Sleep As Medicine - Part 1

SPEAKER A This programme presents ways to optimise health and well being. When considering lifestyle changes, please consult with your health care provider to assure they are suitable for you. Hello and welcome. I'm Kaysie Vokurka. E. Joseph Kossman once stated, the best bridge between despair and hope is a good night's sleep. Indeed, quality sleep can have a huge impact on our sense of well being. So stay with us as we explore this important topic. This is your Lifestyle as Medicine, a production of 3 ABN in Australia Television. I'm so glad you've joined us for this programme where we explore ways that you can shape your lifestyle as medicine. Today we're going to talk about safety, sleep and its importance and this is something that's relevant for everyone to discuss this topic. With me here in the studio is Dr. Eddie Ramirez, a medical doctor, researcher, author and international speaker. Welcome to the programme. Eddie, thank you for coming today. So glad that you're so willing to contribute. SPEAKER B Thank you so much. Thank you for this invitation and talking about a personal passion of mine, the topic of sleep. SPEAKER A Very good. So I'm glad that you expressed. I think everyone should be passionate about sleep because it does make such a huge difference in our lives, doesn't it, when we feel so nicely rested? SPEAKER B Yes, absolutely. I'm a personal testimony of this. When I went to medical school, I made the commitment to go to bed very early in the evening every single day. And it seems the strategy worked as I graduated first place in my class. So it worked. SPEAKER A There you go. It helped keep that brain sharp for you, didn't it? That's right. That's excellent. So you're here to tell us today a lot about some research that you've been involved with that is about sleep and what things can enhance sleep. Tell us a little bit about to begin with, just a little bit about, I guess, some key principles of sleep that we want to take on board. SPEAKER B That's right. So as we're learning more about the topic of sleep, we're learning that it's not only to sleep X amount of hours, but when you sleep it has an impact. See, you cannot say, okay, I'm going to sleep from two and then because I need to sleep my eight hours, I'm going to sleep until 10pm it doesn't work. You are going to have problems with your quality of sleep if you choose to do that in the day because you're supposed to sleep in the night, not in the day. And because of the modern lifestyle, we have changed the way our ancestors used to sleep in the Old days, everybody was working outside in the fields, and they were, you know, tired from working the whole day in the sun. And the last thing they wanted was to stay up late in the evening, they would come home. There was no, you know, Netflix and these type of things, and they just hit the pillow and they were nice asleep. And things like insomnia in that type of lifestyle was something extremely rare. So as we have changed from the ways of our ancestors, that's when we got ourselves in trouble. And this is such a big problem. You know, I even put a video on my YouTube page about sleep, and it became viral. That tells me that there's a lot of people that have issues with sleep. That video, the moment, has 2.8 million views. And the questions that I get and so forth from the video, it tells me that worldwide, this is a big problem. SPEAKER A Absolutely. I used to work at a health retreat, and sleep was one of the most common things that came up. People having sleep troubles. And so you're suggesting that the timing of when you actually sleep is important. SPEAKER B That's right. SPEAKER A Not just any time of day, like if you have it in those night hours when it's dark, that makes a difference. SPEAKER B So this is the way that it works. We have an extremely important hormone by the name of melatonin. Melatonin is what makes you sleep deeply. And that melatonin has a certain cycle. So when there's nice brightness of the sunlight, melatonin is not being released. As soon as the sun is starting to set and darkness starting to come in, the amount of melatonin starts to increase, preparing your body for later in the evening time when you're actually going to sleep. So it starts prepping up things. So as darkness is taking place, melatonin starting to go up. Now, we modern men think that we're pretty smart, and we have nowadays all these lights all over the place. So that just confuses our melatonin. In our body, melatonin is being released with the help of the optical nerve. So you have your eye, and then there's an optical nerve that runs through your brain. And then that optical nerve passes through an area that senses light. So if there's too much light, that area of your brain is telling the melatonin, wait a minute, wait a minute. We still don't have complete darkness. Maybe the night hasn't arrived fully. You know, let's decrease a little bit the melatonin. So this is one of the challenges we have because the body is prepared to release a bunch of the melatonin. Early in the evening. But if you choose not to go to bed early in the evening, by early in the evening, I'm talking about 9, 10pm, you're going to lose a big chunk of your melatonin of the night. So that's why it's not the same if you go to bed at 10pm and as if you go to bed at 2am, even though you slept the same amount of hours, you're not going to feel the same due to the fact that you are missing some of that melatonin of the night. SPEAKER A So that's interesting. So that means the melatonin is actually having an effect to help rejuvenate us. Is that what's going on? SPEAKER B That's right. So that melatonin is helps you with anxiety, helps you fight cancers, helps you control your blood pressure, helps you control your nervousness, helps you rejuvenate the body at night. It's an antioxidant, it's a super important chemical in our body. So I do not want to have less. Now some people try to take shortcuts and they say, oh, I'm just going to take melatonin, it's not the same. As I tell my patients, we need to try to optimise your internal melatonin. If after we tried every single thing in the book is not working, then we may consider a step like that. But some people want to try to jump into it beforehand. Also we need to understand that latest research is showing that we have also release of melatonin from our retina. So the back of the eye, when there is complete darkness, will actually secrete some of that melatonin. Also, a lot of the melatonin that you're going to be getting is from your digestive tract. So the digestive tract generates a bunch of the melatonin that we're going to be generating in a night. If there is food circulating in that digestive tract, the amount of melatonin is going to be released. That's one of the reasons why I wanna have a nice four hour or more hours after my last meal, by the time that I go to bed in order to have that intestine prime for optimum amount of melatonin. SPEAKER A That's very fascinating because obviously there's multiple strategies. There's, you know, regulating the light in your eyes. There's about when you're eating that's making a difference as to how much the quality of sleep is going to be affected, isn't it? SPEAKER B That's right. Even the retina, the latest Research is showing that light above your eyes actually can potentially have a negative effect regarding your sleep quality because there are some special sensors in the very bottom of your retina. Retina, that organ of the eye that senses the light. So if there is light above you, that light is stimulating that bottom part of your retina, blocking a lot of your melatonin. Also, watch out for devices, things like your cell phone and computer. Ideally you shouldn't be using them after sunset, but if you have to use them, you need to turn on that light function. Today, pretty much most of the modern devices, the new operating systems have this programme. From Ubuntu to Windows to Apple to your cell phone, Android to your cell phone, and from other brands, there's usually that night light function. And they even time it sometimes so that when the sun sets, automatically blocks that blue light, because from the whole spectrum, the blue light is the one that blocks the most, the melatonin. SPEAKER A That's really helpful practical tips. And I was interested at what you said then about the highlight, because for me in the evening my preference is to have like a little lamp on rather than the top light. That's just a preference. SPEAKER B Exactly what you're doing. SPEAKER A But now you've been explained why it feels good to do that. That's very interesting. Yeah. SPEAKER B And we can see here on the first slide on the screen, as you can see, sleep is worth far more before than after midnight. Two hours of good sleep before 12 o' clock is worth more than four hours after 12 o' clock. I mean, to me this is fascinating because this is exactly what the latest research shows. In fact, when I was doing quite a bit of hospital work, I would trade with the physicians. Whenever I had to do that night duty, I would tell them, okay, look, I'm going to go to bed at 10pm Two hours before midnight says there. And you let me sleep right now, I'll sleep, you know, a little bit and then I'll cover you later on. And that way I knew that I was optimising, you know, that melatonin, because the sleep is worth twice it says there. And now we know why. Because you generate in higher amounts that melatonin before midnight than after midnight. SPEAKER A That's very, very fascinating and so helpful to have that understanding. And I know you've been involved in a lot of research and study about mental health. SPEAKER B That's right. SPEAKER A And what have learned about the connection between sleep and mental health. SPEAKER B Yeah. We can see on the screen another one of my papers, this one about how depression has causes and the inquiry we were having is what has been documented as things that can affect mental health as regarding causes of that mental health problem. And you can see in the next screen, we have written this paper that we call the ten hit hypothesis. So basically, if somebody has four or more of these factors active at the same time, they're going to have a mental health problem. And if you notice factor number four is something called the circadian rhythm. And that one has to do with, with irregularity. The body likes to be regular. So things that cause irregularity in my eating, in my sleeping, are going to have a negative effect on my mental health. Now something interesting is that if you ever talk to somebody with depression, they're going to tell you one of the challenges they're going to have is the problem of sleep. And the reason why they're having problems with sleep is the following. Somebody that has depression. There's a change in the chemistry of the brain, but especially a chemical by the name of serotonin is too low. And at night when there's complete darkness, serotonin becomes the melatonin. So if they have low serotonin which is causing their depression, they're gonna have low melatonin. And that's gonna be interpreted through different places, different ways, such as having problems going to sleep, waking up too early in the evening. In fact, that's a relationship how early in the night you're waking up. You're waking up at 2am, 1am the more severe your depression, the earlier that that's going to wake you up. So as you start making the right lifestyle changes, one of the first things you're going to notice, the sleep quality will improve. SPEAKER A Interesting. SPEAKER B Yeah. SPEAKER A Wow. So definitely it's those hormones that are having the interest because the effect there, the serotonin is like the happy hormone. SPEAKER B That's right. SPEAKER A And it's connected to melatonin. So that's the pathway there. SPEAKER B That's right. And then you can see also my next study on the screen, this very interesting study was showing that going outside, this is from my tweets. Even if it's cloudy, even though you may not be able to see the sun, the sun is still is there. If you remember, we're mentioning that the bottom of the eye has those special sensors. So in the night I don't want to stimulate those, but in the day I want to stimulate those. So first thing you can do if you want to start improving your sleep, you're going to go outside. Early in the day, as the sun is starting to shine, it doesn't matter if it's cloudy, you are going to get that benefit from that bright light and that's going to help to start programming your cycles of sleep so that you can start becoming a little bit regular. In our programme of depression, we have the key of every single one of our patients. And if the patient refers that, oh, I had a really bad night's sleep, I'm just going to stay in bed the whole morning, no, sir, you're not going to do that, because if you do that, you're going to cause the same problem in the night. You're not going to sleep well, you're going to want to stay in bed again. So we need to break that cycle. We knock on their doors. If they don't open, we'll open the door and we're going to take him outside where there's bright light or through one of those blue lights. We're going to be stimulating that retina so that the patient starts to increase the serotonin, which will improve the melatonin and will start making him feel much better. SPEAKER A So it seems like we really have to act on principle here and not how we feel. If you want to break. SPEAKER B That's right. SPEAKER A Poor sleeping cycle. SPEAKER B You got it. SPEAKER A That's very interesting that you share those things. And, you know, these days there is a real challenge that we face with so much artificial lights around. SPEAKER B That's right. SPEAKER A It makes it really difficult. SPEAKER B Like in the tweet that I was putting recently, you can see it on the screen in this interesting newspaper article from Los Angeles, Time, Earth is losing its darkness with implications for human health. See, studies show, for example, that if you're sleeping and in your window there's one of this little bothersome type of light. Not necessarily like super bright, but it's bright enough there. Even though your eyes is closed, your sensing retina still is functioning. So, for example, there was a recent study showing that you actually increase the risk of metabolic problems, diabetes and so forth if you're sleeping in a place where there's some light outside your room. So if that's the case, you're going to have to have one of those masks that covers well your eyes. Unfortunately, some people unconsciously take off the mask at night and that's something that certain people need to get used to it. So if you don't deal with that, you're going to have trouble. And that's the problem that we have. As more artificials are coming up, artificial light that is causing what is called light pollution. And that's not good for Our health. SPEAKER A And especially if people are located in cities, that's very difficult because you have to, I don't know, thoroughly block out every window and put extra sheets or something up to keep the light out, just to achieve that darkness that we need for health. SPEAKER B That's what I used to do. I used to live in Norway. You know, in Norway, the sun sets around 11 something in the evening, where I was, so I had to block my window. You know, there's no way it was just too bright to sleep in the summers. SPEAKER A Yeah. To get that cycle continuing. SPEAKER B That's why. SPEAKER A Yeah. SPEAKER B And then also, we can see this other study on the screen. This is one of my studies in which it was showing how regularity in eating and sleeping seems to improve depression. That's how we title our study. Basically what we're doing. We're taking a big sample of our database, more than 5,000 people, and through different questionnaires, we were trying to understand how regular or how irregular you are at going to bed. And it was very clear from the results, people that are not regular in their eating and in their sleeping patterns tend to have a worse mental health. So there's another tip there. If you want to improve that mental health, you need to become regular. Now, the temptation of some people is that they say, well, Doctor, my problem is that I am a night person. I'm a night owl. SPEAKER A Night owl, yes. SPEAKER B So I function better in the night and I become more productive and so forth. Well, that's what you think, but that's not necessarily what your body does. In an interesting study, they took those night owls and they put them all on tents outside, camping tents, and they took away their cell phones and something interesting happened. You know, when you're camping outside, you don't have any artificial cell phone or tablet. I mean, there's only so much you can talk about in the evening and you need to go to bed. And the advantage of sleeping on a tent is that when the sun comes up, the whole tent illuminates, so you know when the day is there. So that caused every single one of those night people to become morning people by the end of a few days. SPEAKER A Wow. SPEAKER B So. And that's not only what that study shows, that's what happens to our patients. As our patients come to our programme, as we expose them wisely to that bright light at the right time, then their clock starts changing and they start becoming day people. SPEAKER A So that's the solution. Put them out in a tent for a few days and switch the clock around and that'll Make a big difference. But that's very interesting because I guess what you're highlighting here is the light extension exposure is very key for setting that natural rhythm of the sleeping and the waking and the timing of the sleep. SPEAKER B See, that's why our ancestors, that most of them were farmers, knew this very well. For example, they knew that if they didn't go out to the field to start working early in the morning, they would have to start doing it a little more during midday. And the midday was nice and hot. So they knew this by experience. So you would see that most of those workers were out early in the morning working those fields and by doing that, they were exposing themselves to the bright light of the sun. And that helps regularise the rhythms and wonder why they didn't have all the sleep challenges that we as modern society have. SPEAKER A Now, the study you mentioned before about regularity in eating and sleeping. Does eating play more of a role in relation to sleeping for. For your mental health? I guess, in terms of the consistency, I know you mentioned before that if you eat too late, it's a problem for sleep. SPEAKER B That's right. SPEAKER A Is there any other relation there? SPEAKER B Yeah, no, definitely. Both play a very important role. Both are as important. So regularity in your time to go to sleep is very important because as we mentioned, the melatonin and there's other chemicals that the brain secretes at night. If you keep your brain guessing, oh, last night you went to bed at 9, then the next night you went to bed at 11, then the next night you went to bed at 1:00am, then the next night you went back at 11. And all this changing and changing and changing. The brain is like, well, then when I release these chemicals, you know. So by becoming regular, your body knows, okay, you know, we're going to bed at 10:00pm, okay, at that time I'm going to be optimising and secreting all these chemicals that are needed for good sleep, therefore optimising the quality of the sleep. SPEAKER A Nice. So it's really making the whole operation of your body system efficient because it can predict exactly when it needs to do certain things. SPEAKER B So in that way you're able to optimise the functioning of those chemicals at the same time. Also, the order of your meals is important. Also, you shouldn't be keeping your body guessing by when the food comes and so forth. In fact, studies show that that's why you should be eating a good breakfast, because a good breakfast starts to create synchronisation of the body clocks. Body clocks that are not synchronised is what causes all kinds of troubles in people that have problems with sleeping. So by optimising and synchronising your clocks, you improve how you feel and things like your sleep are going to start improving. SPEAKER A That's very interesting. And now you're an international speaker, you travel around and you're going through multiple time zones. This is well known to play a lot of havoc with your natural body rhythms. How do you manage that? SPEAKER B So what I do is a few things. One, I programme my trips. I just don't take any flight. I'm very picky what flight I'm going to take. So I have this algorithm in my head in which I know when I'm going to do my exercise, when I'm going to eat, when I'm going to sleep. So by programming my flights, I know when to do what. So I have this complex algorithm in my head in which I time things so that I'm able to expose to the bright light when I'm supposed to. I'm able to block the bright light when I'm not supposed to. I'm able to to eat so that I can start synchronising my clocks. In that way I'm able to transition time zones faster. Like in this trip, literally that I am here in Australia, I am at the end of a 15 country trip. I've been to 15, almost 15 countries. So by optimising those clocks, I'm able to do that. SPEAKER A Wow, that's, that's amazing. And certainly nice to see how you're able to put that in practise in your own life situation. Well, thank you so much for sharing with us. I look forward to the next programme with you where we can talk more about this. We've been talking with Dr. Eddie Ramirez all about sleep and in the next episode we will talk more about this topic, including some practical strategies to help you sleep better. You won't want to miss this, so please stay tuned. If you have questions or comments about this programme or if there's a topic you'd like us to discuss, contact us on healthreeabnaustralia.org au and remember to shape your lifestyle as medicine. SPEAKER A You've been listening to Your Lifestyle as Medicine, a production of 3ABN Australia television.