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Sleep Disorders

Sleep disorders include a range of problems -- from insomnia to narcolepsy -- and affect millions of Americans. Dr. Michael Breus shares information and advice on sleep disorder and insomnia treatments and causes.

Monday, October 19, 2009

Tick-Tock: News about Your Clock
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I love a study that debunks an old theory long believed true. Last week scientists at the University of Michigan came out with a bold statement: everything we know about the human biological clock is wrong.

According to these researchers, who hail from mathematics, the cells responsible for maintaining the clock in the part of the brain called the suprachiasmatic nuclei, or SCN, don't fire all day and night like previously thought. The cells that control the clock are silent during the day. Though these cells sustain an electrically excited state, they don't actually fire until a brief period around dusk, and then remain quiet throughout the night before releasing another burst of activity around dawn. Think of a clock that only chimes twice a day - because the time only needs to be announced at two particular times. The clock keeps ticking during the silent periods, to make sure the time is accurate when it is time for the chimes to sound.

This may not sound like big news for you (or even mean all that much), but it means a lot to people in sleep medicine and in general medicine for that matter. I've written often about biological clocks in the past. It's a fascinating area of research that has so many applications to everyday life. Consider how much your internal clock determines the quality of your life. And if you don't know what I mean by that, then here's a quick summary. All of the following relate to your internal clock:

  • Your sleep/wake cycles.

  • How refreshed you feel in the morning.

  • How easy it is for you to fall asleep at night.

  • Whether you can recover quickly from jet lag.

  • The fate of a shift worker who has to be productive at odd hours.

  • Whether you're a lark or an owl.

  • Your mood and energy level.

  • The strength of your immune system.

  • Your ability to ward off diseases, including cancer and Alzheimer's.


It may seem unfathomable that your body's clock can influence diseases like cancer, but it's true. Think of your clock as your body's central pacemaker - a means by which the body can remain balanced and, in medical speak, in a state of homeostasis.

I expect future studies to validate some of this new information. It's been suggested that there's more than one clock in the body. Perhaps these math gurus should apply their mathematical model to these other clock ideas and see what emerges. Time will tell...tick-tock...

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctorâ„¢
www.thesleepdoctor.com

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Posted by: Dr. Breus at 8:15 AM

Friday, September 18, 2009

Beware of Late-Night Eating
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Don't eat after 7 pm.
It's okay to eat late at night so long as you didn't pig out during the day.
Scratch that. It's not about timing, it's about calories.
No, it's about timing and calories!

Confused? I know, the messages tend to get mixed and muddled. So let me set the record straight (for now) based on a recent finding that will have you thinking twice about that late-night snack.

Northwestern University has just come out with a study that shows what a lot of people don't want to hear: eating when the body prefers to be sleeping (ahem, when it's dark outside and most of your neighbors are in bed) can have an impact on weight gain - regardless of your calorie load for the day. Timing your meals, it turns out, plays a much bigger role in your weight equation than previously thought.

This doesn't surprise me in the least. We've known for quite some time how influential the body's internal clock, or circadian rhythm, can be on its physiology. Recent studies have also confirmed that this clock regulates energy use, suggesting the timing of meals may matter in the balance between caloric intake and expenditure. In other words, time a meal badly in relation to your body's clock, and you'll gain weight. Time it perfectly, and your body will use those incoming calories to burn for energy rather than store them as fat.

Without even getting into the scientific details of how this is so, it's easy to imagine how the body would prefer to not have to work so hard when it wants to sleep. The moment you put something in your mouth when the body is trying to slow down and get some rest, it's screaming back at you: What are ya doing? It's time for bed! I don't want to burn these calories now. Let's save them for tomorrow...and put them on the shelf for now (as fat).

So, based on these findings, let me offer some advice short of writing the new diet book:
  • Set a time after which you try not to eat anything prior to bed. Ideally, this time should be at least an hour before hitting the pillow.

  • Choose bedtime snacks intelligently. If you eat dinner on the early side, and need a snack before bedtime, go for something that entails complex carbs and a little protein, such as a piece of toast with a small smearing of a nut butter on top.

  • Avoid fatty foods before bedtime. This is not the time to be chowing down on hot fudge sundaes, triple-cheese pizzas, and the classic burger and fries.


I've always said that getting good sleep is one of the easiest (and cheapest) ways to lose weight. Now there's one more reason hit the hay on a empty stomach.

Sweet Dreams.

Michael J. Breus, PhD
The Sleep Doctorâ„¢
www.thesleepdoctor.com

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Posted by: Dr. Breus at 10:10 AM

Friday, May 01, 2009

Tips for Sleepless Mariah Carey
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I'm not usually the sort to wade through celebrity gossip pages, but this one came across my desk because it is, well, directly related to my area of expertise... and I am compelled to reach out and offer some advice.

Word travels fast: no sooner did Mariah Carey Twitter about her sleep problems did her issues show up on various websites. Here's what she apparently wrote on her Twitter page:

"I just finished working out. Whooo! Quite naturally, 'its 5am and I still can't sleep' Who's up? Nick is too cute when he's sleep! I wish he didn't have to work tomorrow so he could help me sleep all day and I could sing all nite [sic]!"

How many red flags can you find in that tweet? Did she work out just before 5 AM and is only now trying to go to bed while the rest of the world (and the sun, let's not forget) is about to get up? And does she normally live like a vampire - going to bed in the morning and getting up in the evening to sing all night long?

There's nothing "quite naturally" about any of that. Her body is rebelling, thrown totally off key (pun intended) by the crazy break in its natural rhythm that wants to sleep at night and sing during the day. I help lots of jet setters and shift workers who struggle with weird working hours and blocks of time when they do, in fact, live during the night and sleep during the day due to their job.

Being a rock star (or singing sensation or pop queen or however you categorize Ms. Mariah is your choice) has its downsides. The music industry has to be one of the worst fields to work in if you love your sleep. I honestly don't know how some musicians do it when they travel constantly across continents and time zones-going from one late-night show to the next. And I have no idea how someone living on such a schedule can find time to exercise. It's hard enough for the rest of us.

The three simple things Mariah should heed:
  • Exercise can be stimulating for some people, making it hard to fall asleep soon thereafter. She might want to try scheduling in her exercise earlier in the day (er, I mean night - maybe before her show?). Or exercise first thing after waking.

  • Jumping right into bed and expecting to fall asleep quickly is unrealistic. It can take time for the body to unwind and prepare for sleep. This is when having good sleep hygiene is key.

  • Consider re-calibrating the body clock for the short-term when there will be days when she expects her body to keep up with an unusual sleep-wake cycle

I wonder how her hubby fares once Mariah gets into bed. Does his sleep get disturbed? And when he rises, does it disturb Mariah? Ah, the joys of marriage. Hopefully they can sync up their schedules once in a while to enjoy one another.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

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Posted by: Dr. Breus at 5:00 AM

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