Participants: Agatha Thrash, Don Miller
Series Code: HYTH
Program Code: HYTH000166
00:01 Hello, I'm Agatha Thrash, a staff physician
00:05 at Uchee Pines Institute
00:07 and I'd like to talk with you today about sleep.
00:11 I have a number of people who will be helping me
00:14 and we will be trying to help you to realize the sweetest
00:19 words in all of sacred Scripture I think... and that is,
00:25 "He giveth His beloved sleep. "
00:28 Sometimes we know we're beloved of the Lord...
00:32 but still, we don't sleep.
00:34 Is there a reason for that?
00:35 And can we do something about it?
00:37 We'll be talking about that and we hope you will join us.
01:00 Welcome to "Help Yourself to Health"
01:02 with Dr. Agatha Thrash of Uchee Pines Institute
01:06 And now, here's your host, Dr. Thrash
01:10 You know, all kinds of things interfere with people's sleep.
01:13 Sometimes people tell us that the noise interferes
01:16 with their sleep.
01:17 Sometimes people tell us that the quietness interferes
01:20 with their sleep.
01:21 In fact, at Uchee Pines, we are far out in the country
01:26 We hear no sirens, no horns, no traffic, no people...
01:31 just the quietness of the out-of-doors.
01:36 Now, sometimes people say to us...
01:38 "I couldn't sleep last night. "
01:41 Oh... why?
01:42 "It was so QUIET."
01:44 And I always laugh a bit about that because
01:47 some people simply must have a little background noise
01:51 in order to sleep... in fact, we call that "white noise"
01:54 And, some people want a little bit of that, so that they
01:58 don't hear anything that might attract the attention
02:02 and make it so that they would wake up and... that's all right.
02:05 If that is what helps you to sleep, that's fine.
02:08 Some people like to sleep with a tape...
02:12 So they plug in a tape and they listen to music,
02:15 or they listen to a sermon.
02:18 One woman told me that I put her to sleep every night...
02:22 and I didn't know whether to feel complimented
02:24 about that or not.
02:26 But, if a tape can help you to go to sleep,
02:31 then by all means, you can use a tape.
02:35 What other things might keep someone awake?
02:38 Well I have asked Dr. Winn Horsley to
02:41 help me discuss this problem with you.
02:44 So, Dr. Horsley is a staff physician
02:46 at Uchee Pines Institute, and welcome to this program.
02:51 So, we'd like to talk with you about some of the problems
02:55 having to do with interference of sleep...
02:58 And what would you like to start with?
03:00 Well, one of the most common, I think, is illustrated by
03:03 a patient that came to Uchee Pines,
03:06 about a 40-year-old, white, gentleman
03:09 from up in the New England area...
03:12 who complained of great difficulty sleeping and
03:19 so, I went through the history and couldn't really identify
03:27 I think he had a job with some of its stresses
03:31 But we'd about finished with things
03:35 when, in fact, we maybe even finished with the exam...
03:38 when it came to the surface that he drank
03:41 quite a bit of coffee...
03:42 In fact, he said that he drank how many of these
03:51 potsful per day.
03:53 It was enough to make the equivalent of 50 cups
03:55 of coffee a day...
03:57 OH... he was not even well-hydrated...
04:03 Well, you know, that is an interesting thing that
04:06 caffeine... most people, of course, know how caffeine
04:11 does stimulate and get the heart and the nervous system going
04:14 But most people don't know that caffeine affects the kidneys,
04:18 and makes the kidneys put out more water in the urine.
04:22 And in doing that, the person then, when he takes a
04:28 cup of coffee or of Coke or other caffeine beverage,
04:33 he is better hydrated for a few minutes
04:36 But in fact, once the kidneys start reacting to the caffeine,
04:40 he's more dehydrated than when he took the beverage.
04:42 Yes, it's an interesting thing...
04:44 Here is a model of the kidney, a plastic model
04:47 with the little cap up here of the adrenals...
04:52 Yeah... and then right here, we have what is called
04:56 the kidney cortex and the kidney cortex is the place
05:01 where the urine is formed and then it travels down
05:05 this... it's illustrated in brown here, and drips into
05:10 the little kidney pelvis
05:14 But out here, caffeine exerts its diuretic influence
05:20 It causes a dilation of blood vessels here in the
05:25 kidney cortex and that increases the rate at which
05:30 the blood plasma filtrates through the kidney
05:34 and that, of course, has the capability of producing
05:37 more urine.
05:38 So the net result of drinking a cup of coffee is actually
05:41 a little loss of fluid... Exactly
05:43 You know, I'd like to return to this issue of the effect
05:48 on the nerves... Um hm
05:49 And for that matter, on the heart...
05:51 Most people don't think of caffeine as a drug,
05:54 I don't think... it's just used so routinely and habitual
05:57 And it's classified in pharmacology books, I believe,
06:01 in the toxicology section
06:03 Toxicology... poisons Yes
06:05 As a matter of fact, right here, in the Merck Manual,
06:10 a standard textbook, it has a section at the back
06:14 where poisons are dealt with and right there...
06:16 IS caffeine... Is that right?
06:18 It's together with a few other drugs, such as
06:22 theophylline which is used for asthma.
06:24 And, you know, among the toxic effects which we all know...
06:30 wakefulness, but then restlessness, anorexia, vomiting
06:33 and so on, and it can actually become dangerous.
06:36 It talks about when people are hypersensitive...
06:39 "Possible immediate vasomotor collapse"
06:42 And I was surprised to notice a greater susceptibility
06:44 in adults, "especially after an acute overdose
06:47 on top of chronic intake. "
06:49 If a person stayed up all night and drank a
06:53 cup of coffee every hour, they might really be
06:56 in serious trouble... Yes... If they were chronic
06:58 overusers anyway... Exactly
07:01 One other point about coffee, right here in the same book
07:09 They mention that several studies show that drinkers of
07:14 more than 7 to 8 cups per day, when this was a woman...
07:19 with pregnancy, there was an increased incidence of
07:22 stillbirths, preterm deliveries, low birth weight infants and
07:26 spontaneous abortions.
07:27 Now, they weren't accounting for the presence of
07:33 the use of tobacco and alcohol...
07:36 But, you know, those things go together almost all the time.
07:40 So, it is hard to sort out.
07:41 I've seen some studies done on animals where the mothers
07:46 ...before birth, like with rats, were made to drink the
07:51 caffeine in their food, or they took it ground up
07:54 in their food and the liver weights and brain weights
07:58 and muscle weights of the newborn was much reduced
08:04 below the normal in rat mothers that did NOT take the caffeine.
08:10 So it has a serious effect on babies...
08:13 And that would fit perfectly with what
08:14 the Merck Manual said there...
08:16 And would actually tend to single out the caffeine
08:18 as perhaps as dangerous as any of the other things.
08:21 Well, I wanted to take a little bit of time here to look
08:29 at the issue of sleep...
08:31 ...The nature of sleep and what does it consist of...
08:34 because it is rather mysterious. Yes it is.
08:36 It's right when the Bible says.. "The Lord giveth us sleep"
08:41 And we, of course, don't know that much about how we sleep
08:45 since we're unconscious. That's right.
08:47 What I want to show you is a graph...
08:51 again in this reference book.
08:53 A graph of normal sleep and on this little graph,
09:02 it starts from the awaking state...
09:11 The waking state is this area up on top,
09:16 and then as one falls asleep, you go through various stages
09:20 There's stage 1, which tends to be short.
09:22 Stage 2, where one is in a deeper sleep,
09:25 and that lasts longer.
09:26 Stage 3 and down to stage 4.
09:28 All of these are with greater relaxation
09:33 occurring as one goes deeper...
09:34 I think it corresponds somewhat to the stages of anesthesia.
09:39 Now there is a very interesting added phase of sleep
09:45 which is called "REM" sleep.
09:49 And that is the deepest stage down here below stage 4
09:53 "REM" stands for rapid eye movement.
09:57 During this stage of sleep, the muscles, which have been
10:02 relaxing gradually more and more down to stage 4...
10:05 they become, in a sense, totally paralyzed.
10:07 There aren't even reflexes when they've checked it
10:11 with scientific studies during this time...
10:13 BUT, one set of muscles in the body is just working overtime
10:19 ...It's the rapid eye movement, the external ocular muscles.
10:24 The muscles that make our eyes move are rapidly working
10:27 Now another curious feature about this REM stage of sleep...
10:32 the lowest one here, is that during that stage, one dreams.
10:39 When they wake a person up right at that point,
10:42 in general, he's in the middle of a dream.
10:44 It has been noted that if people, during their sleep...
10:50 if they're in a sleep lab and they interrupt the sleep,
10:53 and don't let them have any REM sleep,
10:56 that they then do not get the restorative value of sleep.
11:01 They are not refreshed the next day.
11:04 And people have called this the time of sleep in which
11:10 one's brain is reorganizing the material of the day.
11:15 Well, that's a little explanation of what has been
11:18 shown in studies about sleep...
11:21 And, I find it interesting what happens to this when
11:25 people use sleeping pills.
11:26 Tell us about that.
11:28 I think we can see better if you point with this... Oh, okay.
11:33 Makes your hand in the way a little bit...
11:36 The biggest class of sleeping pills is called benzodiazepines.
11:42 And some may have heard the names... Dalmane, Restoril,
11:49 These are sleeping pills that are commonly used which are all
11:52 in this class of drugs called benzodiazepines.
11:55 Now, in a publication for doctors,
11:59 I was quite interested to note what they concluded
12:04 about the effect of benzodiazepine sleeping pills
12:07 It was this... when someone started taking them because of
12:11 insomnia, at first, yes... you would get a bit longer
12:14 time asleep.
12:17 He would get more time in these first 4 stages.
12:21 However, they noted that the deep stage, the REM sleep,
12:28 the one that's shown in some of these deep areas,
12:33 was obliterated.
12:36 The person did not get this most restorative phase of sleep.
12:40 And so the benefit of the sleep, of course, was less.
12:44 Now another curious thing that happened was that
12:47 as time went on, after a number of days, not many weeks anyway,
12:51 they found that the person's total hours of sleep
12:57 that is only in stages 1 thru 4, actually went back
13:01 to the amount of time he was sleeping before he started
13:04 taking the sleeping pill.
13:05 Oh, that's very damaging to the drug isn't it?
13:09 ...The reputation of the drug.
13:11 That's right and, you know, this person then...
13:14 he's kind of locked in his situation.
13:17 He's got a worse sleep because he's got no REM sleep.
13:20 He's just as bad as he was before he took the drug
13:22 ...except NOW, if he tries to STOP taking the drug,
13:25 he's going to have rebound insomnia... a bad situation.
13:29 So he's got 2 things...
13:31 Number 1, he has lost REM sleep.
13:33 Number 2, he has no more sleep than he had before but
13:38 now he does not have this restorative property...
13:44 And he cannot do away with the drug because, if he does,
13:47 he won't sleep at all.
13:49 Now, we've worked with people that have tried coming off
13:53 and it is... you pretty much have to tell them...
13:55 "You'll need to bite the bullet. "
13:56 "You're going to have to go through some time of insomnia. "
14:01 And, if they're willing to do that...
14:04 By the way, there is some of that with a number of drugs.
14:09 If they're willing to do that, in this case with insomnia,
14:13 then after it's not too many days that they'll begin to
14:16 start regaining some of the sleep they were getting before.
14:19 A few things that can help them are such things as
14:22 exercising... Absolutely.
14:24 If they exercise abundantly, then their ability to sleep
14:28 that night, after they had been exercising a lot,
14:31 is a lot better than it could be.
14:33 And if they stay well-hydrated, sometimes we think,
14:35 "Well, the person is going to have to get up more at
14:38 night if they're well-hydrated,
14:40 but actually, the brain is a lot water and the work of
14:48 sleep is a positive work of the brain...
14:51 And so, if the brain is well-hydrated, it can
14:55 do its work better.
14:57 Can you tell us something about sleep apnea?
15:00 Now that's a curious kind of problem.
15:06 Actually, it's very related to snoring. Um hm...
15:08 And just like snoring, most people don't know they do it.
15:14 I thought I didn't snore...
15:16 You don't find out maybe until you're married...
15:18 and then your partner informs you.
15:21 I was able to inform the other way too but...
15:23 People that snore heavily tend to be
15:28 ones that do have sleep apnea.
15:30 Now sleep apnea is actually a further stage than snoring...
15:33 with a fair amount of body weight and,
15:38 therefore, generally fat.
15:40 There is going to be some of that fat deposited back
15:44 in the palate... the soft palate area.
15:47 And, when there's too much there, then it can actually
15:51 weigh down and obstruct the airway.
15:58 Now, sleep apnea then... there are things that could be
16:05 done... Maybe I should say something
16:06 about a problem that occurs with it...
16:08 It can actually be bad enough that a person will get
16:11 rhythm problems in their heart.
16:13 And, of course, going for periods as they do...
16:16 a minute, perhaps even longer, without breathing
16:19 of course, this is kind of a dramatic thing...
16:22 And then they can't stay awake well during the day
16:24 So, what can you do?
16:29 Well, there's not a whole lot that is really good
16:36 before surgery.
16:38 Maybe we could say this...
16:39 There is a machine called the CPAP machine... that is
16:42 used quite a bit... that helps the person breathe,
16:45 puts a bit of pressure there.
16:47 There can be a little bit of help from the mouth device
16:51 that moves the jaw forward, the lower jaw is forward like that
16:56 and that tends to keep it away from the soft palate.
16:59 But, I think the biggest thing, the best thing to do of all
17:03 would be to lose weight... Absolutely.
17:07 Yes, because that helps with the opening up of the airway,
17:12 and makes it so that they can sleep better.
17:15 Thank you so much.
17:16 I think that that's all very helpful and can make it
17:21 so that we can know better how to sleep.
17:23 I'm so thankful for this information about sleeping pills
17:27 because a lot of people who are having difficulty sleeping
17:32 ...They think, "What I need is a sleeping pill and that will
17:36 solve ALL my problems. "
17:38 But that really doesn't solve problems.
17:41 Now, there are some things in foods that have been
17:45 noted to be helpful...
17:46 Some people say that when they eat a certain type of food,
17:50 they're going to sleep like a baby,
17:54 and some others say... "Well that doesn't help me,
17:57 but something else will. "
17:58 And so, some people need to have a little encouragement
18:02 with the food that they are going to eat.
18:05 And so, I am smelling the aroma of something that is
18:10 absolutely wonderful!
18:12 And this is Lidia Seda, who has something that
18:16 smells SO GOOD!
18:18 Can you tell me what this is?
18:20 Lidia Seda is a Lifestyle Counselor from Uchee Pines
18:23 and one of my long-time helpers... Lidia
18:26 Thank you Dr. Agatha.
18:28 What is here... we have tomato soup and a potato
18:33 baked potato with a sour cream and some crackers.
18:37 Now one of the key things about this...
18:40 is that this is not necessarily one meal...
18:43 Actually, this is 2 meals.
18:45 And this is what many of us should be having...
18:48 ...is a light 3rd meal and this is a great sleep-inducer... Why?
18:52 Because it will digest easily and it will not
18:57 stay in the stomach while we're sleeping.
18:59 It's very important not to have food in the stomach
19:02 while we sleep.
19:04 There have been studies that show that individuals
19:06 that do have any food in the stomach while they're sleeping
19:10 ...while the food is being digested, passing from the
19:14 stomach to the intestines, that they have a tendency of
19:17 turning... they are more restless,
19:19 so they don't have a restful sleep.
19:21 So it's very important, Dr. Agatha, to have your food
19:24 digested and to just be able to go to sleep and have a
19:28 restful, peaceful sleep.
19:30 So that when you lie down, your stomach is resting also.
19:33 Exactly! That's a good way to put it.
19:36 And, another factor we have to remember is that
19:39 it would be even better not to have a 3rd meal at all.
19:43 But you might be saying... "Well Lidia, I'm not used to
19:46 NOT having a 3rd meal.
19:48 So at least this is a way of meeting you where you may be
19:52 at this time.
19:53 But the ideal is to try not to have a 3rd meal at all...
19:57 And if you want to have even something lighter
19:59 than what we've shown you here,
20:02 you can have a fruit meal which actually digests itself
20:05 in about 2 to 3 hours...
20:07 And this way, you are assured that you will have NOTHING
20:10 in the stomach to disrupt your sleep.
20:13 Another important factor to keep in mind is that fasting
20:17 ...if you do plan NOT to have that 3rd meal,
20:19 actually helps with melatonin production.
20:22 It has been shown that individuals who do fast
20:26 ...or, let's say, not have a 3rd meal
20:28 because that's actually a fast until the morning,
20:30 that they will have a more youthful melatonin production.
20:35 It will last much longer throughout their lifetime.
20:38 They're individuals, as they enter their golden years,
20:41 who are not able to sleep as well.
20:44 So, if you're not there yet, think about that.
20:47 You want to be able to have a better and a more restful sleep
20:50 And if you already are in your golden years,
20:52 try fasting and see if that doesn't help
20:55 your melatonin production.
20:57 What do you think, Dr. Agatha?
20:58 Well, I think I'm one of those in the golden years...
21:02 And certainly it is best for me that I haven't eaten suppers
21:06 for MANY years... even before I reached the golden years,
21:10 I found I did much better on just 2 meals a day...
21:14 and that has been my long-time practice.
21:18 Now, I'm very interested in THIS dish... and in that one!
21:22 Which one is it that smells SO WONDERFUL?
21:25 Well I think it's a combination of both... at this point.
21:28 But this way, since I'm sure all of you would
21:31 also like to know how you may be able to have these meals
21:35 ...Let us show you what the ingredients are.
21:38 For the first one, which is the Supper Soup...
21:44 It's basically a tomato soup... and what you need is:
22:08 Well I can say that this nice combination of herbs and
22:14 tomato REALLY smells good!
22:16 I'm sure it would be a delightful thing and
22:18 anyone eating it... in place of a big supper
22:21 should sleep well.
22:23 Now I notice here that you have a cream on this potato...
22:27 I'd like to know how you made that?
22:29 Do you have a list of ingredients on that one?
22:32 Yes, I do, Dr. Agatha. It's very simple...
22:34 The ingredients are:
22:51 And you place them in a blender, blend them up...
22:54 and you have your sour cream for your potatoes.
22:57 Do you have to heat it together or is it ready to put on...
23:01 It's ready to go... Ready to go!
23:04 Simple enough!
23:05 That's what I like... quick and easy!
23:08 Yes, that's right.
23:09 Well thank you so much, Lidia
23:11 I really appreciate that and I know that it's
23:13 going to be a benefit.
23:14 Now, we have also a variety of things that we can do
23:20 that we might call sleep hygiene.
23:23 And I have asked Don Miller to present some things to you
23:28 that will be helpful in the way of what is good to
23:33 do and NOT to do just before you try to sleep...
23:37 Don Miller, a Lifestyle Counselor at Uchee Pines.
23:40 Thank you, Dr. Thrash
23:41 There are a number of things we can do along the lines of
23:44 sleep hygiene and the term hygiene you might think
23:48 we're talking about... make sure you have clean sheets
23:50 and, indeed, that is important that we have clean sheets,
23:52 but there are other things in our lives that we can do
23:56 or NOT do that will either give us good sleep
23:59 or interfere with the possibility of having good sleep
24:02 And the first thing is regularity.
24:03 Our sleep should be as regular as clockwork.
24:06 We should go to bed at the same time every day
24:08 and get up at the same time every day
24:10 And we don't sit there and sleep in on Sundays...
24:12 It's every day exactly the same time.
24:16 It's already been mentioned that exercise is a good thing
24:18 that we can do to make us tired at night
24:20 but it's only exercise during the day.
24:23 We should do nothing stimulating for about 2 hours
24:26 prior to going to bed...
24:28 We don't exercise. We don't read anything stimulating.
24:30 We don't do anything along these lines.
24:32 It's already been mentioned that coffee
24:35 is going to interfere with our sleep...
24:36 But tobacco and alcohol also will interfere with our sleep.
24:42 We should watch taking naps during the daytime.
24:44 I've known people who say, "I can't sleep at night"
24:47 But all day long, you see them out there sleeping...
24:49 and say, "Well, don't sleep"... He said, "Oh, I'm tired. "
24:51 Go to bed earlier. "I can't sleep at night. "
24:53 I say, "Try this one thing"
24:55 Get up tomorrow morning at 4 o'clock and take no naps.
24:58 I can pretty much guarantee you'll go to sleep.
25:00 There are other things we should do...
25:02 Make sure our rooms are cool... They're quiet...
25:05 and they're dark at night.
25:06 And I like to take along with me, some places,
25:08 little ear plugs.
25:09 The ear plug in your ear... the most disturbing sound
25:13 I know of when you're trying to sleep, is that little...
25:16 mosquito sound.
25:17 A couple of ear plugs... let them have their drink
25:19 ...they'll go off someplace else
25:21 and you'll be able to get some good sleep...
25:23 And so, rather simple, Dr. Thrash, but if we do
25:26 these simple things, I think we might get a better
25:27 night's rest... I'm sure.
25:29 You know, there is another thing, too, that one can do
25:33 but it requires a helper
25:34 and I've asked Shannon Jenkins and Melissa Thrash if they
25:38 will demonstrate this for you.
25:40 It's a simple massage thing and this is Shannon Jenkins
25:43 and this is Melissa Thrash, my granddaughter.
25:46 So Shannon, show us this nice little thing...
25:49 So Melissa, would you hop up here on our table
25:53 and let us have your back and this can be done
25:58 with the bare skin but it can also be done just
26:01 with the clothing on.
26:02 So, this is called "raking"...
26:04 What Shannon is doing is taking one hand and bringing
26:08 her hand down, then the other hand.
26:09 It's a hand-over-hand VERY slow, very light...
26:14 It doesn't have to be hard.
26:16 If the person feels that a harder rake would be relaxing,
26:21 then do it hand-over-hand, a very regular pattern
26:26 constantly raking down 200 strokes...
26:31 and so you can count those 200 strokes down the spine
26:35 in this way... rather gentle toward the end
26:39 But can be firm at first if a person really wants it firm.
26:43 Now after the person has had that,
26:45 of course it is going to be stimulating and soothing...
26:49 At first, it stimulates and then it soothes,
26:52 and relaxes the muscles beside the spine.
26:56 And with this, I can almost guarantee that you will sleep.
27:00 In fact, as I watch Shannon doing this very nice
27:04 raking massage on Melissa's back,
27:07 I could almost sleep right now.
27:10 The interesting thing about the nerves is that they
27:14 send impulses up to the brain through a little window
27:20 or gate at the base of the brain.
27:24 This sending up of impulses at that time shuts out
27:29 other impulses... things that we might feel
27:33 from other parts of the body...
27:34 perhaps a little pain here or there,
27:37 or perhaps a tingle or a tickle that we might feel.
27:41 ...And the raking tends to crowd out these other impulses,
27:48 and in this way, make it possible for us to be able to
27:51 say that our Heavenly Father
27:53 giveth His beloved sleep!