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Geriatrics Grand Rounds presented by Kerrie…
Speaker
Kerrie Moreau, PhD Date Recorded
February 13, 2024
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Geriatrics Grand Rounds: "Sleep and…
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Krishna M. Sundar, MD, ATSF, FCCP, FAASM Date Recorded
February 06, 2024
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Sleep often gets sidelined in men's health…
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July 25, 2023
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To some guys, sleep can seem so easy, a baby…
Date Recorded
November 01, 2022 Health Topics (The Scope Radio)
Mens Health
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It seems like a badge of honor for some men to…
Date Recorded
February 22, 2022 Transcription
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.
Scot: Getting up at 5:00 in the morning and then grinding into the night to get things done, that's a badge of honor. "I'm not lazy. I'm getting it done. I'll just get a couple energy drinks and do it again tomorrow." Probably heard the saying, "I'll sleep when I'm dead." That feels pretty manly to say, by the way.
Regardless, if it makes you feel good to tell people how little you sleep, or there are other reasons you're not getting sleep, sleep has proven health benefits and not getting enough can have similar downsides as not getting enough activity or good food.
You could have the other three core four dialed in and if you're not getting enough sleep, it could sabotage at all. That's how important sleep is.
So today, on the "Core Four: Back to Basics" series, we're going to talk about sleep, how good sleep improves your life and how to get better sleep.
My name is Scot Singpiel. I bring the BS to the proceedings here, and the MD to my BS is Dr. Troy Madsen. And before you say hi, I want you to say, "I'm Dr. Troy Madsen, and I'll sleep when I'm dead," in your manliest voice.
Troy: I'm Dr. Troy Madsen, and I'll sleep when I'm dead.
Scot: Also we've got Mitch Sears in the mix. Same thing.
Mitch: I'm Mitch Sears, and I'll sleep when I'm dead.
Troy: Sounded like you were thinking about it. You're like, "I'll sleep tonight."
Scot: We have one opportunity for our manliness to be saved here, and that's Thunder Jalili.
Thunder: I'm Thunder Jalili, and I will sleep when I'm dead.
Scot: There you go. All right. So, today, we are going to talk about the benefits of good sleep. And for some reason, I think society kind of undervalues sleep. What do you guys think of that? When we think about being healthy, it's pretty common to come to nutrition or exercise, but sleep is just as crucial as we're going to learn in a couple of seconds. Is it just me, or does society kind of devalue it? And why do you think that is?
Thunder: I think actually American society maybe does devalue sleep. I think it's part of our work hard work ethic, get it all in and don't be a wimp, and get your stuff done, because other cultures around the world aren't like ours. The Spanish, they value sleep. They have a nap built into the day. We're not like that.
Troy: Yeah, I agree. I think we definitely undervalue it and it certainly is a badge of honor for a lot of people. And as someone who works in the healthcare profession, I can say it is absolutely a badge of honor. If you can talk about how little you sleep or let's say you say, "I just came off a night shift and I didn't go home and sleep, and now I'm here in the office working all day," that's a badge of honor. It's not like, "Wow. That's stupid." Yeah, no question about it.
Mitch: I remember when I was working in broadcast, you would come in and the night shift would be coming off and they would have their pile of energy drinks and they would just be very proud of how much caffeine they were functioning off of and "still getting a good job done." That was always very like, "What are we doing?"
Scot: Dr. Madsen or anybody, do you think that people just don't realize the benefit of sleep? Because a lot of times it's the first thing to get jettisoned, right? When things get tight in your life, that's where you'll cheat, either getting up early or staying up late to get things done. Do you think it's just because people don't realize what that tradeoff is actually costing them?
Troy: Yeah, it may just be that we don't quite realize the magnitude of the effect. I think we recognize, "Yeah, there's some detrimental effect, but those effects are more immediate. I'm tired, but I can use caffeine. I can drink some caffeine or whatever, and that will eliminate that short-term effect." But I do think we definitely undervalue the long-term effects.
Thunder: Yeah, I agree with that. I think cutting sleep is an easy thing to do in the short-term to get things done, and there are ways to get around it, like Troy said, with caffeine. So I agree with him completely.
Scot: All right. I think that's a good segue into talking about the benefits of getting enough sleep and how it can impact your health. Thunder, go ahead and kick us off on that.
Thunder: So there are many benefits to getting good sleep. I'll just share a couple with you. One is sleep is actually tied into maintaining healthy body weight. And I know that's a big focus of what we've talked about on this show in the past. We talk a lot about the exercise and the nutrition component, but getting enough sleep is also a valuable contributor to healthy body weight.
The other thing that's great about sleep is it helps you keep your stress levels low and it helps improve your mood. If you think about it, think about the nights that you haven't gotten a good night's sleep and you wake up the next day and you're just kind of a little grumpy or a little off and things are bothering you. That's something everyone has experienced, and that's really that function of not getting enough sleep.
So having that regular sleep schedule can definitely improve with that. It gives your mind a chance to reset at night and reduce your stress level.
Troy: Yeah. Thanks, Thunder. And the other thing too that I've definitely seen plenty of studies that have shown that sleep lowers your risk for diseases like diabetes and heart disease and cancer as well, like long-term studies.
It's a little scary because I've often seen these studies done with shift workers like myself, which is kind of depressing, but it is one of those things. They do find those who don't sleep well do have higher risk of diabetes, heart disease.
I think the obvious thing we've talked about already is it does help you to think more clearly. But this is something that's been quantified in multiple studies. They've kept people awake for 18 to 24 hours and just noted their ability to perform tasks just declines over time to the point where . . . At 18 to 24 hours, you're at a point where your technical skills, and your focus, and your attention are on par with if you were legally intoxicated. So definitely effects there.
I think we all know we've had those experiences when we don't sleep well, we get sick. Sleeping well helps us to stay healthier, get sick left less often, and helps us look better too. We look better. We look healthier. Our appearance is improved when we sleep well, when we're well-rested. So that's a big thing as well.
Thunder: Don't have those bags under your eyes.
Troy: Exactly. Get rid of the bags.
Scot: I'm noticing the last two episodes that that's been Troy's thing, appearance. So do you want to talk about something?
Troy: I'm feeling self-conscious about my appearance and I need to sleep more. Maybe that's it.
Scot: You look wonderful.
Troy: Thanks, Scot.
Scot: We're going to hit up here some of our sleep struggles and then what we've done to try to work through those or not work through those.
But first, Mitch, let's talk about, like we have in past episodes, the basics. These are kind of the rules that you want to try to incorporate when you're talking about sleep.
Mitch: Yeah. And these are the ones that have been kind of tried and proven from research and studies, etc. So these are kind of the things that have the most evidence behind them.
The first thing that you want to do with your sleep is to prioritize it. And it's important to realize that when you prioritize sleep, it also means that it's not just quality of sleep. It's also quantity of sleep.
So what they're saying is that you need to get at least a minimum of seven hours and that you can't really just make it up. You can't sleep four hours one night and nine the next and expect it to be as healthy as if you were to get seven hours each night.
The other thing is that in order to get a better quality sleep, try to go to bed at about the same time every night and wake up at the same time every morning, which is something that we've kind of talked about before with Kelly Baron on a previous episode about everything from your sleep hygiene to making sure that you're going to bed and waking up at the same time every morning.
Now, the other thing you want to make sure to do is to not underestimate how things you do during the day can impact your sleep. A lot of things you do throughout the day can really impact not only the quality, but the quantity of sleep that you're actually getting. So make sure that exercise, nutrition, and mental health are all big factors that go into your sleep.
Stress, anxiety, depression can all impact how well you sleep every night. Activity, exercise during the day is good, but not less than two hours before bedtime. They've shown that that can kind of interrupt your sleep cycle, if you work out too close to going to bed. And finally, caffeine, alcohol, and nicotine four to six hours before bedtime and big meals before bed can impact your quality of sleep.
So you just want to make sure that you're not working out too close to bed, but you should be working out through the day, and to kind of avoid some of these different chemicals that can really impact the quality of your sleep.
The other thing is that sleep environment needs to be dark, quiet, and a comfortable to temperature. By making sure all of those things are kind of in place, it will really improve the quality of your sleep.
And make sure that you are not doing things that engage your brain like screens, TVs, games, radio, talking on the phone. If you do those things too close to sleep, it can also impact the quality of sleep that you get.
And finally, if you've tried everything else and you are still having trouble with sleep, go talk to a doctor and rule out that you don't have a sleeping disorder.
Scot: Some good basics there. So let's hit the sleep struggles. I want to start with Troy because you work in the ER, you work crazy shifts, you might be working during the day for a few days and then you do an overnight shift. What is one of your sleep struggles?
Troy: My sleep struggles are so plentiful, it's difficult to choose from them. But like you said, Scot, I do shift work, so I end up working nights, evenings. And for me, evening means I get to bed at like 2:00 or 3:00 in the morning. Night means I get to bed at like maybe 9:00 or 10:00 in the morning.
Scot: Wow.
Troy: Yeah. And so I'm trying to do that and then turn around double back and do a 7:00 a.m. shift the next day and do a 10-hour day on that.
So I have no doubt, and I think talking to Kelly Baron, it was very clear I do suffer from shift work sleep disorder. It's not something I really had prior to doing shifts when I started my residency training.
I have plenty of times where I think I don't struggle so much to get to sleep. I generally fall asleep once I get back into my regular routine, but then I will often find that I'm awake four hours later and just lying there and not sleeping. So that's probably the biggest for me.
I feel like I can get to sleep, I can fall asleep, but then I'm often awake a few hours later and not sleeping at that point. So that's definitely a struggle and I think not an uncommon struggle, definitely for people who do shift work, but I think a lot of people I've talked to have that issue as well.
Scot: Yeah. I look forward to hearing if you have some things that you've figured out of work around that. I mean, you can't totally fix it, right? The best you can do is kind of make the best out of a worse situation.
Troy: Yeah.
Scot: Thunder, how about you? Do you have any sleep struggles or you do all right?
Thunder: In general, I do all right. But my sleep struggle that does come up from time to time, believe it or not, is temperature. If it's too warm, I have trouble sleeping. So I have to be aware of that. Most of the time it's fine, especially in my own house, but when I travel, sometimes you're out of your comfort zone and you're someplace where the temperature may not be right.
So I try to do what I can, make sure I'm not putting too many covers on the bed because if it's too warm, it's tough. Hopefully I can adjust the temperature in a room, things like that. But that's my main challenge.
Scot: I'm pretty fortunate that I haven't had a lot of struggles. I have a job that allows me to have a pretty regimented sleep schedule. And for the most part, I fall asleep. For the most part, I sleep through the night. And then for the most part, I'm able to wake up in the morning when I need to. So I am pretty fortunate.
I think my biggest challenge, though, is I'm always thinking. My brain is always going, and sometimes I'll just lay in bed and I can't quite shut it all off. And part of it might be my fault. Maybe I was doing something too close to bedtime, but that's kind of mainly the struggle that I have.
How about you, Mitch?
Mitch: So I guess I have a slightly different story here. I have always struggled with waking up feeling refreshed. Every single night, it just feels like I haven't gotten any sleep the night prior and it's day after day after day, month after month.
I've been working with my doctor for the last year to try to figure out what I should be doing. And from stuff that we've talked about on the show, I've made sure that I go to bed at the same time every night. I'm waking up at the same time in the morning. I've played around with using a little bit of melatonin sometimes before bed. I've tried making sure not to look at screens or anything beforehand, and it doesn't seem to help.
And it was just recently after trying all of these things, my doctor had me do an at-home sleep study and they think they have found that I have sleep apnea. So I am waiting to go to do a formal sleep study in the next month or so and kind of figure out what's going on.
The struggle I've been having is I try everything and I still feel so tired. And when it comes to the Core Four, I'm working on my nutrition, I'm working out, I'm doing all the mental health things I can, but sleep has been one that's been really troublesome. And it eventually led me to talk to the doctor and we might be able to actually fix it now that we can find what's going on.
Troy: That's great you did that, though, Mitch. You talked to them and you went and looked for help. Yeah, that's a common story I hear from people where they say exactly that. They feel like they're getting plenty of hours of sleep, but they are just awake and they are not refreshed.
And I'm guessing they talked to you about in your sleep study, or in the sleep study you'll do, if they do see that, you wake up so many times at night due the sleep apnea that you're really not sleeping a whole lot, or at least good, deep REM sleep.
Mitch: Yeah. And that's kind of what they've explained. It's like, "Hey, if you have a sleep disorder, whether it be apnea or . . ." They talked about some restless leg syndrome. They talked about all these different kinds of things that can keep you up through the night. It doesn't matter what you're doing. It doesn't matter how often you're going to bed. It doesn't matter how healthy you are with your sleep hygiene and your hours and everything. If your body has something a little messed up that is waking you up all night, it doesn't matter. So that's where I'm at.
Troy: You're going the right direction. That's good. That's good to hear.
Scot: Mitch, do you find that impacts you, any of your other Core Four, like your nutrition, your . . .
Mitch: Oh, yeah.
Scot: How so?
Mitch: So I find that on days where I have not had any restful sleep and it's been day, after day, after day, when your energy level is so low, the idea of cooking a meal goes right out the window, right? In my sleep deprived state, all I want is a Big Mac. You go straight to the fast food whenever you can.
When I'm tired, I find that I can't work out the way I'm supposed to. When I go out for a jog or something like that, I can't go nearly as far as I think I need to. The whole process is really kind of frustrating and your heart rate gets up higher than it's supposed to, etc.
And mental health-wise, things . . . We're living in a very stressful time right now and I find that on the days where I don't get enough sleep or I'm not able to sneak off and take a nap in the middle of the day, I get really stressed and my anxiety gets high and I'm quicker to be frustrated and all sorts of things.
And it's been really surprising, ever since starting working on this podcast, that I'm focusing so much on all aspects of my health, but sleep was the last one. Sleep was the one that was like, "Eh, that one will figure itself out." But here I am learning that maybe I have something else going on. And hopefully, by working with my doctor and finding out a treatment plan, maybe in the next little while I can start seeing better results elsewhere.
Scot: That's a great point about how "maybe it'll just work itself out," right? This notion of "something might fix itself," I think that can be kind of dangerous, and I think a lot of us guys have that.
Mitch: And that was kind of the thing that was interesting when I first started speaking with my doctor. He was like, "Well, yeah, if you're having trouble sleeping, you might be having mental health stuff. Why don't you go talk to someone about that?" and, "Oh, when you start getting more activity, I'm sure you'll feel tired by the end of the day," and, "Oh, if you improve your nutrition and drink less caffeine, I'm sure your sleep will kind of fall into place."
And so, for the last year, I've really been working under that assumption that sleep is easy, sleep is going to just happen if I do all these right things. But if you're out there and you've been trying everything, maybe it's time to talk to a doctor.
Scot: All right. Let's go ahead and talk about maybe three struggles or three things that we've learned and what we've done to overcome those. And again, the hope is that if somebody else is struggling with something similar, this might be a new, fresh idea for them.
So I'm going to kick things off with this notion of a dedicated bedtime, being sure that you get to bed at the time that you've decided to get to bed. For me, it was 10:00. And it was challenging because if it was 9:15 or 9:30 and my wife and I were up and we were hanging out and she wanted to start a show, I'm like, "Well, it's going to be 52 minutes. I can't do that. That's going to put me past my bedtime."
Or sometimes I feel like I don't have enough time in the day to get things done. And I'm sure that's something that a lot of men deal with. And so, as a result, you push into the night, or what I've learned is you kind of have to prioritize what's important or ask for help to get all the things done that you need to get done. You can let go of some of those things.
So a dedicated bedtime has really, really helped me, and it helps me wake up a lot more refreshed, but it is challenging for those reasons and other reasons as well.
Troy: Scot, I'm going to jump right on that, and I'm going to say also a dedicated wake-up time. That's been big for me. We talked about that also with Kelly and just saying, "I'm going to get up every day." For me, it's, "I'm going to get up every day by 7:00 a.m. regardless."
And certainly, I have shifts where I have to get up early. I don't care if it's the weekend, whatever. Granted, I did mention there those times I'm getting to bed at like 3:00 or 4:00 in the morning, so I might sleep in a little after that. But once I'm in my regular routine, I'm up at 7:00, and I know I'm going to get up at 7:00.
Just knowing that, it kind of helps mentally, because before, I would kind of give myself this nebulous wake-up time. If I didn't have a shift or if I didn't have something going on early, I'd be like, "Well, I'll just get up when I wake up, because I have to make up for my missed sleep."
And then during my night sleeping, I would just lie there and I wouldn't really fall back asleep and I would just be like, "Well, I don't really have to get up. Okay. Maybe 9:00. Maybe it'll be 10:00." Kind of this mental thing where I just kept putting it off in my mind.
But I think knowing, "Hey, I'm going to be up at 7:00," something about that mentally just lets me know, "This is my sleep time, and I'm going to take advantage of it and I'm not going to sleep past that, so don't think I'm going to be able to make up what I'm missing now by sleeping in until 9:00."
Thunder: So I'm going to jump on the regular schedule bandwagon as well. I'm also all about that, going to bed about the same time and waking up about the same time.
I will add one thing about the waking. I usually wake up around 6:30, give or take a little bit, and I never have to set an alarm because I'm used to waking up at 6:30. So all the things that you have to do in life that you have to wake up early for and you need to set an alarm for, I never do that, and I find it cuts down on my stress level the night before. You're not thinking, "Oh, I've got to wake up extra early," or, "My alarm is going to go off," or something. You just wake up at your normal time.
The new thing I'll add to that is I have a bit of a relaxation routine that I engage in almost every night, and that is I read a little bit before bed. And for me, that works. I'm talking reading out of an actual book, or a magazine, or sometimes I'll read on my Kindle with a black screen.
So that kind of helps my mind disconnect from whatever was going on during the day and get lost in something else for a little bit. And I don't last too long reading. Maybe I can do like 10 minutes to 30 minutes, depending on what it is. So that's part of my routine, that little relaxation moment.
Scot: All right. Mitch, you're up.
Mitch: So the thing that it really helped me out is I'm the worst millennial. I am on my phone up until . . . I used to be, at least. I was on my phone up until the moment of my bedtime. What I have found is that regardless of your phone, most modern phones, whether it be an iPhone or an Android, they have digital wellbeing settings. And if you can go into there and turn them on and respect them, it has really helped me make sure that I'm not doing too much screen time before bed.
On my phone, at least, I set in my bedtime. I'm like, "Hey, I want to start winding down. I want to stop using my screen for an hour before bed. Here's when I want it." And when the phone hits that time period, it turns off all my notifications, it turns super-duper dim, and black and white.
And it seems kind of dumb because it's like, "Well, I can still use the phone." But for some reason, the lack of color, the fact it's super dim, the fact that you can't hear anything, it really helps just kind of disconnect and set it aside before I go to bed.
Scot: That was a big thing for me too. Up until recently, I would go to bed and I'd get out my iPad and I'd scroll social media, and then I'd find something that enraged me and then I couldn't stop thinking. Somebody would make some comment and then I would spend the next hour coming up with what my comment would be back to them, right? So, for me, getting rid of that social media has been absolutely crucial.
And the other thing that I struggled with too, and, Mitch, tell me if you did this, are the Instagram Reels, which are like TikTok videos, right?
Mitch: Oh, yeah.
Scot: I'd watch those. And even if I'd quit an hour before bedtime, then I'd have one of those stupid songs playing in my head and I couldn't get it out and fall asleep.
Mitch: Well, it's so easy to just get sucked into that hole too. You're just scrolling, and swiping, and swiping, and swiping and the next thing you know, it's like, "Oh, man, I've been doing this for two hours."
Troy: And how much of our life do we waste just thinking about snarky replies to other people's snarky replies?
Scot: Right?
Troy: I totally hear you on that. It's like, "What am I going to say to this?"
Scot: That I would never ever actually enter in, but I'll spend a lot of time thinking about what it's going to be.
Troy: Yep. I'm going to think about it, and it's going to be good. It's going to keep me up all night.
Scot: All right. Number two for me. Now, I don't know if this is a type of meditation or what, but it's a little exercise I do. It could be considered maybe a form accounting sheep or whatever. But if I'm struggling falling asleep, I will pick a color. That kind of tends to be my go-to. So I'll pick the color green, for example, and then I'll just let my mind go and think about things in my life that are green or in my past that have been green.
Troy: Oh, wow.
Scot: It takes me down this kind of memory lane. My parents' first car that I remember was this big green Plymouth from the 1970s. And then I'll think, "Oh, I had a toy box. It was a frog, and it was green." I just kind of let my mind go where it wants to with whatever color I've picked, and I find that after a few minutes of that, I feel kind of tired or I might just fall right asleep. So it's a little weird, but it's worked for me.
Thunder: So it's so boring that it puts you to sleep?
Troy: I guess so. I just feel like that would be too engaging. You would really be thinking way back into your childhood and trying to come up with all different things. I don't know. That's interesting. You just kind of let your mind wander and somehow that puts you to . . . I've never heard of people doing that, but whatever works.
Scot: Yeah. I mean, I get the engaging part because I have caught myself in the trap where I'm engaging and thinking about it too much. I think, for me, the trick really is just to let your mind wander through your past and just those things that were green. So anyway, that's mine.
Thunder: It almost sounds like a type of meditation. You pick one thing and you just kind of reflect on it and just let your mind go on it.
Scot: I don't know why it works, but it works. Who's next?
Thunder: Another thing that works to me for me is related to . . . We talked a little bit about temperature of the room is important. So we have this Nest thermostat in our home and it's programmed to start reducing temperature around 9:00. And it's great in a winter because by the time I want to go to bed around 10-ish, the temperature of the bedroom is probably like around 65 degrees, which for me is a good temperature.
So it's kind of good. It's automated, so I don't have to do it. It just happens every evening, and that is part of what helps with my sleep schedule.
Troy: Well, kind of along the lines of making sure you're addressing external factors, for me, it's about white noise and sleep mask.
Six years ago, I reached a point where I said, "I'm going to do everything I can to try and optimize my sleep and do what I can to optimize it and control what I can in terms of environment." For me, that meant white noise.
And for me, white noise means I actually have earbuds I sleep with that are made for sleeping. They're comfortable. They're soft. And then I just have a white noise thing I play that I listen to there, just kind of a sound of a fan or something. And I wear a sleep mask.
For me, that's made a big difference just being able to have that, control what I can, trying to eliminate the light, and noise, and all those sorts of things.
Mitch: And even for people who aren't doing shift work where you might be trying to sleep during the daytime, there are a lot of little itty bitty lights that are turned on in every room, in my house at least, whether it be a little power indicator light, or whether it be the light on a fan, whatever. And it has been night and day since I've gotten my sleep mask how quickly I'm able to fall asleep and stay asleep.
Scot: Tell me more about these earbuds that you have in because I've seen Bose advertise these sleep-only earbuds, but they're super expensive, right?
Troy: Yeah, crazy expensive.
Scot: Yeah. So did you find a cheaper alternative, and how do they work?
Scot: Mine are super, super cheap. It's like $10. They're designed to be ergonomic flat. They're noise-blocking. So they're just earbuds. They're soft. It did take about a couple weeks to get really used to them and comfortable with them.
Thunder: Hey, Troy, have you ever tried just foam earplugs?
Troy: Yes, I have.
Thunder: I've done that on occasion when I'm somewhere where there's a lot of ambient noise.
Troy: Trust me, Thunder, I've tried everything. And once again, I'm probably going to admit things here that are very embarrassing, but I not only have tried foam earplugs, I've tried foam earplugs with construction-type . . . like those noise blockers, those big headphone things that construction workers wear.
Mitch: Oh, my.
Troy: I'm a side sleeper, so I actually took an old pillow and I actually hollowed out a little spot in the pillow.
Scot: Oh, my.
Mitch: Oh, wow.
Troy: I was that desperate to try and block noise that I tried it. And I actually used that for a couple months. I took a lot of heat from Laura, from my wife, making fun of me, that I was that desperate that I tried that.
Finally, just these ergonomic things, these earbuds with just white noise going through it, that's what worked for me. So trust me, I've tried it.
Scot: Mitch, what do you have?
Mitch: So one of the things that is a constant struggle for me is I'm a list maker, like, "What is my to-do list? What am I doing next?" And when I try to fall asleep, for the longest time, it would just be, "Okay. What do I have to do tomorrow? I'm waking up, I'm doing this, I'm doing this, I'm doing this."
And what I found is that I keep my day planner . . . When I'm going to bed, as part of my ritual, I take the day planner, I climb into bed, I take my little pen out, and I write everything down that I'm going to be doing the next day. And for me, at least, that has really helped cut down the anxious thinking about the next day that typically happens when I try to fall asleep.
Troy: Yeah. I've heard of people doing that. And just doing a notepad, not typing it on your phone because you don't want the blue eye to mess you up. You just have a notepad, something is on your mind, write it down, deal with it later. That's a great idea.
Scot: My last one is another weird one. It works for me. I don't know if it'd work for anybody else. But sometimes when I have a hard time falling asleep . . . I'm a side sleeper, but I will lay on my back with my knees bent. Can you kind of picture what that looks like? What? Why are you laughing?
Mitch: You're just curled up and thinking about colors, and that's . . .
Troy: That's called a fetal position, Scot. You're doing it on your back.
Scot: No, I'm not on my side in the fetal position. I'm on my back and I've bent my knees, right? So if you were to come in the room, you would see this big bump of where my knees are in the comforter, right?
Troy: Yeah.
Scot: So I will lay on my back with my knees up. I mean, 99% of the time, if I can't fall asleep within five minutes, if I do that, I will fall asleep.
Troy: Wow.
Scot: I don't necessarily fall asleep on my back, but I get so tired from that position that I will turn over to my side and I can fall asleep. I don't know why it works. I don't know how I discovered it, but there it is.
Troy: I just want to be a fly on the wall in your house, Scot, and just see this, just see you lying there and sleeping with your knees brought up to your chest.
Mitch: And then talking about snakes and cars.
Scot: No, it's not all way up to my chest. I'm not that flexible. It's just like a 45 . . . Yeah, it's like a 45- or 90-degree of your knees.
Troy: I'm trying to think of the physiology of this, how this might work. I will tell you there are certain things called vagal maneuvers that basically increase the blood flow to the head and slow the heart down.
If someone comes in with a very rapid heart rate in the ER and something called super ventricular tachycardia, we will do a procedure where we lay the head of their bed down and lift their legs up at the same time to increase that blood flow. And that sort of has a calming effect on the heart rate.
So I'm trying to think of this physiologically, Scot. I don't know if there's anything to that, but it's interesting you do that and you found that works. Maybe there's something to it.
Scot: Thunder, you're up next.
Thunder: Well, this last one may be kind of old fashioned, and it doesn't actually pertain to me exactly. But I think having a television in the bedroom, a lot of people have that. I think that could actually interfere with sleep. I've never done that, but similar to being on the phone, being on a tablet, laptop, whatever, I think having a TV on when you're in bed trying to go to sleep . . . Again, it's something to engage your mind and keep you active. So that's something I think we should consider.
Scot: And Kelly Baron, when she was on the show, talked about the bedroom is for two things. It's not to watch TV. It's to sleep and to . . . I guess we're going to go to Troy next.
Troy: And to make sweet love. Is that what you want me to say, Scot? Anyway, Scot, moving on from that, this third thing I'm going to say is something I am going to try. And I will tell you I recently celebrated a birthday. For this birthday, I received a gift, and my sister was so excited to send me this gift. She said, "This is something I heard about on the podcast." The gift I received was a toilet light. So Mitch suggested this. This is one of the gifts Mitch suggested getting.
Mitch: Yes.
Troy: And I have now been using it for about a week. It's awesome. It's got a motion sensor, Mitch. It's everything you described. You come in . . .
Mitch: I told you.
Troy: Yeah, it's so cool. It's like a joke kind of gift, but I've used it and I'm like, "I love it." You come in and it just . . . I've got it on this very dim, purple light. It just hangs over into the toilet. It just lights up the bowl like this little beacon in the night, like, "Oh, there it is." I don't have to flip on lights. I'm not struggling to find the toilet. It's great.
I think it definitely helps you to avoid those interruptions in your REM sleep where you're flipping on lights and you're too focused on the task at hand, so to speak. Instead, you've got the toilet light, great, in and out, go back to sleep.
Mitch: I love that. A couple of my friends also purchased. So I don't know how much reach we have in this podcast, but some toilet lights were bought this Christmas season because of what we were saying. And I cannot be more delighted because everyone has been saying, "This is ridiculous. I can't believe I spent $10 on this." And then the next day they're like, "It's wonderful. This is the best thing. I don't have to wake up. I don't have to turn on the lights."
Thunder: Yeah. Add me to the list. I also have a toilet light.
Scot: What?
Mitch: Yes!
Thunder: Yeah. And it is, it's awesome. The only thing that I don't like about the toilet light is it . . . or maybe it's just the one we have. When the batteries start to go low, it flashes red like a police siren.
Troy: Oh, no.
Mitch: Yeah.
Thunder: So that's the one thing. You walk in there and batteries are always like, "Flash, flash, flash." It's like, "Oh, my gosh." It's very bright red. But love it.
Mitch: It's interesting you thought police siren. I thought poltergeist the first time I woke up in the middle of the night and there was a flashing light in my bathroom. I was like, "My house is haunted. I've got to go figure this out."
Troy: Your toilet. Something is going to emerge from the toilet.
Mitch: Yeah.
Thunder: But all in all, it is really a great invention.
Troy: Well, we've got three believers here, Scot. I think you're next.
Scot: Yeah, I guess.
Troy: Now I know what I'm going to get you for your graduation.
Scot: Oh. Yeah.
Troy: Because we know that's coming up soon.
Scot: Oh. Mitch, you're taking us out with number three.
Mitch: So the last one is actually a tip for my partner, Jonathan, and it's kind of this same thing. If you have difficulty sleeping and it has something to do with not being able to turn your brain off or not being able to just let go of the anxieties of the day, the thing that he does every night as part of his sleeper team that he's come up with is he has a series of positive affirmations and mantras that he tells himself.
At the start, again, I think there's a touch of toxic masculinity where I'm just like, "You're doing what? You're positive self-talking before bed?" I don't know. I need to be better about that. But he has seen a significant . . .
Scot: Go ahead and incorporate that into your self-talking.
Mitch: Right. I've got to bring that in to me, right? But he's found a lot of real benefit from it. And I've been trying it out recently where it's just . . . If you are someone who's struggling with any sort of negative self-talk or any sort of . . . if you go to bed and you replay the bad moments that happened through the day, if that's you, this has been really helpful.
And it sounds cheesy and it feels ridiculous. You're looking in the mirror telling yourself something, but it works for him. And since I've been doing it, I've been finding myself able to go to sleep faster.
Thunder: Mitch, I think that's awesome because I think we're good at being hard on ourselves about different things and replaying those in our mind, but we're not good at the opposite, patting ourselves on the back when we need to.
Scot: This turned out to be a far more entertaining show than I could have expected.
Mitch: Not the snooze fest?
Scot: Yeah, not the snooze fest I thought it was going to be. I was like, "What are we going to talk about?" But I think we've learned a lot about each other.
Troy: And I'm so glad you shared, Scot. I'm so intrigued by your sleep techniques. Anyway, it's definitely been entertaining.
Scot: Yes. It's been a good show. So I think the takeaway is that the Core Four . . . Sleep is one of them. And a lot of times, if you get your activity, and your nutrition, and your mental health right, the sleep will take care of itself. But sometimes it doesn't. Sometimes maybe the sleep is the first thing that you need to tackle.
The Core Four don't live in isolation. They all impact each other. And like Mitch explained to us, how sleep impacts those other three for him is absolutely huge.
So hopefully you got some good tips here. Hopefully you have a better understanding of the importance of sleep, and thanks for listening.
We are going to talk about next week, in our "Back to Basics: Core Four" series, mental health. So that'll be next.
If you have a technique that you would like to share, you can get a hold of us. It's so easy.
Troy: Yeah. You can reach out to us, hello@thescoperadio.com. We're on Facebook, facebook.com/whocaresmenshealth. Call our listener line, 601-55SCOPE. I would love to hear who is going to try Scot's elevation of the knee technique tonight when they can't sleep and tell us if it worked. I'm going to try it, Scot. If I can't sleep, I'm trying it, and I'm going to give feedback.
Scot: All right. I look forward to that.
Thunder: I'm going to try the color technique.
Mitch: Oh, yeah.
Troy: The color technique. I'm going to start with color and then I'm going to move on to knees. That's my strategy.
Scot: I'm glad I had an influence on you guys today.
Troy: You did.
Scot: As always, it's awesome. Thanks for listening and thanks for caring about men's health.
Relevant Links:
Contact: hello@thescoperadio.com
Listener Line: 601-55-SCOPE
The Scope Radio: https://thescoperadio.com
Who Cares About Men’s Health?: https://whocaresmenshealth.com
Facebook: https://www.facebook.com/whocaresmenshealth
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Learn how the U.S. Olympic weightlifting team…
Date Recorded
October 26, 2021 Transcription
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.
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.
Relevant Links:
Contact: hello@thescoperadio.com
Listener Line: 601-55-SCOPE
The Scope Radio: https://thescoperadio.com
Who Cares About Men’s Health?: https://whocaresmenshealth.com
Facebook: https://www.facebook.com/whocaresmenshealth
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Sleep is vital to how we function as living…
Date Recorded
October 25, 2021 Health Topics (The Scope Radio)
Womens Health
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For most of us, we know when it is time to…
Date Recorded
December 14, 2020 Transcription
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.
Circadian Rhythm is Set by Cues Inside Our Bodies
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.
Are You a Morning Lark or Night Owl?
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's Affect on Your Sleep
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.
What Happens When You Don't Live According to Your Chronotype?
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.
Your Chronotype and Intellectual Wellness
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.
Spiritual Aspects of Circadian Rhythm
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.
Co-existing with Different Chronotypes
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.
Live Your Chronotype for a Healthier, Happier Life
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.
Health Haiku
Do you go to sleep?
Wake up now, get up later
It is in your genes
Relevant Links:
Contact: hello@thescoperadio.com
Listener Line: 601-55-SCOPE
The Scope Radio: https://thescoperadio.com
7 Domains of Women's Health: https://womensseven.com MetaDescription
For most of us, we know when it's time to eat and we know when it's time to sleep. We know if there are certain times in which our minds and emotions are "better" than other times. This is called our circadian rhythm, and it's set by cues from inside our bodies. Chronobiologist—and Dr. Kirtly Jones' life partner—Dr. Chris Jones joins this episode of 7 Domains of Women's Health to discuss chronotypes—why we do certain things at certain times—and how our chronotypes affect our lives and the lives of people around us.
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Sleep is important for both our physical and…
Date Recorded
March 30, 2020 Transcription
Interviewer: You know, sleep is so critically important for both physical and mental health, and during times of stress and uncertainty, you might find that you're not able to sleep, which then starts the cycle of worrying about not sleeping which then leads to more sleepless nights which then can impact your physical and mental health.
It's a big circle, and Dr. Kelly Baron is a sleep expert at University of Utah Health, and she's here to help us to start sleeping better again. So Kelly, what can a person do when they're experiencing stress to the point that it's impacting their sleep?
Dr. Baron: So stress and sleep are really known to have a bidirectional or a two-way relationship. So if you're under stress, it affects your sleep. I would really describe the state that we're in right now as a state of hypervigilance or hyperawareness to what's going on, to the threats in our environment. You know, if you just think about it, at any moment we're going to get a text or a notification that our job has changed or that we're forced to work from home, that schools are canceled, ski resorts are closed. It seems like any moment of the day we're going to get an update of how our life is going to significantly change, and I don't know about you, but that has me totally on edge.
And so that sort of feeling of being under threat impacts how deeply you sleep, because if you think about it, we're really not supposed to sleep deeply when we're under stress. That's a basic survival mechanism that organisms have. You know, you would be someone's lunch if you're a little mouse in your hole and you're sleeping deeply and there's a fox outside. That's what I explain to my patients. It's just not normal to sleep under stress.
The problem is that we've been under this stress for weeks. You know, it was the anticipation and the planning and that sort of thing, and now that things are changing they change so rapidly. I know my clinic, for example, between 8:00 and 10:00 a.m. last Monday, went from optional, "Do you want to do a phone visit?" to, "We're canceling everyone. Everybody is over the phone. We've got to figure this out as we go." You know, it changes just hour by hour, which really, really leaves you feeling frazzled.
Interviewer: Yeah. Are you finding it's affecting your sleep as well?
Dr. Baron: I think in two ways. First of all, it's affecting my sleep that I'm home more and I'm actually . . . I think I'm sleeping a little more because I'm making an effort to wind things down. I've got more time to do the little things at home that I normally don't have time to do, like just put everything away, to get my laundry done. So I have a little bit more time to sleep because I'm not commuting, and my work day is kind of chopped up in a weird way that it just leaves me a little more time to unwind and go to sleep.
The other thing though is . . .
Interviewer: I hadn't considered that. Yeah.
Dr. Baron: . . . these like notifications and constant vigilance that I think we're all experiencing right now, I find that that's impacting my sleep because I wake up in the night and I think, "What's going on in Italy?" Or I think, you know, "What's going on, what's going to change today or, you know, what do I need to cancel or reschedule?" So there's certainly a sense of anxiety.
Now the other direction, though, is that if you're not sleeping, that affects how you perceive stress. There's actually a lot more data showing that if you sleep poorly or if you don't sleep enough, you interpret stress differently. You're affected by it differently. It makes you more emotional. You handle it worse. I don't know if you've felt like that before, but even in a normal day, if I sleep poorly, I'm more easily irritated by things that don't normally get under my skin, or I might get more emotional when something happens during the day. On the other hand, if you sleep better, you can more go with the flow. And so, you know, at a time like this is that we're kind of getting wound down. You know, over time, we're getting more and more sleepless and stressed. That can lead to just a cascade really of effects.
Interviewer: So are there two kinds of concerns when it comes to sleep when you're stressed, one not being able to fall asleep at all, and two, you might fall asleep, but you're just not getting that deep sleep?
Dr. Baron: Stress can affect your sleep by either trouble getting to sleep, because you're thinking, you're ruminating, or maybe you're doing things to prepare, you're working later or trying to get things done, like behaviorally. It can cause awakenings during the night. It can also cause people to feel like their sleep is less restful. So even if you aren't up for large periods of time, perhaps you're not sleeping as deeply as you normally would, or you're more restless in your sleep. Also people do have early morning awakenings. So that means you're waking up an hour or two before you intend to wake up and you're struggling to get back to sleep.
Interviewer: So what is the solution if somebody is having difficulty sleeping or feeling like perhaps they're not getting the sleep that they need?
Dr. Baron: The first thing that I talk about with my patients is that when you're under times of stress like this, it's normal to have some disruption to your sleep. That's a normal human thing. So being stressed about being stressed is never going to help anyone. So just accepting that some people are more vulnerable to having stress-induced sleep disruption. That's just a characteristic of who you are. I tend to be one of those people that was, you know, having trouble sleeping before my first day of school or those sorts of things. I mean, that's just a feature that some individuals are more sensitive to that than others.
But then on top of it, you know, if you can't sleep, we say don't force yourself to sleep. You know, wind down, turn off the news, give yourself a good hour to relax before you go to sleep. If you're not ready to fall asleep, then do some reading, do some other things, but don't get stressed about not sleeping.
The other thing to think about too is that we're all off of our schedules, our schedules for eating, for exercise, for sleeping. You know, our routines are totally shooken up right now, and that can have a big implication for sleep. And so I recommend that people stay on a routine and kids as well to have a consistent bedtime, rise time, to make sure that you're having a regular eating pattern, and then also getting physical activity during the day. Now that I'm working from home, especially I'm trying to intersperse that throughout my day. So I'm getting up and working out as I normally would in the morning before work, and then also trying to get a little lunchtime walk and get a walk in the evening with the kids so we're all getting some activity, some sunlight, some stress relief, that sort of thing.
Interviewer: Yeah. I like that because keeping that routine can be so important, and I never considered that exercise and eating could also contribute to an inability to get the kind of sleep that you need. And during stressful times, a lot of times we don't have an appetite, or we decide, oh, I don't have time to work out. And I guess it's in times like that that really you should almost double down on those things and just really commit to them.
Dr. Baron: Or the appetite can go the other way. You know, being home I have more availability of snack foods and things like that. You know, and some people might have a tendency to graze. So I made sure to position my office on the far other side of the house from the kitchen so I'm not tempted to go in there for the Fruit Roll-Ups or other things we got for the kids so they could help themselves while we're working. But on the other hand, you know, when you're under stress, you do have more of a craving sometimes for these comfort foods. You know, if your sleep is off, your eating is off, you know, it can just lead to generally feeling worn down and stressed out. And so trying to pay attention to these routines, healthy eating . . . you know, an interesting thing I noticed was that in the grocery store they're not out of lettuce. You know, there's no run on carrots.
Interviewer: No. Right.
Dr. Baron: You know? I mean, so I'm actually having plenty of fresh fruits and vegetables in my diet right now. You know, they're not out of that stuff, apples and that sort of thing. So, you know, people should take this as an opportunity. I don't know if you've seen the blogs from Korea, how people who have never cooked in their life, these sort of young adults who are mostly focused on take-out, they're learning how to cook and they're sharing this, and this is how they're bonding over Instagram and different recipes. I think that's great. I mean, people should really focus on getting a healthful diet. Again, you have a little bit more time if you're not commuting, so focusing on these routines of having regular meal times, healthy foods, getting adequate time in bed, it's actually an opportunity for some people.
You know, but I don't want to be insensitive to the fact that there are some people who are being extremely disrupted right now, that they've lost their jobs, their hours have been cut way back. You know, that's an enormous stressor, and it can really contribute to insomnia, especially if they don't know how long this is going to go. In those situations, we really talk about trying to, you know, make sure that you're getting through the day, kind of stay in the moment. You know, you can only deal with the information that you have.
Interviewer: So managing stress, those types of skills, mindfulness during the day, trying as much as possible to not, you know, I guess not let it affect you is not the right word, and then just accepting that maybe you might not sleep as well as you should, and that's okay. Don't get stressed. Don't add that to the stress, because then that just is that vicious circle.
Dr. Baron: Absolutely.
Interviewer: Is that a fair summary?
Dr. Baron: That is a fair summary.
Interviewer: All right.
Dr. Baron: It's an extremely stressful time for a lot of people right now, and it's going to understandably affect your sleep. MetaDescription
What you can do if stress or anxiety is affecting your sleep.
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Does that expensive sleep tracker on your…
Date Recorded
July 02, 2019 Health Topics (The Scope Radio)
Mens Health
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A newborn waking up in the middle of the night is…
Date Recorded
April 23, 2019 Health Topics (The Scope Radio)
Kids Health Transcription
Dr. Gellner: It's 3 a.m. and you hear that cry from your infant or toddler's room that you dread every night. Why do they do that and what can you do? I've got tips on little ones sleep issues for you today on The Scope.
Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kids Zone" with Dr. Gellner on The Scope.
Dr. Gellner: I'd like to start by calling this Scope piece the "Don't do what I did with my own kids." podcast. I was that mom who felt so bad that I wasn't home for my kids because I had to work that I used any excuse I could to have extra snuggle time. Boy, was that a mistake. I try to let my patients' parents know about my experiences so they can hopefully get more sleep than I did during those years.
Recent data shows that one in five infants who have trouble sleeping may continue to have challenges during the toddler years. And, yes, some of this can be blamed on the behavior of parents. You hear your little one crying. You wait to see if they go back to sleep, and then if they don't, you go rush in there to pick them up or give them a bottle.
Well, guess what? Your child is training you very well to do what they want. It's not on purpose really. Babies learn to be comforted when they wake up from newborn on. Then as they get older they should start sleeping through the night. But some babies become trained night criers or trained night feeders. These are called sleep associations. They really don't know how to go back to sleep on their own unless they're rocked or cuddled or fed.
Parents often will tell me that they will go into their baby's room and the baby only feeds for a few minutes and then is sound asleep again. That's because they aren't waking up for nutrition. They're waking up to go back to sleep in the manner that they were put to bed in the first place.
This is learned hunger. This occurs in children who are drinking a bottle or two of milk or nursing for prolonged periods at night. They have learned to expect food at night to go to sleep. So when they wake up, they're looking for it.
If your child is over seven months, healthy, and feeding multiple times a night, then this is your problem. Most babies are able to sleep through the night by six months old. Now, of course, kids are going to wake up more if they're sick or something is off with their routine. But, in general, they should be able to get back into good sleep patterns easily if you are consistent. If kids are waking up several times a night, both you the parents and the child are going to be cranky the next day.
So how do you fix this? First thing is to get your child to go to sleep on their own by putting them to bed when they're still sleepy but awake, no bottle, no pacifier, no cuddling. Have a good bedtime routine and do the same thing every night. For our kids, it was PJs, brush teeth, story time, usually the same three books every single night to the point I didn't even need to look at the book anymore and then say the good nights.
Sometimes you have to move bedtime 15 to 30 minutes later to make sure they're really ready to conk out. Yes, they may fuss for a few nights, but they should learn, if you are consistent with this, that when it's time for bed, it's time for bed, not an extra drink of water, not just one more story, or being rocked for 15 more minutes.
Bedtime routine done, then lights out. Dark, quiet, maybe a night light if needed, or soothing music. We have an ocean sound CD that our kids have listened to since birth, and they're double digits now.
Trust me, I know how hard this sleep training thing is. My older son decided that 11 p.m. was a good bedtime. I would hold him as he fell asleep, again, mom guilt, and then when he woke up, he'd need me to hold him until he fell back asleep again.
Funny thing is that if his dad put him to bed and he woke up, he'd be like, "Oh, it's just you, dad," and go back to sleep, because my husband made my son self-sooth from early on, and so our son learned that Dad wasn't going to pick him up or cuddle him.
Now if I put him to bed and he woke up, you'd think that me closing the door was because I was putting him in a torture chamber and he'd scream and cry until I went back and held him or stayed by him and then he went back to sleep. Our younger son was just a sleep nightmare for a variety of reasons, including night terrors, but that's a whole different subject.
Bottom line is this is a very common issue and one that most pediatricians have experience with either as parents or having worked with other parents facing the same problem. If you're having a hard time with getting your little one to fall asleep and stay asleep without waking to eat or be comforted and your child is over six months old, talk to your child's pediatrician, we can help.
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 MetaDescription
One in five infants who have trouble sleeping may continue to have challenges during their toddler years as well. How to distinguish if your child's sleep pattern is normal, or if it’s something more serious.
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Getting a good night’s sleep is one of the…
Date Recorded
October 24, 2018 Health Topics (The Scope Radio)
Family Health and Wellness Transcription
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.
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Most research says getting less than the…
Date Recorded
August 08, 2018 Transcription
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.
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For some women, waking up in the morning can be a…
Date Recorded
July 27, 2023 Health Topics (The Scope Radio)
Womens Health
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Parents know a sleep-deprived kid is a cranky…
Date Recorded
September 04, 2023 Health Topics (The Scope Radio)
Kids Health
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If you're having trouble sleeping and ran…
Date Recorded
September 21, 2017 Health Topics (The Scope Radio)
Family Health and Wellness Transcription
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.
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