awake

The Human Condition: Is The Light Bulb Killing Us?

Just in the lifespans of our grandparents and great grandparents, life has changed completely. Its not just televisions, internet, cell phones and other electronics. The arrival of electric power had a dramatic effect on human life. We extended our waking day. For some of us it enables us to stay awake as late at night as we want. And many of us do want to stay up at night. It would not have been practical to stay awake at night without lights. Now, of  course lighted gadgets make it even easier. In those dark days without artificial light, insomniacs would still be counting stars, singing and telling each other stories, if it were not for the light bulb.

As we have made progress, and seemingly made great strides in improving the human condition, we have also come across a great hurdle. Our bodies are not designed the way we are trying to use them. Try using a truck as a sports car or vice versa. You get the idea.

The human body, by design, functions on a day/night cycle. The presence of light during the day and the absence of it at night is designed to set up a series of chemical reactions that depend on these signals. It is called the circadian rhythm. How is it supposed to cope with a never ending presence of light then?

The system by its design allows the body to maintain its functions during the night by synchronizing it with the onset of sleep. Sleep allows us to rest, recharge, manage the immune system, maintain metabolism including body weight, appetite, blood pressure and blood sugar levels, process our thoughts, consolidate and process memories and performs countless other functions.

When, by extending our daylight hours through the use of technology, we constantly tellour bodies that days are consistently long, we interfere with the ability of the body to allow us sufficient sleep. Short sleep equals disruption in all those functions listed above and more.

So now, with us trying to do more, more, more, with our bodies and minds, with less sleep, less consolidated memory, abnormal blood sugar and blood pressure controls, weaker immune systems that are poorly modulated, increased appetite, and feeling tired, is it fair to complain that we have a generation of overweight people; that diabetes, hypertension and heart disease occur earlier in life; that we have more allergies and immune system problems; that the businesses of energy drinks and coffee are booming; that we use billions of dollars worth of sleeping pills, antidepressants and anxiety medicines?

By not understanding how our bodies are designed to function, and not following the rhythms of nature, are we not killing ourselves?

Later Addition:

On September 10, 2012, the New York Times published a blog article about light exposure and sleep. A link to the article is copied here:

http://well.blogs.nytimes.com/2012/09/10/really-using-a-computer-before-bed-can-disrupt-sleep/?smid=pl-share

Really? Using a Computer Before Bed Can Disrupt Sleep
A recent study showed that exposure to light from tablets significantly lowered levels of the hormone melatonin, which plays a role in the sleep cycle.

On Life, Death, Health and Sleep

I have had a few enlightening encounters with my patients in the last few weeks. Recently, one of my patient's wife made an intense comment: "He gasps and chokes in sleep. I can't let him die like this! Two of my family members passed away in the last few years and I could not save them. I can't let it happen again!!" This led to a discussion. Another young patient in his 70's said to me today he probably has five to ten more years to live considering how sickly he is. This led to another discussion. A third patient said: "I know I have neglected myself and my family for the last several years. I have been spending all my time at work. I now want to switch my life around."

I just want to share a few of my thoughts from these encounters.

We all know we did not choose whether, when, and where to arrive in this world and won't choose the time of our death either. This fact however gets lost on us while we struggle in our lives to go to school, learn, have jobs and families, in the process developing a false sense of control over ours and our loved ones' lives.

Its not about how long we live. Its how we live. A healthy, useful, long life. A productive, loving life. The duration does count, but the quality does lots more.

While death is certain for every living organism, a realization of this absolute fact makes the job of making the best of every second, minute, hour and day of life even more significant.

Given good health care and a balanced lifestyle, people should be able to live happily way past 100 years. To have a fatalistic attitude towards life as one gets older prevents the person from enjoying every day of life that they still do have.

Its not about choosing between work and family. Its about finding a balance.

We can not hang on to those we love. We have to let go of them in order to love them.

The need to control.... a quality shared by many smart, intellectually gifted people is most often a major factor in them feeling unable to relax, let go, fall and stay asleep. This is a sign of loss of that delicate balance in life that is necessary for health, wellness and happiness.

This is exactly why we need to work hard towards restoring that balance, learning to control and let go, learning to live and die, by retraining our minds.

We need to learn to Relax, Sleep better and Perform at our best, for a healthy, longer, happier, more fulfilling life.

 

 

 

Teen Texting Trouble

Being able to text a short message to someone is a blessing of the times. It works when you can't pick the phone up and call, when you are in an environment where speaking is not appropriate and in a lot of situations. Like any other useful technological feature, young people find uses for it to suit their life style. In my medical practice I started seeing teens who were texting 5 to 6000 times per month when texting plans had not even been invented by the phone companies. Now, those appear to have been ancient times. With unlimited texting plans, and parents losing control of their children's phone usage, texting continues to reach new highs. The Pew Research Center published a study earlier this year about increasing texting use in teens. Click here to read: Pew Research Center Study on Teens and Texting

One of my teen patients recently told me there were some very important people texting her at 2 in the morning and she HAD to respond. Come to find out it was her suspicious controlling boyfriend checking on her. One sleep problem solved.

Anecdotes aside, my concern as a sleep doctor is that the frequency of use and obsessive use, particularly during sleeping hours, interferes with a teen's ability to sleep restfully, keeping them on the edge, waiting for the phone to buzz, then alerting themselves to read and respond. Adrenaline levels, blood pressure, anxiety levels, moodiness, complaints of being tired all the time and many physical symptoms worsen with these habits, and are frequently overlooked. Often the adults in the household are not even aware of this behavior.

As I have written before, there is solid science supporting the observation that lack of sufficient good quality sleep leads to weight gain, behavior issues and accelerated aging; It triggers headaches, dizziness and even fainting besides making all kinds of existing physical problems worse.

I spoke to the local Sacramento radio channel KFBK today on this subject. Click here to listen: Teens and Texting on KFBK Radio 06-13-2012

On The Subject of The Active Mind Syndrome - Do You Have It Too?

To be very frank there is no such condition identified in the Diagnostics and Statistics Manual that mental health providers use, at least not so far. Could it be that the prevalence of this problem is so high it is considered kind of normal to suffer with it?

Society has been hard at work to train our children and adults alike, to work hard, be responsible, worry about the consequences of our actions and be held accountable. Nothing wrong with any of that but there are ramifications to this training that we never see coming.

In going through the process of developing these necessary traits in our personalities, we de-train ourselves from how were were as young children, happy go lucky, taking a day at a time, relaxed and unhurried. Some of us can cope with the change simply because they have been blessed with a calm demeanor implanted genetically into their minds. The rest of us suffer. We worry about getting to places on time, paying bills, caring for loved ones, making money, spending money, socializing, networking, entertaining, being entertained, even sleeping. We take our busy minds to bed with us and rise with these busy multi tasking, active minds. Our minds keep busy problem solving, thinking, recalling what happened and planning ahead for what might happen, even when we are supposed to be resting.

Rest doesn't come easy, sleep doesn't come, and if it comes it is not restful. We keep tossing and turning in bed trying to fall asleep. We wake up within 2-3 hours of falling asleep often staring in the dark, counting sheep, checking text messages and emails, turning the TV on and off and finally giving in to the temptation to take some sort of sleeping pill. Some will keep going to the bathroom or get up and eat. Then comes the dreaded morning and back to the race to finish tasks, be on time, finish the work, on and on and on.

I see these people every day in my sleep medicine practice. Nice, responsible, good people. Suffering people. Distressed people. "Doctor, the more I try to sleep the harder it is to fall asleep. My mind just races and doesn't stop, even when there is nothing stressful happening. What should I do? Can you help me?" And I find myself thinking, here is another patient with the undiagnosed and so far unnamed Active Mind Syndrome.

There are many ways to treat it should you be one of those people who have experienced the ill effects of this condition. Its important to know two facts first though. Firstly, there is no use asking the doctor since most doctors don't know what it is (and likely they have it too) and they wouldn't know how to treat it. Secondly, the answer is not in a pill.

What is your motivation? How strong is it? How bad is your suffering?

We at Sehatu Sleep think we have the answer. We call it Deep Relaxation Training (www.sehatusleep.com). We feel it requires re-training the mind to make the best of both worlds. People can learn to be productive, efficient, high achieving, and at the same time able to let go, relax, and loosen up on demand; able to sleep like a baby. It does require hard work, commitment and consistency but is very do-able. It is very powerful and gives you the capability to deal with life as it happens.

It is certainly not the only answer. Many paths can lead you to the same goal. We think ours is the most comprehensive. If not us, there are many wise people around you wherever you are. It just takes recognizing the problem and then seeking help. Its around the corner. Waiting for you. Wherever you are.

Happy dreams!

The Magic of Melatonin! (Requires a Magic Wand)

People looking for over the counter sleep aids often find melatonin along side other supplements. Since it is easily available, considered a supplement and not a medicine, there is plenty of incentive to at least try it. There are dozens of melatonin products on the market, freely available at supermarkets, pharmacies, health food stores and online. People take it in increasing doses (I have known people to take as much as 15 mg in one night), combine it with Benadryl products or alcohol, with various vitamins and in combination with various herbal preparations. It may make you briefly drowsy. It may seem to help you fall asleep for a few days. Unfortunately, that's about it. So what about the magic?

The magic wand you need to unleash the powerful magic of melatonin is to know the science behind what the substance is and how it works, and most importantly what it works for. Melatonin works fantastically well for people with "delayed sleep phase syndrome", a medical term describing the inability to fall asleep at a socially acceptable time and wake up at a socially acceptable time in order to be productive. It is a very common sleep problem often misdiagnosed as insomnia. It is more common in adolescents, and in creative people, musicians and artists; and often runs in families.

These people are fully capable of getting sufficient sleep but end up not getting enough because they don't get sleepy until later in the night and have to wake up early to go to school or work. If they could sleep in every day and work started later in the day they would be fine.

If melatonin is taken in the smallest amount available, it works best. Take more and you will likely be groggy when you wake up. It should be taken no earlier than 8 hours after naturally waking up, and about an hour before intended bed time. The product has to come from a reliable manufacturer since no one is effectively regulating the quality of the product.

Most of all, if you expose yourself to bright sources of light after taking melatonin you will cancel out its effects. These bright sources include all kinds of handheld and electronic device screens that emit light. Its effect will also be reduced if you activate your mind, get busy thinking, worrying or performing mental tasks.

Lots of caveats, true. But the potion's magic has the potential to change countless lives, provided it is used properly, with wisdom and knowledge. It is typically inexpensive and works much better than sleeping pills, for the person with "delayed sleep phase". For everyone else, unless your sleep physician specifically recommended it, you are probably wasting your money.

 

Which one works best for insomnia: Ambien, Lunesta, Sonata ..... or a golf club?

 

 

"There is no difference between taking a sleeping pill or asking someone to club you on the head"

The inability to fall or stay asleep, or waking up too early and then feeling the effects of sleep deprivation is commonly termed insomnia. The cost of insomnia to the US economy is estimated at over $35 billion each year. There are many types and many causes of insomnia. The commonest problem by far, is a state of mind called "hyper arousal" in which the person feels their mind continues to work and be active, even if they are not worried about anything. The problem tends to run in families, affects millions of people and affects smart people more, should that be consolation to some.

Since doctors have few tools to work with besides medicine, they tend to offer their patients the least addictive of the sleeping pills they know of, but end up in a wild goose chase of changing doses, managing side effects and development of tolerance to the sleep inducing effects. The pharmaceutical industry has also found insomnia therapy to be a major money maker. Ambien, also known by its generic name Zolpidem is one of the most commonly prescribed sleeping pills. The ever present Lunesta commercial on TV has inspired many comedy show spoofs. Trazodone has been used for many years. Ativan, Valium, Seroquel, Risperdal, Restoril; there are so many . Never mind the dozens of so called "natural" remedies, supplements (a chemical is a chemical, call it natural or pharmaceutical), gadgets, even iphone apps. None of these however address the issue of hyper arousal of the mind or do so ineffectively over the long term.

Research has shown over and over that sleeping pills i.e. "clubbing your head", works for short periods of time only. Cognitive behavior therapy, relaxation training, stress management techniques including yoga and meditation work better, and work long term. The problem so far has been that trained therapists are hard to find and even harder to make health insurance companies pay for it.

Uniquely, Sehatu Sleep, a small start up company in Northern California, has taken up this challenge. They offer on site and online, "Deep Relaxation Training" to empower insomniacs, to calm their minds and get restful sleep. No chemicals, no gadgets, no gimmicks. This, is what we need, not clubs on our heads!