Tag: sleep therapy

What Depletes Your Melatonin Levels?

Actually, quite a lot of things.

Why should you care?

Because Melatonin is a neurohormone that supports sleep at night.  If you don’t have enough of it, you might have to resort to being sedated or exhausted in order to sleep.

In addition, Melatonin improves the quality and depth of our sleep.  Hours and hours of light sleep are seen in a “club” nobody wants to belong to:  patients with dementia!  The research on the benefits of high quality, sustained sleep with sufficient periods of deep sleep is piling up as we speak.  We aren’t certain that poor sleep causes dementia.  We know that no one with dementia displays healthy sleep, even if they seem to sleep all day long!

Nobody thinks that being sedated, exhausted, or demented sounds like a good deal. 

Here is an incomplete (but still impressive) list of the ways that Melatonin can be depleted:

  1. Age.  The pineal gland produces the Melatonin that supports sleep (your gut produces Melatonin too) and it calcifies in most of us as we age.  
  2. The prescription drugs we take:  Cardiac meds, NSAIDs for pain, SSRIs and SNRIs for depression and anxiety all decrease the production of or the accessibility of Melatonin for sleep.
  3. The recreational drugs we take:  Caffeine, alcohol, and tobacco suppress and therefore decrease Melatonin.  You don’t get a rebound once you sober up or put out your smoke.
  4. Sleeping with the lights on.  Even a dim light will reduce your Melatonin.  This is why every article mentions blackout curtains as a sleep strategy, and why eye masks work.

What can you do?

Well, you can reduce the risks above by discussing your prescriptions with your healthcare providers.  Relying on medications when there are non-pharmaceutical strategies to manage symptoms is a mistake.  Try to build out your toolkit so that you get relief from a number of sources.  Reconsider your recreational drugs.  And replace your lights with motion sensor lighting that eliminates blue light.  Turn the devices with lights away from your bed.  Or plug them into a strip that you can turn off in one motion.

Small amounts of Melatonin supplementation aren’t dangerous for most adults.  Not all.  And definitely children need special considerations from a licensed provider.

If you are also taking a sedative like Lunesta, have a medical condition that causes you to awaken very groggy or even dizzy, or are taking blood thinners or daily steroids, please discuss the use of Melatonin supplements with your healthcare providers.

Time-release formulations have the potential to be more effective for getting a deeper full night’s sleep for adults that can get at least 6-7 hours of sleep per night.  Less than 6 hours of sleep risks excessive grogginess on awakening.

Want more help with YOUR sleep?  Contact me for a complimentary consultation to determine if online sleep therapy, on your schedule, is right for you!  Go to the Contact Me section on the Menu, and send me a message today!! 

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Can Your Sleep Tracker Make Your Sleep Worse?

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If you are the type of person who becomes more anxious when you Google your headache symptoms, or fixates on whether your retirement fund went up a percent or down a percent…you probably aren’t a candidate for a sleep tracker.  It could make your sleep issues worse, and that can happen more quickly than you realize.

Why?

stethoscope with heart

Because the information from a wearable device or the app on your iPhone isn’t as actionable as the designers want you to believe it is.  After all, that doesn’t move products.  You will have a lot of data to digest, and some of it is useless, some of it is helpful, and some of it is only valuable when looked at in the context of your day, your week, and with your attitude attached to it. When the device assesses the data, it is making assumptions about you.  You, and your sleep issues, are probably more unique than they think.  The stress of not knowing what to make of the data, or getting it wrong and taking useless or counterproductive actions, could mess with your sleep.

What good sleep looks like isn’t distillable to only the data.  This is why getting a polysomnograph at a facility that does sleep studies doesn’t tell you how to fix your sleep.  It simply doesn’t.  More often, your data tells the clinicians about what you don’t have.  Nice for them to know.  You don’t have OSA, and you don’t have a neurodegenerative disorder.  You still sleep poorly, and you still want help for your sleep.

Understanding the psychology of sleep, as well as the biology of sleep, will help you more.  And if you are someone that has to do things “right”, worries that every cough is TB, or whose day is sunk when you calculate that you slept less than the recommended 7.5 hours…toss that tracker in the nightstand drawer.  It could make you stay awake tonight, wondering if your sleep issues are killing you, making you a bad parent/partner/friend/employee, or if those numbers are an indication that you already have some dread disorder.

Want to feel good about yourself and your sleep?  

Do sleep coaching with me!

 

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Are There Alternatives to CPAP?

ghordianknot

Short answer: Maybe. Under certain circumstances.

Longer answer: How you manage your breathing, your diet, your schedule, and even what position you sleep in can make a difference!

If you have severe obstructive sleep apnea, you probably don’t have an equally effective alternative to CPAP. And you need to get in front of this thing. It can really damage your heart. Sorry. You will have to make peace with this appliance. It can be done. I promise to write a post on that soon!

If your obstructive sleep apnea is mild, and you are certain that you don’t have a form of central sleep apnea, (your brain is stopping you from breathing while asleep), there are some alternatives less disruptive than CPAP, stomach stapling, and getting a divorce from your bedmate.

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  • Try sleeping on your side.  Your tongue and your uvula (that thing that hangs down in the back of your throat) are less obstructive in this position.
  • Avoid drinking alcohol at night.  The sedative effects of alcohol can make the tissues in your throat floppier, creating more of an obstruction.
  • Eat a lighter dinner and a bigger lunch.  Filling your belly late at night and then thinking that it won’t make it harder to breathe isn’t logical.
  • Make sure you aren’t congested.  Use a saline nose spray and perhaps use a humidifier if your central air system can’t moisturize the air well enough.
  • Get enough sleep.  This is a desperate cycle, in which short sleepers eat more and want to use alcohol to quell their anticipatory anxiety around insomnia.  Work on all the other aspects of your sleep to boost both the quality and the quantity.  

You should always discuss any type of treatment for sleep apnea with a trusted medical provider.  Not every idea is a good one.  Not every strategy is as safe as it seems.  

Many of my clients are surprised when they discover that strategies that seem innocuous could harm them.  Weighted blankets, for example.  If you have osteoporosis, placing something heavy on your bones when you are unconscious isn’t smart.  Or magnesium supplements;  it is possible to buy the wrong type.  There is a formulation of magnesium supplementation that easily gives you diarrhea.  Talk about not being able to sleep;  you could end up seriously dehydrated and admitted to the hospital overnight for IV fluids!  

Pay attention to the responses you receive from your healthcare providers when you mention alternative strategies to address mild OSA.   Their responses will vary from dismissive to open and curious to rapidly enthusiastic.

 Beware the dismissive provider as well as the immediate embracer.  Neither of them are giving your ideas enough attention.  The best responses are either in the category of “I will investigate and get back to you.” and “Here is what I know about your diagnosis and symptoms that makes me concerned about/interested in  the X approach.”   

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Want to do sleep coaching with me online?  I  make it easy !  Go to my “Contact ” page and send me an email today.    

We work on your specific sleep goals together, using the latest techniques drawn from sleep science and behavioral health.  

Don’t compromise…optimize!

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Sleep Trackers: Do They Help? Should You Get One?

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Many of my new clients tell me that they have been using sleep trackers and sleep apps that promise to measure sleep.  They aren’t always certain that the information they receive is accurate or even useful.  They want to know my opinion(s).  And anyone that knows me is aware that if you ask my opinion, you will absolutely receive it.  In detail.

Well…..

These are mostly either apps that sense your body movement while you are in bed, or wearables that monitor your heart rate, breath rate, and more.  Some are attached to CPAP machines.  What they DON’T measure is what a somnograph does:  brainwaves.

They can’t measure brainwave activity.  That happens in a sleep clinic.

This means that your app and your wearables are using secondary signs of sleep to provide feedback about your sleep.  Not getting the whole story makes taking action harder.

This is like checking the shelves in a store to measure whether the business is making money or not.  Something is selling.  Money is changing hands.  Whether or not profit is being made can’t be definitively determined by shelf stock numbers.  You have to look “under the hood” to know for sure.

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This means that you need to take an app’s/wearable’s interpretation with a grain of salt and interpret the interpretation.  This confuses people, and they often prefer to take the readouts and the interpretations at face value. Do that, and you could end up with inaccurate beliefs about the quality of your sleep.  In both directions.  Without somnography, we have to look at your subjective sense of being rested and renewed, your sleep diary and compare it  with your chronotype, and your overall ability to function during the day.

This is one of the best reasons to get a sleep coach.  We drill down and work with you so that you can eventually do your own assessment of your sleep.  You learn so much about sleep that you can figure out how to tweak things months after we finish our CORE sessions.

Being able to look “under the hood”  tells us a lot more about the quality of your sleep than a sleep tracker can offer you.  After all, the older you get, the more likely it is that your sleep issues are complicated.  There is no way that a movement sensor or a breath counter is going to help you solve a complex problem.

So What Can a Sleep Tracker/Sleep App Do?

  1. Motivate you.  Some people like to have numbers.  They like something to record or graph.
  2. Provide information to your doctor or sleep coach.  They have the training to interpret the interpretations.
  3. Give you early warnings that your new sleep plan isn’t working, or your new medication/ CPAP machine isn’t giving you the results you want.
  4. Remind you how important sleep is to your health.  Life is complicated.  Keeping sleep as a priority isn’t easy when you are being pulled in a million directions.  Your app/wearable is a reminder that sleep is important.

Want more information about sleep coaching?  Get in touch with me!

 

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Are You “Wired and Tired”?

alarm-clock

That is a phrase I heard Dr. Matthew Walker use to describe, well, most of us with insomnia.  He is on the staff at UC Berkeley’s sleep program.  It refers to being wide awake but exhausted at bedtime.

We “release” into sleep.  We must sufficiently drop the worries of the day in order to get to sleep and stay asleep.  Or we don’t sleep much or very well.  Disturbing dreams and the inability to fall back asleep are the consequences of being unable to disconnect from the challenges of our awake lives.

What can you do?

Using CBT-i strategies, I teach my clients the 5 most effective evidence-based strategies to let the day go so that they can sleep.  This works well for many clients, but there are additional things we can do to reduce the effects of anxiety in order to get better sleep.

Some clients also need to work on making their daily routines support sleep.  Matching their routines to their body’s chronotype (circadian pattern) as well as their specific sleep needs makes falling asleep easier.   The older we get, the more we need to work with our chronotype rather than against it.

A client  may also need to expand their wind-down routine, making it longer or more layered.  Adapting the bedroom environment to maximize sleep removes another barrier to rest.  We do this together, because there is no benefit in reinventing the wheel.  Sleep therapy is not guiding someone through a manual.  It is tailored to the person like a well-made suit.

breathing trauma

Using the science and receiving targeted support is the most effective way to improve sleep problems that are not the result of a medical condition.  And even if there is a medical condition, most people have to alter some bad habits they picked up along the way to being diagnosed and treated.  CPAP users, this means YOU!

Want more information on improving your sleep?  We can work on this together!

 Contact me:  www.360sleepconsulting@gmail.com