January 27, 2023

In this video, I review the 2nd major cause of our sleep difficulties, Physiological Activation (PA). I specifically focus on how chronic use of sleep medication isn’t a viable solution. I also review why alcohol should not be used as a sleep aid.

The question is why is your sleep not as good as it could be as i noted in my previous videos poor sleep leads to a number of physiological psychological and neurological problems i talked about one of the main causes of poor sleep circadian rhythm disruption i’ve reviewed the importance of getting bright light in the mornings and avoiding bright light in the evenings

Especially blue light i also reviewed some apps you can use on your phone or devices to help reduce the amount of bright light and blue light that your eyes are exposed to in the evenings i reviewed how you can use a light box in the morning if you don’t have access to sunlight i also reviewed how taking melatonin may not be the best strategy to help you deal with

Poor sleep in this next series of videos i’m going to review one of the other main causes of poor sleep what i call physiological activation i’m going to review what it is what you should avoid and what you can do about it i’m dr chris friesen from freezin performance where i help you achieve your greatest potential by optimizing your psychology physiology and

Neurology if you want to take your performance and productivity to the next level you’re going to need to improve your sleep besides clinical conditions like sleep apnea or restless leg syndrome there are three general causes of poor sleep the first one is circadian rhythm disruption i’ve already covered this in previous videos in this video and in upcoming videos

We’re going to cover physiological activation finally we’re going to have videos covering cognitive over activation each of these contributes to difficulties with sleeping so what is physiological activation this refers to when our brains and bodies are over activated especially at a time in the evenings when we wanted to calm down the sympathetic division of our

Autonomic nervous system the fight or flight system the stress system we need that to calm down in the evenings so we can go to sleep but we’ve evolved not to be able to sleep if we’re physiologically activated think of our tribal ancestors if there was a growl outside the camp like a saber-toothed tiger it would not be adaptive if we could easily fall asleep and

Not worry about this we’re designed for our physiology to become activated so we can deal with the threat of course we don’t have threats like saber-toothed tigers anymore but we have our own relative threats we want the stress hormone cortisol to peak in the mornings without this we wouldn’t be able to wake up cortisol helps release glucose from your liver and

Your muscles which are stored in the form of glycogen so it can be used as energy but what we want is in the evenings for cortisol to drop most people with insomnia have a peak in cortisol before bed or in the middle of the night in these series of videos i’m going to review what you should not do that are known to activate your physiology and prevent good sleep

In this video i’m going to review the most common substances people use to help reduce physiological activation these are sleep medications and alcohol in the next series of videos i’m going to review what you should be doing instead let’s talk about sleep medication people often use sleep medication in an attempt to try to counteract physiological activation

But many people tend to forget that the use of sleep medication is only a very short-term solution the sleep you obtain when you’re on sleep medications is not quality sleep it’s more like sedation there’s research showing an association between sleep medication use cancer and overall mortality there’s also research linking the use of sleep medication and dementia

Especially alzheimer’s disease later in life one class of medications that’s often used to help treat sleep difficulties are benzodiazepines these are things like diazepam clonazepam and lorazepam these are also prescribed to treat anxiety and seizures in one study when older individuals took benzodiazepines for more than three months these individuals had a 50

Percent more likelihood of developing alzheimer’s disease in the next six years there’s another class of medications often used to treat sleep difficulties these are called anticholinergics anticholinergics basically block acetylcholine acetylcholine is a neurotransmitter but it also works in the body as well acetylcholine is important for muscle contractions

Reducing heart rate and for attention and memory it’s also important for rem sleep or rapid eye movement sleep one thing we know is that alzheimer’s patients tend to have lower levels of acetylcholine in their brains this is why one of the main classes of medications used to treat alzheimer’s essentially tries to increase the amount of acetylcholine available in

Their brains i’m going to avoid naming particular brand names when it comes to anticholinergic medications but these are popular medications they’re medications that are often over the counter these include medications for allergies colds motion sickness incontinence hypertension and depression these include medications such as diphenhydramine which is used to

Help treat sleep difficulties but also allergies another medication called diamond hydranate that’s often used to treat motion sickness and nausea has been associated with the development of alzheimer’s disease later in life other anticholinergics include amitriptyline which is a tricyclic antidepressant but also muscle relaxants that you can get over the counter

Like methylcarbamol cyclobenzoprene is another muscle relaxant but i believe this one requires a prescription another popular sleep medication called zolpidem is technically not an anticholinergic but has been associated with dementia there’s research showing that the use of zolpidem reduces neuroplasticity and also reduces your brain’s ability to learn there’s

A well-known problem with the use of sleep medication this is a rebound effect i often see this with patients they’re convinced that they can’t sleep without sleep medication the evidence they use for this is that when they don’t use the medication for a night or two their sleep is really bad but the problem is they don’t realize they’re physiologically addicted

To the medication recall that our brain and body works on a 24-hour clock so if you take a depressant medication a sedative every evening your body will ramp itself up in preparation for that because it wants to stay in a steady state so once you remove the drug your body will be more physiologically activated than normal most of us have experienced a similar

Phenomenon with the use of caffeine in the mornings when we miss our morning dose we can feel unbelievably tired groggy and irritable this is not really our normal state this is a state of withdrawal because what happens is our body is preparing for the stimulant to come into our bloodstream so it does this by slowing itself down but if you don’t take the drug

Which is caffeine the body is pushing itself down and keeps going down because it’s waiting for the stimulant to come and push itself up remember it’s trying to stay in a state of homeostasis or a steady state this feeling when we’re off caffeine for a few days this is not our normal state this is withdrawal we don’t really know how we’re going to feel until

We’re off caffeine for about a month this is the same with sleep medication you need to be off medication for a number of weeks to know what your real sleep is like when you stop taking sleep medication you’re going to feel more physiologically activated than normal you may even feel anxious and this will prevent you from being able to sleep like i said your body is

Going to require weeks to reach its normal state again so sleep medication is not a long-term solution to your sleep difficulties when you take sleep medication even though you’re sedated you’re not getting good quality sleep you’re not getting good deep sleep that’s necessary for your body and your brain to rebuild and recover always talk to your doctor but it’s

Probably not a good idea to use sleep medication for more than a few days in a row and try not to use it for more than a few days in a month like sleep medication people often use alcohol to help counteract physiological activation in order to help them sleep alcohol is an interesting drug it acts like a stimulant at low doses but after a few drinks it becomes a

Strong sedative or what we call a central nervous system depressant difficulty walking blurred vision slurred speech slowed reaction times and impaired memory these can occur after only one or two drinks in a person who hasn’t developed tolerance of course heavy usage can lead to both liver damage and brain damage the majority of those who are addicted to alcohol

Go on to develop a vitamin b1 deficiency or thiamine deficiency this can lead to something called wernicke korsakov syndrome part of this is wernicke’s encephalopathy this is a medical emergency and is characterized by mental confusion like easily getting lost paralysis of the nerves that control the eyes and difficulties with muscle coordination most of these

Patients go on to develop something called korsakoff psychosis this is a chronic and debilitating disorder it’s characterized by severe learning and memory problems this includes both retrograde amnesia which means a hard time remembering information from the past and anterograde amnesia which has difficulty remembering new information these patients present very

Uniquely they tend to confabulate or make up information that they can’t remember of course what i’m describing here is extreme use of alcohol but most of us know that alcohol is not healthy for your brain don’t buy into the myth that drinking a few glasses of wine is good for you you’re better off eating a couple of grapes alcohol is a neurotoxin some people are

Under the false assumption that alcohol helps some sleep while it’s true alcohol is a sedative when you drink you tend to fall asleep faster but your sleep is fragmented so you’re waking up multiple times a night and often you’re not even aware that you woke up this is not good quality sleep it also blocks your brain’s ability to go into rapid eye movement sleep

Or rem sleep rem is extremely important for your psychological health i hope this video helped you see how sleep medication and alcohol are not long-term solutions to your sleep problems in the next video i’m going to go over how nicotine caffeine thc and cbd affect your sleep in upcoming videos i’m going to go over how other things can affect your physiological

Activation and interfere with your sleep after that i’m going to have a series of videos about what you should be doing instead to reduce your physiological activation if you like this video please hit the like button subscribe to get alerted when new videos come out share with friends or family or others you think might benefit from the content until next time keep moving forward you

Transcribed from video
Why Sleep Meds or Alcohol Are Not The Solution to Your Sleep Problems– Optimizing Sleep Part 8 By Friesen Performance with Dr. Chris Friesen