Hi guys! Today I want to talk to you about mind racing. Racing thoughts are a real bugger when it comes to sleep so let’s take a closer look at what they are and what we can do about them. Racing thoughts tend to occur when we are sitting alone with our thoughts, in neuroscience we conceptualize this network of regions in the brain as the “Default Mode Network.” The default mode network was first discovered by researchers using functional imaging (PET) to map task specific functions in the brain. They noticed when the subjects were in a passive state this collective group of brain regions woul ..read more

Hey guys today I wanted to discuss immediate release (IR) and prolonged release melatonin (PRM) and some of the factors I consider when choosing these formulations. The most important factor I consider when determining if melatonin has a role in each case is figuring out what the root cause of the sleep disturbance is. For example, if my clinical assessment is that patient has undiagnosed sleep disordered breathing, melatonin isn’t going to be my first choice for treatment. Unfortunately, thousands of people will continue to self medicate with hypnotics rather than having a sleep study to inve ..read more

The sleep fairy is a cousin of the tooth fairy. She visits 3-5 year olds who are having trouble staying in bed at night. Parents tell their child the sleep fairy checks on them during the night and if they are in their beds, will leave them a small gift under their pillows. The sleep fairy will visit every night at first and then after a week may visit every day or every other day on an inconsistent schedule. After a two weeks, the sleep fairy leaves a small note under the child’s pillow telling them what a wonderful job they’ve done and explains they are off to help other children! Has the sl ..read more

Wrapping up this three post series on napping with a discussion of the nappuccino. The first time I heard the portmanteau “nappuccino” was not from a sleep expert but from an entrepreneur @danielpink. BTW check out his @MasterClass it is awesome. The idea behind the nappuccino is to ingest a dose of caffeine right before taking a power nap timed in the afternoon dip in the circadian alerting signal. The caffeine will just be rising in the bloodstream as the 10-20 minute nap ends, producing a boost in cognition. This should also help those of us who struggle to end the nap after 10-20 minutes ..read more

‍Naps are one of the most effective tools for enhancing performance when we’re short on sleep. However, the best strategy varies, for example if you’re talking about total sleep deprivation versus sleep restriction. ‍Let’s look at a study after a night of five hours of sleep (this seems pretty applicable to real life whether it’s a sick child, catching an early flight, or burning the midnight oil at work). An Australian study comparing the benefits of different nap lengths after one night of sleep restricted to 5 hours was followed by a nap at 3 pm varying from from 0, 5, 10, 20, and 30 minute ..read more

Sleep deprivation has been shown to adversely impact reaction time, accuracy, strength, vigor, endurance as well as cognitive skills such as judgement and decision making. Research has also shown athletes are particularly susceptible to sleep deprivation because of their training schedules, travel, and jet lag. This is true regardless of the sport and whether it is a team or individual sport. In addition to utilizing sleep hygiene and behavioral strategies for improving sleep, sleep banking has also shown benefits for reducing the negative impacts of sleep deprivation. This has been studied in ..read more

‍Sleep training is, by far, the most common query I receive on DMs. It dominates the thoughts of many parents or really anyone with a child in their lives. In this week’s issue of @newyorkermagSam Knight discusses the topic (link in bio) and describes their experience working with Brenda Hart, a London based sleep coach with a cult following. Their description reminded me a bit of @nannyconnie , whose book I read with great interest as a new mother. Actually, she reminded me a bit of Mrs. Doutbfire and Mary Poppins too, for good reasons. ‍We could get into a deep debate about sleep training ve ..read more

While myofunctional therapy and playing the didgeridoo are known to improve snoring and mild obstructive sleep apnea, these options are not always practical or easily accessible to the millions of Americans with snoring and mild OSA. Enter the new kid on the block @eXciteOSAwhich was FDA approved in February 2021. How does it work? @exciteOSA is a retainer that fits around the tongue with two electrodes and the top and two on the bottom. It is worn during the daytime for 20 minutes while neuromuscular stimulation is delivered to the tongue muscle. It is used daily for 6 weeks at increasing lev ..read more

A few years ago I was attending a  conference and the lecturer (a sleep doctor) presented a case of shift work sleep wake disorder in one of the night technicians who worked in her sleep lab. During the presentation she joked that the best solution was for the technician to quit their job. At the time all I could think was wow she really doesn’t get it, how in the world would that advice be helpful or realistic? Had she considered if the patient was supporting a family or was so passionate about their work that leaving it was not an option. A conundrum many of our colleagues also face. I tell ..read more

One of the most common sleep issues that arises in this age group is nighttime fears. This age is unique because children are developed enough to express fears but are not yet able to distinguish between fantasy and reality. Dr. Avi Sadeh, a pediatric sleep researcher-developed “The Huggy Puppy Intervention” as a strategy to help reduce stress and fear in young children in extreme situations (such as war zones or natural disasters). In clinical trials, the HPI has shown to reduce fears. Here’s how it works: Huggy is introduced as a sad, scared, and lonely puppy who needs a friend. It is far aw ..read more