Insomnia and Sleep Issues with Dr. Michael Breus [Episode #413]
Insomnia and Sleep Issues with Dr. Michael Breus
413Welcome to the Feel Good Podcast with Kimberly Snyder. Our goal is to help you be your most healthy, confident, beautiful and joyful! Our topics focus on health and wellness (physical, emotional/mental and spiritual), holistic nutrition, medicinal plants, natural rhythms and cycles, beauty, meditation, self care and rituals, spirituality and personal empowerment.
Feeling Good means we are healthy, balanced, peaceful, confident and joyful, right in the midst of our perfectly imperfect lives. Feeling Good requires us to tune in and nourish our whole selves, which is made up of the four Solluna Cornerstones: our food, our bodies, our emotional well-being and our spiritual growth. Feeling good naturally leads to also looking good, in a much more powerful way from glowing skin created from within, a beautifully healthy body, radiant energy, and a greater level of overall well-being and personal growth.
Every week, we provide you with interviews with top experts in their field to support you in living your most beautiful, inspired and joyful life, with a focus on physical health, wellness, meditation and spirituality and personal empowerment.
Iâm your host, Kimberly Snyder, founder of Solluna, New York Times best-selling author and nutritionist. Iâm so grateful and honored we found each other!
I am so excited to have my very special guest, Michael J. Breus, who is an award-winning medical writer, a clinical psychologist and both a diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine. Listen in as Michael shares the many issues that cause sleep deprivation, knowing your chronotype, and tips on how to get a good nightâs rest!
- Michael shares his expertise on what causes sleep deprivationâŚ
- What is the so-called sludge that is said to detoxify from your brain at nightâŚ
- Pharmaceutical drugs and the alternative to not sleeping, and how it detrimentally affects your healthâŚ
- What is blue light and how to reduce its effectsâŚ
- We discuss what is recommended for patients who have sleep issues due to anxiety and depressionâŚ
- What are chronotypes and its historyâŚ
- Why women need different sleep at different times in their menstrual cyclesâŚ

About Michael J. Breus
Dr. Breus has supplied his expertise with both consulting and as a sleep educator (spokesperson). For over 14 years Dr. Breus served as the Sleep Expert for WebMD. He also writes The Insomnia Blog and can be found regularly on, The Huffington Post, Psychology Today, and Sharecare.
Dr. Breus has given hundreds of presentations to professionals and the general public. He has published original research and worked on grant funded projects and clinical trials. He lectures all over the world for organizations, hospitals and medical centers, financial organizations, product companies and many more. Dr. Breus has been in private practice for 19 years and recently relocated his practice to Los Angeles.
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Michael J. Breusâs Interview
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Transcript:
Note: The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate. This is due to inaudible passages or transcription errors. It is posted as an aid, but should not be treated as an authoritative record.
Kimberly Snyder: Okay, hey beauties. Welcome back to our Monday interview podcast and I am super excited for our guest today, who happens to be a personal friend of mine. Heâs amazing, his name is Dr. Michael Breus PhD. Heâs an award winning medical writer, a clinical psychologist, and both a diplomat of the American Board of Sleep Medicine and a fellow of the American Academy of Sleep Medicine. He is popularly known as the sleep doctor though, and heâs been on the Dr. Oz Show dozens of times. We actually met checking into the Dr. Oz Show. They put you in the same hotel, so we met in line a couple years ago and then we periodically run into each other. Heâs fantastic, he has so much information on sleep. I cannot wait for you to hear about everything he has to say.
Fan Of The Week
Kimberly Snyder: All right beauties, before we get into our interview today with Dr. Bruce, I want to give a quick shout-out to our fan of the week and her name, or his name, hard to tell sometimes, is Mike Hills 1207, and he or she writes, âThe title of your podcast is perfect. Since the first show I listened to that my sister shared with me, I keep going back to listen to previous podcasts and/or eagerly awaiting new ones to be posted. Iâve shared this with friends because I want to pass on the love and support you provide. Thank you for being my inspiration during my morning runs as that is when I dial in and it makes me happy for many, many miles.â
Kimberly Snyder: Oh Mike Hills 1207, thank you so much for being our Fan of the Week. Thank you so much for your beautiful review. I am so grateful for you being in our community. I send you a virtual hug wherever you are listening to this right now. Thank you, thank you, thank you.
Share The Podcast & Write A Review on Itunes
Kimberly Snyder: And beauties, for your chance to also be shouted out as the fan of the week, please also just take a minute or so out of your day to leave us a review on iTunes. Super easy. I know sometimes itâs like we put off stuff, I know I do too sometimes, but maybe today is the day where you just take a moment, pop over there, leave a review, and from the bottom of my heart, thank you so much in advance because it really helps the show grow and helps people organically find the show, which is what we want for people to benefit from this information, it can really change peopleâs lives.
Kimberly Snyder: So thank you so much in advance and also a little reminder to please subscribe to the show, if you havenât yet already. Itâs a really great self-care thing to do for yourself, so you stay tuned in to motivation and inspiration and you donât miss a Monday interview podcast or a Thursday Q&A podcast. All right, all that being said, letâs get right into our interview here with Dr. Michael Bruce.
Interview with Michael Breus
Kimberly Snyder: So Dr. Breus, thank you so much for being here with us today. It is exciting to have you.
Michael Breus: Oh, thanks for having me. Iâm super excited to be here.
Michael shares his expertise on why there are so many issues with sleep today
Kimberly Snyder: Dr. Breus, I think I read somewhere recently that something like 50 million Americans have sleep disorders, which range from insomnia to sleep apnea, all these different iterations. Why are there so many issues with sleep today? Do you think it has to do with electronics and blue light and people being stressed, or is there some sort of physiological reason? What is going on right now? Why arenât people sleeping well?
Michael Breus: So first of all, Iâm glad you noticed, thereâs so many people that havenât figured this out yet. There was actually data that came out within the last probably month or so just looking at something called sleep apnea, which is where people stop breathing in their sleep. Itâs now estimated that over 980 million people have undiagnosed sleep apnea around the world. Thatâs almost a billion people, not in the United States, mind you, but around the world, right? So itâs almost a billion people out there with a sleep disorder. I mean thatâs crazy when you think about just the number of folks that have that.
Michael Breus: So to answer your question, why? Why do so many people have sleep disorders? Whatâs been going on? I think thereâs different reasons based on the sleep disorder, so as an example, with sleep apnea, I would argue, not in all cases, but in many cases being overweight is definitely a risk factor and as we know here in the United States, there are a lot of folks who are overweight and also quite a few people that are obese. I mean you donât have to be big in order to have sleep apnea, but most people that have sleep apnea unfortunately are big and so thatâs certainly one of the reasons why weâre starting to see this. Of course, anatomy has a big effect on sleep apnea as well.
Michael Breus: If youâve got big tonsils, big adenoids, those kinds of things. If you move on over to something like insomnia, the reasoning is very different. While, it doesnât matter if youâre big or youâre small, you can certainly have insomnia. But that a lot of times has to do with stress. One of the things I can tell you, Kim, is since 9/11 Iâve had a backlog of people wanting to see me for insomnia, since 9/11. So itâs really, 75% of insomnia is either stress or depression and insomnia, it affects almost a third, a third of the population.
Michael Breus: I mean if thereâs 400 million people in the United States⌠30 million people at any given time are not sleeping too well. So itâs just, itâs rampant and I think the biggest reason is people donât put it as a priority. I mean, youâve noticed it, you and I have had many conversations about how important sleep is and youâve said how you want to educate your group, your tribe of people to learn more and understand, I mean, sleep is healing. Why would anybody do anything to affect their bodyâs ability to heal? It just doesnât make sense to me.
Kimberly Snyder: Well, I think like you said, historically, some people donât really value sleep. They kind of siphon it off at either end. Theyâre like, âOh, well Iâm going to focus on eating. Iâm going to focus on getting to the gym and exercising.â And maybe not really understanding sleepâs effect on balancing our hormones and autophagy and detoxification that goes on in our brain. One thing Iâve heard a little bit about too, speaking of detoxification, Dr. Breus, sorry, I didnât mean to call you Dr, Breus, I know you said I could call you Michael, but-
Michael Breus: Call me Michael.
The so-called sludge that is said to detoxify from your brain at night
Kimberly Snyder: Whatâs up with this so-called sludge that is said to detoxify from your brain at night. Can you talk to us a little bit about that?
Michael Breus: Absolutely, so one of the things that we know is that during stage three and four sleep, one of the things that we know is that itâs kind of like a waste removal and we get out all of the bad proteins that are building up in our brain. Amyloid proteins, something called tau. These are things that have been linked to things like Alzheimerâs, dementia, cognitive decline.
Michael Breus: So one of the big things that weâre always talking about with people is, âHey, think about something like this because stage three, four sleep actually helps keep your brain healthy, helps keep that out there for you.â And people donât really think about it that way because longterm effects could be disastrous. And thatâs really where autophagy hits hard, right? Thatâs when we start to see people really understanding more about something like autophagy, which is that cleansing out of the system. But sleep has a dramatic effect on it.
Pharmaceutical drugs and the alternative to not sleeping and how it detrimentally affects your health
Kimberly Snyder: So letâs say we start to understand how important sleep is and then some, and after this I want to get to some natural solutions, but if itâs between not sleeping and not having proper autophagy and potentially really disrupting your hormones and taking pharmaceutical drugs, I mean this is a hard decision that a lot of people have or family members. I mean, we know Dr. Breus that, sorry, Michael, thereâs millions and millions of people are in pharmaceuticals. I mean, what? What is your take on that, if the alternative is just not sleeping and really detrimentally affecting your health?
Michael Breus: Right, so to be fair, there are definitely people who require pharmaceutical intervention for sleep. Itâs unfortunate, but itâs true. Now these people might be in very specific medical situations. These people might be in very specific mental health situations, things of that nature. So thereâs a lot of different people out there that can definitely have some pretty significant-
Kimberly Snyder: Well what percentage would you say that is, of people that are medicated? Is that like a high percentage, a fraction-
Michael Breus: Well thatâs a great question, Kim. I mean, hereâs what I would tell you, is in my practice, almost every patient that shows up shows up on drug and theyâve been on drug for extended periods of time. So a lot of times the first thing people are saying to me is, âWell, my Ambien, my Restoril, my Sonata isnât working any more.â And so the first thing I say to them is, âWell, why do you keep taking it if itâs not working?â You know what they say to me?
Kimberly Snyder: What do they say?
Michael Breus: They say, âCan you imagine how bad my sleep would be if I didnât take it?â So what weâve got is weâve got this fear, right? So once somebody gets on a sleeping pill, then theyâre afraid to come off of it, which keeps them on the sleeping pill. So not only are some of these things highly physiologically addictive, but thereâs a mental addiction that goes along with these as well, and a fear and thatâs the thing that we really have to break. And so I would argue that probably anywhere from less than 15% of the people that are on sleeping pills probably need to stay on sleeping pills.
Michael Breus: Now, to be fair, I donât want anybody listening to just pull themselves off of their sleeping pills, okay? That is a dangerous thing to do. You have to do a drug taper, you have to do it with a physician, preferably your prescribing physician, things like that. So please, please, please donât just cold turkey stop taking your sleep meds. Number one, youâll end up being awake for three or four days. Number two, it could be quite harmful, but I would argue that most people donât need a drug to help them sleep.
Michael Breus: Now there are people where supplementation can be helpful. There are people who just have, by the way, an underlying medical disorder that looks like a sleep disorder. An example of that would be hyperthyroidism. When peopleâs thyroid is overactive, it actually looks like insomnia. So again, going to a sleep specialist and learning more about what could this be? Turns out to be very, very important. But no, to be fair, not everybody needs to be on a pharmaceutical. I would argue that most people do not.
Whether a baseline test of all organs is important to do and what those tests consist of
Kimberly Snyder: So when you see patients at your clinic is one of the first things you do, sort of a baseline test of all organs. Like you mentioned thyroid. Do you think thatâs important to do initially?
Michael Breus: I do, so what I do is a little bit different than what many other sleep specialists do because I work with physicians and so theyâll order the blood work and we do a full screen. So we look at everything from thyroid to iron. We look at vitamin deficiencies, we look at mineral deficiencies, things like vitamin D, magnesium, things like that. So the first thing we want to figure out is could there be something deficient or could there be something wrong with the system thatâs causing this sleep problem, physiologically? Then the next thing we look at is, could this be mental health? Remember if itâs insomnia, 75% of the time itâs either anxiety or depression.
Michael Breus: So thatâs the second area that we start to look at. And then we also look at environment, right? So could it be, you mentioned earlier in our conversation about blue light is blue light causing problems? It is causing problems. Itâs not the biggest offender, but itâs definitely causing problems. If I had to pick the biggest offender of sleep, I could easily say that, that was caffeine, right? Itâs arguably the most abused substance in the world. It by far affects peopleâs sleep and I guarantee you, Kim, there are people in your audience who are saying, âHa, sleep doctor. He doesnât know what heâs talking about.â Theyâre saying, âI can drink a cup of coffee and go right to bed, no problem.â
Michael Breus: So hereâs the truth. We now know that people do have different caffeine sensitivities. However, caffeine is a stimulant, whether you like it or not and it doesnât get metabolized as quickly as most people think. On average, the metabolization of caffeine occurs between six and eight hours. So if you stop drinking coffee at letâs say 3:00, 2:00 to 3:00 in the afternoon, six to eight hours later, only half is out of your system. So what we really want to see people doing is stopping caffeine by about, like I said, 2:00 PM so at least half of it can be out of their system, so they have a greater opportunity to sleep. Now people-
Whether chocolate is a stimulant and how much is too much
Kimberly Snyder: What about chocolate, Dr. Breus? What about chocolate as a stimulant?
Michael Breus: Thereâs nothing wrong with chocolate. My wife told me long ago if I started getting on media and telling people that they canât have chocolate, we would be divorced before the end of the day, thatâs number one. Number two, thereâs not enough caffeine in chocolate to really make that big of a difference. Now to be fair, if you eat a three pound Hershey bar before bed, itâs going to have an effect.
Kimberly Snyder: I am one of those people, Michael, that eats chocolate, even a little square or a few, I pretty much eat chocolate almost every night after dinner. It calms my sweet tooth, I donât know, it just makes me feel settled, so Iâm very happy to hear that. So 2:00, 3:00 okay, thatâs interesting because a lot of people, we meet for lunch or not even lunch meetings, coffee meeting, tea meetings and so, âOh, Iâll just have a green tea.â And all that caffeine, thereâs still caffeine in green tea, if youâre not having coffee. That is still going to have a hyper effect on your sleep then.
Michael Breus: thereâs no question about it. I mean, I would argue that caffeine is easily our biggest offender, if you will, when it comes to sleep and people donât even think about it because itâs so ubiquitous, itâs everywhere. Almost anywhere you go, I mean, I went to get my haircut the other day. They were like, âHey, do you want a cup of coffee?â I was like, âUh, what time is it? Like whatâs going on here?â So I think that, thatâs a big thing that a lot of people donât really think about. Environmentally, we also look at things like blue light, right?
Kimberly Snyder: Yes, yes.
What is blue light and how to reduce its effects
Michael Breus: And so when we look at blue light, hereâs how blue light works. So first of all, itâs not blue. Itâs actually, itâs called cyan, C-Y-A-N and that is considered blue. That is a particular wavelength of light and so when we look at wavelength, itâs between 450 and 480 nanometers. And what that does is, when that light, which by the way, blue light is in every LED, every regular white light that we see, when it hits a particular cell in our eye, called our melanopsin cells, which we have a couple of million of in each eyeball.
Michael Breus: It actually sends a signal to our brain to turn off the melatonin faucet, right. Thatâs bad for sleep. This is the reason why we donât like blue light at night, but we do like it in the mornings. So getting as much sunlight in the morning as you possibly can will help clear the brain fog, but you donât want light at night. Thatâs why I personally use things like blue light blocking glasses. We have specialty light bulbs that you can buy for like less than 20 bucks. They can sit in your bedside table lamp, things like that.
Kimberly Snyder: Wow, thatâs interesting because I actually did think blue light was more blue, which is why when you put your phone in night mode it kind of looks more red, so itâs-
Michael Breus: So thatâs an interesting point, Kim, in that if you put your phone in night mode, it does no good. It doesnât help you one-
Kimberly Snyder: What? Why?
Michael Breus: Because all itâs doing is, itâs not changing the actual wavelength of light, itâs just changing the brightness.
Kimberly Snyder: It doesnât do anything for your brain. It does nothing?
Michael Breus: Nothing.
Kimberly Snyder: Wow, so you do have to get the blue light blocking glasses.
Michael Breus: Yeah, especially if youâre going to look on your phone and to be fair, look, I donât have a problem with people watching television to fall asleep. I even do it. But what I donât like is if youâre on your phone right before bed, youâre emotionally tied to whatever it is youâre looking at. Whether itâs Facebook or email or trying to get to a high score on candy crush or whatever, right? All of that is not sleep inducing. So what we want is calmness before bed. We want people to chill out. We want people to be mellow, we want people to read, we want people to meditate, we want people to pray, we want people to do all the relaxing things they can do to help themselves fall asleep.
What is recommended for patients who have sleep issues due to anxiety and depression
Kimberly Snyder: And you mentioned, Michael, thereâs the caffeine, thereâs the blue light and you said a lot of the insomnia is related to anxiety and depression, which again, unfortunately is a huge category besides straight sleep pharmaceuticals where people are also medicating. So what do you say to your patients that have these⌠you mentioned meditation and chilling out, but I mean as a doctor, what do you say to them when they come to you and you check out their organs, you check out their lifestyle, cut the caffeine and you know itâs an