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Is Caffeine causing you Insomnia? Part 2 of 3

March 10th, 2020

Insomnia Part II: Caffeine

The following is a collection of the research, thoughts and writings of some of the best sleep scientists and authors in the world today. My only contribution here, is to have put their words and works into a compact and accessible form. A list of those writers and scientists appears at the end of this blog for your further reading.

Quick Summary:

Caffeine gives energy, alertness, stamina, focus and concentration.

But does that come with a price? Yes, it does – a big price for us as individuals and for us as a society.

Psychoactive Molecules – Sleep and Wakefulness

Caffeine is an interesting little molecule. It binds to an important central nervous system receptor that normally binds the molecule adenosine. Adenosine starts building up and binding to its receptors from the time we wake up. As the buildup of adenosine increases throughout the day, we get more and more tired, most noticeably in the evening. This is called “sleep pressure.”

Caffeine is an adenosine antagonist. It binds to the adenosine receptors and blocks the attachment of adenosine. Caffeine gets in the way of adenosine. Adenosine builds up anyway and comes on like a flood when the caffeine is metabolized. This is the “caffeine crash.”

Both molecules are psychoactive. Adenosine is a central nervous system depressant, a sedative hypnotic which induces sleep. Caffeine is a stimulant which works by blocking the depressive effect of adenosine.

Adenosine slows our brain function and prepares us to go to sleep, if caffeine or other stimulant doesn’t get in the way. Caffeine blocks the signals to turn out the mental lights.

With caffeine on board, you may feel wide awake and alert, but all while adenosine is building up in the background. You’ve been temporarily tricked by caffeine. This trick gets reinforced by the fact that caffeine also increases serotonin, adrenaline and dopamine. The release of dopamine is typical of drugs of abuse and probably accounts for caffeine’s mood enhancing qualities.

Caffeine is habit forming, a mild diuretic, temporarily raises blood pressure and relaxes the body’s smooth muscle which may account of its laxative effect.

Most interesting is the targeted way that caffeine interferes with one of the most important biologic functions – Sleep.

Unsupervised Drug Study

The neurobiologist, Matthew Walker, in his book “Why We Sleep,” argues that the consumption of caffeine, the most widely used psychoactive stimulant in the world, represents the largest and longest unsupervised drug study conducted on the human race.

In the U.S., caffeine is the only psychoactive drug routinely given to children, mostly in the form of soda pop.

We now know the results of that study and if Walker is correct (my daily clinical observations say he is!), those results are downright alarming.

Caffeine, Interrupted Sleep and Disease

Does caffeine cause heart disease, mental illness, hypertension, etc. etc?  No, not directly, but yes it probably contributes to these, and others, indirectly by the sleep fragmentation that it causes.

In pharmacology, it is well understood that the dosage of a drug can determine its action – a small dose may heal and a large dose may kill.

With that in mind, if coffee isn’t consumed to an excess, some research shows that it is actually associated with a reduction in breast, prostate, endometrial and colorectal cancer as well as cardiovascular disease, Type II diabetes, Parkinson disease and possibly depression and suicide.

BUT, as soon as caffeine interferes with sleep, even in the slightest – all bets are off.

We at the TMJ & Sleep Therapy Centre of Kansas are in agreement with Dr. Matthew Walker: We are here to alert the world to an invisible health crisis, which is that we are not getting nearly enough sleep and the sleep we are getting stinks and the principle culprit  is caffeine. Caffeine itself may not be bad for you, but the sleep it steals from you may be deadly.

The research suggests that insufficient quantity and quality of sleep may be a key factor in the development of Alzheimer’s, arteriosclerosis, stroke, heart failure, anxiety, depression, suicide and obesity. The shorter you sleep, the shorter your life span.

None of the younger sleep researchers, I have professionally had contact with, consume caffeine.

Is My Sleep More Interrupted than I Think?

Questions to ask yourself, spouse, friends, children or grandchildren or anyone:

  1. Can I fall asleep easily?
  2. Do I stay asleep?
  3. Do I wake rested and ready for the day (without caffeine!)

Regarding “2.” above, the more interruptions of your sleep, of any kind, the poorer our quality of sleep.

Deep Sleep

These interruptions are called arousals. They disrupt the deep, slow wave which is so important to repairing and rejuvenating our bodies for the next day. During deep sleep, low frequency brain waves set out from the frontal cortex and travel to the back of the brain, synchronizing many thousands of nerve cells. This harmonizing of our brain cells in a sort of neural symphony, helps us to distill and consolidate the blizzard of information we have taken in during the day.

Memories are carried on these slow waves from sites of short-term, daily storage to more permanent locations. These are stored in their proper place or trashed; just like organizing your desktop at the end of your workday.

Microarousals, full arousals or deep sleep interruptions of any kind, corrupt this memory and learning storage process.

Fragmented Sleep and Aging

For most people, the quarter life of caffeine is about twelve hours. So, 25% of the caffeine in the cup of coffee you had at noon is still swimming around your brain at midnight. That could well be enough to wreck your deep sleep.

Coffee after dinner? Some people say they can drink coffee and go straight to sleep. Perhaps, but that will reduce you slow wave sleep by at least 15-20%. Dropping your deep sleep by that much is the equivalent of aging you by 15-20%.

More Reasons for Fragmented Sleep

Caffeine is not the only cause of our sleep crisis. Screens, alcohol (which is as hard on REM sleep as caffeine is on deep sleep), pharmaceuticals, noise, work schedules, poor nasal breathing, light pollution causing glare, skyglow, and over illumination  and anxiety play a role in undermining the duration and quality of our sleep.

Caffeine the Two-Edged Sword

But caffeine is at of near the top of the list of culprits. Matthew Walker points out that if you plot the rise of Starbucks over the last thirty-five years and the rise of sleep deprivation, those lines look very similar.

Here is what is uniquely insidious about caffeine. It is not only a leading cause of sleep deprivation; it is the principle tool we use to remedy the situation. Most of the caffeine consumed today is being used to compensate for the lousy sleep for which caffeine bears responsibility. This means that caffeine helps to hide the very problem it creates. It also means that caffeine may be an offender in your insomnia.

Charles Sisler (who no longer uses caffeine) is a circadian rhythm researcher at Harvard Medical School. In a National Geographic article by T.R. Reed, he states, “the principle reason people around the world use caffeine is to promote wakefulness. At the same time, the principle reason people need that crutch is the inadequate and/or ineffective sleep that caffeine causes.” Isn’t this “Catch-22” the very dilemma faced by anyone using an addictive drug?

The Caffeine – Insomnia Spiral

Caffeine is only hiding or postponing our exhaustion by blocking the action of adenosine until liver removes the caffeine from circulation. When this dam holding back the pent-up adenosine floods the brain, you will crash – feeling even more tired than before that first cup of coffee, soda or tea.

There is no free lunch. The apparent energy achieved by drinking caffeine must be paid back, either by requiring more sleep or in accelerated aging. If this caffeine induced debt is not paid back, it may also be the cause of insomnia.

Acknowledgements: Michael Pollan, Christian Guilleminault, William Dement, Matthew Walker, Steven Olmos, Sigrid Veasey, Maiken Nedergaard, Allan Rechtschaffen, Charles Sisler, David Rapoport, David Gozal, Richard Lang, Tim Olds, Jodi Mindell, Michael Grandner and many others I failed to record in my notes as I prepared this blog.

Thanks to all of these researchers, clinicians, educators and writers for their dedicated efforts to improve the health and well-being of everyone on this planet. Thanks as well to the institutions with whom they are associated.

To Your Better Health,

Dr. Joe Baba for the Doctors and Staff or the TMJ & Sleep Therapy Centre of Kansas

“MY HEAD IS SPINNING, AND I CAN’T GET TO SLEEP” - Part 1 of 3

February 5th, 2020

The Role of “Stress”, Worry, Anxiety and Depression in Insomnia

 

Good sleep is critical to a healthy life. This blog is intended for those of you who have trouble getting to sleep due to not being able to “turn your mind off” at night. Insomnia has multiple causes. This addresses a common one.

Usually articles like this are written with the reasons for a method or technique at the beginning of the article, and the technique itself afterwards. I am writing this is reverse order to get right to the point.

The Method

For Three Weeks, avoid as many media sources of upset and antagonism as possible. That means:

- News             - Politics          - Violent or Disturbing Movies, TV or Novels

- Negative comments/ Negative Facebook / Twitter / Instagram posts, Podcasts, etc.

- Negative Emails       - Newspapers             - Magazines    - Negative or Toxic People

Unless you need a media for your work or critical communication, avoid it!

NO PHONES AT BEDTIME!

Try to avoid as well, any people who evaluate you, invalidate you or suppress you. Often, no one thing these people say is particularly harsh, but they send out a constant stream of little invalidation. Unfortunately, sometimes these people are family and those who we love. Do the best you can.

Before you start this project, write down how and what you are feeling; especially regarding your sleep. Include:

  1. How long it takes you to get to sleep
  2. How many times you wake up and for how long and
  3. How rested are you when you wake.

Put it away until after the three-week test period.

At the end of the three weeks, do the same: write down how and what you are feeling.

Compare the two journals; see how much better you feel!

Then make a decision, as to what and how much media, and who, you will allow back into your life.

 

The Background and Reasons

The reasons for insomnia are varied: body pains, snoring sleep partners, animals, illnesses, hormonal conditions, nasal congestion, nutritional deficiencies, mental / emotional distress and so on.

This “test” addresses one of the causes of mental / emotional upset – our consumption of media chaos.

From the Dawn of Time, up to this very second, the great observers of the human condition have remarked upon how certain people and situations create upset in those around them. These suppressive people and situations can directly cause disease and ill health in us! Thanks to research over the last 90 years, we also understand the mechanisms of how this happens in our minds and bodies. This gives us the means to handle these people and situations and improve our health; particularly our sleep.

This report is limited to our response to these people and how these responses affect our sleep; and in turn, the basics of how to remedy that. There is much more to know about these people and situations cause distress and other disease in our lives.

Over the last ten years and especially in the last year, patients have been telling me that they are under greater mental and emotional stress and that they are more anxious, worried and depressed than ever - and that it is affecting their physical health to an unprecedented degree. That is the primary reason that I am writing this, to help you be a healthier you.

Stress / Distress and the Mind - Body Connection

Did you realize that your body is still designed to deal with the stress of a prehistoric world? If a wild animal threatened you, your fight-or-flight response kicked in…your heart rate, blood pressure and breathing all sped up. The hormones adrenaline and cortisol spiked. Inflammation increased in cases where there was an injury or infection. Then, when the threat was gone, your body returned to a state of relaxation in 20 to 60 minutes.

Do you feel tired, have no energy and get overwhelmed?

December 30th, 2019

Let us help you feel refreshed and ready to tackle your day, every day!

Do you want to perform better mentally and physically?

Healthy, refreshing sleep helps us live more vibrant, enjoyable lives in addition to reducing our chances of developing the myriad of disease and dysfunctions listed below. We are more pleasant to those around us, we are more able to handle life’s challenges with less stress.  We are more likely to accomplish the goals we set for ourselves in this lifetime. It is well established that healthy sleep improves sports and mental / academic performance as well.

Can you remember the last time you felt truly rested, refreshed and ready to take on life? Have you ever?  Do you need caffeine or nicotine to feel awake in the morning or maintain energy through the day?

Sleep is so important to our health that without it we can become anything from fatigued to irritable to low-grade anxious to neurotic - and more people than we care to admit are at least a bit psychotic - all because of poor sleep or insufficient sleep.

Nearly every system in our body suffers because of poor sleep. It reduces the effectiveness of our immune system and makes us more susceptible to diseases of all kinds, including:  heart disease, cancer, headaches, high blood pressure, weight gain, Alzheimer’s disease, and more.

Additionally, medical research tells us that head, jaw, and face pains are associated with poor sleep 68% of the time. By actual test in our practice, that number is closer 85%!!

If you have jaw and head pains, it is very likely that you have some sort of sleep disturbance as well. Without solving both problems, you will get partial results at best.

X-rays or blood work are common tests at routine medical or dental appointments. But our sleep, and our breathing during sleep, are far more likely to be major factors in our overall long-term health. However, they are rarely evaluated!! Let’s change that and make sure that our breathing and sleep are checked routinely.

Nothing is more vital than breathing (especially nasal breathing) and sleep is close, if not equally important.

After all, three or four minutes without air and a person is likely dead. Try three days without sleep and they are probably psychotic! That’s how important breathing and sleep are. How we breathe in our sleep is more important yet.

Handling and resolving head face and jaw pains is what we excel at here at the TMJ & Sleep Therapy Centre. There are many components to pain and sleep.  In addition to the many state-of-the-art therapies we provide for pain and sleep conditions, we collaborate with other medical partners when necessary, to ensure that you get the greatest improvement in your pain and sleep as possible.

For tips on how you can get better sleep, visit our website at www.tmjsleepkansas.com and click on the Health Living tab then select Sleep Hygiene Tips.

For more technical information, check out the Articles section located in the Provider Information part of our website.

Another great reference for more sleep information is: www.sleepfoundation.org.

We all want more vibrant, energetic lives, and better sleep is a major step to those goals. Call us today to get onto the pathway to a better life.

Yours for Better Health,

Dr. Joe Baba

 

 

 

 

How to Shoo the Flu?

December 11th, 2019

Every news media tells us that flu and cold season is here! The evidence is around us - people who are sniffling, coughing and achy.

Sleep plays many important roles in our health. Especially important this time of year, is sufficient, restful and restorative sleep to strengthen our immune system.

During deep sleep, our bodies produce various substances which help protect us from bacteria, viruses, molds and yeasts. Research shows that people who get more deep sleep have fewer colds and flu. So, among the ways to reduce your chances of getting sick anytime, but especially this time of year, get plenty of restful sleep!

Of course, there are more ways to defend against illness such as washing your hands, avoiding unnecessary contact with sick people, managing holiday stress and eating nutritious food and reducing sugars, but remember that good sleep is still one of your powerful tools to increase your immunity against flu and colds.

If you are having trouble sleeping or getting the restful sleep you need to feel vibrant and vital, call our office today and schedule a consultation. We are ready to help.