Explore every episode of Sleep Unplugged with Dr. Chris Winter
Dive into the complete episode list for Sleep Unplugged with Dr. Chris Winter. Each episode is cataloged with detailed descriptions, making it easy to find and explore specific topics. Keep track of all episodes from your favorite podcast and never miss a moment of insightful content.
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Pub. Date
Title
Duration
27 Jun 2022
#1 - Welcome/Introduction to Sleep Unplugged
00:33:18
There are few things more universal and fun to talk about than sleep. We all do it, and it impacts everyone's health and sense of wellness. For the last 30 years, I have been involved in some way or another with sleep. I began studying sleep as a researcher in the early 1990s and am now a neurologist who specializes in treating sleep disorders in adults and kids. In this episode, I share a bit about my background in sleep science and how I have come to spend three decades in the field. Future episodes will include:
practical sleep information, tips, and strategies for resting better and understanding sleep
interesting and illustrative patient stories
experiences with the many professional sports organizations for whom I work
excerpts from my books
debunking sleep myths and misinformation
explanations and responses to current research and popular topics
items that go beyond traditional biomedical sources like music and art that involve sleep
Insomnia treatment in this country is hindered by one simple fact - very few people really understand what insomnia is and how it is defined, including many physicians who treat adults and kids with insomnia. In this first (of many) episodes about insomnia, we will:
start with the basics of insomnia definitions: What is insomnia?
understand that insomnia is not and individual who "can't sleep"
touch upon the academic definitions of insomnia and how they can often take away from the patient problems by arbitrarily relying on useless timeframe parameters
learn (via a story that admittedly goes on way too long) that anything, even a Fantasy Football game, can precipitate a night of transient insomnia
understand that a patient's perceived disability is at the core of the insomnia definition, and only the patient gets to define that disability
begin to uncover that an individual's perception of what happen when they sleep is not always an accurate representation of what actually happens, creating problems both diagnostically and therapeutically for many clinicians and patients
#3 - Sleep and Menopause: Why Don't We Talk About This More?
00:36:50
When I wrote my first book The Sleep Solution: Why Your Sleep Is Broken and How To Fix It, I made the decision to cut the chapter on menopause because of length. I have regretted that decision ever since. It is by far and away the most common question I get asked about the contents. "Is there a chapter about menopause?"
No, but there is a podcast episode entirely devoted to the topic. In this episode we will cover:
the basics of menopause and how it affects sleep
some data that tries to understand the impact menopause has on women's sleep architecture
the consequences of hot flashes and how predictive they are regarding sleep issues
how menopause can lead to a higher incidence of sleep disordered breathing
the role of hormone replacement therapy
how other factors could influence sleep in the menopausal population
strategies for minimizing the impact of menopause on sleep
White noise is everywhere, and it's association with sleep has been discussed for decades. But what exactly is white noise, and does it play a role in optimizing sleep?
In this episode we will cover:
the science of white noise and what it represents
how the history of white noise machines has evolved
relationships and research looking at white noise, sleep, memory, and cognition
the recent research linking white noise to brain damage
the emergence of pink noise and how it differs from white noise
differences between other "colors of noise" specifically purple/violet, grey, brown, and blue.
binaural beats, what they are, and the science linking them with better sleep
NOTE: Your AirPods are working fine. The recording software used to record this episode completely suppressed all of the noise samples played during the episode. To hear examples of the noise colors mentioned in this podcast, visit: https://en.wikipedia.org/wiki/Colors_of_noise
Sleep apnea constitutes the lion's share of the diagnoses sleep clinicians see in their clinics. One of the most misunderstood and poorly managed conditions I see is mild sleep apnea, or individuals who generally have 5-15 breathing problems/hour. In this episode we will:
start with the basics of sleep apnea: What is it?
understand the difference between obstructive and central apnea
define what constitutes and apnea (or hypopnea) and how those tallies are utilized to arrive at not only a diagnosis, but a severity designation for the condition
look at the literature and why some experts advocate treating mild sleep apnea and while other do not
understand how patients can sometimes get caught in a situation where they are aggressively treating a mild condition in which the benefits may be few or nonexistent.
begin a much larger dialogue aimed at understanding the nuances of sleep apnea, a very common sleep disorder.
In episode 2, I talked about what insomnia was not--namely sleep deprivation. In this episode, we begin to explore what insomnia is and who is most at risk. I also explore the unique role of trauma both as a precipitant, but also a perpetuator of insomnia. In this episode we will:
revisit how insomnia differs from sleep deprivation and why confusion between the two creates therapeutic problems
examine risk factors for developing insomnia
review studies that demonstrate insomnia patients are generally sleeping relatively normal amounts
uncover studies that reveal that insomnia patients generally do not share identifiable sleep study deficiencies
understand why insomnia patients often develop negative views of their sleep and how this factor alone, irrespective of sleep quality and amount, predicts disbility
explore how trauma can create or precipitate insomnia, but more importantly how insomnia itself, over time, can become its own form of trauma, helping to perpetuate the condition.
appreciate that when a sleep specialist tells a patient that he does not have sleep deprivation when he has insomnia, she is not saying the patient does not have a problem.
While insomnia is often not the problem the patient thinks they have, it can be a tremendous burden in and of itself, and trauma is often playing a central role.
After sleep apnea, narcolepsy is the most common cause of excessive sleepiness in sleep clinics across the country. A large portion of the nearly 200,000 people who have narcolepsy in this country alone are children and teenagers. As these individuals struggle with disabling sleepiness, why is their plight (a treatable plight) largely ignored? In this episode, we will:
define narcolepsy and look briefly at its origins
recast the image of a narcolepsy patient from something cartoonish and unhelpful to a real person with an unfathomable degree of sleepiness
contrast the disability of sleepiness with other "seen" disabilities
explore why disorders of excessive sleepiness are largely ignored by the media while conditions like insomnia are embraced and reinforced at all levels
understand why narcolepsy and disorders of hypersomnolence are routinely mistaken for other disorders or dismissed by clinicians entirely (even many sleep specialists)
learn that these conditions are not rare and their sufferers are often unseen--they are in fact people we know and work with on a daily basis--and they need our support.
In the late 1990's, Dr. James Maas coined the phrase "power nap" and since that time, there have been many trendy sleep terms. In this episode, we discuss three popular sleep concepts and the stories/science behind them. In this episode we will:
define the term orthosomnia and learn more about the concept's origins
understand how orthosomnia applies to the greater concept of sleep monitoring
explore what a sleep divorce entails and the difficulties with the term
dissect the reasons why couples may choose to sleep apart, and how this can ultimately fail to address serious underlying medical conditions
touch upon relationship power imbalances that make sleep apart not an option for some individuals
understand the origins of revenge bedtime procrastination
differentiate "in-bed" procrastination from "going to bed" procrastination
work towards ways to minimize the factors that exacerbate bedtime procrastination
#9 - The Controversy Surrounding School Start Times
00:29:31
Students everywhere are beginning to head back to school soon, so in this Back-To-School episode, I examine the ongoing school start time debate in this country. In the United States, the vast majority of middle and high school students start school early and thus do not have access to adequate sleep. In this episode, we will:
identify the healthy range of sleep school-aged and high school students require
target the biggest threats to the sleep opportunity of school students
explore the nature of the school start time debate and the organizations/studies supporting the change
explain the factors that tend to derail schools from delaying school start times
dive into the emerging research that came out of the COVID lockdown that overwhelmingly shows that delayed start times and virtual learning tends to increase total sleep time and the percentage of kids sleeping adequately.
dissect the negative psychological outcomes of virtual learning that confound the benefits of some studies
learn what can be done at a local level and beyond
Alarms clocks may be responsible for the most dreaded sound in our lives. Despite their constant presence, how do you choose the right alarm for your circumstances and maybe more importantly, how does that alarm fit into a healthy morning routine?
In this episode we will cover:
the definition of sleep inertia and why some people struggle to wake up in the morning
the science behind the different types of sounds alarm clocks utilize and which tend to awaken individuals more effectively
the circadian influence of alarm clocks that utilize lights
the ‘Snooze Button’ and should you use it
strategies for utilizing escalating alarms
the variety of more extreme alarms (shaking a bed, shocking a sleeper) for helping people awaken on time.
the importance of a scheduled awakening and how it fits with other activities in the morning
In January of 2015, I spent the night in a haunted hotel in Oklahoma City and wrote about the experience in The Huffington Post. That would begin a series of articles I called "Sleeping Around" where I explored unusual sleeping situations and what they could teach us about our own sleep.
In 2020, I began working with Sleep.com to create content for their new website completely devoted to sleep and topics surrounding it. One day, Sam Bennett, their senior vice president of marketing asked me what my dream sleep project would be.
Easy. I want to make a film version of Sleeping Around.
A few weeks later we were filming three episodes: a few days on the road with musical artist Shakey Graves, 24 hours with the Fort Worth Fire Department, and a night sleeping on a portaledge with professional Red Bull climber Sasha Digiulian.
To mark the milestone of recording our tenth episode, I wanted to record this bonus episode for listeners to take them behind the scenes of this project, and hopefully share why it is so important to me.
As a sleep physician, I am constantly confronted with sleeping pills and the misunderstanding that seems to be inherent to their existence. While I do feel like there are specific instances where sleeping pills are helpful, I think the vast majority of sleep experts and behavioral sleep therapists would generally frown upon their use. In this episode, we will cover:
why I feel sleeping pills are largely unnecessary, particularly given the fact that everyone sleeps (Episode 2)
to whom these pills are marketed and how ad prey upon fear of sleeplessness as a means to create a market for their product
the surprisingly modest sleep improvement results (sleep latency, sleep efficiency) these medications produce and how these stand in direct opposition to what the average user thinks is happening
the risk of sleeping pills
how the relevance of these promoted benefits is of unclear significance
failure of sleeping pill research to prove health or performance benefits
the repetitive history of the sleeping pill cycle and how history has judged the fate of many that have come before
#12 - Sleep and Athletic Performance: Major League Sleep
00:36:54
The intersection of sleep and athletic performance, relatively speaking, is a new frontier. In the last two decades, the interest in how sleep optimization can improve achievement within sports has exploded. In this episode I will discuss:
the history of how sleep has been looked at in sports and the earliest observations on the subject
how I became interested and eventually involved with research in sleep and sport
the story behind my initial studies with Major League Baseball and travel
the topic of circadian advantage and how we measured it over ten years of Major League Baseball games
how chronotype seems to impact the performance timing of elite athletes
the influence of sleepiness on athletic performance, success in a sport, and potentially longevity as an athlete
other influential research and researchers in the field
what it all means for not only professional sports organizations, but also the average athlete
Restless Legs Syndrome (RLS) is a unique and relatively common sleep disorder that quietly affects the sleep of 15% of individuals (by some generous accounts). Despite its initial description dating back to 1672, it still remains somewhat of a mystery--suffered miserably by many but often missed as a sleep diagnosis. In this episode, we will:
learn the unusual history of the multiple 'discoveries' of RLS
give an overview of the symptoms of RLS and the varied ways in which they are described and experienced
dissect the diagnostic criteria of RLS
differentiate primary RLS from secondary RLS
list the risk factors for RLS including low iron, pregnancy, and certain medications
discuss the treatments (both medicinal and non) of RLS including weighted blankets
Even though circadian rhythms seem initially to be exclusively linked to our sleep, these primitive timing mechanisms reach back to virtually the dawn of life as we know it. Understanding circadian pathways lays the groundwork for not only understanding circadian disorders like jet lag and shift work, but also for understanding how to optimize our own health. In this episode we will:
define circadian rhythms
understand the mechanisms in the nervous system that govern circadian rhythms and biological timing
find out about some of the early pioneers of circadian science and how their experiments helped to shed light on intrinsic rhythms
learn why human circadian rhythms are slightly longer than 24 hours
list the multiple systems within our bodies that depend on these rhythms
examine research that indicates how harmful biological timing is to our health and the diseases/conditions they influence
determine ways to optimize our own health through improved circadian scheduling
When it comes to sleep, I'm not sure there a topic that frustrates more than waking up at night (sometimes referred to as sleep maintenance insomnia). The struggle to make it from bedtime to wake can be a long and tortuous journey for some. In this episode we will:
explore the history of sleep and nocturnal awakenings
define the prevalence of nocturnal awakenings in the adult population
understand both the definition of arousal and its relationship to awakenings
investigate the concept of sleep efficiency, how it relates to sleep expectation versus sleep need, and how this itself can lead to increased awakenings at night
determine how the presence or absence of excessive sleepiness can help to understand the cause and seriousness of nocturnal awakenings
learn the risk factors and predictors that often lead to nocturnal awakenings
find out that an individual's determination of the cause of their awakenings can be unreliable
discuss the role of sleep studies in determining if there are pathological causes for nocturnal awakenings
explore the role of anxiety and worry in nocturnal awakenings
summarize the numerous studies that have shown the role of exercise in reducing both frequency and duration of nocturnal awakenings
Almost half of all people will experience the terrifying feeling of awakening from sleep unable to move. Sleep paralysis has its roots deep in history and separating fact from lore is not always easy. this this episode we will:
explore the history and mythology surrounding sleep paralysis, the night hag, incubus/succubus, and the origin of the term nightmare
contrast different cultural interpretations of sleep paralysis as well as the various treatments believed to ward off the condition
explore the incidence of the disorder both as an isolated phenomenon as well as a chronic state
describe the various ways in which it manifests in individuals
list the risk factors and predisposing conditions for sleep paralysis
detail the neural pathways and highlight the neuroanatomy of the process and how it links to causes and risk factors
discuss treatment options and for whom they may be appropriate
Has there ever been a topic more fraught with misunderstanding and misinterpretation than napping. Should we nap? Should we not nap? What if I can't nap? This episode will cover it all. In this episode we will:
Understand how napping can benefit our health and performance
Evaluate how in some populations, excessive napping can be a marker of poor health
Learn how napping can be employed to supplement nocturnal sleep and repay sleep debt
Find out the ideal way to structure the environment and timing of naps
Recognize when napping may be a sign of poor health.
#18 - Daylight Saving Time: What Exactly Are We Saving?
00:34:49
Twice a year, daylight saving time takes center stage as we talk about it, worry about it, plan for it, and either rejoice or renounce its very existence. Now, as the United States government debates whether or not to legislate an end to the practice, let's take some time to explore the topic. In this episode we will:
explore the origins of daylight saving time and its particularly unique history in the United States
understand the reasons for not only implementing the practice of daylight saving time as well as the reasons why it has persisted
differentiate the various aspects of daylight saving time and standard time
touch on the actual energy savings created (or not) by daylight saving time
probe the public's sentiment for keeping DST or adopting permanent standard time
evaluate the health risks (and sleep risks) of the biannual changes (as well as a potential intrinsic risk of DST itself) and why we should adopt permanent standard time
list some possible strategies for lessening the impact of the transition
#19 - Nightmares and Night Terrors: Whatever You Do, Don't Fall Asleep
00:33:45
On this special Halloween edition, we will wander into the dark and terrifying forest of nightmares and night terrors. In this episode, we will:
Explore the origin of the term nightmare
Differentiate nightmares from bad dreams and learn what constitutes the diagnosis of nightmare disorder
List other REM-related parasomnias besides nightmare disorder (like isolated sleep paralysis (Episode 16), REM Behavior Disorder, and catathrenia
Characterize the prevalence of nightmares and nightmare disorder as well as its risk factors
Look in depth at treatments in particular Image Rehearsal Therapy and the newer Targeted Memory Reactivation technique
Name medications sometimes employed in nightmare disorder therapy
Define night terrors and other non-REM-related parasomnias like sleep talking (somniloquy), sleepwalking (somnambulism), sleep-related eating disorder (SRED), and various sexsomnias
Characterize the prevalence of night terrors as well as their risk factors
Review treatments and best practices for these disorders
#20 - Paradoxical Insomnia: The Insomnia You've Never Heard Of
00:42:17
There is nothing in the realm of sleep medicine that creates more confusion (both among patients and providers) than paradoxical insomnia. Known by many terms over the years, paradoxical insomnia (or sleep state misperception) is at once common and rare, This is unfortunate because more awareness could improve the overall recognition and diagnosis or insomnia as well as improve treatment outcomes. In this episode we will:
Review the definition and incidence of insomnia disorder
Explore the inherent problems that result from patient sleep reporting (sleep latency, sleep duration, etc.)
Describe the origins of sleep state misperception and how it was a natural outgrowth of the more widespread use and formalization of the polysomnogram
Define paradoxical insomnia and detail the shortcomings of the definition
Differentiate between a formal diagnosis of paradoxical insomnia and a patient who underestimated their sleep amount/overestimates sleep latency
Look at historical studies that first quantified the number of insomnia patients that underestimated their sleep amount and to what degree
Define the Misperception Index (MI) and how it can be used to create a spectrum and diagnostic structure for paradoxical insomnia.
List the risk factors and causes of paradoxical insomnia
With the holidays around the corner, I have reached out to my favorite sleep product companies as well as my favorite sleep experts to get product recommendations, discount codes, and all kinds of weighted blankets, ear plugs, cooling units, and sleep hoodies to try out. Buying gifts for people this time of year can be difficult, so I'm making it easy for you. Who wouldn't want a gift that encourages better sleep. In this podcast we will look at the following:
Ayo circadian lighting
Bearaby weighted blankets
Chilipad/DockPro bed cooling unit
Dēp Slēpwear cooling bed clothing
Dodow sleep/breathing device
Hatch sound machine
Muse meditation device (Interaxon)
Oura Ring sleep monitoring device
Ostrichpillow travel pillow
Pavlok shock alarm
QuietOn sleeping earbuds
Sleepys with Reactex cooling pillow
Somnox sleep robot
Swanwick blue-blocking glasses
ThisWorks sleep spray
Umay digital eye relaxation tech
Withings ScanWatch Horizon sleep/fitness watch
*I have no financial relationship with the companies listed above but may have received products to trial/demo.
When it comes to healthy sleep, plays a huge role. The discussion often vilifies light, in particular blue light, but is it always bad? In this episode we will:
Discuss light's role in the regulation of our circadian rhythm and by proxy, sleep.
Understand the anatomy of how light interacts with the eye/retina, the suprachiasmatic nucleus, the pineal body, and eventually creates melatonin suppression
Understand how blue light came to be acknowledged as the fundamental light color of this process
Differentiate light quality and light intensity and further differentiate light intensity at the source (lumen) and destination (lux)
Find out that even small amount of light or sustained light at night (LAN) can disrupt sleep and diminish health
Explore how lighting that capitalizes on these characteristics can promote sleep and also support wakefulness.
Learn about products meant to diminish light and enhance light
Touch upon the practical/research implications of light pollution and light manipulation in novel environments (submarines)
#24 - Alcohol and Sleep: Raise a Glass to Terrible Rest
00:32:46
There may be no topic in sleep that is more studied yet often misunderstood than alcohol. Even a casual overview of popular media is full of references relating alcohol and peaceful relaxation and easy sleep. Is there truth to this depiction? Can alcohol share a space with healthy sleep? In this episode we will:
Examine the numbers of people using alcohol to help with sleep and insomnia
Explore the neurotransmitters affected by alcohol intoxication and how they relate to the chemistry of sleep
Detail the ways in which alcohol affects sleep architecture
Compare the differences between the first and second halves of the night, and how they differ in relation to alcohol effects
Contrast the differences between acute and chronic alcohol use on sleep
Finds ways that alcohol can be enjoyed and its effects on sleep minimized
#25 - Temperature and Sleep: In the Cold Cold Night
00:27:16
We have been dancing around this topic since pretty much the beginning of Sleep Unplugged. Sleep and Menopause...Circadian Rhythms...Insomnia...even some of the products in the holiday gift guide referred to temperature, but why? What is the relationship between temperature and sleep? In this episode we will:
Learn why humans and many animals display nesting behaviors designed to warm up prior to bed
Understand the classic sleep research protocols exploring the "warm bath effect"
Follow the process of sleep initiation and falling core temperature, and how this affects sleep quality, depth, and continuity
Contrast the core temperature changes with peripheral vasodilation during sleep initiation and how warming the distal extremities can hasten and improve sleep
Define the concept of a temperature gradient, and how that can be applied to distal and core temperatures, and how this influences sleep at various points in the process
Touch upon theories about sleep and temperature regulation and how melatonin plays a role in both circadian light and circadian temperature regulation
Explore the differences seen in body temperatures upon awakening
Use this information to better inform how we can manipulate temperature in our own environment to sleep better
#26 - Narcolepsy: The Rare Sleep Disorder That Isn't
00:39:12
Given that approximately 1 in 2000 people in the United States has narcolepsy, and their symptoms are so dramatic, there is a good chance you know someone with this disorder. Narcolepsy is fundamentally a debilitating, lifelong disorder of excessive sleepiness and sleep dysregulation. In this episode, we will:
define narcolepsy and learn how it presents in individuals
trace the pathophysiology of the chemical disorder related to orexin/hypocretin dysfunction
list the 5 main diagnostic characteristics of the disorder
differentiate the causes (hereditary, autoimmune) of narcolepsy
outline the diagnostic pathway and the pitfalls of narcolepsy testing
learn how diagnostic momentum applies to the diagnosis of narcolepsy
briefly touch upon treatments (but will largely leave this for a future episode)
It has been a truly incredible year for the Sleep Unplugged podcast. In operation just over six months, the success of the podcast is both exciting and humbling. As we come to the end of the year, the podcast wants to shine a light on some of the brightest stars within the field of sleep and give their work some much earned praise.
This year's Sleepy Award winners are:
Social Media Warrior Dr. Anne Marie Morse (@DAMMGoodSleep)
Best Insomnia Advice Dr. Brandon Peters (@BrandonPetersMD)
Sleep Outsider Award Diane Macedo (@SleepFixMethod, @dianermacedo)
Sleep Vanguard Organization Philadelphia Phillies
Book of the Year The Power of the Downstate: Recharge Your Life Using Your Body's Own Restorative Systems Dr. Sara Mednick (@Sara_Mednick)
Sleep Crusader Award Dr. Karin Johnson (@drsleepykarin)
In 1987, Arthur Spielman put forth a model for understanding insomnia that came to be known as the 3-P Model. It laid out the progression of the disorders in 3 steps: Predisposing factors, a precipitating event, and perpetuating influences. In this Insomnia Monday episode of the podcast, we expand the model to include 9 "Ps" and explore each. In this episode, you will:
Learn about the original 3-P model including predisposing factors for insomnia
Understand how caregivers can preindoctrinate (or parent) in a way that increases insomnia likelihood
List common insomnia precipitants
Explore the crucial role panic plays in insomnia origination
Briefly touch upon sleeping pills (for more information, listen to episode #11)
See how one's perception of their insomnia impacts severity and influences treatment
Touch upon factors of perpetuation as well as looking at how insomnia in youth may predict insomnia in adulthood
Revisit pain and trauma in insomnia (Episode #6 covers this more thoroughly)
Conclude with the consideration of pessimism and powerlessness as factors in insomnia
#29 - Snoring: The Sound That Drives Us Out of Our Heads
00:38:47
Snoring is a common sleep problem that affects many individuals either directly or indirectly. There is a significant amount of confusion around the topic of snoring as it is often mentioned in the same breath with sleep apnea. Snoring is it's own entity with its own unique pathophysiology, risk factors, and treatments. In this episode you will:
Glimpse at some historical perspectives of snoring
Learn about the scope and demographics of those who snore
List the causes of snoring and where they exist anatomically
Explore the risk factors for snoring
Evaluate the numerous consequences both inside and outside of health
#30 - Catathrenia/Sleep-Related Moaning: Here She Comes Now Singing Moany Moany
00:27:52
Individuals who moan or groan in their sleep are not uncommon...at least we think so. Catathrenia, the medical term for the disorder, is poorly studied and poorly understood. Despite the relative lack of public awareness, bedpartners everywhere are keenly aware of the disorder. In the episode we will:
characterize catathrenia as a breathing disturbance (or parasomnia) distinct from snoring and sleep talking (somniloquy)
revisit the initial description of the disorder
consider the consequences of nocturnal moaning
discuss the qualities of the nocturnal vocalizations that distinguish catathrenia
attempt to describe the characteristics of catathrenics
list the risk factors for and conditions associated with catathrenia
Perhaps no topic in sleep is more filled with more wild claims and unsubstantiated research than polyphasic sleep. The division of sleep into several distinct periods is not new. The question is, does it hold the key to enhanced health and performance? In this episode, we will:
Define polyphasic and monophasic sleep
Learn about the sleep of other animals and contrast their typical polyphasic sleep to the monophasic sleep of most humans
Follow the history of polyphasic sleep through medieval times up through the Industrial Revolution.
Explore specific types of polyphasic sleep including the Uberman Sleep Schedule and that followed by Buckminster Fuller
Understand how sleep cycles work and how increasing fragmentation can interfere with the health benefits of sleep
Conclude with the scientific recommendation concerning the health risks of polyphasic sleep practices
There are many controversial topics in the world of sleep. Not many spark more conversation and controversy than various forms of co-sleeping. In this episode we will:
Define co-sleeping
Learn about the various forms of co-sleeping: babies/children, pets, siblings, and spouses
Examine the research about co-sleeping and SIDS as well as accidental death
Look at the various risk factors surrounding co-sleeping with babies
Weigh the pros and cons of co-sleeping with pets
Touch upon sibling co-sleeping
Conclude with the science behind couples co-sleeping and ways to mitigate the negative effects
#33 - The Scientific Results Are In: CBTi is the Cure for Insomnia
00:38:47
Clickbait title comments aside, cognitive behavioral therapy for insomnia (CBTi) is the scientific gold standard when it comes to insomnia therapy. It's effective and medical governing bodies and consensus statements lauding its benefits are too many to count...but what exactly is it? In this episode, we will:
Learn about the overwhelming support for the use of CBTi for the treatment of insomnia
List the various medical boards and governing bodies that support it and its overall efficacy rates
Understand why there is often reluctance to engage in the treatment and why the work involved often makes fad treatments seem appealing
Evaluate why sleep education is generally felt to be the foundation of CBTi
Define cognitive restructuring and how thinking about sleep can reinforce positive and negative thoughts
Layout the tenets of stimulus control therapy and how they affect individuals with insomnia
Contrast the various methods of relaxation techniques
Highlight physician and clinicians with special training in CBTi
#34 - Next Position Please: The Science of Sleeping Positions
00:32:41
Back sleeper, side sleeper, stomach sleeper...which is the best position for quality sleep? Body position is a popular topic in the media, but how much evidence is behind the recommendations? In this episode we will:
Explore sleeping positions and our ability to perceive and control them
Briefly touch upon considerations like facial wrinkling and glaucoma for which there is inconclusive evidence
Revisit how back sleeping in infants is thought about currently in the relationship to SIDS and infant sleeping safety (listen to episode 32 on co-sleeping for more information)
Explore body position options for pregnant women
Learn about body position and joint pain
Examine the role that body position plays in GERD and the mechanism behind the recommendations
Evaluate the evidence for improved cardiovascular functioning based upon sleep position
Critique the 2015 study linking Alzheimer's disease risk to sleeping position and its relevance to humans
Touch upon ways adults can improve sleep apnea, snoring, and GERD via sleeping position technology.
#35 - Sleep and Cardiovascular Health: Stop Draggin' Your Heart Around
00:33:54
The link between cardiovascular health and sleep is beyond compelling and is probably the most researched topic related to sleep health. This has taken on greater meaning as studies show the cardiovascular health of all age groups is declining. Recently, the American Heart Association added Sleep Health to its 'Essential 8'--a collection of the meaningful steps individuals can take to improve their cardiovascular health and outcomes. But what constitutes the relationship between sleep health and cardiovascular health? In this episode, we will:
Introduce the American Heart Association's Essential 8, and how sleep health not only factors into the list, but directly affects the other seven items.
Trace the long history of sleep being associated with coronary artery disease.
Explore the relationship between sleep and stroke risk
Understand the mechanisms of increased atherosclerotic plaque burden in people getting inadequate sleep
Learn about the relationship between inadequate sleep and elevated blood pressure/"non-dipping," and how sleep extension may improve those measurements
Characterize the increased risk or arrhythmias in patients with sleep=related breathing disorders and their underlying mechanisms
Probe the link between inadequate sleep and systemic inflammation and how these changes can be permanent
Touch upon the topic of poor sleep and impaired glucose homeostasis
Conclude with looking at the confusing relationship between insomnia and cardiovascular disease
#36 - Jet Lag: Take Your Chance on a Big Jet Plane
00:40:08
Anyone who has traveled a significant distance has felt the effects of jet lag...the fatigue, the altered appetite, the sleep irregularities. The science of jet lag and sleep is topic of tremendous interest both scientifically and in popular culture. In this episode we will:
Define jet lag and how it relates to the circadian rhythm
Examine how jet lag can influence our general and cognitive health as well as cancer risk
Contrast the biological difference between eastward and westward travel and how they relate to circadian advances and delays
Explore the various ways jet lag can be mitigated
Understand the use of light exposure to lessen the impact of jet lag and how the timing of light relates to our body temperature curve
Learn about the use of melatonin as a toll for jet lag mitigation
Touch upon how caffeine and napping can be jet lag strategies
Characterize the merits of hypnotics for travel
Discover the surprising relationship between fasting and jet lag
Conclude with the folly of alcohol as a jet lag strategy
#37 - Marijuana and Sleep: The Drugs Don't Work, They Just Make You Worse
00:29:18
The explosion of both medicinal and recreational marijuana use (as well as its derivatives) has led to the obvious question: Does marijuana help an individual sleep better? If you pay attention to those who sell it, the answer seems to be a resounding yes...but is that true. In this episode we will:
learn about marijuana and the chemical cannabinoids that are often proclaimed to be sleep-promoting
understand that in many ways, using marijuana for insomnia is no different than other pills and its success leans heavily on how we measure sleep success...or how it "works"
touch upon older research about marijuana
learn the differences between transient sleep effects and the sleep effects of long-term use
explore cultural conversations and myths about marijuana use, in particular that it's helpful in pregnancy
discover the misperceptions surrounding marijuana use in college
uncover how the bottom line of some studies can be affected by pharmaceutical companies trying to develop novel sleep therapies
look ahead to potential therapies for conditions like REM behavior disorder and Restless Legs Syndrome
#38 - Coffee and Sleep: There's Too Much Caffeine In Your Bloodstream
00:36:00
There is no chemical on the plant more tied to sleep disruption and wakefulness promotion than caffeine. As every research paper on the plant points out in the first sentence of the manuscript, caffeine is the most widely consumed psychoactive drug in the world. The consumption of caffeine as spawned its own culture and massive business machine. In this episode we will:
discover the history of caffeine research in sleep
learn about caffeine and the related methylxanthine chemicals theophylline and paraxanthine
analyze the antagonistic effects that caffeine has on adenosine signaling
touch upon the differential effects of caffeine based upon age
explore the negative effects of caffeine on sleep including new research on its effects on REM sleep
detail the research looking at the timing of caffeine ingestion related to bedtime and how its effects may be more prolonged than most thought
uncover the reality about the wakefulness effects of caffeine and the facts that predict it.
break down the caffeine and performance findings of the International Society of Sports Nutrition
In episode 26 of the podcast, we began a discussion about narcolepsy...what it looks like, how it's diagnosed, and why it's so often overlooked. Diagnosis is just the first hurdle as many patients are unaware of or simply not offered the best therapies for the disorder. In this episode, we will:
touch upon theories of treating narcolepsy include non-medication therapies
list the major pharmaceutical therapies
differentiate the mechanism of actions among these medications
outline the drug strategies for managing narcolepsy symptoms including excessive daytime sleepiness and cataplexy
learn why so many patients are denied optimal therapy because of doctor's ignorance or insurance company denials/red tape
briefly touch upon the obstacles involved specifically in narcolepsy care
#40 - Tired Sleep Advice: Got To Search For Something New
00:35:59
Sleep tips are everywhere and the more 'surprising' the advice is, the better. While the majority of what is out there is helpful at its core, over time, these tips can distort the actual goal individuals have to develop not only healthy sleep practices, but a deeper understanding and sturdier relationship with sleep. To that end, it's important to dissect these ubiquitous instructions and figure out what they are really telling us. In this episode, we will:
dive into why we are constantly ordering people to never be in bed awake, and how it can erode the positive feelings and impact resting can have in our lives.
push back against techniques that promise faster sleep
dispel the myth of fluid restriction at night and why hydration restriction is not only unhealthy, but also largely ineffective
evaluate the idea that delaying caffeine intake scientifically reduces a mid-afternoon 'crash' and overlay his theories on the two-process model of sleep/wakefulness
learn how going to bed at the same time every night might be unhelpful over time
explore the idea of not watching television 2 hours prior to bed and why that is an impractical notion for most people
understand why sleep hygiene alone is not likely to fix a significant sleep problem
briefly touch upon the current fad of mouth taping, it's like of rigorous scientific backing, its academic opposition, and how medical trends (sometimes dangerous ones) are perpetuated
#41 - How To Shut Off Your Racing Mind: It’s Late, You Can’t Turn Out the Lights
00:30:52
"I can't shut my mind off at night" is a very common refrain among insomnia patients. Is this a real phenomenon and if so, how does it relate to the disorder of insomnia. In this episode we will:
Review the cognitive role of mental hyperarousal in insomnia
Explore how mental de-arousal is an integral part of managing insomnia
Learn how insomnia patients raise their level of arousal as they approach bedtime and are often cued to do so by their sleep environment.
Differentiate poor sleepers who often view their racing thoughts or inner monologue as an impediment to their sleep versus normal sleepers who do not.
See mindfulness as the countermeasure to our culture's propensity to stress mental escalation while ignoring techniques for de-escalation
List some methods, including the use of biofeedback devices, for practicing how to manage a racing mind
Touch upon the idea that the "racing mind" is something to embrace, not fear
#42 - Severe Sleep Apnea and Treatments: Quit Holdin' Out and Draw Another Breath
00:38:36
In Episode 5 of the podcast, we explored the confusing entity of mild/borderline sleep apnea and the treatment confusion it causes. In this episode we look at the other end of the sleep apnea spectrum...severe sleep apnea where the only confusion is, "Why didn't your primary care doctor order a sleep study sooner?" In this episode we will:
Define sleep apnea and learn how the Apnea Hypopnea Index (AHI) helps us classify an individual's sleep apnea severity
Briefly touch upon other metrics being considered to grade the severity of sleep apnea
Look at sleep apnea through the lens of a recent patient who averaged 155.8 significant breathing disturbances/hour and understand what that means in terms of health and medical risk factors
Examine the process by which one slowly develops sleep apnea and ask the question, "Why, in the midst of elevated weight, high blood pressure, and/or diabetes do more doctors not order home sleep studies to screen for sleep apnea when it is a modifiable risk factor with massive potential for health benefit?"
Understand how the concept of CPAP therapy "working" or "not working" needs to be clearly defined as different therapy modalities are considered.
Examine Inspire therapy, understand what it entails, who is eligible, and how there is much more to consider than their advertisements seem to indicate
Compare sleep apnea therapies and their strengths/drawbacks
Note: I let an f-bomb slip in this episode…sorry to those offended by this.
#43 - In A Deep, Deep Sleep: Where Do You Go For Deeper Sleep?
00:29:58
Everyone wants slow wave sleep, commonly referred to as deep sleep. It's the sleep of youthfulness. It's the sleep of performance. It's the sleep of recovery. It's the sleep through which growth hormone flows. Lots of things promise a deeper sleep, but what really delivers? In this episode we will:
Revisit the reasons deep sleep is so important for optimal health
Examine the research behind exercise and deep sleep
Explore the links between mindfulness and meditation and sleep
Determine if hydration plays a role in slow wave sleep enhancement
Look at the surprising link between lavender and deep sleep
Understand the role temperature plays in this process and why exercise my actually be utilizing body temperature as a pathway for its enhancement of deep sleep
Untangle the complicated research looking at alcohol and its role as both an enhancement and degrader of deep sleep
#44 - Shift Work: I Got No Time For Livin', I'm Workin' All The Time
00:37:20
Maybe the Rush lyric should have been, "I've got no time for sleepin'" because a huge population of people in this world participate in some form of shift work, and it takes a heavy toll on sleep, health, and the bottom line of their employers. In this episode we will:
Examine the inherent sleep deficit that comes with shift work
Determine how much sleep the average shift worker is losing
Debunk the idea that staying on night shift actually creates a true biological adjustment
Explore the work-related consequences of shift work sleepiness
Highlight the unequal 'double burden' women engaged in shift work assume
List the medical consequences of shift work
Define the medical disorder Shift Work Disorder
Evaluate the countermeasures and interventions that can lessen the impact of shift work
#45 - Are You A Good Sleeper Or A Bad Sleeper?: It Was My Attitude
00:36:42
Our identity as either a good sleeper or a bad sleeper plays an outsized role in the development and persistence of insomnia in individuals. In this episode, we will:
Explore the origins of our sleep identity
List the common ways individuals decide whether or not they are "good sleepers"
Introduce the Dysfunctional Beliefs and Attitudes about Sleep (DBAS) Scale, and how its components offer insight into the dysfunctional thinking that often characterizes insomnia
Contrast the use of the DBAS with the Epworth Sleepiness Scale (ESS)
Consider how the ESS helps to identify drive to sleep and what that means to have a high, or a low drive.
Strategize how to use elements of the DBAS and the ESS to begin to construct a new foundation for sleep identity, an identity that is one of a good sleeper.
#46 - Choosing the Right Pillow: Send Me The Pillow You Dream On
00:29:08
It would be tough to argue that one of the most important factors that influence your sleep is right under your nose (literally, depending on what position in which you sleep). Our pillow plays a big role in our sleep comfort and quality. In this episode we will:
Touch upon when kids should begin using pillows for their sleep
Look at evidence suggesting that few people give deep consideration to their pillow and of those who do, the majority may still be making the wrong choice
List the various pillow fillings (feather, wool, latex, etc.) and their relative strengths and weaknesses
Determine which pillow types tend to create the most spinal support
Lay out the factors that go into pillow fitting
Understand the supportive and comfort goals of a well-fit pillow
Dive into the factors that tend to influence pillow purchases
Discuss other uses of pillows besides head support
Go through some disorders that can be improved with proper pillow selection.
Now that lettuce water and melatonin spray has had their moments, mouth taping seems to be the latest sleep social media trend that everyone is talking about. What does the evidence say about the practice? Is it legitimately helpful? In this episode, we will:
Examine the functions of the nose in the respiration process (filtering, humidification, etc.)
Attempt to quantify the scope of nocturnal mouth breathing, both in the sleep apnea and non-sleep apnea population
Rank to incidence of mouth breathing based upon sleep stage
Contextualize the role in increased nitric oxide via nasal breathing
Evaluate the scope of sleep apnea and snoring improvement based upon mouth taping and how it relates to other treatments
Discuss the role of mouth taping and CPAP compliance
Touch upon the role of mouth taping and oral health
Break down the relationship between ADHD and mouth taping, and the influence of sleep-related breathing disturbances in this proposed relationship
Go through the list of considerations related to the practice of mouth taping
Chronic pain is a disabling problem that could affect as many as 1 out of every 5 adult Americans. It is a costly and tragic collection of disorders that often has limited and disappointing treatment options. Could sleep be a central mediator of chronic pain? Could it be a pathway for treatment? In this episode we will:
Contrast the relationship between pain causing disturbed sleep with the condition of disturbed sleep itself causing pain
Examine study numbers showing the high incidence of disturbed sleep in patients with chronic pain
Consider that while many patients with disturbed sleep have concurrent depression, a much higher cohort complains of disturbed sleep
Revisit a 2006 study I highlighted in my first book that shows increased pain indices following relatively trivial reductions in total sleep and REM sleep
Extend this concept as it relates to high incidence of chronic pain in military veterans with sleep disorders/disturbances
View the relationship through the lens of a 2022 Harvard study confirming a relationship but stopping short of endorsing causation
List ways in which sleep considerations could be utilized to improve pain conditions
#49 - Sleeping Naked: Are Your Clothes Getting In The Way?
00:32:31
The media loves to talk about sleeping naked. The topic carries just enough taboo to make it irresistible to readers. Given that up to a third of adults sleep in the buff, is there any real science to supports its sleep and health benefits? In this episode we will:
Examine current research about the metabolic effects of sleeping in cooler temperatures and how being naked might support these theories
Postulate how sleeping naked/in a cooler environment could increase brown fat composition leading to increased metabolism, weight loss, and better glycemic control/lower diabetes risk
Revisit the sleep benefits of colder temperatures (from Episode 25)
Push back on the direct relationship between sleeping naked and healthier skin
Discuss the role of oxytocin on sleep, stress, and sleeping skin to skin
Touch on the role of sleeping naked on vaginal health
Dive into the idea that sleeping naked improved sperm counts and fertility
Explore the ways in which sleeping naked could lead to heightened self-esteem and body acceptance
Determine if there is in fact evidence that sleeping naked promotes intimacy
#50 - Is There A Case For Sleeping Pills?: I Wanted To Be Wrong
00:38:23
While we discussed sleeping pills on episode 11 of the podcast, there is a lot of unfinished business here. A recent conversation with a distinguished and highly educated colleague about sleeping pills made me question my practice and the practices of many providers. In this episode we will:
Examine the role of cognitive behavioral therapy for insomnia patients who do not have the resources, time, or interest in participating in the therapy
Explore the differences in sleep clinics in terms of the demand for these medications. Are these drugs mainly a tool for primary care doctors or do sleep medicine specialist rely on them as a part of their insomnia toolbox?
Review the data on the newest family of hypnotics, the orexin receptor antagonists, in particular their effects on sleep latency and decreasing wake time after sleep onset (WASO)
Discuss the absolute lack of evidence linking any changes seen in sleeping pill sleep use and improved health/performance in their users
Touch upon the proper/ethical ways in which hypnotic data should be shared with patients who are using these drugs. If a drug is helping someone who "cannot sleep" to sleep through the night, what does it mean to withhold this data?
Accepting that these medications may change sleep in very small but statistically meaningful ways, how are we as providers supposed to square these changes with the very different problems our patients bring to our clinic.
#51 - Dispatches from the 2023 SLEEP Scientific Conference: A New Sensation
00:38:22
The 2023 SLEEP meeting just concluded in Indianapolis where the greatest sleep minds come together and share the amazing academic and scientific projects and research they have been working on. I was on the ground in Indianapolis and wanted to share with you some of the more noteworthy research and data that is came out of the meeting. In this episode we will:
Look at research related to the subjective impression of sleep quality and how it relates to sleep stages
Examine how circadian misalignment in kids tends to predict more food consumption even when sleep time is held constant
Find out how lucid dreaming could be utilized as a potential treatment for nightmare disorder
Determine how factors related to male college students and sleep might be predictive of other problematic behaviors like alcohol use
Review associations between sedentary behavior and insomnia severity
Touch upon the role of sleep hygiene and couple dynamics
Explore equity and discrimination as a factor leading to poor sleep health and quality
Answer the questions as to whether or not it is better to athletically train in the afternoon or evening as a young athlete
Reflect upon what we have learned from the pandemic in terms of sleep, working from home, etc.
Look ahead toward hybrid models for clinical CBTi delivery and how they may hold the key to improving patient outcomes
#52 - Finding the Perfect Mattress: The Bed's Too Big Without You
00:27:56
Perhaps the biggest single influence on your sleep is the surface that you sleep on. Choosing a mattress is a process that combines personal preference, but also an emerging body of science. In this episode, we will talk to our first guest and producer of the show Maeve Winter about her quest to find the perfect mattress for her and her boyfriend. In this episode, we will:
Discuss how one uses their current sleep experience to inform how they choose their mattress
Identify what factors matter in terms of mattress selection
Review the research about firmness and temperature and how they can improve overall sleep quality
Touch upon other factors that may be important to individuals buying a mattress: construction, materials, size, and motion-suppression , and cost
Summarize the process of going to a Mattress Firm locally, and how the uniformity of working with a Sleep Expert allows two individuals in different locations to "shop" together.
*Dr. Winter has a financial relationship with Sleep.com and Mattress Firm. The content, opinions, and views in this podcast reflect his own opinions and not those of Sleep.com or Mattress Firm.
#53 - Sleep and Green Spaces: Lay Me Down In the Tall Grass
00:26:30
There has been an explosion of research looking at relationships between one's proximity to nature and sleep. During the Covid pandemic, this research seemed more pressing than ever and rates of disordered sleep and mental health problems soared. In this episode, we will:
Review the research linking improved sleep parameters and access to nature/green spaces
List the potential sleep related benefits being in or around nature may create
Evaluate the categories of benefit related to nature exposure proposed by Markevych: reducing harm, restoring capacities, and building capacities
Highlight CO2 reduction as a harm reduction method for improving sleep
Consider tress and canopy exposure as a separate harm reduction pathway
Explore the role of nature on mental health and its interplay with sleep
Touch upon the ways in which green spaces can facilitate physical activity and social cohesion
Look specifically at green space research as it relates to children and teens
#54 - Insomnia and the Five Senses: See Me, Feel Me, Touch Me
00:38:34
The five senses are our brain's main way of collecting information about our immediate environment. They have a powerful effect on our moods, cognition, and the way we experience the world. They are also integral to the way we sleep and deal with insomnia. I recently met Gretchen Rubin and read her latest book Life in Five Senses. In this episode, we will explore heightening and honing our five senses as a portal for improving our sleep and managing insomnia. In this episode we will:
Discuss visualization and rehearsal as a means to relax and combat insomnia
Explore the creation of an Auditory Hypnotic playlist and how curating music/songs that relax you can be a helpful tool to set the stage for improved sleep
Review the current data on white noise and its effects on sleep outcomes
Discuss smell and olfaction as a tool for sleep
Evaluate different novel smells and their relative effects on sleep and insomnia
Revisit tart cherry juice and other pre-bedtime drinks as a way to establish routine via taste
Introduce the concept of "sleep-touch" and review a recent study about how it effects the sleep of couples
#55 - Are You Sleepy or Are You Fatigued?: I'm So Tired
00:39:10
One of the biggest misunderstandings in medicine is the differences between sleepiness and fatigue. Add to this poorly defined terms like "tired" and "exhausted," and you have the makings for not only utter confusion, but also the basis for misdiagnoses and treatments that miss the mark completely. In this episode we will:
Provide a research background examining the confusion between the terms sleepy and fatigued
Attempt to define sleepiness and fatigue and provide a physiological and behavioral foundation for their characterizations
Evaluate the misuse of the term fatigue in literature regarding excessive daytime sleepiness
Use research to characterize the unique intermediate positioning of the word "tired" in scientific explorations of sleepiness and fatigue
Learn how the lack of a "gold standard" for fatigue evaluation has contributed to the problem
Revisit the Epworth Sleepiness Scale as the de facto standard for quantification of sleepiness and its intrinsic shortcomings
Discuss ways in which failure to properly characterize sleepiness or fatigue can lead to diagnostic and treatment delays and error
Expand upon the multitude of fatigue causes and how primary medicine often stops far short of an exhaustive search for an underlying cause of an individual's fatigue
Link specific sleep and psychological factors to elements of sleepiness and fatigue
An important subset of parasomnias is sexsomnias--sexual behaviors that arise at night with little or no memory reported from the person involved. In addition to being disruptive to sleep, these behaviors bring with them heightened physical, emotional, and in some cases legal consequences. In this episode we will:
Introduce and define sexsomnias
Explore the relative short history of this behavior in medical literature
Characterize was types of behaviors are seen in sexsomnias
List the groups of individuals who are at risk for these behaviors
Examine the unique features of sexsomnias
Describe the numerous medical risk factors for sexsomnias
Provide solutions and tips for individuals struggling with sexsomnias
Over the last several decades, there has been a heightened interested in alternative therapies for sleep disorders, and the practice of yoga as a sleep solution has been frequently investigated. In this episode we will:
Define yoga and outline its fundamental philosophy
Explore why yoga might be uniquely situated to improve sleep parameters
Review research studies exploring yoga and enhanced sleep parameters
Subdivide sleep studies exploring yoga nidra or the practice of yogic sleep
Look at research exploring yoga in the /pregnant/prenatal population
Outline yoga practices within the elderly/institutionalized population
Evaluate yoga as a pain-mediating intervention and determine what that means in terms of sleep
Touch upon yoga as a technique for mitigating restless leg syndrome
Mention yoga as a therapy within the cancer treatment space
The phenomenon of dreaming is an endless fascinating topic for many individuals, and the concept of lucid dreaming is a never-ending source of interest. What is lucid dreaming and what potential does it hold? In this episode we will:
Define the concept of lucid dreaming
Explore the history of the practice from its roots in ancient Hindu and Buddhist practices, to its first description by Aristotle
Follow the changing characteristics that define lucid dreaming from its first scientific description in 1931 (when the term lucid dreaming was coined) to the present
Touch upon seminal research exploring ways of communicating and studying the lucid dreamer and their world
List the various techniques for inducing lucid dreams including reality testing
Review research studying befits of lucid dreaming application
One often overlooked strategy to improve sleep and manage insomnia is to employs bedtime rituals. While most think of these as activities designed to help kids go to sleep easier, their science is deeply rooted in our sleep health. In this episode we will:
Revisit the idea of circadian rhythms and why they are important for sleep health and sleep timing
Define the concept of a zeitgeber and how they work to strengthen the effectiveness of our circadian rhythm and its predictive ability
Understand the concept of weak and strong zeitgebers and how they relate to the actions that make up our bedtime routines
Examine common bedtime rituals and their relationship to known zeitgebers
Touch upon light as historically the strongest/most influential zeitgeber
Differentiate the health (and sleep) benefits of exercise from the circadian benefits and understand how evening exercise could capitalize on both in a bedtime ritual
Evaluate stress (and alleviating stress) as an unexpected zeitgeber
Revisit the concept of temperature as a zeitgeber and how its mechanism in humans is not entirely clear
Introduce the food entrainable-oscillator (FEO) and how it relates to food as a zeitgeber
End on more unusual potential zeitgebers like music, and the research supporting them
#60 - Influencers, Experts, and Bad Sleep Advice: Would I Lie To You?
00:32:39
Information and advice about better sleep comes from more individuals and sources than can be counted. In our current era of "fake news," it can be difficult to determine is the sleep advice or science behind what you are seeing or reading is legitimate. In this episode we will:
Differentiate between misinformation, disinformation, and bullshit
Look at examples of each and work towards understanding their motivations and how they can be spotted and corrected
Explore the consequences of the spread of bad/harmful information, and how current media factors can accelerate the dissemination of false information
List the characteristics of information that spreads quickly
Apply epidemiological tools to social media and the spread of bad information
Evaluate the factors that lend themselves to the spread of bad medical information
Consider how intuition and deliberation affect our ability for comprehensive reasoning and detection of bad information
Review remedies to help improve the situation and reduce the spread of incorrect medical information
#61 - How Much Sleep Do You Really Need? Just Can't Get Enough
00:29:58
Within the field of sleep science, there are few questions asked more frequently than, "How much sleep do we need?" While the answer eight hours seems to make the rounds in the media (and anything less would appear to be cause instant harm or even death), what is the answer? Is the question even answerable? In this episode we will:
Evaluate how age is constantly influencing sleep need
List other factors affecting sleep amount for an individual including sleep quality, activity level, previous sleep deprivation, pregnancy and illness
Explore the inherent difficulties in applying epidemiological sleep data to individual sleepers
Look at the data rejecting the idea that 8 hours is the ideal amount of sleep for adults
Define the "J curve" commonly seen in studies exploring optimal sleep amounts
Understand how sleep behaviors need can be easily mislead in terms of indicators of average sleep need
Touch upon how individuals who can get by better with inadequate sleep may misinterpret this as being a healthy practice
#62 - Sleep and Memory: You'll Forget About Me After I've Been Gone
00:30:55
The link between sleep and memory has been a compelling area of research for many years. New theories about the specific relationship between sleep and memory have recently emerged that reveal much about the roles that sleep plays in this process. In this episode we will:
Touch upon the history of sleep and memory studies
Review the discovery of the glymphatic system and how it is not only involved in cognitive health but also influenced by sleep
Learn how slow wave sleep/deep sleep primes our brains to learning
Differentiate the solidification/activation of memory by deep sleep versus the linkage and solidification of sleep by REM sleep
Contrast declarative hippocampal memory storage via slow wave sleep and implicit memory stored outside the hippocampus
Explore various rodent and human models for studying memory
Introduce the technique and science behind Targeted Sensory Reactivation
It's hard to have a full conversation about insomnia without bringing up the topic of anxiety, the most common psychiatric diagnosis in the world. Treating insomnia often means addressing anxiety. In this episode, we will:
Introduce the concept and history of anxiety and sleep
List the factors that along with anxiety, often influence sleep
Think about the underlying mechanisms that relate sleep to anxiety
Dissect the bidirectional relationship between sleep quality and anxiety
Review the initial sleep interventions
Explore the use of novel mechanisms for refractory anxiety/insomnia
#64 - Sleep and the Gridiron: Your Country Needs You To Play Football
00:27:17
It's that time of the year again...football season. With the excitement building as rivalries renew both at the collegiate and professional level, it seems an appropriate time to look at the sleep through the lens of the sport of American football. In this episode we will:
Preface the episode by considering the first athletic trainer in history, James Robinson of Harvard
Explore some of the early research looking as sleep and football player/team performance
Dissect the controversy regarding the actual risk of sleep disordered breathing in American football players
Differentiate the differences between professional football sleep and collegiate sleep both in and out of season
Touch upon the evidence for increased injury in underslept players
Look ahead to innovative programs designed to manage the sleep of football players both active and retired
#65 - REM Sleep Behavior Disorder: Wild Night Is Calling
00:29:02
We have touched upon REM sleep behavior disorder (RBD) in many episodes of the podcast, but it's never been the star. An individual acting out their dreams can be distressing, and understanding the disorder has many layers. In this episode we will:
Describe the features of RBD and what it clinically looks like
List the characteristics of the disorder and how it fits into the parasomnia family
Review the incidence based upon age
Differentiate primary (idiopathic) from secondary RBD
Touch upon conditions that mimic RBD and why differentiating these is important
Review treatment options
Discuss the relationship between a diagnosis of idiopathic RBD and its predictive value related to neurodegenerative disorders
Outline how clinicians should handle the sensitive nature of this condition when speaking to patients
#66 - Sleep and Longevity: You and I Are Gonna Live Forever
00:30:28
The promise of youth eternal is ubiquitous, and is often related to some new sleep intervention. When it comes to dialing back the years, what is fact and what is fiction? In this episode we will:
List the sleep variables most commonly manipulated to improve health and longevity
Understand the relationship between the sleep, testosterone, and cortisol and its impact on insulin and endocrinological health
Revisit exercise and sleep as it pertains to longevity
Touch upon lighting and how it relates to sleep and longevity
Review digital technology's role in sleep and health
Finish with the relationship between deep sleep/slow wave sleep and longevity
Insomnia is a common sleep disorder that we have discussed frequently on this podcast. It's also a disorder that can have its origins in other sleep and medical disorders. Many disorders can masquerade as simple insomnia, and knowing the true underlying cause can be the difference between solving a medical mystery and suffering needlessly. In this episode, we will:
Differentiate between primary and secondary insomnia
Review the medications that often disrupt sleep
Breakdown the reasons sleep apnea, restless legs syndrome, and narcolepsy can confound medical providers as it pertains to insomnia
Touch on paroxysmal disorders like epilepsy/seizures and migraine and how they can be mistaken for insomnia
Spotlight menopause and pregnancy as an insomnia pretender
Look at the sleep consequences of neurocognitive disorders like Parkinson's and Alzheimer's disease
Showcase pain and itching as unusual causes of insomnia-like behavior
Talk about gastrointestinal disorders like gastroesophageal reflux disease and irritable bowl syndrome
Sprinkle in several other medical problems that can behave like insomnia
#68 - Perinatal Sleep: Hey, Hey, Baby! (All Night Long)
00:29:52
The perinatal sleep experience is often talked about in less than glowing terms. It's often a situation that is cannot be helped, it simply must be endured. In this episode, we will:
Look at the common changes that occur during the pregnancy period, trimester by trimester
Review the incidence of sleep disturbances in all pregnant individuals
Contrast the incidence of sleep disturbances in women with psychiatric diagnoses versus women without psychiatric disorders
Examine how increased sleep as well as decreased sleep during pregnancy can be predictive of depression and psychotic episodes respectively
Perhaps the most common sleep disorder in the world is sleep talking. It most likely affects at least half of all individuals at some point in their life. With the condition being this common, there are still many misunderstandings about sleep talking. In this episode we will:
Define sleep talking as a parasomnia
Review the incidence of sleep talking, the hereditary nature, and how it changes over time
Differentiate it from taking during REM sleep
List the risk factors for somniloquy
Categorize disorders that may lead to sleep talking
#70 - Sleep and Injury: Do You Really Want To Hurt Me?
00:35:52
One of the most common questions I am asked about sleep is, "What are the adverse health consequences of inadequate sleep?" While I am quick to answer something related to cardiovascular or cognitive health, physical injury is not one that comes to mind immediately, but new evidence suggests it should. In this episode, we will:
Discuss sleep mechanisms that might relate to increased injury
Investigate how inadequate sleep may influence the immune system and inflammatory processes of the body
Focus on cognitive changes, particularly in the prefrontal cortex, that might lend to an increased risk of injury
Touch upon concentration and focus impairments as supplemental aspects leading to increased injury risk
Review data within athlete, adult, high school, and juvenile populations that show increased injury risk in sleep deprived individuals
Outline steps that can be taken to address sleep and injury risk factors
#71 - Sleep and Extreme Temperatures: Hot Blooded/Cold As Ice
00:36:05
Saunas and cold-water tanks are everywhere in their personal fitness and recover space. These modalities have also been linked to improving sleep parameters, but is there any science behind the claims? In this episode, we will:
Examine the use of sauna therapy and cold-water immersion (CWI) in elite athletics, and the relative adoption rate for both
Discuss the literature linking sauna/heat therapy with improved health and longevity, particularly in the cardiovascular space, but also emerging in the cognitive health space
Define hormesis and link it to these therapies
Explore the role of sauna therapy as an exercise mimetic, and how that can act to explain the health benefits as well as the sleep benefits of sauna therapy
Link sauna therapy to inflammatory and immune modulation
Touch upon other potential pathways that sauna therapy could benefit sleep
Clarify the confusion about cold water therapy timing and sleep
Review evidence from research showing CWI therapy earlier in the day improving slow wave sleep and reducing sleep latency
#72 - Insomnia and the Gut Microbiome: Empty Stomach, Empty Head
00:32:36
A relatively new frontier of medicine is the exploration of the gut microbiome and its relationship to our body's functioning, health, and susceptibility to disease. The gut-brain axis represents a relatively strong relationship between the gut microbiome and our body's ability to function properly, and it has been proposed that this relationship influences sleep and risk for insomnia. In this episode we will:
Define the gut microbiome
Explore the beginnings of its suspected role in neurological functioning and sleep
List the three proposed pathways by which the gut microbiome interacts with the nervous system
Evaluate the role that the gut microbiome plays in terms of regulating our circadian rhythm via gene expression of the gut biome's own circadian patterns
Discuss metabolic linkages between the gut microbiome and why disruption can increase the chances of metabolic syndrome
Look ahead toward gut biome-based therapies for insomnia
It can be hard to wake up. For some people, it is almost impossible. Sleep inertia is the medical term of an inability to awaken in the morning. In this episode we will:
Define sleep inertia
Describe how sleep inertia interacts with our homeostatic and circadian drives
Understand the occupational hazards of sleep inertia
#74 - The 2nd Annual Holiday Sleep Gift Guide Extravaganza: This Is What I Give To You
00:23:53
The Sleep Unplugged podcast is here to ease your holiday shopping stress with some of my favorite sleep product companies. In this episode, we will explore a host of sleep-themed gift ideas and product recommendations. many with unique discount codes for their purchases. In this episode, we will feature the following products:
Ayo circadian lighting
Beadgear pillows and linens
Bearaby weighted blankets
Eberjey pajamas
Hest travel pillow
Lumi cold water recovery tank
Manta sleep mask
QuietOn sleeping earbuds
SaunaBox home wet/steam sauna
Sleepys pillows and pillow inserts
Swanwick blue-blocking glasses and lighting solutions
The Sleep Solution/The Rested Child books
Withings ScanWatch Horizon sleep/fitness watch
zDen personal/pet sleep environment
*I have no financial relationship with the companies listed above but may have received products to trial/demo. I am a paid consultant for Mattress Firm which owns Sleepys.
#75 - Eating At Night: Bittersweet I Could Taste In My Mouth
00:27:10
Within the world of sleep disorders, there is often confusion surrounding disorders that feature nocturnal food consumption. These disorders share many similarities, but their distinctions are worth understanding. In this episode we will:
Describe the disorders of nocturnal eating
Characterize the incidence of these conditions
List the comorbid diagnoses often seen with these disorders including eating disorders
Define nocturnal sleep-related eating disorder (NSRED) and night eating syndrome (NES)
Differentiate these disorders based upon consciousness/volitional eating and the characterizations of the eating
#76 - Insomnia and Popular Media: I Love To Watch Things On TV
00:36:41
Apple TV (not Max as stated in my episode) has a new show about two friends with Insomnia called Still Up. It is another example of the media portraying sleep disorders, but how accurate is the depiction, More to the point, is it a helpful perspective or does it simply perpetuate harmful ideas and stereotypes? In this episode we will:
Consider the role media plays in illustrating, explaining, and sensationalizing insomnia
Explore the use of sleep disorders like insomnia and narcolepsy for comedic effect
Examine the role media plays in terms of disseminating good diagnostic and treatment information for sleep disorders
Review research that evaluates trends in narcolepsy portrayal in the media
Discuss Still Up in terms of accuracy and helpfulness in terms of a insomnia portrayal
Sleep trackers are everywhere and depending on the voice you are listening to, they are either the secret to hacking your sleep or worthless pieces of plastic on your wrist. The world of consumer sleep trackers is vast and confusing. In this episode we will:
Discuss the basics of monitoring sleep
Understand the role of surrogates in the measurement of sleep
Examine the history of research actigraphy devices and their evolution to become the first generation of sleep wearables
Follow the development of second generation devices and the expansion of the parameters they measured
Outline the uses for these devices
Dive into the strengths and limitations of these devices
Look at what current research has to say about these devices
List the problems with this technology in the marketplace
#78 - Central Sleep Apnea: Let Me Catch My Breath To Breathe
00:36:23
Throughout the podcast, we have shone a light on obstructive sleep apnea syndrome, but the lesser known (and less common central sleep apnea) has gotten little attention. In this episode, we will:
Define central sleep apnea
Differentiate central apnea from obstructive
Understand the mechanisms that create central apnea
Describe how obstructive and central apneas differ both physiologically as well as how they are differentiated diagnostically
Contrast the forms of central sleep apnea seen in adults and children
List the various types and causes of central sleep apnea
#79 - 2023 Sleep Unplugged Awards: I'm Winning And I Don't Intend On Losing Again
00:25:09
Another year calendar year of the Sleep Unplugged podcast has come to a close. With the escalation in podcast popularity soaring, the 2023 Sleepy Awards seem all the more important and exciting. It's fun to sing the praises of these special sleep colleagues as 2023 comes to a close. Join me as we celebrate some of the brightest stars within the field of sleep.
The 2023 Sleepy Award winners are:
Social Media Warrior Dr. Funke Afolabi-Brown (@restfulsleepmed)
Sleep Outsider Award Tommy Tucker (@ttuckerwwl)
Sleep Vanguard Organization MyFitnessPal
Sleep Sports Organization Oklahoma City Thunder
Sleep Podcast of The Year Talking Sleep (AASM/Dr. Seema Khosla)
Best Insomnia Advice Dr. Jade Wu (@dr_jade_wu)
Book of the Year Sleep To Heal: 7 Simple Steps to Better Health Dr. Abhinav Singh (@sleep_vigilante) Charlotte Jensen (@author.char.jen)
Happy new year! It's 2024 and with a new year comes resolutions to join a gym and get into shape. The podcast has explored exercise and sleep relationships before, but is there a benefit to lifting weights? In this episode we will:
Touch on current gym use statistics
Revisit the impact sleep has on weight training, recovery, and athletic gains
Detail the impact on specific strength training exercises and sleep
Understand the impact of weight training on sleep quality and depression indices
Look at research showing sleep apnea improvement in individuals who weight train
#81 - Insomnia and Social Isolation: We’re Afraid To Be Alone
00:36:59
In 2023, the Surgeon General Dr. Vivek Murthy released an 82-page advisory entitled, "Our Epidemic of Loneliness and Isolation" and it details the health consequences of social isolation and lack of social support. In the report, sleep was specifically highlighted as an aspect of health affected by social isolation. This highlights an important connection and potentially and avenue of insomnia treatment. In this episode we wilL
Define loneliness and social isolation
Examine the scope and trajectory of the problem
List contributors including Covid and personal electronics/social media
Understand the role of social isolation in insomnia and how data supports the link
Evaluate the role of work/workplace environment on sleep through the lens of social isolation
#82 - Exploding Head Syndrome: Exploding In The Night
00:29:01
If catathrenia (Episode 30) is the parasomnia that bothers everyone except the sleeper, exploding head syndrome (EHS) is the parasomnia the only bothers the sleeper, and very much so at that. Imaging being awakened by a sound so loud and dreadful that you awaken certain that you are about to die. In this episode we will:
Define exploding head syndrome
Review the key characteristics of the parasomnia
Explore the history and legend of EHS
Examine the demographics of the disorder
Understand the incidence and age range of the parasomnia
Mention theories that might explain its underlying cause
#83 - Brain Fog and Sleep: There's Someone In My Head, But It's Not Me
00:31:42
While brain fog has been described in many contexts, its incidence has soared since Covid. While the existence of brain fog is clearly real, its lack of clear definition and delineation from similar disorders does inject diagnostic and therapeutic confusion into the clinical setting. In this episode we will:
Offer elements central to the definition of brain fog
Touch upon the demographics and incidence of the disorder, with particular attention to Covid
Review the history of the disorder
Look at theories related to the pathophysiology of brain fog
The research on sleep and cell phone use is negative and there is an overwhelming amount of it. The negative impacts on sleep affect all age groups and demographics. While the impact on mood, memory, and attention is clearly sizable, the impact on sleep exists independently from these effects. In this episode we will:
Examine the effects of cell phone use in three populations: adults, college-age students, and adolescents/school-aged children
Determine the scope of cell phone use at bedtime and beyond
Measure the impact phone use has on sleep, including sleep onset, sleep quality, and sleep amount
List the features of phone use at night that may explain the detrimental effects
Review the impact curtailing cell phone use at night can have one sleep
It's hard to find insomnia without a healthy dose of fear or anxiety. Few individuals make an appointment to see a sleep specialist only to let them know that the situation is no big deal and frankly enjoyable. Fear not only plays a huge role in the development and worsening of insomnia, it also offers an insight into a potential solution. In this episode we will:
Review the incidence of anxiety in this country and the percentage of individuals diagnosed with anxiety who also have insomnia
Define anxiety and how it works in insomnia
Look at the role fear plays both in insomnia and how it functions as a central target in CBTi
Consider how some aspects of CBTi can often create fear as well as alleviate it
Look at the insomnia cycle within social media and popular media and how it creates its own fear
Understand the role of fear and the fear response amplitude within our neural circuitry as a potential risk factor for developing insomnia
#86 - Sleep and Bedding: Lay Me Down In Sheets of Linen
00:31:20
Picking the right mattress and pillow is important. Choosing the right material that goes over your mattress is equally essential. Bedding materials come in many forms and they can make a difference in your sleep experience. In this episode we will:
Look at the research about bedding and disease modification
Understand the temperature-regulating properties of various fabrics
Explore cotton as a bedding material and how the addition of performance fibers can enhance the cooling properties of the material
Evaluate linen as a bedding material and learn how newer forms can help is become a cooler fabric while retaining the properties that make if feel more upscale
Provide an overview of polyester, perhaps the fabric with the biggest quality range in the bedding space
Consider silk and how it might be the best fabric for sensitive skin or for people with certain dermatological conditions
Discuss the cooling nature of bamboo and its low impact on the environment
Largely ignore flannel as a bedding abomination
Touch upon Tencel and its unique textural properties
A simple piece of cloth over the eyes can have a powerful effect of the quality on an individual's sleep. The evolution of the sleep mask has been profound and the available literature of their effectiveness, particularly in the hospital setting has be extensively studied. In this episode we will:
Outline the effects of sleep masks on sleep
Review the large body of evidence supporting the use of sleep masks in hospitalized patients
List the specific medical populations that have been shown to benefit from eye masks
Explore the positive impact of eye masks of circadian sleep disorders
Examine a study linking eye masks and episodic learning/memory
Discuss the improvement of sleep in pregnant women who wear sleep masks
Differentiate the various types of masks that are available for individuals to choose from
#88 - Weighted Blankets: Pushing Down On Me, Pressing Down On You
00:34:14
Weighted blankets have soared in popularity over the past decade and they often promise better sleep. What exactly dose the evidence say and for what practical purposes can these products be useful? In this episode, we will:
Review the nervous system pathways for perceiving touch and pressure
Describe how pressure has a calming effect on the body via parasympathetic system activation
Explore the origins of more widespread weighted blanket use in the autism and sensory integration communities
Weigh the available research concerning weighted blankets and sleep/insomnia
Discuss theories on why weighted blankets might exert their effects
Touch upon other conditions that weighted blankets might help treat
Over the last two years, we have covered several circadian rhythm disorders...jet lag disorder and shift work disorder as well as covering the general concept of a circadian rhythm. For some individuals, they have an intrinsic desynchrony with the times they are expected to be awake. In this episode we will:
Review the role of the circadian rhythm in sleep
Touch upon previously covered circadian disorders
Define chronotype its relationship to quality sleep
Examine the parallels with circadian disorders and the transition to daylight saving time
Understand the causes of circadian rhythm disorder
#90 - Sleep and Hospitality: Gotta Hurry On Back To My Hotel Room
00:35:07
One of the most interesting trends in sleep is the growing number of hotels and hospitality centers that are embracing sleep as a primary focus for their patrons. Equinox Hotel in New York City has fully embraced the topic in almost everything they offer their guests from spa experiences to a room that goes "Dark, Quiet, and Cool" with the touch of a button. In this episode, we will:
Highlight some efforts by hotels in the past to fold sleep into their services
Contrast the Equinox Hotel's massive exploration of ways to improve sleep with British Cycling's "Marginal Gains" philosophy
Touch on hospitality research that supports their patrons wanting an enhanced physical environment, and better interactions/outcomes, and how focusing on sleep can achieve this goal
Examine the physical space of the hotel room and understand how its appointments affect sleep
Go beyond the hotel room to look at food menus, fitness club offerings, and spa treatments as means to improve sleep
Think about the potential hotel/sleep industry partnerships with the hotel the ideal proving grounds for emerging sleep products and technology
In a 2017 study, approximately one-third of the respondents reported having fallen asleep driving within the last month. Sleepy driving is a massive public health problem leading to thousands of preventable accidents, deaths, and injuries every year. In this episode we will:
Define drowsy driving
Outline the scope of this public health problem
Evaluate the causes of drowsy driving
Look at factors making drowsy driving more likely or dangerous
Characterize the level of impairment in terms of alcohol consumption
#92 - Sleep and Nicotine: I’d Have Another Cigarette But I Can’t ‘Sleep’
00:29:31
When it comes to substances affecting sleep negatively, it seems alcohol and caffeine hog all of the spotlight. But what about nicotine? While the number of younger individuals who smoke is declining, the advent of vaping and oral nicotine pouches is rising, and the effects on the sleep of the users is not positive. In this episode we will:
Examine the effects of nicotine on sleep
Look at the effects of nicotine withdrawal on sleep metrics
Understand the potential bidirectional relationship of effect
Compare the effects with other stimulants and chemicals
Evaluate the potential nicotine dose effect on sleep
Touch upon the effect of nicotine on sleep spindle activity and how that might impact memory
#93 - 10 Strange Insomnia Treatments: Rock Yourself to Sleep
00:35:59
There are no shortage of insomnia treatments and we have covered many on this podcast. In honor of April Fool's Day, we spotlight 10 unusual treatments and continue our yearly tradition of sharing the funniest listener comments about the show. In this episode we will:
Discuss biofeedback as a potential insomnia therapy
Evaluate the act of rocking or vibration as a sleep-inducing action
Look at various mental tricks like pretending your alarm has just gone off
Touch upon visualization techniques involving rising warmth or light passing through the body
Review acupuncture as an insomnia therapy
List the benefits of a clean room
Find ways the direction of your bed might be influencing your sleep
#94 - Grounding and Sleep: I Felt The Earth Beneath My Feet
00:35:59
Though widely regarded as pseudoscience for many years, there has been a recent resurgence in the practice of earthing/grounding. This practice aims to dissipate excess electrical charge and reestablish electrical homeostasis. While the act of grounding is common practice in high voltage appliances, is it really necessary of beneficial in the human body when currents are miniscule in comparison. In this episode, we will:
Explain the concept of grounding in modern electrical wiring
Discuss the electrical nature of the human body
Review studies claiming physiological changes in grounded individuals such as increased ferritin and lower blood glucose levels
Evaluate studies showing grounding effects on blood pressure
Use stress as a sleep surrogate and review available literature of the effects of grounding on stress in both animal and human models
Switch to pain as a potential sleep disruptor and discuss the studies showing reduced pain and faster recover via grounding
Touch on the large limitations of this small body of research and the ways in which bias and poor study construction can influence results
The health benefits of yoga are widely espoused, but for many, the belief is that the benefits are derived mainly from the physical nature of the poses or asanas. The breathing exercises and techniques (pranayama) are often ignored. In this episode, we will:
-Explore the sleep-specific benefits of breathwork to not only bring oxygen to the brain, but to also influence the energy of the body (referred to as prana or chi). -Review the various stages of breathing and why many individuals practice an incomplete/inefficient form of breathing -Practice a three-part deep breathing diaphragmatic breathing technique called Deerga Sawasam ("Three-part breath") -Link these breathing techniques to the engagement of the parasympathetic nervous system, instrumental in reducing anxiety and relaxing into sleep -List various research studies looking at the positive effects of pranayama in terms of lowering anxiety/stress and improving sleep -Add this to our sleep toolbox as an accessible method for calming our minds and preparing for restful sleep
#96 - Narcolepsy Stories: My Patience Has Reached Its End
00:38:25
Narcolepsy is a misunderstood medical disorder and as such, it generates some fascinating stories and anecdotes when you treat narcolepsy. In this episode we will:
Discuss the difficulties narcolepsy patients go through just refilling their medications
Dissect the idea of narcolepsy patients and abuse of their drugs
Evaluate the enthusiasm the medical community has for the treatment of narcolepsy
Consider some of the less obvious obstacles narcolepsy patients face
Understand the difficulties with the depictions created of narcolepsy patients
#97 - Nightmare Disorder: Nights So Cruel I Thought I'd Die
00:29:28
Dreams happen, and unfortunately, sometimes those dreams are nightmares. For most, these terrifying nights are few and far between. For a small few, nightmares become a frequent and unwanted nighttime norm. In this episode we will:
Revisit parasomnias, in this case nightmare disorder, and determine what defines it
Differentiate this disorder from night terror/sleep terror disorder
Explore the epidemiology of the problem
List its underlying causes
Review the medications often used to treat the problem
Discuss other treatment options often employed in the disorder
#98 - Insomnia and Belief: You Only Perceive What You Believe
00:23:20
One of the aspects of insomnia that can be both a perpetuating factor and and target for treatment is exploring dysfunctional beliefs. In this episode we will:
Explore different types of insomnia beliefs
Understand how these beliefs impact insomnia therapy
Look at the relationship between dysfunctional sleep beliefs and depression and alcohol abuse
Examine sleep beliefs in the general public as well as younger/university populations
Determine ways in which these beliefs can be targeted in insomnia therapy
#99 - Dementia and Sleep: Because I Don’t Remember
00:31:23
In episode 62, we began to look at the role sleep plays in memory. In episode 65, we looked at the condition REM behavior disorder and how this neurodegenerative condition is often associated with telling sleep disorders. We continue both of these dialogues in this episode. In this episode we will:
Look at research linking sleep disorders and inadequate sleep to dementia
Single out Lewy body dementia as a particular concern when sleep is chronically disrupted
Determine how much sleep seems to be optimal when it comes to dementia prevention
Examine other sleep-adjacent factors (exercise, sedentary habits) that tend to predict dementia
Discuss theories as to why sleep and dementia are linked
Uncover the vague nature and lack of evidence supporting how we manage the sleep of dementia patients
Show the lack of evidence supporting bright light therapy in managing sleep issues in dementia patients
List some best practices when it comes to helping patients with dementia sleep better
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