Shelby Harris Quotes
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Honestly, what we use a lot is melatonin. So we use lower dosages of melatonin, taking it at different times, depending upon where we are traveling and that can really help adjust the body's rhythm to wherever you are going.
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Really if it's an hour or two after you've fallen asleep because you're in such a deep sleep at that point.
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There's some debate as to whether you need to awaken from them because there are some patients who are actually starting to say, "I had these horrible nightmares, but I never woke up from them." But they can still recall them when they get up in the morning. So there's still some debate in the field.
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Narcolepsy is a disorder that affects many different areas of life. So in typical patients with narcolepsy, they have something called "excessive daytime sleepiness." So, they're very sleepy during the day. Yet, at night, they're still sleepy, but their sleep is very broken.
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Jet lag depends on which direction you're going and it can be a little complicated, but there are a few different treatments. So one would be if you're going somewhere - sorry it's hard to think about it.
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So, more times than not, but not every time, it can be linked to a medical problem, such as menopause, cancer, chronic pain, it can be linked to anxiety and depression. Those are the more common causes.
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So when it comes to circadian rhythms, it's a clock that's basically programmed in our body. So if you think back to times when people lived on farms and we didn't have electricity.
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There are some patients who just have insomnia and they've had it since they were a kid and we don't quite know why. So when we look at the cause, we definitely want to treat whatever else is going on, but insomnia often because it becomes its own diagnosis and that requires its own treatment.
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Nightmares are distinctly different from dreams in the way that people feel them and experience them. So a lot of people think that a nightmare is something where something is chasing them and you have to wake up screaming. Yes, that's one of the more common nightmares that we see is the person chasing someone or they're being chased.
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If there's a lot of fear that's going on, if there's a lot of anxiety, it's manifesting itself in your nocturnal world so that analyzing it can help open up basically thoughts about what you need to do during the day. So a lot of people who subscribe to the psychoanalysis, the Jungian thought will really focus a lot on dreams, the meaning, and how it can be used to help you during the day.
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We actually don't know the function of sleep all that well yet, but sleep is a time of quiescence in the brain.
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So it's like your brain has a large filing cabinet and it's opening up each drawer and it's taking in various images and memories from the day, consolidating what it needs to and puts in whatever file. And then if there's something that doesn't fit in any of the files and doesn't really belong, you'll forget about it. So it's a way of really getting a succinct way of storing things in your brain.
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We try not using medications initially, and we use something called behavioral therapy for insomnia. This changes behaviors people do in bed, none of the tossing and turning.
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Some patients are still having insomnia, but it's seems worse to them than actually it is. So, if they say they're sleep deprived, they haven't slept at all in three days; if we actually take them into a lab, most of the time we actually do see they're sleeping on and off here and there.
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So if somebody has chronic pain, we want to manage the pain, but we still want to treat the insomnia separately. So what we'll tend to do in our sleep lab is we'll do a thorough evaluation and we usually have myself, who is a Psychologist and a Sleep Behavioral Sleep Specialist, I treat the patients first.
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Some patients will report that they have sleep paralysis. If we see sleep paralysis alone and nothing else, we don't really think all that much of it, but if we see other symptoms, then it might be a red flag for something else that's going on.
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It's uncommon, but there are some people who just have a delayed circadian rhythm and they just - they sleep better during the day then they do at night. So they've - a lot of those people with delayed sleep phase disorder they start to work in bars, they work some of the late night shifts, they sort of adjust to doing it more and more as time goes on.
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Decrements in attention and concentration, being able to learn more efficiently, that's just not as good. Also, there are motor vehicle accidents, workplace accidents, we see that a lot.
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When you're in the more deeper stages of sleep - REM sleep, your body is quiet, but your mind is actually very active. So it's a time when your body and your brain is restoring itself. It's repairing any cell damage that happened during the day, it's really repairing, like I said, repairing your body, but also helps with digestion, helps with memory.
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Now there's some night terrors that happen in adults. And if it starts as an adult and you've never had them before, then there might be other things that are happening; it might be anxiety, depression, stress. And that's when you might have more of a thorough psychological evaluation.
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There's a new line of research showing that people who don't get enough sleep, they're body doesn't metabolize as well. And so they actually - it leads to weight gain. So if you're not getting enough sleep, you might have difficulty losing weight.
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Workplace accidents with people who are sleep deprived or people who work shifts and they don't get the right amount of sleep during the day or at night.
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So, it's not every patient that I see, but I'd say a good 70% to 80% of the patients when they go to bed it's like a stereo is playing at an 11 or 12 and they can't turn it down, at all. So it makes it very hard for their body to down regulate to be able to go to bed at night.
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We think is happening in the brain, the way I like to think about it is, it's almost like, you're brain is going through all these stages of sleep and it's developing in children so fast that it's almost like you're shifting gears in a car. And at some point, you actually stall out a little bit, and that's kind of what happens during a night terror.
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And you cycle throughout so that you do about five to six cycles throughout the night. And we spend more time in REM later on in the night than we do earlier on.
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So when you're in REM sleep, your brain is very active, our body is quiet, but your brain is really processing a lot of things, a lot of emotions; we dream the most in REM sleep. And then you go back down in the deep stages, and so on and so forth.
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Sleep paralysis is something that is actually very common. Many people have it, I've had it myself. And what happens is, when you're in that REM stage of sleep, your brain is very active. You're dreaming your most during that stage, you're mind, your eyes are moving, there's a lot going on. It's like fireworks going on in your brain.
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If you're going somewhere East from here, generally what you want to do is you want to try to have your bed time earlier and earlier so what we'll do is I'll have someone adjust for a week or two by going to be 15 minutes earlier and getting up 15 minutes earlier every night. So that can be a really simple thing.
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So the deeper stages of sleep are really those times of quiescence, you're really restoring your body and we have a few different stages of sleep.
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Night terrors are in deep sleep, and they're more common in kids, as are nightmares, but what happens in a night terror is like a flash - we think a flash of some image or something happens in the brain. We don't really quite know what. And it usually ends up with the child screaming almost like screaming bloody murder. It's very scary for the parents or whoever else is around.
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