sleep – Restored Life Now!

October 11, 2014

Does the lack of sleep affect blood sugar?

We know that sleep is important for our brain recovery. But does sleep directly impact our bodies’ ability to control our blood sugar?

A study of type 2 diabetics found that those reporting poor sleep duration and quality were linked to poor blood sugar control[i]. Similar results were observed in healthy individuals limited to 4 hours of sleep for 6 days.[ii]

Some of the impacts from the lack of sleep:

Decrease lepton (a hormone important in appetite suppression)
Increased ghrelin (a hormone involved in stimulating our appetite)
Possible increase in cortisol (stress hormone)
Reduction in glucose tolerance
Reduction in insulin sensitivity

What a combination! From my own experience, the hunger that is created results in looking for sweet, salty and/or fatty foods—not vegetables.

When we are tired we look for quick energy. The carbs we seek provide a quick short-term boost. Simple carbs not only provide energy but they trigger a dopamine (the feel good brain chemical) response. Both of these boost are short lived. If they did not come with all the nutrients we need then we quickly seek out another boost.

These tired eating binges not only spike our blood sugar, but they also add to our waist line. This further complicates the insulin resistance problem diabetic’s face.

On top of this add the decreased glucose tolerance and insulin sensitivity. All this combined is not good for healthy people, much less diabetics.

In a recent podcast episode of “Healing the Wounds of War” I discuss 10 Tips for Better Sleep. The information is also applicable to those dealing with diabetes.

Here are some additional web resources (besides the journals listed below)

Illustration courtesy of Iosphere on freedigitalphoto.net

[i] Knutson, K, JAMA Internal Medicine “Role of Sleep Duration and Quality in Risk and Severity of Type 2 Diabetes Mellitus” September, 2006 http://archinte.jamanetwork.com/article.aspx?articleid=410883

[ii] Spiegel, K, The Lancet, “Impact of sleep debt on metabolic and endocrine function”, October 1999 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)01376-8/fulltext

October 11, 2014October 11, 2014

HTWW – 027 10 Tips for Better Sleep

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Sleep is extremely important for the whole body. The brain is no exception. When we are recovering from PTSD we need are brains firing on all cylinders.

PTSD introduces some difficult barriers to sound sleep. Hyper-vigilance and nightmares are two obstacles that those with PTSD face.

However, a good night’s rest starts with the same foundation for both those with PTSD and the rest of the population. Once the foundation is in place we are better equipped to deal with specific difficulties.

The foundation

Several sleep improvements list exist. I link to a few of them below. Here are the 10 things I have found helpful.

1. Get plenty of light.

What? I thought dark was necessary for sleep? Well, it is. However, getting plenty of intense light in the morning can help set of up for sleep at night. Daylight intensity triggers our brain to produce serotonin—an important brain chemical, especially during the day, for emotions, thinking and energy. It is made by the same gland in the brain that produced melatonin—an important brain chemical for nighttime for rest that is produced in the dark.

2. Get plenty of physical activity.

Yes, that beloved topic…exercise! Exercise is excellent for reducing stress and balancing out brain chemicals. It is usually best to do it early in the day or at least 4 hours before bed. Your body needs time to cool down and recover.

3. Make sure it is dark.

Just as we need light during the day to help our brains fully function. We need dark to help the properly function while we sleep (see above).

Experiment with getting rid of as much light as possible. Sometimes window blinds are not enough. Curtains over windows (or experiment with putting up a thick blanket.) Clock radios, cell phones, cordless phones, chargers, and other electronics can also be a source of light that might affect our brain activity.

The experts also say the light from TV or computer screens can interfere with melatonin production.

4. Limit or Eliminate Caffeine

It is a stimulant. People often report that it does not affect their sleep. It may not may or may not affect your ability to fall asleep. But it does affect your ability to get the proper rest your brain needs.

At the very least limit your caffeine intake to 1 or 2 servings a day. Stop caffeinated beverages around 2 pm (about 8 hours before bed).

5. Eliminate Nicotine

It is a stimulant.

6. Limit Alcohol

Alcohol is a depressant and it can help someone fall asleep. However, it interferes the deep, restful and restorative stages 3 and 4 of the sleep cycle. In other word, you may fall asleep more quickly but you will not rest as soundly.

7. Watch what and when you eat.

A big meal may make you sleepy but it won’t typically give you a good night’s rest. Digesting a heavy or spicy meal has been shown to interfere with a good night sleep. Try eating a litter earlier in the evening. Consider making dinner a smaller meal. Reserve lunch for the spicy or heavy foods.

8. Limit your activity in bed.

Reserve this space for sleep and sex. From stress to mental stimulation, E-mail, work, electronics each can disrupt our rest.

These last two may be particularly helpful for those with PTSD.

9. Meditation and deep breathing

Practice these techniques during the day. If necessary apply them as you are trying to get your mind in a restful state around bed time. Once learned, these can also be useful with we become overstimulated—loud noise, dream, etc.

10. Medication for nightmare reduction instead of a direct sleep aid.

If nightmares are a problem talk with your healthcare provider. For a long time I use a medication called Prazosin. It is an older blood pressure medication. My provider told me that it was about 80% effective in a double blind study at reducing or eliminating nightmares in PTSD patients.

It was affective for me as well. But be careful. It can seriously lower your blood pressure—especially as your body adjust to the increasing dose. So take care when you rise at night, especially to use the bathroom.

It worked for me. While I was taking Prazosin I hardly had a nightmare.

So why did I stop? I experienced one of the rarer side effect, nocturnal enuresis…aka nighttime urinary incontinence or bed-wetting.

Yet I am glad I took it for a while. It helped me get better sleep. The better sleep helped me better deal with the underlying problems. From time to time I still have PTSD related nightmares, but they are getting less intense and lest frequent.

Question: What has helped you get a healthy, restful and restorative night sleep?

Some Sleep Resources

Image courtacy Stuart Miles, freedigitalphotos.net

February 7, 2014October 18, 2014

HTWW 014 – 3 Practical Steps to Gaining Control Over Anger

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Last week in “Anger!!! What Lies Beneath” we discussed the fuel underneath anger. It seems to be largely connected to fear and its friends: shame, guilt, etc. This week we continue on our path toward growth and victory.

Out of control anger does not only affect our relationship; but it also physically affects our hearts—and a lot more of our bodies. So how do we START to deal with problematic anger?

1. The R and E of RESTORE

Recognize and Evaluate:

But there is more to it R and E. We can learn to detect the sings in our bodies as we start to escalate. We can learn to identify the thinking patterns that start to lead us down the road toward rage.

(See Episodes 002 RESTORE and 003 Recognize)

2. Physically Prepare: Sleep, Eat and Exercise

Sleep:

What happens when you do not get enough sleep? For starters: increased depression and moodiness. Your brain goes through a rest process when you sleep. While sleeping the electrical and chemical makeup of the brain changes. This is apparently necessary for proper function while you are awake. Without proper sleep we are also likely to gain weight, have trouble learning, focusing and remembering.

[CDC Sleep Report; Effects of the Lack of Sleep; Anger and Heart Disease]

A few things about PTSD that can add extra complication to the sleeping problem.

Hypervigilance (always on guard) can make it difficult to fall asleep. For some, they are easily awoken by sounds.

Nightmares: These can interfere with sleep on many levels: (a) wake you out of sleep; (b) keep you from falling back to sleep; (c) interfere with the quality of sleep. Even if it does not wake you out of sleep the thrashing screaming and sweating can interfere with the quality of sleep.

What can I do to get a better night sleep?

Exercise – 5 to 6 hours before attempting to sleep. 20 min of intensive activity (Talk with your Doctor before starting an exercise plan) [Exercise and Sleep]
Get rid of the electronics/TV watch from the bedroom
Exposure to outdoor (bright) light in the morning

Eat: Ok, we constantly being told how we need to eat a balance and healthy diet. Well, it is true. But there is too much to really get into this topic here – although I mention a couple of things that you may find useful in the show.

“But caffeine doesn’t keep me awake.” I hear this a lot! Studies show that it does interfere with the quality of sleep. In other words, even when you sleep it decreases the quality of sleep. Suggestion: don’t drink caffeine after lunch and only a couple cups of caffeinated coffee or tea in the morning.

[Effects of caffeine on sleep]

3. Practice Tactical Breathing

Say what? Yes, you can significantly change your body and mind by learning and practicing a breathing technique known as “Tactical Breathing”.

When the body is in the fight-flight response the blood flow decreases to the reasoning center of the brain and increases to the mid-brain focused on preserving your life. Researchers have developed a breathing technique that has proven useful to people in tactical situations to help them lower their heart rate and help reestablish more control.

It is not difficult but it takes practice. Like with most skills used during a crisis mode we need to first practice them when we are not in a crisis mode.

Question: What helps you deal with anger?

December 12, 2013May 30, 2014

009 – Substance Use Vs. Abuse: 3 Warning Signs

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In this episode we will discuss:

Substance Use/abuse and PTSD.
3 Signs Substance Use has become Substance Abuse
3 Strategies for dealing with Substance Use/Abuse

Substance Use/Abuse and PTSD

Both civilian and military suffers of PTSD are more likely to also deal with Substance Use Disorder (SUD), according the U.S. VA
Self-medication
Why? Deal with intrusive memories (forget for a while), sleep problems, covering feelings of: anger, numbness, depression, etc.
http://www.ptsd.va.gov/public/pages/ptsd_substance_abuse_veterans.asp

The following is not an exclusive list. Add your own thoughts to the comments.

Also, this is not intended to diagnose any mental or physical disorder. This is based on the host’s experience with family members who suffered from substance use/abuse, his experience as a pastor/chaplain dealing with many individuals and families and his reading of the literature in the area of addiction. Please consult a qualified healthcare provider for your specific needs.

Prefrontal cortex is the blue shaded area on the left of the diagram of the brain — Prefrontal cortex includes the blue shaded area on the left of the diagram of the brain.

[Special Note: The adolescent brain is still in development until about the age of 25. The region to last develop is the reasoning center of the Prefrontal Cortex. Don’t mess with it! Why is this so important for our discussion? Some sufferers of PTSD are below the age of 25. Much research show that illicit drug use at younger ages run significant additional potential psychological and neurological problems. For more info: http://science.howstuffworks.com/life/teenage-brain1.htm]

3 Signs Substance Use has become Substance Abuse

Used to escape, avoid or “deal” with problems
Lying about or hiding use
Defensive about use

What can I do if I think substance use has become abuse in my life?

3 Strategies for Dealing with Substance Use/Abuse

What can I do if I think substances use has become abuse in the life of a loved one, friend, or coworker?

Individually (or with another) Confront: Do this only when all are sober and there it is a safe environment with no risk of violence or abuse. Also, be prepared for resistance, denial, defensiveness, other manipulative tactics and/or hostility. A first discussion about substance abuse rarely result in the abuser willingly surrendering for the necessary help. Be patient.
Set boundaries: Let them know what is acceptable and unacceptable behavior in your presence, work or home. They may deny the problem that does not mean that the problem does not exist. It is important to let them know that how they are handling things in their life is affecting your life as well. There are consequence for their choices. Do not hesitate to get counsel on what would be healthy and reasonable boundaries for your specific situation.
Intervention: At some point you may determine that an intervention is necessary. It may take a group of people who care for the individual to get through to them—especially if the first actions have not been successful. Be prepared. Make sure the group is on the same page. It is extremely helpful to have someone experienced present at the intervention. Make sure you have resources lined up to deal with the needs if the individual is ready to accept help. For further help with an intervention read the following link from the Mayo Clinic http://www.mayoclinic.com/health/intervention/MH00127

Question: How has reaching out to help other assisted you in your journey?

[For a discussion of the medical distinction of use vs. abuse see: http://methoide.fcm.arizona.edu/infocenter/index.cfm?stid=201]