100% of the top conditions seen by a General Practitioner can be related to poor sleep. Some of these include:
- Alzheimer’s Disease
- Anxiety and Depression
We have different phases of sleep including:
REM sleep (Rapid Eye Movement):
The body is paralysed but brainwaves are most similar to when awake.
This is important for memory consolidation and emotional control
Important for physical repair and learning
Brainwaves are slow, growth hormone is secreted. Children have a lot of this phase of sleep, it gradually decreases across adulthood.
During sleep, the brain has a special detoxification and clearance system called the Glymphatic System. Breakdown products and proteins are cleared by immune cells specific to the brain.
Sleep complaints are very common and include:
- Snoring while sleeping – 48%
- Snort, gasp or stop breathing – 11%
- Trouble falling asleep – 16%
- Unrested during day regardless of hours of sleep – 27%
- not enough sleep – 26%
Poor sleep and chronic pain have a vicious cycle with new research showing sleep disruptions increase pain, more than pain disrupts sleep.
Quote: The best bridge between despair and hope is a good night’s sleep. E. Joseph Cossman
The most common sleep disorder in the USA is “insufficient sleep”. The number of recorded sleep hours is steadily declining, with reports in 2001 of 7h sleep on worknights, compared with 6.7h in 2008. Almost 50% of adults get less than the recommended amount of sleep and up to 57% of children get less than needed.
Global effects of insufficient sleep include:
Mental health: anxiety, depression, panic
Physical health: inflammation, high blood pressure, obesity
Cognitive Performance: reduced short term memory, verbal fluency and creativity
Physical performance: decreased reaction time and coordination
Emotional Intelligence: ethical decision making and identifying emotional states.
Tips for better sleep:
- Start with a good wind-down before sleep. Avoid strong overhead lights as these make your body think it is daytime. Have a minimum of 1h wind down time to bring your body into parasympathetic mode ready for sleep.
- Control light exposure: use blue light blocking glasses 2h before bedtime when using devices or watching a screen. Use night time control for screen brightness/blue light blocking on your mobile phone.
- Turn mobile phone into Airplane mode or ideally keep in another room where you won’t be disturbed.
- Choose your bedtime so you get sufficient sleep – adults need 7-8h per night. Wake up time may be decided for you as per your schedule, YOU have the choice of when to go to bed.
Set up your bedroom for a good night’s sleep:
- No pets
- No wakeful stimuli eg devices
First thing in the morning ensure you have exposure to full spectrum light (ideally sunlight) for 30 minutes of the first 2 hours of waking. This will help set your day-night clock for better sleep. Aim for 10 minute bursts of light every couple of hours.
So how are mitochondria and brain health linked?
Very intricately indeed! Neurons which are nerve cells which send messages all around our body, use a lot of energy to do so, and the mitochondria provide the energy for this. So if mitochondria become damaged or dysfunctional (not working properly), there can be slowing down or limited messages getting through.
In terms of what this might look like for a person, symptoms could include:
- brain fog
- reduced endurance for tasks that previously were easy
- lack of motivation
- lethargy or fatigue
- inability to concentrate
All of these symptoms are suggestive of mild to moderate neuroinflammation.
The brain can become inflamed (aka neuroinflammation) from many causes including:
- Traumatic brain injury
- Post-Traumatic Stress Disorder
- Ageing – yup we’re all at risk of it!
- Pro-inflammatory diet – think junk food
- Depleted antioxidant reserves – not enough colourful veg and fruits
- Inflammatory bowel disease
So what can be done for a brain on fire?
I would start with a general overview of:
- Maximise: Exercise – specific to the individual
- Minimise: Alcohol and Stress
- Prioritise: Sleep and good nutrition
Then tailor a program specific to an individual person and their contributing factors.
Sleep is the number one medicine everyone should be taking!
I highly recommend a good intake/dose/amount of sleep every night. Research shows on average we are sleeping 2-3 hours LESS per night than in the 1980s – that is a big loss of sleep over 365 days.
So why is sleep so important for good health? While we sleep our brain cleans out metabolic waste products, so we can think more clearly, create more memories and be more engaged with what we do. The most important time to have undisturbed sleep is from 11pm to 3am.
Why do so many people have sleep issues?
I believe there are a whole range of reasons for this including lifestyle, nutrition, stress and environmental. Firstly I strongly believe and have read the research on the impact of screen time on our health. This has been a big change in our daily routine over the past decade and a half since portable devices have become easily available. So what is the issue with screens in the evening? Our screens emit blue light which is part of the natural light spectrum. Blue light tells our brains it is daytime and that we should be awake and not be producing melatonin (our go to sleep hormone). So by using a blue light emitting device right up until you close your eyes (your head may already be on the pillow!), your brain is wired and active and takes longer to relax into the restful state.
What can you do to help your body and mind settle into sleep better?
There are a range of supportive measures you can use:
- Avoid using technology including tv, computers, ipads and phones for 90 minutes before bed.
- Avoid overhead light globes and use warm lighting for example salt lamps or warm globes.
- Buy some blue-light blocking glasses if you must use a screen late in the evening.
- Use a screen dimming application on your computer for example f.lux, to decrease the blue light emitted from the screen – it looks slightly yellow.
- Use the Twilight mode with an Android phone and Night Shift with an iPhone to automatically dim your screen from 7pm to 7am.
- Go for a morning walk to get sunlight on your retinas (back of your eyes). Sunlight is a trigger for our circadian rhythm and if you teach your body when it is morning and time to be up and active, it will help train it to slow down and rest in the evening. Failing time to have a walk, even 5 minutes outside for your morning cuppa is beneficial.
If you can improve your sleep you will notice changes in your health in as little as 24-48 hours. It is fundamental to good health and there is no medicine that can replace regular restorative sleep.
As we get into the deep mid winter here in Orange, what can you do to reduce the chance of catching a cold, or shorten the duration of a cold?
I have 3 young kids at home and sniffles and sneezes are pretty common at this time of the year. As a starter I often swap dairy intake for a non-dairy source. Dairy proteins are known inflammatory triggers in the gut, and can contribute to mucousy symptoms in the nose, sinuses and throat. I would recommend avoiding all dairy for 30 days to allow gut repair to happen. Most of our immune system is in our gut so it’s a great place to start.
Other triggers may include dust including house dust mite waste products. So what can you do to reduce the circulation of these microparticles?
Air your house often, yes even in winter, a fresh breeze can do wonders for cleaning up the air in your home.
Wash doonas regularly, change pillows annually, use a mattress protector.
Take your shoes off when you walk in to reduce dirt and toxins picked up from outside.
Some people regularly use essential oils to freshen the air, and these natural oils have anti-bacterial and anti-viral properties.
How good is your nutrition? If you are deficient in certain nutrients it may take longer to get over a common cold. For example zinc is essential for good immune function. Zinc is naturally found in red meat, oysters and pulses. It is important to discuss this with your doctor if you are supplementing with zinc tablets as high levels can be dangerous.
Vitamin D has a multitude of good functions in the body including immune health. Ideally we can get this through sun exposure, however over the winter months a supplement may be of benefit as the strength of the sun is less over winter and it’s cold so we don’t get our skin out so much!
Vitamin C is a powerful antioxidant that can be found in a wide variety of fruits and vegetables including citrus fruits and green leafy vegetables. Did you know that we are one of the few mammals on earth who cannot make vitamin C? So we are dependent on nourishing foods to supply enough vitamin C for our system.
And finally, I would include in any patient consultation or when looking at the health of my kids, that they are having enough sleep on a regular basis. Our bodies need enough sleep to regenerate, detoxify and maintain a healthy immune system. So for an adult aim to get eight hours of good restorative sleep most nights and your body will be able to work on any pesky bugs who may be responsible for a common cold.
If you are getting coughs and colds more often than usual, it may be wise to visit your health care provider to ensure your body, including your immune system, is working well.
I am so keen to share with you the knowledge that Alzheimer’s disease can be reversed! This was not something ever taught to me during my medical school or specialist training. In my more recent studies I have learnt about the work of Dr Dale Bredesen who has developed the first programme to prevent and reverse the cognitive decline of dementia. He has written an excellent book “The End of Alzheimer’s” and presents many examples of reversing mild cognitive impairment.
We now know that there are changes happening in the brain 10-20 years before symptoms start. Often people feel absolutely fine, then start noticing difficulty recognising and remembering faces, or getting more tired later in the day to do mentally challenging tasks. Other changes an individual or loved one may notice could be a decreased interest in reading or an inability to follow or engage in complex conversation. Sometimes words can be mixed up using a completely wrong word in a sentence. Early physical signs include a change in walking/gait, where someone might make more noise when they are walking, shuffling their feet and taking shorter steps.
Optimising brain health is something dear to me as my wonderful father has Alzheimer’s disease with moderate cognitive impairment. I have seen him slowly decline in communication, energy and endurance, getting lost in new or familiar places, and a slowing and shuffling of his gait. Fortunately he has remained positive and warm-hearted during these challenging times. He is supported by my amazing mother and some additional home help. Mum encourages him to do the concise crossword with her, go for at least a daily walk with her and catch up with friends on a regular basis.
So some of the lifestyle areas to address when looking to reverse Alzheimer’s include:
- Avoid all sugars which cause inflammation in the body.
- Avoid gluten which is inflammatory to 80% of the population and can cause intestinal permeability.
- Eat a wide variety of colourful fruit and vegetables every day. Aim for a 1, 2, 3 plan: 1 veggie at brekkie, 2 with lunch, 3 at dinner.
- Ensure you have a 12h gap between meals overnight.
- Avoid fatty fried foods which have Advanced Glycation End products – these get stuck in the end of tiny capillaries (blood vessels) and can induce AD.
- Sleep: Aim for 7-8h sleep per night. This is essential for the brain to clear out any debris and be ready for the next day ahead. Lack of sleep = debris build up.
- Stress: address your stress is one of the most important areas to target. Low-grade chronic stress is terrible for our systems. We were designed to have short bursts of stress that stopped. Work on up-regulating your Rest-and-Digest system (Parasympathetic Nervous System):
- Sit down to eat
- Take 3 deep breaths before you start
- Chew your food well
- Chill out after a meal
- Hum, sing, laugh or gargle to stimulate your vagus nerve
- Dental health: Brush your teeth 3 times a day. Dental health is related to the risk of AD. Mid-life tooth loss and lack of brushing teeth increases risk of AD. See your dentist regularly to check on dental hygiene and conditions like periodontitis.
If you know of someone who would benefit from this information, please share it so they can improve their brain health. As always, if you have a question please email me directly or contact my rooms if you would like to book an appointment.
Have you ever thought what your “grey-stuff” does when you’re in a deep slumber?
There’s a lot that goes on when we are asleep….and guess what? It’s really important for good health!
I’m really passionate about empowering you to achieve good health and sleep is the number 1 medicine I recommend. Above what you eat, how you manage your stress and how much you exercise, sleep is top dog.
Numerous functions of the brain are restored by, and depend upon, sleep. We have different stages of sleep – NREM (light and deep) and REM – and they all offer different brain benefits at different times of night.
Memory: sleep has proven itself time and again as a memory aid: both before learning, to prepare for making new memories and after learning, to cement those memories and prevent forgetting.
In my brain-injury rehabilitation clinic, I am always checking in on sleep with my clients, who often are challenged with short term memory. Good sleep patterns (including daytime naps in the recovery phase) are very important for brain recovery.
Creativity: at nighttime your sleeping brain creates a theatre, making connections between vast stores of information. This all happens during REM sleep in our dreaming state. These connections would never occur during wakefulness.
Cellular cleaning: while we are sleeping, metabolic debris is removed by the exceptional support team of our neurons – the glymphatic system. It is important to remove unwanted metabolic products from the areas surrounding hard working neurons, so the brain can work better the next day. This may even link with the development of Alzheimer’s disease. Amyloid protein is a poisonous element associated with AD and is usually cleared out at night. In mouse experiments depriving mice of NREM sleep, there is an immediate increase in amyloid deposits within the brain. Another way of saying this is “wakefulness is low-level brain damage, while sleep is neurological sanitation”.
Quote from Why we sleep by Matthew Walker (a fantastic read!).
Getting too little sleep across the adult lifespan will significantly raise your risk of developing Alzheimer’s disease. This has been reported in numerous epidemiological studies, and two anecdotal cases include Ronald Reagan and Margaret Thatcher. Two heads of state who appeared proud and were certainly vocal about sleeping only 4-5 hours a night. They both went on to develop the ruthless disease.
So what can you do to help your brain while you’re sleeping?
- Prioritise sleep! Aim for 7-8 hours per night
- Develop an evening routine to wind down
- Turn off screens 1-2 hours before bed
- Keep your bedroom cool
- Remove any blue-light emitting devices from your bedroom:
- phone, alarm clock/radio, TV