Episode Transcript
Speaker 0 00:00 Welcome to aim for health root cause conversations with Dr. James Biddle. All content from the conversations in this podcast are created and published for informational purposes only. This is not intended to be a substitute for professional medical advice and should not be relied on for personal medical decisions. Always seek the guidance of your doctor with any questions you have regarding a medical condition. Now onto the show. Enjoy.
Speaker 1 00:29 Well, hello again. Hi, I'm dr Bidel and I've got our new patient coordinator at Asheville, Andre of medicine here. Uh, joy Lambert to help me out today. Hello. And we are going to be talking about sleep and insomnia today.
Speaker 2 00:46 Yes, we are. As I'm stifling a yawn, I'm still trying to recover from this time change. So I'm really glad that we're gonna talk about sleep today. Oh, time changes. What a silly thing. So I wanted to start out by asking you so I have better understand what exactly our body's doing while we sleep.
Speaker 1 01:05 There is not consensus on why we sleep, but I will say sleep must be extremely important because all animals do it and we're extremely vulnerable during asleep. So we pay a big price to sleep. We're unconscious and not on the lookout. We're not being productive in other ways like feeding ourselves and protecting ourselves. So in order in a biological system to be willing to pay that cost, sleep must be essential. It sounds like it even for example, I understand some mammals which have gone back into the water, like dolphins, they sleep one half of their brain at a time really and keep one eye open. Literally kind of, I did not know that. So, so they're doing something with half their brain and then to do something with the other half of their brain later. Uh, so here are the current theories, leading theories. Number one, dump toxins.
Speaker 1 02:03 There's good evidence that we had these pores on the cell membranes of our brain cells of our neurons that when we're in certain stages of sleep, they enlarge up to 10 fold and we dump toxins from metabolic waste basically from all the activity. You know, when you're doing a desk job or playing chess or something like that, your brain can use up to like a fourth of the energy you're using. Really? Yeah. So I mean our brains use can use a huge amount of energy and that of course creates metabolic waste that we have to get rid of. So that's the leading theory. Uh, but most likely sleep does more than one thing. So the next theory is that has a lot of evidence behind it is that we store and process memories using computers as analogy. We're taking it from short term to long term.
Speaker 1 03:00 Sure. So if you don't sleep well, if you have frequently interrupted sleep, if you don't stay in deep sleep long enough, you're not going to remember tomorrow what happened today. So you can study all you want but you're not gonna, you're not going to turn that over from short term memory to long term memory. You're not going to download. So it's part of the processing function as part of the processing function. And the terms often used are connectivity and plasticity and the connectivity and plasticity re you know, refers to both physically what's happening into our brain. And also, um, the thought processes. Like we can connect one thought to another and we have plasticity and how to, how to kind of bend and reorganize our thoughts together. And when your lack sleep, there are certain bad things that happen in that you lose the past as deeper brain, you become rigid.
Speaker 1 03:48 And that also shows up as emotional dysregulation. So is that why sometimes people might say if they don't, if you don't get enough sleep or you go too long without sleep, you could go crazy. Yeah. In a way. And you know, even with just minor sleep disruptions, you get a temporary add it attention deficit. You can't focus, uh, and, and emotions. I mean, we all know this, your emotions, you're emotionally dysregulated, uh, because of that. Uh, so there's, we know there's a big difference between REM sleep, the rapid eye movement, which is what happens when you're dreaming. And that's thought to be more about storing and processing these memories. So, you know, whatever happens to you through the day, you're kind of massaging and processing that and figuring out how to come to terms with it. And on a subconscious level, and you know, many great inventors and, and mathematicians and, and people who are on the edge of, you know, physicists who are, who are, who are on the edge of human knowledge trying to figure out the next step.
Speaker 1 04:46 They'll wake up with their answers to their problems because their brain is subconsciously chewing on it while they sleep. And artists also like they'll wake up, wake up with a guitar, rift in their head and have to lean over and grab a recorder and, and, and catch it. And then there's non-REM REM sleep, which we know we make new brain proteins. Um, and that's probably more dumping toxins also this, the non-REM deep sleep. Um, so you know, the different parts, stages of sleep probably have different functions, but they're both, they're essential. Interesting. So they've got asleep. So it's still a mystery of exactly what's happening with sleep. There's some leading theories, but we have to have sleep to stay healthy. Everybody needs it. Other people may need different amounts. Uh, for example, young people who are growing need more and older people need less. And this is a classic, I see in my practice all the time, you know, in their thirties and forties people generally like seven and a half hours sleep on the average.
Speaker 1 05:50 And by the way, we, most people sleep in 90 minute increments. So an hour and a half. And I people not to worry if they wake up every 90 minutes or every three hours, don't worry, just remind yourself that you're lucky to be alive. He didn't die in your sleep, you know, count, count your blessings and go back to sleep. It's not a big problem. This whole concept that we should stay completely unconscious for eight hours straight makes people worry. And then that, that then causes insomnia cause they're laying there worrying. Oh yeah. So you know, don't worry about waking up. You can, you know, from my point of view, you can wake up every 90 minutes as long as you're not awake for very long and you go right back to sleep and you can get, we're supposed to have five segments of those 90 minutes, about seven and a half hours. But as people age, they'll find they need less sleep and then they get, the problem with that is they, they're also often less involved in their lives and they have more hours in their day to fill with less to fill up with. Um, so now they're only sleeping, you know, maybe five, five and a half, six hours, and they've got these extra hours to fill in the day. And that's what makes them anxious.
Speaker 2 06:57 I find sometimes I, uh, talking about processing our thoughts through our sleep, sometimes I wake up thinking about the exact same thing I was thinking about as I fell asleep. So it'd be, it'd be so curious to know what, what is the brain doing?
Speaker 1 07:12 Mulling over all of that. Right? Yeah. Chewing it. It's chewing on things. Um, I've also heard people talk about how our sleep is related to something called a circadian rhythm. What is that? Well, circadian rhythm is, are that day night rhythms. It's, it's the, the um, what happens when the sun is up versus what happens when it's dark. Uh, and obviously that the ratio that changes through the year, we're just coming into the time of year and spring where it's getting to be more even. But in the depths of winter you have much, you know, the shortest days and the longest nights. And then the reverse is true in the summer, the shortest nights in the longest days. And of course, you know, humans are not nocturnal and not sure what the term is for day turn on the news. We're awake during the day and asleep at night, you know, whereas other animals, like bats are nocturnal.
Speaker 1 08:05 They're awake during the night and asleep during the day. Right. But those are examples of circadian rhythms and they go beyond that. And even in the morning, there's, there's many fascinating studies, which I don't know in depth, but showing that you'll have better surgical outcomes if you have your surgery at a certain time of day versus another time of day because of stress hormones and such. Um, so, so that's the circadian rhythms. And in our society, of course, we have people working, uh, you know, shifting schedules. The night shift nurse for example, who works three 12 hour shifts at night and then has to go back on the, you know, be awake during the day, deliver life the rest of the time, uh, or people who are actually rotating shifts in a factory where there'll be working the early shift, uh, for four, six weeks. And then the late shift for six weeks in the night shift for six weeks. Really tough because you don't ever get to adjust, right? And, uh, that a number of studies show that's not good for your overall health, especially for things that, you know, stress levels and cardiovascular disease and things like that.
Speaker 1 09:14 So, but the big thing everybody worries about is sleep is insomnia, right? When you can't go to sleep. So the first thing talk about there is different types of insomnia. There's early insomnia where you just don't fall asleep easily the first time when you go to bed. Then there's middle insomnia when you're waking up in the middle of the night and have a hard time getting back to sleep. And again, if you, if you fall back asleep within 20 minutes, that's not really insomnia. Uh, so 20 minutes is about the cutoff. Uh, so if you know, if you're awake for less than 20 minutes, just don't even worry about it cause that's just gonna keep you awake worrying. Cause as soon as you think I'm not going to be able to fall asleep. Yeah, if I don't get back to sleep, I'm going to have a horrible day tomorrow. Now you've really screwed yourself over.
Speaker 1 09:57 So, and then there's late insomnia, which means you wake up far earlier than you want to. You know, let's say you get, let's say you go to bed at 10 and you want to wake up at six or six 30, but you're awake at four or four 30 in the morning and now you can't go back to sleep. And so you're, you're losing, you know, total hours of sleep that way. Um, and a little bit different approaches to each of these, but, but, uh, you know, for the most part we're going to treat them very similarly so that the different ways to approach insomnia. There's a kind of about chemical ones, there's lifestyle ones, and then of course there's medications, but let's talk about the things that disrupt sleep in our, in our lifestyle these days. Yes, please. So, electromagnetic fields. Yeah. Maps, EMS. We're surrounded by them.
Speaker 1 10:46 We are surrounded by them and they kind of go, you know, parallel to some degree with light to our eyes. Um, so, you know, the light to our eyes, uh, affects our melatonin production. Uh, blue light turns off our melatonin. So melatonin is a hormone that the brain makes, uh, in our pineal gland and our brain starts making it in response to darkness and stops making it in response to light. And it's supposed to start making it around sunset. But if you're up hours after sunset looking at your television or computer screen, or even just reading in bright light, uh, then your brain is not going to start making melatonin when it's supposed to and then you're not gonna go to sleep as well. So when you say blue light, you're talking about blue, like the frequency of the light, if we can see it.
Speaker 1 11:44 The light. Yeah. So a regular white light contains blue light wavelengths, right? And it also contains a red light wavelengths. And so what I use when I get up at night to tend to fire or something like that is I have a flashlight that has a red bulb and usually get these a sporting good stores because a hunters actually have known this information for a long time. Uh, and so you use the red lights at night and you don't want to use the blue lights, uh, or full spectrum lights at night and that can help you, uh, to produce your own melatonin better. We also have blue blocker glasses. So, uh, if you have trouble falling asleep, then an hour before you go to bed, put on these blue blocker glasses and they'll block the blue light wavelengths out of your light bulbs and your computer screen and stuff like that so that your melatonin production doesn't get sanitized.
Speaker 1 12:41 Right, exactly. Gotcha. Um, and then we even had blue lights, which turn off your melatonin in the morning and that treats wintertime depression or seasonal affective disorder. But it can also treat insomnia because it puts you back on your rhythm. Cause you're supposed to make a lot of melatonin at night and not much during the day. But if you mess up that whole cycle, you're going to be flatlined. And when you're flatline, you're depressed all the time and you're not sleeping well. And this happens in Seattle in the winter, for example. Uh, and, and other places, but also happens in the hospital. It happens. Uh, it's in called intensive care unit psychosis where people don't know if it's day or night. They have no more melatonin rhythms cause the lights are never off and they're not able to get good sleep. Uh, so it's important to have those rhythms.
Speaker 1 13:37 So it's not just people coming in and out of your room all the time in the hospital. It's actually in the lights too. That can be affecting you. Right, right. So this comes, you know, as part of what we call sleep hygiene. Uh, so in sleep hygiene, we want a really dark bedroom at night and we don't want really any lights. If you need, if you need a nightlight, you want to be a red nightlight or if you have a clock that you need to be visible, you want it to be a red clock. Um, well that makes sense. Yeah, I get really, I get really irritated by companies that are producing things that are supposed to be in your bedroom, are supposed to be on at night and they have a blue light or a green light on them. Here's the worst possible thing now you to like, I have a, uh, an air filter that has a blue light and I've got to, you know, like, you know, put a cover monkey tape, gorilla tape over that blue light in order to be able to use that at night and, and hide that.
Speaker 1 14:34 Um, so you want to have a really, uh, a dark places. The first part of sleep hygiene, the next person hygiene is scheduling. You want to go to bed at the same time every night. You know, I get up at the same time every day. We can only adjust our sleep schedules by about an hour a day, which means if morning your alarm clock is going, go off at 6:00 AM, then on Sunday morning, you should not sleep past 7:00 AM really, I know. And the horrible news, I didn't want to know that. And on Saturday morning, you shouldn't sleep past 8:00 AM because if you sleep past, you know, an hour longer on a Sunday, then you have to get up on Monday. You are not going to be a happy camper on Monday morning cause it was Monday. You think it's just cause it's Monday but it's because you can't adjust your sleep schedule by more than an hour a day.
Speaker 1 15:21 Oh they're sleeping in on the weekends isn't, it's not helpful. It's much better to get up and do things and schedule nap is actually a way better for your system, uh, to kind of, you know, make up for sleep. I know that was one of your questions you're going to ask is can you make up for lost sleep? And I believe you can to a certain extent. If you look at these functions of dumping toxins and building proteins and storing memories, now after a certain point, those short term memories are gone and you can't go back in a storm into longterm. So there's some things you can't make up for very much later, but there's some things you can make up for, you know, over the last few days or weeks to kind of catch up on sleep of, of, you know, uh, the physiology, physiological functions of making proteins and dumping toxins. I think you can catch up some, well, it's good to know for sure.
Speaker 1 16:13 Um, more with, uh, sleep hygiene is actually having your bedroom cold. Really? Why is that? Well, there's many studies show that people sleep better in cold rooms and by cold it's usually about a 68 degrees or less, even better, 65 degrees or less in your bedroom. And then, uh, you know, warm heavy blankets. Uh, some people do really good with a weighted blankets. Uh, that pressure on the bodies feels great. On the other hand, I've got to regularly have people get rid of their down comforters. Oh, why is that? Because they, they, they tell me they're having hot flashes when in fact what they're really having is a buildup of heat. And when they get rid of the down comforters, they do better because the down comforters are our weight more efficient than what they need. It's like if you're going to use it down comfort yet have your bedroom like 55 degrees or so.
Speaker 1 17:05 I mean, that's fine if you're out in a cabin and you're really got to survive the cold, but you want something that regulates more evenly, uh, and we're not going to build up that excess of heat. So we would sleep better if we were actually kind of hibernating for the winter, so to speak, with a colder bedroom, colder bedroom, but at the same time to sleep better. If you wear socks, you want to keep your feet warm. So socks can be good. There's some people don't, you know, that's an individual thing. But for some people it's real important to keep their feet warm too.
Speaker 1 17:38 So that's, uh, there's also, I kinda hate to say this, uh, but I heard this on an in depth interview on NPR that'll a lot of people need to get separate beds or separate bedrooms and their spouses. Why is that? Because we wake each other up. And one of the worst things for a marriage is resentment from your partner, waking you up and disrupting your sleep. That's a real thing. That's a real thing. So if your partner, you know, is allowed snore or you know, obviously they should had treated, that's a whole other issue. Or if they have restless leg syndrome or jumping around or if they're just restless and get up, you know, four times a night, you know, that can disrupt your sleep and you know, you might need to rethink your sleeping arrangements.
Speaker 1 18:25 That bigger bed, a bigger, a bigger bed can help. That's right. That's one way to do that. My wife and I found out that a big bed with separate covers so that there's not stealing of covers from one other person at night. Can't steal a covers. Right. Perfect. That's war. That's right. All right. So other simple things. Uh, avoiding blood sugar fluctuations and avoiding stimulants. Uh, many people can sleep fine. You know, after three cups of coffee in the morning, my parents used to have a pot of coffee after dinner when I was a kid. But you know, that was 50 years ago. It was a different world back then. Um, but I know people that if they just get rid of their one cup of coffee in the morning, that cures their insomnia and it turns out that the Metabo, the liver metabolism of caffeine can have a thousand fold different speeds in different people that big.
Speaker 1 19:29 Yeah. So some people do fine with caffeine and some people really cannot tolerate any caffeine without causing insomnia. Even if it was, you know, 16 hours ago. I am not liking where this is going. Well, I mean, yeah, look at yourself and all I gotta do is, you know, try it out. Right. You know, and I gotta say never cold Turkey caffeine because you'll have a roaring headache for three days. You always want to taper down gradually on caffeine. Uh, but it's always worth a try going caffeine free to see if that's the cause of your insomnia and then blood sugar fluctuations you don't want to be. And we of course talk about this in our nutrition, uh, educational series, but you don't want to be having your blood sugar going up and down, uh, because that disrupts sleep and causes a lot of the middle insomnia people wake up in the middle of the night with, uh, you know, bugger crashes from having eaten ice cream or cookies before bed. And, uh, so we got to stabilize that out by eating fat, fiber and protein with all meals. And you really shouldn't eat for two or three hours before going to bed. I mean, you know, you're going to get acid reflux if nothing else, uh, and it's just not good for your metabolism.
Speaker 1 20:41 So other things, uh, to start doing is exercise. Yes. Right. So regular exercises much better after I've exercised. Exactly. Actually when I am in the habit of doing it three to four times a week. Yeah. When you do it regularly and you're able to recover well and you're not hurting yourself and you're not doing it right before bed. No. Uh, you know, I think, you know, the best time to do it for sleep is right in the morning when you wake up. The best time probably do it for your body is middle afternoon cause you're less likely to get hurt that way and you recover better. Uh, and then sunshine. All right? And this goes back to the melatonin. But if you can get up and get sunshine to your eyes during the day, then that, that helps everything work better.
Speaker 1 21:29 Um, while we're talking about physical things that you can do with your CBE space. Grounding, grounding, grounding. Yeah. There is something that happens when we put our bare feet or any, any of our bare skin onto the earth. Uh, and people experience this when they go walk barefoot on the beach is the one place people still go barefoot is when they're at the beach, right? And then they sleep soundly. And it's because the earth actually, uh, gives us electrons that reduces our inflammation and free radicals. This is the opposite of a flow of electricity. So another way to think about that is the earth drains the excess electricity that we built up through our modern living. And this sounds woo woo, but it's not, we would all, I guarantee you this is very scientific. There's a lot of studies on this that show that by grounding regularly, you, uh, improve your adrenal functioning, you decrease inflammation in your body, you decrease coagulability and your risk of blood clots and things like that.
Speaker 1 22:39 And of course you sleep better. Uh, what we have people do is every new patient comes to our clinic, gets a grounded pillowcase, so it's a pillowcase with a little silver wires in it and then a wire attached to it. And you can either plug it into a grounded outlet and it's just a one pump. It just goes into the round prong of that three prong plug, right? You cannot electric, you can not electrocute yourself. Nope. Or I like, even better, you can, you know, run a wire out your window and put it into a grounding rod in the earth and be directly grounded while you're sleeping. And some people don't feel it. And some people give me testimonials that their fibromyalgia has gone that way after 20 years, that their insomnia is improved, that their chronic pain is better. So we get lots of testimonials about it. So I'm completely convinced that it really works. There's an important thing to try out is grounding. All right? Uh, and then EMS, you know, start with EMS, but you can actually test EMS, uh, with a meter and look in your bedroom and see if you have excessive EMS and then you can figure out how to mitigate. That's a whole nother topic. I'm not an expert in that, but I do recognize it's an important, important field. Sure.
Speaker 1 23:53 So additional behavioral things before we get to the biochemical things. If you have a emotional things going on, if you have a lot of emotional than in our stress management class, we teach tapping or EFT. That's the emotional freedom technique. So you can do that, you know, whatever, whatever your is bothering you, you want to deal with that before you can try to go to sleep. You can journal, right? Uh, you can listen to white noise or listen to music, things like that. Um, you want to avoid looking at your phone or watching TV or things like that.
Speaker 1 24:31 Well, ideally an hour. And if you are, then you got your blue blocker glasses. Got it right for an hour before bed. And that's assuming that you're going to bed at a reasonable time. Like, you know, nine, 10, or 11:00 PM. You know, I once heard it said that every hour of sleep you get before midnight is worth two hours after midnight. Really? And I think that's just following the wisdom of it's best to sleep when you're dark. What is dark, right? Otherwise you're sleeping in after sunrise and right. Your room's full of light. And most of us have had the experience when you sleep in, you actually wake up really groggy. It's almost like the earth energy comes up and grabs you and tries to drag you under from sleeping too long. So you know that, um, you know, sleeping in late, uh, is not really, restorative is not, it's not energizing. You don't, you don't wake up like ready to go. Generally, no, but it makes it harder to get up. I mean, Benjamin Franklin early to bed early to rise. Exactly.
Speaker 1 25:33 Um, reading something. Uh, you know, reading is a lost art, right? But you want to read something spiritual or contemplative. You don't want to read a suspense novel. You don't want to read something you can't put down. You want to be stimulating your mind. No. You want to read something that's gonna, you know, really calm you and not something scary. All right. Uh, now let's get onto the biochemistry. So we talked some about melatonin and how to support its production by getting sunshine during the day and having your bedroom very dark, exercising supports melatonin, really avoiding avoiding blood sugar fluctuation, supports melatonin production. Cause all those, you know, all those, uh, can be thrown off. Uh, and then you can actually take melatonin. And I run to people all the time are like, Oh no, if I take melatonin, it'll, it'll mess up my own production of melatonin.
Speaker 1 26:29 And as far as I know, that's bogus. I have looked at this and I've never found any evidence that taking melatonin blocks your own melatonin production because melatonin is one of our oldest hormones. Even plants, melatonin, they do to track their circadian rhythms. You know, like flowers open up during the day and close at night except for moonflowers which opened at night and closed during the day. <inaudible> cacti, right? That's right. But day lilies, right? You know, and they follow the sun, but they make melatonin. We even have a N a really low dose melatonin, a fruit for really sensitive people. It's a 0.3 milligrams of melatonin called urban tone on this actually derived from plants. Um, but melatonin is produced in the pineal. Glen is controlled by sunshine and darkness. It's not controlled by a feedback loop on itself like most of the hormones are. So I think it's quite safe to take melatonin.
Speaker 1 27:23 In fact, melatonin is a brain anti-inflammatory that's been shown to decrease your risk of dementia and even macular degeneration. So I look for excuses to give people melatonin. We give them very high doses when they have cancer because there's good evidence that it's also, uh, helps to slow down cancer growth. Um, so the, the usual dose, the physiological dose is about a third of a milligram, but the usual dose is one to three milligrams, uh, that we use. Uh, we will go up regularly to six, nine, 12 milligrams and I usually will end up at the 20 milligrams for cancer patients. But melatonin is quite safe. It doesn't have adverse side effects except for some that are just uncomfortable, not dangerous. So the sooner you take it before bed, do you do it an hour before or right as you're getting in bed? Like what's the optimal window to take it at night?
Speaker 1 28:19 Right. Excellent question. It depends upon the type of melatonin. Okay. And your own particular problem. If you fall asleep, fine, but then are waking up in the middle of the night. What you want to do is take a prolonged release melatonin because regular melatonin only lasts about three to four hours and then you're done. So if you take a regular melatonin, then you make yourself worse because your melatonin levels are going to drop in three to four hours and that's when you're waking up anyway. So prolonged Rees, no autonomy to go six to seven hours. So you want to take it at the last possible minute before you go to sleep. So it'll carry you through the night, whoever. If you have early insomnia and can't fall asleep, then you want to take a quick acting melatonin. Like we have a life as almost sublingual spray of melatonin. Yes. And so that that'll start working, I'm not sure exactly how quickly, but five to 15 minutes it'll start working or you take that prolonged release like an hour before you go to bed.
Speaker 1 29:12 So it's starting to come on board, uh, by the time when you go to bed. Um, but yeah, the two adverse side effects are vivid dreams that are just too technical or to be comfortable. It's like, like really intense, intense Spacey dreams, uh, or grogginess in the morning, like a hangover. Like kind of like you drank too much alcohol. And again, that's very individual as the slow metabolizers, um, that it'll, you know, too long for them. And this is, you know, you just adjust your dosage. She just got back off and just the timing and the dosage, but almost everybody can tolerate melatonin. I think it's good for us. Uh, and I, I think, uh, most of us should probably be taking it more often. Yeah, I know, I will. Great. So other things that we, uh, use biochemically, uh, magnesium, two-thirds people are low in magnesium and magnesium as a cofactor for our enzymes that make our neurotransmitters like trip to fit, uh, like serotonin, uh, from trip to fan, uh, and melatonin, which actually is downstream from serotonin.
Speaker 1 30:23 So if you're magnesium deficient, like two thirds of Americans, you're not making enough melatonin for sure. And then that those cofactors also include B six. But I got a warning for about B six. Uh, you should never take vitamin B six. Why is that? Because it has impurities that can cause neuropathy. What you should take is activated B6 called paradoxical five phosphate P five P. that's right. So that's the active form of B six, and that's very safe in the usual dosage is 25 to a hundred milligrams a day can depending upon what you're after. Um, and then you can also just take a trip to fan. Uh, L trip to fan is an amino acid and it gets turned into five hydroxy tryptofan or five HTP. And then that goes on to serotonin and that goes onto melatonin. So all of these can help you. And they're also used for depression or anxiety.
Speaker 1 31:18 Um, there's some other biochemical things. I really like a new on the scene as CBD oil. It's the non psychoactive component of hemp. So it does not have the THC, at least not North Carolina and something like, what is it, 19 States now, either by prescription or over the counter, you can get also the THC. That's a whole other topic. Sure. Um, uh, but you know, some people, THC will keep awake. Some people that help sleep, it's hard to know, uh, but the CBD is almost always calming. Uh, and it's use for either insomnia, for pain or for anxiety. And, uh, in my experience is kind of like the grounding. For some people it's a miracle. And for some people it's a placebo. They don't notice anything. Uh, but it's certainly worth a try. And the costs come down just in the last two years has come down to a fourth of what it was.
Speaker 1 32:10 So yeah, it's a way more affordable now that it's legal nationally. Um, I asked like kava kava, kava kava, uh, that's a route, uh, of an herb of a shrub and it's classically used in Polynesia. It's, it's, it's a fermented in big vats and they use it in their rituals. Uh, but it's the closest thing that nature has to value them. It hits our benzodiazepine receptors and it's, uh, extremely calming and don't raise, not addictive. You'd have to take like, you know, two bottles a day to get addictive and it's unlikely you're going to do that now. Isn't there something to be aware of when choosing cava? What cava to take? There's at least two things to be aware of. One is I think the liquid is important. I don't, I've never found the kava capsules to work very well. So you want to liquid cava, but you don't want it now alcohol cause that'll burn your mouth.
Speaker 1 33:02 See, so you want it. And glycerin, which is very nice tasting. And the last thing is you want a good company because cheap companies might use the stems and the leaves, which are kill your liver. Oh yeah. They have liver toxic alkaloids. So you want to use a company that only uses the roots. Got it. Otherwise, you know, if you've got a good company, cava is perfectly safe. But those are the things to watch for. For coffee. There's another amino acid called GABA gamma aminobutyric acid. And that's actually one of our neurotransmitters. And that, uh, uh, just helps calm down. And this is, uh, we find particularly good for people who have that thought pattern that goes around and around and around in your brain. DLT, very Kelsey. Yeah. So journaling, tapping with the EFT, and then Gabba is really the combination, you know, for you, for when you have that and you're all excited.
Speaker 1 34:02 Um, there's some classic herbal combinations. Uh, valerian, Kemah meal, hops, passionflower, we have all that in a combination and those can be useful. The one side effect of that is valerian causes a lot of photo sensitivity. So if you're out in the sun a lot, some people get rashes from it. So you had to watch out for valerian, but you know, you have good valerian cause it's really stinky. You can smell it out of the bowl. You open that lid that you can not, Oh, that is not tasty smelling. It must be good for me. Must be right. So those are the big ones that we use. Uh, biochemically. Um, sometimes we go deeper, sometimes even those don't work for people. Um, and then we'll start to do other things like a brainwave and uh, modulation or entrainment. And this for the most part we refer out to.
Speaker 1 34:59 Uh, but you can, you can go to, uh, centers that, that do EEG biofeedback also called neurofeedback. Heard that phrase before. Yeah. So neurofeedback, they, they put a little thing on your head and they look at what your brainwaves are and where you're too, too much and where there's too little, and then they have machinery to, uh, give a feedback loop to kind of balance that out. And that can be really helpful for some people. Um, it usually looks like, uh, like an hour session, uh, once or twice a week for 10 to 20 sessions. And then a maintenance of, you know, maybe once or twice a month, uh, innocent investment. You know, you're going to invest a $2,000 in something like that over time. But if it helps you sleep, it helps you sleep, you know, you can regain your life. That's right. Uh, we do a thing called neurotransmitter testing where actually looking in your urine, we can look at kind of your total body tendency for being high or low in, uh, things like dopamine, serotonin, GABA, and then your excitatory neurotransmitters, epinephrine, norepinephrine, and glutamate.
Speaker 1 36:07 And by knowing that we know kind of which supplements or prescription medications to give you, uh, to set that straight. And I think that's very important cause you know, if you go use the prescription medications, there's debt, real downsides. So for example, even Benadryl, diphenhydramine, which some people use for sleep, right? And just a few years ago I used to say yes, you know, it seems safe. Go ahead and do it. Uh, that has now been published to pre dramatically increase your risk of dementia long term really, which kind of makes sense cause it's an anticholinergic and our frontal lobes of our brains where we think run on acetylcholine. So it's kind of blocking our major neurotransmitter that we think with. So we don't want to be using Benadryl regularly. And for guys with prostate problems, they can cause urinary tension. Those types of drugs do, uh, cause it decreases your urinary outflow.
Speaker 1 37:06 Um, and then the other, uh, sleep medications, um, like Ambien and um, what are some of those other, uh, I don't prescribe them very often. Lunesta butterfly, right. Uh, they've been shown to quite frankly, increase your risk of death from multiple causes, like pretty quickly, like, you know, one third increased risk of dying, um, compared to your baseline risk over the next few years is significant. Yeah. And some of the things they do is like, you know, waking up on the night and falling down and breaking your hip or you know, cause you're dis coordinated, you know, getting up and driving and having a car accident, worsening sleep apnea and choking to death because you're not breathing. Uh, so I mean those are at least three of the ways that people are dying from those. Um, maybe by worsening dementia risk, uh, but they haven't really teased out exactly, you know, what people are dying from, but they're pretty substantial, uh, fascinating data on that.
Speaker 1 38:14 And you gotta kind of wonder how they stay in the market that much risk seems like a lot. Yeah. And the other thing is once you start using and people become rapidly addicted to them and then it's a really hard to get off of them, so don't like to go there easily. Uh, and then I want to talk about sleep apnea itself. And people get very confused. You know, there are people that, uh, their sleep is disrupted by sleep apnea, but most people who have sleep apnea sleep really soundly and they sleep right through it. So sleep apnea is not insomnia and sleep apnea is not breathing while you sleep and it only happens while you're asleep, so you, you're not there to watch it happen. And sleep apnea comes from the base of the tongue blocking the airway. And most people think about sleep apnea only happening in very heavy people.
Speaker 1 39:04 Uh, there was a, a novel I believe by Dickens with a heavy person named Pickwick who snored heavily, so it's been called pick Wiki and syndrome. Um, but you know, I'm a perfect example. I'm a perfect body weight and I have terrible sleep apnea. And the, you know, the new theory of sleep apnea is that our jaws aren't big enough for our tongues. And in fact, I've had eight teeth pulled. I had four wisdom teeth and four teeth pulled for braces for pre molars. And I can't imagine to how bigger my mouth and jaw would be with eight more teeth in my mouth. Uh, but you know, unrecognized sleep apnea is a huge health issue. Uh, and for some people it's such a big stressor that their is just, doesn't, they don't want to go to sleep or they wake up in the night with, uh, this kind of racing heart and, and, uh, anxiety and panic attack and they don't realize it's because they're almost choking to death in their sleep.
Speaker 1 40:07 I know, you know, my brother won't go to bed without his CPAP machine cause he's had that experience. Um, and I'm pretty much the same way now. Uh, so it, you know, if, if you're asleep for a lot of hours, but you have non-restorative sleep or if you have a hard time losing weight or if your partner just tells you you snore horribly, right, then you can hear it, then you can hear it. But not everybody does that. I, I mean, I, I have tested people who have sleep apnea who don't snore. They just stopped breathing. Uh, then you need to get tested. And you know, the problem with testing for sleep apnea is most doctors order a full sleep study, which is 1500 to $2,000. And that's a huge hurdle. Uh, so we screened with a $35 overnight pulse oximeter. Just take a little, you know, box home that has a probe that, you know, clips onto your finger with a wire attached to it and you just sleep with that on your finger for one night in your own house.
Speaker 1 41:04 And if your oxygen stays normal, you're fine. And if you block your airway off by going, you know, like that all night, then uh, your oxygen will look like a zigzaggy pattern going, going down below 90% over and over and over again. You know, I'm one of those people, I thought I don't have sleep apnea because I don't snore. <inaudible> and I did the pulse ox test overnight and sure enough, there it was from there it is. Now Beck has a few other behavioral things. Uh, you know, I've got one article by somebody who says, don't use an abrupt alarm or clock that, that this thing about, you know, being woken up with a startle doesn't help you relax and go to sleep very well. Uh, and they actually have alarm clock now that listen to your breathing patterns and you give it a timeframe. Like, I want to wake up between seven o'clock and seven 40 and it'll wake you up when your, when your sleep cycle ends and your breathing changes to where you're in light sleep.
Speaker 1 42:09 Because we all know what it's like to be woken up in the middle of a deep sleep cycle. Right? It's terrible. And Rocky headed, it takes you hours to recover. So you can get these fancy alarm clocks that actually wake you up at the right time. You can get other alarm clocks, they have a light that comes on gradually to light up your room and start to turn off your melatonin for you. Oh, that's clever. Yeah. And I'm sure you can get both of those. So, so you can work on the other end too of what's the right way to wake up. And if you can wake up more gently than the theory is, is that you can go to sleep more easily. I'm sure the adrenals would appreciate not being startled awake either. Right, exactly, exactly. And you know, we always talk to people about the um, what time they wake up and all night.
Speaker 1 42:56 Like, you know, are you waking up, you know, between one and two or is that between three and four? And it kind of gives us an idea whether that's adrenals or liver from the Chinese medical system. You know, it's kinda reminds me to talk about alcohol. A lot of people who have sleep problems will try to medicate with alcohol, make them groggy, make them groggy, and it does, you fall asleep. Right? But as that alcohol is being metabolized through your liver into formaldehyde, basically into aldehydes and you're being pickled from the inside out, that's a horrible for your overall sleep quality. And people, you know, if you've ever had, you know, a bad hanger, wake up with that cotton mouth at three or four in the morning with the headache and everything else you'd know that's bad for you. But anything over one drink disrupts sleep patterns more than one and one means one ounce of liquor, five ounces of wine, 12 ounces of beer. I don't know what it means. If you have asphalt beer, that's 7%, maybe that's nine ounces. It's scaled down for this town scale down. That's right.
Speaker 1 44:10 So based on what we've talked about then, and you mentioned coffee earlier, um, I guess coffee and caffeine, it's not really a replacement for not getting enough sleep. Well, you know, we all certainly use it. Many of us certainly use it to, you know, get ourselves going in the morning and most us can then fall asleep at night. Uh, you know, in natural medicine we believe less is better that way. That, you know, I'm not against, I've been watching the science around coffee in particular, uh, for 20 years. I've got a whole file of articles on coffee and the vast majority of them actually come out to be fairly positive for overall health. Um, meaning like less cancer, uh, living longer, less dementia, less Parkinson's disease, things like that. The main things that coffee seems to be bad for is fiber, cystic breast disease and the women and prostate enlargement. And guys then when you think about breast tissue and prostate tissue, they, they are almost identical and they respond to the same things. Now it does not increase prostate cancer or breast cancer. It just makes those tissues irritated and swollen and cystic. Um, so guys who are having trouble urinating and women with, you know, tender, swollen breasts, you know, decreasing coffee is a good idea, you know, otherwise I think it's just about moderation and how you metabolize and how it affects you.
Speaker 3 45:42 Yeah. And
Speaker 1 45:45 just to wrap it up in conclusion, um, so what would be the next step? You know, let's say, I'm not sure if I'm sleeping well or I know I'm not sleeping well. Well, first thing is I always talk to people about what is their actual sleep patterns. And how do they feel in the morning when they wake up. And a significant number of people are like, well, my energy is fine. I'm on nine out of 10 and I feel fine, but I'm just worried about not sleeping enough. I'm like, you need to stop worrying. You know, you don't really have insomnia, just, just, you know, get over it. Uh, and then, and then we find out, you know, what, what part of insomnia they have, how can you work with their, with their behavioral issues. Uh, you know, all that kind of falls into sleep hygiene.
Speaker 1 46:30 Um, and then we just start doing trial and error with melatonin and with kava and with GABA and with trip to fan. You know, everybody goes on magnesium. Yeah. Cause everybody's low in magnesium. And some people we put on a P five P for the B6 support. Um, and if that's not enough then we'll get fancy and do the neurotransmitter testing and get a bit more sophisticated. Um, and if that's not enough, then we refer them out for the, for the biofeedback and neurofeedback training. Um, they can also, there's a wonderful website called the amen clinic. That's dr amen. Just like you say at the end of a prayer, a M, E, N, uh, and, uh, there's a quiz on there and you can take their quiz for five bucks and they will tell you what they think is the best approach for you just based upon his decades of correlating quizzes like that. Two brainwaves, two trials of supplements and medications to people. Oh, I'll have to check. That's a wonderful service. Yeah. Yeah. So that's what we know about sleep and insomnia. Sleep is essential, otherwise we wouldn't make ourselves so vulnerable to put ourselves out of commission for, you know, seven to eight hours a night and you got to have good sleep because that's one of the most important parts to aging gracefully. Well, thank you so much. I appreciate all your wisdom and I look forward to learning more. All right, thanks, joy.
Speaker 3 47:56 <inaudible>
Speaker 0 48:01 thanks for listening to aim for health root cause conversations with Dr. James Biddle and our host joy Lambert. Be sure to visit <inaudible> dot com to access the show notes and discover other valuable free content and support of reclaiming your health. Bye for now.
