Aug 6, 2019

Interview Transcript

The following is a summary of this episode. For the full experience, we encourage you to subscribe and listen - it's more fun that way.

What is Insomnia?

Dr. Kelly Baron, is a clinical psychologist in behavioral sleep medicine from the University of Utah sleep center. According to Dr. Baron, while many people have trouble sleeping for one reason or another, insomnia is a very specific sleep disorder that is characterized by:

  • Difficulty falling asleep, staying asleep, or waking up too early
  • Difficulty sleeping occurs at least three times a week
  • Lack of sleep could cause negative effects in your daily life

If these symptoms last for longer than three months, it is considered chronic insomnia.

Acute, or short-term, insomnia may be triggered by stressful life events. Whether it be a major exam or a big presentation at work, you may understandably have difficulty falling asleep with stressors.

The problem is that insomnia can take on a life of its own. Those nights of lost sleep from a stressful event can become a "precipitating event." After a person loses sleep for a couple of nights, they can become stressed about getting sleep. They may try short term fixes like taking naps and drinking more coffee just to get through the day, but these fixes actually further harm a person's ability to sleep. It can quickly become a cycle that's hard to break.

"A person can't 'try to sleep'," says Dr. Baron, "You just have to let it happen."

CBTI is the Best Treatment for Insomnia

Cognitive Behavioral Therapy for Insomnia, or CBTI, is the top rated treatment for the American College of Physicians. As many as 80% of insomnia patients see an improvement in their sleep after CBTI therapy. It's been proven to be even more effective than sleep medication and is used as a first line treatment for most sleep disorders.

CBTI focuses on changing a patient's relationship with sleep. It focuses on getting a person on the sleep schedule their body needs, then training them to relax and fall asleep. This is achieved through:

  • Sleep restriction
  • Stimulus control
  • Cognitive intervention
  • Relaxation training

Don't Lie in Bed Trying to Sleep

CBTI begins with working towards sleeping on a schedule that actually works for a patient. A physician will look at when the person is actually sleeping and go from there.

It may seem backwards, but CBTI starts with reducing the amount of time a person spends in bed. It doesn't help to lay in bed for 10 hours or more, when they only get six hours of sleep. That's a lot of wasted time spent stressing about falling asleep and not getting any. It's more important to work on getting a sleep schedule where you go to bed and then fall asleep.

Try CBTI Yourself

Dr. Baron shares a few resources on CBTI that a patient can try at home before seeking professional help.

She highly recommends The Insomnia Workbook by Stephanie Silberman or Quiet Your Mind and Get to Sleep by Colleen Camey. Both are books that help walk you through CBTI and provides exercises to help you finally get to sleep.

For people interested in a more tech savvy approach, there are apps like CBTI Coach, Sleepio, and SHUTi that all turn the tenets of CBTI into fun coaching apps that help you track your progress.

It's important to know that a lot of the techniques in CBTI can be difficult when you first start doing them. The exercises can take a few weeks to see any results. They require commitment and a bit of discipline to be effective. Your sleep health is a lot like you physical health. You can't go to the gym twice and assume you'll be fit, it takes work, repetition, and forming good habits to reap the benefits of the therapy.

If You're Still having Trouble Sleeping, Seek Help

If self guided CBTI doesn't seem to be working for you, you may want to seek professional help. Meeting with a sleep doctor make sure they don't have any other serious sleep problems besides insomnia. They can also act as a coach assisting in further CBTI help.

It can take a few weeks to get into a sleep clinic. Dr. Baron suggests that while you wait you start logging your sleep, so that you can discuss the results with your doctor on your first visit.

Treatment at a sleep clinic usually takes 3-4 visits, and over 70% of patients see improvements in their sleep at the end of the series of treatments.

Sleep clinics are covered by most insurance providers.


ER or Not: Mountain Biking Went over the Handlebars

Say you're soaring down the trail on a mountain bike. You hit a rock going a bit too fast, and go up and over the handlebars. Should you go to the ER?

Troy says it depends on your injury.

Any road rash, scrapes, or minor cuts are not an emergency and can be treated by yourself or at an urgent care clinic.

Broken bones, twisted ankles, or injured joints can be serious, but can be scanned and treated at an urgent care. The clinic physician at these facilities can take an x-ray and determine if you need emergency care.

The most serious injury in a mountain bike accident is a concussion. If you hit your head and are experiencing confusion, vomiting or you lost consciousness, go the the ER immediately. Concussions can be potentially life threatening and need to be assessed by a doctor as soon as possible.


Facebook Changes Algorithm to Reduce Reach of Sensational Health Claims

Medical misinformation is spread mostly through social media. These stories often have no evidence and can promote remedies that can be downright harmful. These stories include stories about smoothies that can cure cancer, essential oils as alternatives to important medical intervention, and - in a more dire situation - a series of articles that claimed that drinking bleach could cure children of autism.

According to a recent pair of articles by INC.com and FastCompany, the sharing of these stories have become such a problem that Facebook has been retooling its algorithm to help reduce the spread of medical misinformation.

Troy admits that even physicians can have trouble making sense of scientific and medical claims, especially those shared online. Bad science can sometimes even be published by trusted news outlets. So how can you make sure the information you read online is real?

  1. Make sure the article references a study with a link that you can read yourself. Often a quick read of just the abstract of a study will show serious problems with the research the article is based on.
  2. Check to make sure the article is based on multiple studies from reputable journals. Single studies are often proven wrong by additional tests and more exhaustive studies. Additionally, there are scientific journals that will publish anything for money. Make sure the study isn't from one of those.
  3. If the article wants you to click on a link or buy something, it probably isn't real.
  4. Be skeptical. Always. The internet is full of more bad information than good. You should assume an article is fake until proven otherwise.
  5. Google the medical claim. If there's been a medical breakthrough, other places online will be publishing about it. Double check it isn't a one-off study.
  6. Doubt articles that make you emotional. If an article aims to make you fearful, frustrated, or upset, there's a good chance they're trying to sell you something. Good science isn't overly emotional.
  7. Read more than the headlines.

According to the article by Fast Company, 75% of the top 10 most shared health articles were false or based on bad information. In fact, some of these articles included advice that was potentially harmful.

One study about depression was shared in The Guardian. It claimed that depression was not due to a chemical imbalance, but by a lack of fulfillment in one's life. Researchers found that the claims made were not backed by and research. The article was actually based on an excerpt from a book by a lay person who was vehemently against psychiatry.

Be diligent and a critical online consumer. If you read something, don't act on it, don't share it until after you see if it's worthwhile.


Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot is still doing Tai Chi and learning the most challenging part of learning something new and Troy bought new socks as a treat for his feet.


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