleep a little bit better. Any final thoughts on that?

Troy: Yeah, it's got some interesting points in there. Again, I hadn't heard that about the shower and then cooling your body core down after that. That's an interesting concept.

The other stuff, like you said, Scot, the screen time, that makes great sense, and having that 30- to 45-minute wind-down time, definitely essential just to slow the brain down, decrease all the external stimuli, and then be ready to go to sleep.

Scot: Hey, this is Scot. Thanks for checking out the "Sideshow" episode. By the way, I've got a couple of extra little sleep tips. So these are some thoughts and concepts that have come up over the course of the podcast tying back into the core four, and just remembering how your activity, your nutrition, your stress, your sleep, and your genetics can impact your health. They all interrelate. They're not separate things.

So, over the course of the podcast, we've learned nutrition can also have an impact on your sleep. So take a look at how late you're eating, how close to bedtime you're eating, how much you're eating.

We've talked to Thunder Jalili about intermittent fasting. And if you stop eating before bedtime a few hours, sometimes that can help you sleep. I know it definitely changed the way that I sleep when I stopped eating, say, at 6:00 p.m. versus having a snack at 9:00 p.m. or 10:00 p.m.

Another one of the core four is activity. So getting some activity can help you with your sleep. Again, I know from personal experience if I get the activity that I need to get during the day, but not too much because if you overtrain, that can actually limit your sleep, but getting some activity, making sure that you get out and being active will help you with your sleep as well over time.

Of course, stress can really impact your sleep. So we have some old episodes on some better tools to deal with stress you might want to check out. Or you might want to get some sort of help and find somebody you can talk to to get those tools to deal with stress.

Alcohol and other substances can impact your sleep as well. Alcohol is notorious because a lot of people think it actually helps them fall asleep, but research has shown that you do not sleep as well after you've had alcohol. You don't get into that deep sleep. So that could be another cause. And other substances you might want to check out for smoking or drugs.

And then there could be some medical conditions that some of the symptoms might be sleep-related. They impact your sleep. Obviously, the obvious one is you have to get up and go to the bathroom. It could be something going on with your bladder, your kidneys, or it could be a health condition that you're not aware of.

So if you're not sleeping, those are some other things you can check out. A good first step is to go to your primary care physician and just let them know that you're not sleeping very well, and you can start working through some of those things.

You can also check out some of our past episodes where we talked about sleep. Episode 6, we talked about if sleep trackers work or not. Episode 11, how to beat your insomnia. So some tips there from our sleep expert, Kelly Baron.

And then Episode 44, tips for better sleep. And those are some of the sleep hygiene things that we briefly talked about here, but we have a little bit more of an expanded conversation with sleep expert, Kelly Baron.

And then Episode 45, that's your mental health toolbox episode. Just such a great fallback episode with some exercises, some breathing exercises that might help you as well.

All right. Thanks for checking out the show. Next week, we're really super stoked because we're going to have a migraine update. We had a show about men and migraines and we learned . . . Well, we knew Troy had migraines, but we learned that Mitch also suffered from migraines, even though he wasn't admitting it to himself. And they both went to a doctor to find out more to see if they can get help, and we'll find out about that next week on "Who Cares About Men's Health."

One last thing, if you know somebody that would get use out of this podcast, please do us a favor and share it with them whether it's on social media or in person just by saying, "Hey, I've got a really cool podcast you might enjoy," if there's a specific episode that might help somebody. It's the best way to help us get into the ears of more men and help more men care about their health.

Other ways you can reach out to the show if you want to contact us include hello@thescoperadio.com. You can go to our Facebook page facebook.com/whocaresmenshealth. And then we also have our listener line. You can leave a message at 601-55SCOPE. That's 601-55SCOPE.

Thanks for listening. Thanks for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

There are times when you know it's right to sleep and you know that there are times of the day that your mood's a little better than others. And you know that there's a time of day when you're hungry and there's a time when you're not. And there's a time when you emotionally go up and down, and it turns out that your body, our bodies, have a circadian rhythm.

That means throughout the day, some things are more or less on and some things are more or less off. And this is called the circadian rhythm, and it turns out there are controls of our circadian rhythm that don't have anything to do with necessarily when the last time was you ate or what the lights are outside although there are social cues to how you decide when you're going to eat and sleep and be happy and take your tests. But in general, your circadian rhythm is set by cues inside your body.

Now, with us in the studio today is Dr. Chris Jones. Dr. Jones is an MD and a PhD, and he studies when creatures do stuff. He's a chronobiologist. He studies when creatures do stuff and why they might do those things when they do.

Dr. K. Jones: Can I call you, Chris?

Dr. C. Jones: Oh, all right.

Dr. K. Jones: I can call you Chris, as long as they don't call you late for dinner, right? And in the interest of full disclosure, Dr. Chris Jones has lived with my chronotype for over 45 years. So he has a lot to say about chronotypes, and he can speak up about mine if he ever wanted to. So welcome to the studio. Now, we're going to ask Dr. Jones or Chris, Chris, how would you define chronotype?

Dr. C. Jones: Basically, there are two obvious chronotypes. One is the so-called morning lark, people who wake up very early and they're very happy when they wake up early. And then there are night people who don't fall asleep until sometimes well after midnight, 2:00 or 3:00 in the morning, and we call those people night owls.

Dr. K. Jones: So how is your chronotype determined, and are you born with it?

Dr. C. Jones: Yes, definitely. We think this is a genetic predilection to be either a very morning or very night person.

Dr. K. Jones: So, certainly, there are mutations that make people morning people or evening people, but in fact, all of our genes work together to fine tune our chronotype. So if you were to look at people, there are some very few really morning people, and there are some very few really late people, but then there are sort of morning people and there are sort of evening people, and there are a bunch of people in the middle. There's a bell-shaped curve of times that people like to go to sleep. So does your chronotype change as you go through life?

Dr. C. Jones: Yes, absolutely. The adolescent period is a time when we become later and later and later sleep onset people. In other words, sleep phase delay, and every parent of an adolescent knows that their kid is wide awake at midnight, who knows what they're doing out on the town. And even in very rural circumstances, like the jungles of Central America, sociologists know that the moms and dads in the jungle have no idea where their children are in the dark at night and what they're up to.

Dr. K. Jones: But they do know that they kind of stay up late when everybody else is sleeping and then they wake up late. And we know from researchers in the Kalahari Bush that the word for teenagers means owners of the shade, meaning they keep sleeping in the shade all day because they've been up all night. And this is part and parcel with being an adolescent is you get to be more of a night person. And then what about later in life?

Dr. C. Jones: Well, some people actually use 20 years old as the end of adolescence because that is the age at which people stop getting more and more of a night person or sleep phase delayed sleep schedule. Later in life, things get more variable, whatever your sleep schedule was in your teens, 20s, and maybe your 30s, you know, we're pretty healthy and our genes are working well, but you get to be my age and you don't sleep quite as deeply and sleep schedule could be a little more variable. So it's like everything else, the older you get, things start to fall apart.

Dr. K. Jones: Don't say that. Well, so older people tend to be a little bit more morning people, but whether it's their biology or just because their joints hurt or it's time to get up because they can't sleep that much more.

Dr. C. Jones: Well, the bladder and the joints are the two biggest complaints that elderly people have about their disruptive sleep. They attribute it to bone and joint pain and the bathroom calling and things like that.

Dr. K. Jones: Oh, the bathroom calls me.

The planet has its own chronotype, and it changes where you are in the planet. And particularly, in the very upper and lower latitudes, when the days are very, very long in the summer and the nights are very, very long in the winter, there are some serious problems when the planet doesn't want to work with your own chronotype. What happens to people who are living in very northern climes when it's bright all the time, what happens to their mood or their sleep?

Dr. C. Jones: First of all, it's thought that the sleep-wake cycle and a lot of the way our brain works evolved in the deserts of Africa, Equatorial Africa. And then we migrated north into the Scandinavian countries. So the folks who live in the Scandinavian countries may or may not have evolved as much as they would have liked to those northern climes. But basically, it's as you said, there are months in the year where it's dark for most of the 24-hour day-night cycle.

Dr. K. Jones: And during the time that it's light people get a little manic when it's light all the time. There's a famous movie called "Insomnia" with Robin Williams and Robert De Niro, and a detective moving up to Alaska to solve a mystery gets a little crazier and a little crazier because he can't go to sleep. It's easier to kind of huddle in when it's cold and dark, so you tend to sleep a little bit longer in that winter months. People get a little more depressed in the winter months. So the planet has its very own chronotype, but it changes through the year.

Your circadian rhythm isn't only just about your sleep. It's about your emotional highs and lows. People tend to get a little bit more depressed at night and are sometimes a little bit more activated and positive in the morning. And there's also some evidence that the evening time is time for people who have a tendency toward depression. It's a time when people tend to involute. They tend to look inward a little bit more. In the evening time, they're tired. They have a tendency toward depression.

And so, when you're thinking about having conversations with people that might be important, it's important to know where they are. In the morning, people are often a little bit more activated. Not everyone. Certainly morning people are, they got the get up and go. They're feeling pretty optimistic. I think of all the farmers on the planet who have to get up early and get going and they have to feel like they can get stuff done, and there's some biological cues for this.

But in the evening, before we go to sleep, we tend to be more involuting or turning inward and shutting down a little bit all our activities in the brain. And some people get a little bit more depressed at that time and having conversations that might be important, you have to spend some time understanding where somebody might be in their daytime schedule.

Dr. K. Jones: So you have a certain chronotype, you would like to get up at a certain time, but life isn't always like that.

Dr. C. Jones: Usually, that means the person is sleep-deprived. If you don't have the option of falling asleep when your brain really wants to fall asleep, you probably will not fall asleep. And therefore, you'll be sleep-deprived the next day, and that has profound implications for relationships with other people because you're irritable. It also does not impress the employer because you've been late to work. Whatever your work schedule is, it may or may not work with your circadian rhythm.

Dr. K. Jones: Well, and there's some data that says shift workers or night workers who haven't flipped over completely to working nights have a higher rate of cancer. And this has to do with an important hormone made by the brain and now we know it's made throughout the body called melatonin.

And melatonin seems to have some anti-cancer activity in our own bodies, maybe because it's such a powerful antioxidant melatonin is. And people, particularly women, and we've studied this in nurses is that nurses who spent most of their career working night shifts have significantly higher rates of breast cancer. Melatonin may be acting, perhaps there's an antioxidant effect. It's important not to suppress your melatonin because it's there for a number of reasons, and people who work in bright lights all night long and are trying to sleep during the day may be suppressing their melatonin. And that might be some of the activity that might make women more likely to get certain cancers.

Adolescents who are often taking tests, so when I think about my test taking years, although as a physician, I took tests right up until my 60s, but you take tests and when you take your tests, your intellectual health, so what is the chronotype of your brain? When I think about adolescents who might have to take SAT tests at 8:00 in the morning or they have to go to school at 8:00 in the morning and their brain says they should still be asleep, so your intellectual health, there are times of your day when your brain is really on and you've sat across the table from me, looking at me at 9:30 at night and looked at me and said your computer is shutting down, I can watch it. So there are times when your brain isn't working. What do you do about that?

Dr. C. Jones: Oh, it's really hard to argue with your genetic morningness, eveningness sleeper type. There are some things you can do to nudge it one way or the other, and the most powerful is to fix morning wake-up time with lots of light and fix the evening as very dark, as dark as you can, but that doesn't always work for everybody with a very morning or very evening biological genetic sleep schedule.

There are times when you're feeling really sharp and there are times when you're not so sharp, and actually in some of the web-based chronotype questionnaires, they would ask you as they're trying to figure out whether you're a morning person or a night person, when you feel like your work is most productive, or when you feel like you do best on a test. And people often know this, they know when their brain is the sharpest, and that plays into their chronotype, their intellectual wellness.

Dr. K. Jones: Clearly, if you're doing finances, it's important for you to know when your brain is the sharpest, when does it like doing arithmetic. Now, I love arithmetic and I'm a morning person. So I like to do my finances and think about finances certainly before 2:00 in afternoon. But for couples who might have different chronotypes, our sleep psychologist has a really important quote about when couples should talk about money.

Dr. C. Jones: Absolutely. This is from the experience of Dr. Laura Czajkowski, a psychologist at University of Health Sleep Center for quite some time. And her recommendation, very strong recommendation for people who have insomnia or difficulty getting to sleep, one major factor is to schedule the money discussions before noon. Do not wait until the afternoon. It's too close to the evening bedtime. What you want is to get the real sort of irritating discussions that can arise long before you have to go to sleep.

Dr. K. Jones: And when you're actually interested in solving problems and not interested in going to bed or not going to bed angry with someone, so always do your financial discussions before noon, according to the sleep psychologist. Just that you know, you do your finances when you're cognitively most alert and you don't do your financial discussions with your bed partner after noon.

Culturally, around the world, there are some cultures whose religious practice is focused on the rising of the sun and certainly Eastern Indian practices in terms of morning yoga. Yoga is not usually done at 10:00 at night. It's something you do in the morning. And some spiritual practices are morning-based.

In Western culture, we go to church in the mornings, but we tend to pray at night. And everyone has a different way of expressing their spiritual life. But it often is based either on morning or evening. It's not usual that we are expressing our spiritual practice throughout the day, except in some quite observant religious cultures. And I think specifically about many monasteries, which might actually pray seven times a day and their prayer is based on the first thing in the morning, the midday, noontime, afternoon and evening prayers, and then there is a bedtime prayer. And, of course, in Islam, they pray multiple times a day.

However, for many cultures, their spiritual practice may be morning based or evening based. And for people who don't have a particular culture, they may find their own time, which is best for them. And it may be based on their chronotype. It may be based on their social time. It may not be so busy in the morning that moms don't have a minute to think about their spiritual life. And it's something that's done later in the day.

But people who tend to work on their spiritual life tend to do it at about the same time of day. And knowing when that time of day is, recognizing how it's important to you, being able to express it to the members of your family, so that you have a little bit of quiet time to indulge, or it's not an indulgence, it's actually important practice of your spiritual life is going to be important in terms of being able to make sure you have the time to do your own spiritual awareness and connections.

What happens in a household with 2-year-olds and 17-year-olds and 40-year-olds and 75-year-olds? How do you work a house when you've got so many people with different chronotypes either because of their age or because of their biology? How do you get along and do so without disrupting each other's hard-wired biological sleep-wake schedule?

Dr. C. Jones: It's really an exercise in relationships between people. And I hate to say that because I'm a guy, but that's really what has to happen. People have to realize, you know, mom's been up early because she's breastfeeding or she's up late because she's feeding somebody or somebody's screaming. And we know from a brainwave recordings that even a whimpering noise can bring a sleeping mother up very close to wakefulness and sometimes full wakefulness. So now you've got a sleep-deprived mom, and sleep-deprivation is really good at causing irritability.

Dr. K. Jones: Well, that's not personal. You're not talking about this personally, given that I spent so many years as an OB, was chronically sleep deprived for about 35 years. But so your brain works . . . when you're sleeping, your brain actually is working, it's sorting out what's important, it's remembering things that are really critical. So you may wake up at 2:00 and if you're really awake, it's like, oh, I forgot to send someone . . . I need to send someone something. And in the olden days, you wrote it down and when you woke up in the morning, you gave someone a call. But now, we can actually post something at 2:00, even knowing that someone won't get it until they wake up.

It's not uncommon for people to remember something that's important when they wake up at 2:00. And that's a time when your brain has been sorting out what you need to remember and what you don't need to remember. That's when you'll say, "Oh, I'll just send her a text." Now, I don't recommend doing that in the middle of . . . because then you really wake up and then you get very fragmented sleep. So it's better just to roll over, not turn on a bright light screen. Just roll over, write down the note. Just tell yourself to remember it in the morning, because things that you tell yourself before you go to sleep tend to be things that you remember.

We've been talking for about a half an hour about sleep, wake, your chronotype, circadian rhythms, when you wake up, when you're sad, when you eat, are you a night person or a morning person, and all parts of your life which are affected by your circadian rhythms. And tomorrow is another day. So not living your chronotype has some biological effects. People who do shift work are more likely to gain weight. So people who aren't sleeping well. So increased rates of obesity, increased rates of cancer, increased irritability, difficulties at home, all those can happen when you're not able to live your chronotype.

Do you go to sleep?
Wake up now, get up later
It is in your genes

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This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Sleep is absolutely crucial to your health. A lack of sleep can contribute to an increase in stress, weight gain, and a whole slew of potential health problems. Getting a good night's sleep is so important to your health, we consider it one of our Core 4. For optimal health, adults should be getting seven to nine hours of restful sleep a night.

Yet, a recent Harvard study said that as many as 70% of people in the U.S. are getting less than six hours of sleep a night and experiencing "sleep difficulty" at least once a week. Considering so many people struggle to get a good night's rest, what are people to do?

Dr. Kelly Glazer Baron is a clinical psychologist specializing in sleep. She works with patients at University of Utah Health to improve their quality of sleep through behavioral modification rather than medications. It's called Cognitive Behavioral Therapy for Insomnia (CBT-I) and it may prove beneficial to most people struggling with their sleep.

Dr. Baron suggests patients try following these four basic rules for CBT-I to start improving their sleep.

1. Spend the same number of hours in bed that you sleep.
2. Don't stay in bed unless you're actively sleeping.
3. Don't go to bed unless you're tired.
4. Wake up and get out of bed at the same time every morning.

Like any health journey like weight loss or getting in shape, the road to consistent good sleep takes time. Don't expect immediate results, but following the rules of CBT-I may help a person see significant improvement in their sleep in just a few short weeks.

If you are still struggling to get a good night's sleep, talk to your doctor and consider working with a sleep specialist. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Dr. Kelly Baron, is a clinical psychologist in behavioral sleep medicine from the University of Utah sleep center. According to Dr. Baron, while many people have trouble sleeping for one reason or another, insomnia is a very specific sleep disorder that is characterized by:

• Difficulty falling asleep, staying asleep, or waking up too early
• Difficulty sleeping occurs at least three times a week
• Lack of sleep could cause negative effects in your daily life

If these symptoms last for longer than three months, it is considered chronic insomnia.

Acute, or short-term, insomnia may be triggered by stressful life events. Whether it be a major exam or a big presentation at work, you may understandably have difficulty falling asleep with stressors.

The problem is that insomnia can take on a life of its own. Those nights of lost sleep from a stressful event can become a "precipitating event." After a person loses sleep for a couple of nights, they can become stressed about getting sleep. They may try short term fixes like taking naps and drinking more coffee just to get through the day, but these fixes actually further harm a person's ability to sleep. It can quickly become a cycle that's hard to break.

"A person can't 'try to sleep'," says Dr. Baron, "You just have to let it happen."

Cognitive Behavioral Therapy for Insomnia, or CBTI, is the top rated treatment for the American College of Physicians. As many as 80% of insomnia patients see an improvement in their sleep after CBTI therapy. It's been proven to be even more effective than sleep medication and is used as a first line treatment for most sleep disorders.

CBTI focuses on changing a patient's relationship with sleep. It focuses on getting a person on the sleep schedule their body needs, then training them to relax and fall asleep. This is achieved through:

• Sleep restriction
• Stimulus control
• Cognitive intervention
• Relaxation training

CBTI begins with working towards sleeping on a schedule that actually works for a patient. A physician will look at when the person is actually sleeping and go from there.

It may seem backwards, but CBTI starts with reducing the amount of time a person spends in bed. It doesn't help to lay in bed for 10 hours or more, when they only get six hours of sleep. That's a lot of wasted time spent stressing about falling asleep and not getting any. It's more important to work on getting a sleep schedule where you go to bed and then fall asleep.

Dr. Baron shares a few resources on CBTI that a patient can try at home before seeking professional help.

She highly recommends The Insomnia Workbook by Stephanie Silberman or Quiet Your Mind and Get to Sleep by Colleen Camey. Both are books that help walk you through CBTI and provides exercises to help you finally get to sleep.

For people interested in a more tech savvy approach, there are apps like CBTI Coach, Sleepio, and SHUTi that all turn the tenets of CBTI into fun coaching apps that help you track your progress.

It's important to know that a lot of the techniques in CBTI can be difficult when you first start doing them. The exercises can take a few weeks to see any results. They require commitment and a bit of discipline to be effective. Your sleep health is a lot like you physical health. You can't go to the gym twice and assume you'll be fit, it takes work, repetition, and forming good habits to reap the benefits of the therapy.

If self guided CBTI doesn't seem to be working for you, you may want to seek professional help. Meeting with a sleep doctor make sure they don't have any other serious sleep problems besides insomnia. They can also act as a coach assisting in further CBTI help.

It can take a few weeks to get into a sleep clinic. Dr. Baron suggests that while you wait you start logging your sleep, so that you can discuss the results with your doctor on your first visit.

Treatment at a sleep clinic usually takes 3-4 visits, and over 70% of patients see improvements in their sleep at the end of the series of treatments.

Sleep clinics are covered by most insurance providers.

Say you're soaring down the trail on a mountain bike. You hit a rock going a bit too fast, and go up and over the handlebars. Should you go to the ER?

Troy says it depends on your injury.

Any road rash, scrapes, or minor cuts are not an emergency and can be treated by yourself or at an urgent care clinic.

Broken bones, twisted ankles, or injured joints can be serious, but can be scanned and treated at an urgent care. The clinic physician at these facilities can take an x-ray and determine if you need emergency care.

The most serious injury in a mountain bike accident is a concussion. If you hit your head and are experiencing confusion, vomiting or you lost consciousness, go the the ER immediately. Concussions can be potentially life threatening and need to be assessed by a doctor as soon as possible.

Medical misinformation is spread mostly through social media. These stories often have no evidence and can promote remedies that can be downright harmful. These stories include stories about smoothies that can cure cancer, essential oils as alternatives to important medical intervention, and - in a more dire situation - a series of articles that claimed that drinking bleach could cure children of autism.

According to a recent pair of articles by INC.com and FastCompany, the sharing of these stories have become such a problem that Facebook has been retooling its algorithm to help reduce the spread of medical misinformation.

Troy admits that even physicians can have trouble making sense of scientific and medical claims, especially those shared online. Bad science can sometimes even be published by trusted news outlets. So how can you make sure the information you read online is real?

1. Make sure the article references a study with a link that you can read yourself. Often a quick read of just the abstract of a study will show serious problems with the research the article is based on.

2. Check to make sure the article is based on multiple studies from reputable journals. Single studies are often proven wrong by additional tests and more exhaustive studies. Additionally, there are scientific journals that will publish anything for money. Make sure the study isn't from one of those.

3. If the article wants you to click on a link or buy something, it probably isn't real.

4. Be skeptical. Always. The internet is full of more bad information than good. You should assume an article is fake until proven otherwise.

5. Google the medical claim. If there's been a medical breakthrough, other places online will be publishing about it. Double check it isn't a one-off study.

6. Doubt articles that make you emotional. If an article aims to make you fearful, frustrated, or upset, there's a good chance they're trying to sell you something. Good science isn't overly emotional.

7. Read more than the headlines.

According to the article by Fast Company, 75% of the top 10 most shared health articles were false or based on bad information. In fact, some of these articles included advice that was potentially harmful.

One study about depression was shared in The Guardian. It claimed that depression was not due to a chemical imbalance, but by a lack of fulfillment in one's life. Researchers found that the claims made were not backed by and research. The article was actually based on an excerpt from a book by a lay person who was vehemently against psychiatry.

Be diligent and a critical online consumer. If you read something, don't act on it, don't share it until after you see if it's worthwhile.

On this episode's Just Going to Leave This Here, Scot is still doing Tai Chi and learning the most challenging part of learning something new and Troy bought new socks as a treat for his feet. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

Announcer: Need reliable health and wellness information? Don't listen to the guy in the cube next to you. Get it from a trusted source, straight from the doctor's mouth. Here's this week's listener question, on The Scope.

Interviewer: Today's patient question is about sleep. This particular individual's having a hard time falling asleep at night. So they'll go to bed, they lay down, but you know, they can't get to sleep. Dr. Tom Miller, what do you recommend to your patients in that situation?

Dr. Miller: Well, first thing I ask is, what's changed? Is there more stress in their life? Is there something going on at work? Is there a family problem? Is it related to depression, perhaps? I'll look at those issues.

The next thing is, are they following a sleep schedule? Are they getting to bed at the right time, same time? And are they getting up at the same time each day? Because of our busy lifestyle we're sometimes all over the place. Monday through Friday, we may have some variable times in which we go to bed because of when we're going to work and we have morning meetings. And then on the weekends maybe we stay up late and go out and then get up late.

These kinds of disruptions in sleep patterns make it difficult, even more difficult to get a normal night sleep. The first thing I'd say is let's try to get you back into a regimented sleep pattern, so that you go to bed at the same time each night. After that try to mitigate the stress. You know, what are you doing at work or what can you do with work or family that would help you. Sometimes this may result in counseling or maybe even in the most extreme case, a change in job, you know, so that they . . . if it's bad enough, that they can get sleep.

And then ultimately if folks are still having trouble falling asleep, a short course of medication designed to help people fall asleep can be helpful. But I don't like the idea of using those long term because they have some problems associated with them. So there are number of medications on the market as prescription medications that do help people fall asleep, and they're pretty effective in small doses, for, say, up to two weeks. The other thing that I will talk to folks about is alcohol. If they're using alcohol to get to sleep, that's not a good idea.

Interviewer: All right, so you're not a big fan of the medications generally because they can actually cause more problems down the road when you stop taking them. Is that correct?

Dr. Miller: I think the problem with meditation is we jump to that as a solution before we look at sort of lifestyle issues. Whether you're, you know, increasingly stressed at work, whether you have frustrations, whether there might be depression, those are the issues that I like to tackle first before moving on to medications. You can do them simultaneously, but not assessing the lifestyle aspect of insomnia would not be the right way to approach this problem.

Interviewer: So take a look at the lifestyle, try to get that consistent sleep pattern. If you go to your physician at that point, if those other things aren't working, they might put you on a short course of some sleeping medication. If you come off . . .

Dr. Miller: As you're working on your lifestyle changes.

Interviewer: Yeah, yeah.

Dr. Miller: Getting to bed at the same time, tackling those frustrations at work, trying to regiment your lifestyle in a way that allows you to reduce the amount of stress and frustration that you might have in your life.

Interviewer: Yeah, those are underlying causes.

Dr. Miller: Underlying causes.

Interviewer: And if they get to the point where they've tried those things and they feel that they've put in a good effort towards those things, still not working, where do you go from there?

Dr. Miller: We start looking at sleep patterns and thinking about things like obstructive sleep apnea. We think about depression. Has the physician done the right evaluation to sort out whether the person has anxiety state or is depressed? There are different treatments for those problems. So, as we go down, you say an algorithm for insomnia, we will get to those sorts of things where we are digging in a little deeper to try to find a solution and treatments.

Interviewer: So it sounds like the first step for a lot of people is something they can do on their own. It's just take a look at their life and see are there causes of stress and what can I do to perhaps reduce that, maybe finding professional help.

Dr. Miller: Yeah, the majority of folks with insomnia usually have this for a short period of time. It doesn't go on for a long periods of time. So, for instance, in grief response if someone in the family has died and you're not sleeping, you know, treating that short term likely will result in a return to normal sleep patterns, as would be the case with stress at work. These things usually disappear as soon as the stress is resolved.

Announcer: Have a question? Ask it. Send your listener question to hello@thescoperadio.com.

Announcer: Health information from experts supported by research. From University of Utah Health, this is thescoperadio.com.

Interviewer: We all know someone that sleeps six hours or less each night and then they claim that doesn't bother them. Actually, they say they thrive on little sleep. Is that really the case, or is it really not good for their health? Paula Williams is an associate professor of clinical psychology at University of Utah. And Brian Curtis is a clinical psychology PhD student. And they are part of a research team that is researching a phenomenon called "short sleepers," and these are people that sleep six hours or less a night and report no ill effects.

So the first thing I think we need to do, and Paula, would you please define what a short sleeper is? I kind of summarized, but did I miss anything there?

Dr. Williams: Well, at the broadest level, it is someone who sleeps six hours or less a night on average. The recommendation is seven to nine hours. The people we're interested in, though, are also habitual short sleepers. That is, regardless of the work schedule or vacation schedule, these are people who tend to sleep six hours or less.

Interviewer: Yeah. And we all know, maybe, you know, you are one. Are you a short sleeper?

Dr. Williams: I am not.

Interviewer: How about you? Are you a short sleeper, Brian?

Brian: I'm an insomniac, but that's a whole different . . .

Interviewer: Oh really?

Brian: Yeah. I've had insomnia. My mother has insomnia. My three older brothers have insomnia. So it's in the family.

Interviewer: Sounds like it, yeah. I'm definitely not a short sleeper. But about 30% of the United States are short sleepers the way you define them. But then there's a 10% subset. Explain what that group is like.

Dr. Williams: Right. So about a third of the population report they don't sleep more than six hours. And within that group, however, there is a small percentage, maybe 10% we think, that feel fine on six hours or less. They don't feel the usual negative effects that most of us would. That would include fatigue and irritability, etc.

Interviewer: And they claim they're different almost. It seems like.

Dr. Williams: Yes. For some it's a badge of honor that, "I can, I feel fine. I don't need much sleep. I feel good." And so they're a fascinating subgroup of people that we want to understand better.

Interviewer: And it can be concerning because the question is, is that really the case? Or are they just as susceptible to the detriments of lack of sleep that the rest of us are?

Dr. Williams: Right. At a minimum, we can say that they feel better. And so that's something in and of itself. But there are lots of other questions about whether cognitively, objectively they are functioning as well as they perceive themselves to be. There is a whole area of psychology that is looking at the discrepancy between self-assessments and objective assessments. And that's something that's of interest to us.

Interviewer: And, Brian, short sleepers think that they function just as good as somebody who's gotten the seven to nine hours if not better. Why do they think that way?

Dr. Williams: That's the million dollar question.

Dr. Brian. That's why it took me aback. I mean, that's just how they feel. I mean, they are reporting that in fact they feel just as good and in my experience, talking to these individuals, often better. I mean, these people they tend to be almost the flipside of what you would expect, at least what they're reporting, of somebody who has been sleep deprived or who's sleeping six hours or less. In other words, instead of having less energy, they report having more energy. Right? So this concept of behavioral drive, these people are always on the go it seems.

A couple of these participants have told me that their idea of hell is just nothing to do. Like what if we put you in a room, you don't have your phone, you have nothing to read, right, that to them is very, very off putting.

So this high degree of stimulation, behavioral drive and they just feel fine. They've been told by many, many people that something is either wrong with them or, you know, there are a bunch of negative health consequences, but they just feel fine.

Interviewer: So I would love to be able to get two extra hours a day, right? So is there a way I can become a short sleeper? Are there strategies that they're using to actually survive on less sleep, or are they just genetically different than you and me?

Dr. Williams: Right. We don't know, and that's why we're researching this question. It's a question that we get a lot because everybody wants to do more in less time, to have more time, etc.

But, you know, there's too much research out there on short sleep duration and health consequences that we need to look at this subgroup more specifically.

Interviewer: To see if that applies to them.

Dr. Williams: Exactly. So it's possible that someone is feeling fine, but they're not fine. So we just need to know more. And we need to know how their partner perceives them as well. So part of what the research would look at is, what do other people report in terms of their behavior and their functionality.

Interviewer: How could a person determine if they or a loved one are a true short sleeper? I mean, is it just simply cut and dry as they're not getting the seven and nine hours of sleep that they should?

Brian: I think the most important thing there is, if you take away societal obligation, you take away needing to wake up early for work or to stay up late to study, whatever it is in your environment that's dictating your sleep schedule. If on the weekends with a lot of opportunity, right, you're still getting six hours or less a night, if you're on vacation, that's still the case, often with these individuals this isn't something that started in college or when they got a high pressure job. A lot of these people report that they've kind of always been this way, reaching far back, even into childhood.

And it's also not uncommon to hear that they may not be the only person in their family that tends to have this sleep pattern as well. So there seems to be a familial pattern of short sleep. And that's been borne out at least in one study that our research colleagues, Chris Jones and his geneticist collaborators, they found a mutation in a mother and a daughter. And when you put that human mutation into mice, you now have short sleeping mice. And not only short sleeping mice, but these mice run more on their running wheels during the day. So you have a behaviorally driven mouse.

So this was back in 2009. That's almost a decade old. And since that time, we haven't found a similar slam dunk mutation in families. So it does appear that these genetic short sleepers may be very, very rare. But assessing them objectively into the lab and getting more of these people is the goal now.

Interviewer: I would be a little scared if I was a short sleeper right now, because of all of the evidence that's out there that says, "If you're not getting seven to nine hours, you know, it could be detrimental to your health." And we don't know a lot about whether or not it is. So if I am a short sleeper, do I worry? What should I do? Should I try to get more sleep?

Dr. Williams: No. These are important questions. But the reason we don't know is that the vast amount of medical research is epidemiological. It looks across the population and looks at associations. What we're trying to get at now are individual differences. That is, are there differences between people in the effects? And we know that at least in perception there are.

Interviewer: But as far as behavior changing, if I'm a short sleep or have a loved one, really, at this point, nothing you should do. I mean, if it's true short sleeping, that you're not, you know, getting up because you have responsibilities, you're not sleeping because of stress, but you just naturally do that, just get up after six hours.

Dr. Williams: You know, a question I would ask somebody is, what are they doing to stay awake, for example, because one of the things we think about some of these short sleepers, given what Brian just said about behavioral drive is that they are seeking out stimulating activity in the night. And what I would recommend is pulling all environmental stimulation. You know, what we should be sleeping in is the equivalent of a cool, dark cave. If you put yourselves in that kind of situation, do you still not sleep? Right?

Interviewer: Yeah. So that might be a good thing to check.

Dr. Williams: Yeah.

Interviewer: A good experiment to do.

Dr. Williams: I would do that. And all kinds of things we know, like having a routine, trying to sleep at the same time, not having in a hot environment, noisy environment, all of these things, light blocking shades. Try all of those things. And then see how your sleep is.

Interviewer: And you might discover, it turns out, you're a regular sleeper.

Dr. Williams: Right. Or, I mean, part of what I study is personality and so that's part of what we see is that people are behaviorally different around sleep. In fact, sleep might really be part of personality.

Interviewer: So if somebody is concerned that maybe they should take a look at some of their sleep hygiene things or some lifestyle things. Ultimately it might end up that they're just sleeping six hours, because that's just how they're wired, and at that point, I mean, at this point, what do you do then?

Brian: They get in touch with us.

Interviewer: And become part of your research study.

Dr. Williams: Part of the research.

Interviewer: Okay. And how would they do that?

Brian: So our laboratory has a website. It's restlab.psych.utah.edu. And on that website there there's a section for the short sleepers study. They can go there, read up a little bit about the background. And if they're still interested, there's a quick questionnaire that they can complete online about eligibility criteria. And then a member of a research team will get back into and go forward from there.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com.

Announcer: Need reliable health and wellness information? Don't listen to the guy in the cube next to you. Get it from a trusted source, straight from the doctor's mouth. Here's this week's listener question on The Scope.

Interviewer: So Tracy has sent us an email. She says she's been having trouble sleeping lately and she says that one of her girlfriends gave her a sleeping pill for the same problem. She says that so far, so good. But Dr. Jones, what's your take on this? She's wondering if this is actually okay by a doctor's point of view.

Dr. Jones: Okay, well, let's talk about sharing your prescription drugs. First of all, it's not a good idea to share your prescription drugs. Although it's not uncommon for women who often share their medical problems, meaning they'll discuss it with a girlfriend, and they may have medications that they feel like they've got extras. And that could include Valium-like drugs for anxiety, or it could include sleeping pills.

Usually birth control pills, I don't recommend that because then you're missing some so someone's missing out. And the person who's getting them isn't getting enough to make a difference, so that's not such a great idea. So in general, taking other people's medications is a bad idea. Also, dispensing drugs without a license is a felony.

Interviewer: Oh, that's illegal?

Dr. Jones: That's illegal. So your girlfriend, she's got a little problem with the law. It's a good thing you didn't give us your girlfriend's name, Tracy.

So what about sleepers? It turns out that 30% to 50 % of Americans have difficulty sleeping on occasion, and it's not uncommon to have an acute episode, maybe it's a divorce or it's an upcoming test or it's financial trouble. They keep you from sleeping. You say, "God, if I could just get a good night, one good night's sleep, I could solve this problem."

There are medications that are available over the counter that work a little bit for sleep. They are sedating antihistamines and you can get them. Benadryl and doxylamine under Benadryl you can get over the counter, and it's used as a sleeper. Unisom is a brand name you can get over the counter. These antihistamines, antihistamines are drugs people use for allergies and things like that, are mildly sedating so they can work for some people. I'm not the only one who's taken a hit of NyQuil when I didn't really have the worst cold in the world because I just couldn't get to sleep. And NyQuil has Unisom in it or doxylamine.

Now, taking somebody else's drug for that one time makes you kind of think that another time would be okay and then another time. And first of all, you don't know how that medication is going to affect you. That medication was given to that specific person for a specific reason in a dose that at least someone thought was appropriate for them. Just because you're like your girlfriend and the same age, maybe you even wear the same clothes, that doesn't mean your biology is the same and it may not be the right drug for you.

So taking another person's sleeper can have some unexpected consequences. Most sleeping pills actually don't give you that much extra sleep. They do make you close your eyes, but your sleep quality is not that great, and you can have difficulty with sleepwalking, sleep talking, or sleepy driving. You may have difficulty waking up in the morning. So if you're worried about something and you need a really careful brain, sometimes taking a sleeping pill may not be so great for you.

So in sum, most sleeping pills are not all that great, although the placebo effect is big. So you took the pill, you fell asleep, now you know it's good for you and you want some more. Mostly in general studies, sleeping pills aren't that great for sleep. Taking somebody's medications that aren't yours may actually harm you. My guess is you've already taken it and you feel okay and now you think, "Wow, maybe I'll ask her if she's got some more." That kind of diversion of drugs is illegal, so I don't think that's such a good idea.

I think that if you're having difficulty sleeping you should see your health professional, or there are actually some free online techniques for helping you sleep, cognitive behavioral in therapy for insomnia, CBTI. There's some online tricks for helping yourself sleep better. Don't share your birth control pills. Definitely don't share your narcotics. Don't swap out your antibiotics because the person who was given them should have taken all of them, the full dose.

I think taking somebody else's sleepers, it didn't kill you, that's good news. You think it's great, you want some more. I think that usually there's some other medications that might be better for you, and I don't recommend taking somebody else's pills. You can share your peanut M&Ms but don't share your drugs.

Announcer: Have a question? Ask it. Send your listener question to hello@thescoperadio.com.