October 29, 2020

How Daylight Savings Affects Our Sleep

Show Notes

On this episode, Chuck Gaidica is joined by Dr. Angela Seabright, care management physician for Blue Cross Blue Shield of Michigan. Together, they discuss how daylight savings affects our sleep.

In this episode of A Healthier Michigan Podcast, we explore:

  • How living in a 24/7 world has made a significant impact on our sleep.
  • Our internal clocks and how to realign them with the time change.
  • The impact of sleep aids on our sleep and if they’re worth using.
  • Habits we can build to get a restful night of sleep.
  • Ways to improve our sleep hygiene.

Transcript

Chuck Gaidica:
This is a Healthier Michigan Podcast, episode 66. Coming up we discuss how daylight savings time affects our sleep.

Chuck Gaidica:
Welcome to a Healthier Michigan Podcast. This is a podcast dedicated to helping us all improve our health and well-being through small, healthy habits we can start implementing right now. I’m your host, Chuck Gaidica, and every other week, we sit down with a certified health expert from Blue Cross Blue Shield of Michigan and we dive into topics that cover nutrition and fitness, and of course, today, sleep and a whole lot more. On this episode, we’re discussing the impact of daylight savings and how we can now look for better sleep, what we can do to reset our internal clocks. And so with us today is Care Management Physician for Blue Cross Blue Shield of Michigan, Dr. Angela Seabright. Good to have you with us, Doctor.

Dr. Angela Seabright:
Thank you for having me.

Chuck Gaidica:
Oh sure, it’s our pleasure. Dr. Seabright has her pre-med studies at University of Michigan Ann Arbor then went on to complete her medical degree at Lake Erie College of Osteopathic Medicine in Pennsylvania. And she’s also a primary care physician. So, sleep. We know we want to go to sleep and we know that we want to wake up rested, but it seems like as we head toward this time every year, at least in Michigan, where we’re now going to fall back, this becomes a topic that a lot of us talk about with our spouses, with family members, with friends, et cetera, this idea that we’ve got to somehow prepare our biological clocks for a change that’s coming. Why is sleep so important for us, for the reasons that may not be so obvious to guys like me?

Dr. Angela Seabright:
Well, sleep is essential and I have to kind of laugh. It’s a little ironic that I’m here talking about sleep because I have three young children. My youngest is seven months old so for me right now, sleep is a precious commodity. And I’m sure a lot of people can relate.

Chuck Gaidica:
Yeah, you don’t get it.

Dr. Angela Seabright:
I don’t. But sleep is very important. We know that while we’re resting, our body is actually conserving energy, restoring and repairing important functions and consolidating memory. We also know that lack of sleep is linked with inflammation, heart disease, increased risk of weight gain, obesity and type two diabetes.

Chuck Gaidica:
So we’ve heard this phrase, at least I have this idea of circadian rhythm, circadian biology, this thing, I guess, going back to when man was first here on earth, that we’ve evolved and adapted to a 24 hour solar clock. And now we’re living in a 24/7 world, a lot of us.

Dr. Angela Seabright:
Exactly.

Chuck Gaidica:
So how have things changed and how have those changes in our lifestyle, kids included. I mean, that happens for a lot of people. But what has changed that you see making a big impact on our sleep patterns, our healthful sleep patterns?

Dr. Angela Seabright:
While we kind of have this culture where we want to just keep going and going and going and burning the midnight oil. And there’s always so much work to do. And even now with people working from home and having their bedroom also doubling as their home office, there’s so many distractions and so many ways that we can interfere with our sleep, but it’s very important to make it a priority. And we know that with the time change, if you ever want an example of how a one hour time change, either forward or backward can wreak havoc, just ask parents of young children. I can attest to it. We dread daylight savings time. You worked so hard to establish this bedtime and this nap routine. And then everything is just thrown off. I still remember my first daylight savings with my oldest and he was a baby. And of course I didn’t plan ahead. I didn’t even realize it was that weekend. And I just remember sitting in my living room with my husband at 5:00 AM with this toddler who was ready to go for the day. And I thought, never again, I’m going to plan ahead. So it definitely affects us from the very young to the old.

Chuck Gaidica:
Well, we’ve got five kids and now we’ve got three grandchildren, which is a blessing. It’s such a great new season of life. But a couple of our granddaughters. I mean, when they are up, it’s like six or 7:00 AM. They’re up, they’re ready to go. It’s time for Muppet Babies. And it’s like, Whoa, I got to… So we now have our kindergarten age granddaughter spending Friday nights, a lot of Friday nights with us after she does virtual school kindergarten. And of course, if we wake up Saturday morning in the old days, that was the sleep in morning. And now it’s like, boom, we’ve got to get going. So you’re living it. And then there’s the other part of having young kids in the household, which is, they don’t always have a pattern anyway. They may just decide 3:00 AM is the time to get up, right?

Dr. Angela Seabright:
Right. And you have to be ready and you could be getting up every hour on the hour with that baby. And at 6:00 AM, they’re ready to go and you better be ready as well. It’s kind of that bright eyed and bushy tailed. And so a lot of us wake up kind of groggy, and that’s kind of your clue that maybe you’re not getting enough sleep. If you wake up feeling alert and refreshed, then you’ve probably hit your target for sleep quality and duration. And most adults should get at least seven hours of sleep per night. And we all seem to know that person who can survive on less, but in general, adults should be getting seven hours as a minimum.

Chuck Gaidica:
So I’ve heard that our bodies are filled with a little clocks, like a network of little clocks, everything from our organs down to the gene size. And if that’s true and we now come up against this end to daylight savings time, how do we reset our clocks, the overall body clock and then all of these little clocks that have to somehow fall into sync?

Dr. Angela Seabright:
You’re right. You’re resetting all the clocks in your house, but then also our internal clock has to get back in sync with our new environmental time. So unfortunately for the fall, we’re gaining an hour and I know we can all use an extra hour in our day. It sounds great. We make all these plans, we’re going to meal prep. We’re going to make the exercise that day. It never seems to happen that hour can be fleeting. But one thing you can do is make sure that you are getting enough light exposure during the day. That’s very important to set our clock. As the daytime progresses and then leads into the evening then you may want to start dimming the lights and preparing your body and signaling to your body that, Hey, it’s nighttime. We need to start getting ready for bed. That’s where the hormone melatonin, which is kind of our sleep hormone that signals the brain to sleep. That starts producing higher amounts in the evening hours.

Dr. Angela Seabright:
There’s little environmental cues that signal our body to sleep and light exposure is one of them. Exercise is another one. As we’re exercising, we’re increasing our body temperature and we know that lower body temperature helps us sleep. So people that exercise close to bed, that’s probably not a good idea. It may be throwing off your sleep because it’s altering that body temperature, not to mention it’s increasing adrenaline and other hormones that kind of keep us alert. And then our meal times also, how we eat during the day, your body uses that as a signal for when it’s time to sleep. You probably shouldn’t be eating huge meals before bed, that can also throw off that circadian rhythm or our sleep/wake cycle.

Chuck Gaidica:
And you talked about the environment. So here in Michigan, at least we also have the environment outside, where sometimes it seems like we go into the clouds in November and we don’t come back out until March. So when it’s darker outside, even during the day, does that tend to throw us off a little bit?

Dr. Angela Seabright:
Yes, it definitely can. And natural sunlight is always preferred, but some people who have sleep disorders or seasonal affective disorder, or SAD, which is related to not having enough sunlight, they are sometimes recommended to get a light box and have a certain amount of time of day next to this light, this artificial light that mimics the sunlight to kind of help with some of those processes.

Chuck Gaidica:
So I guess a good word for a lot of us is disruption. We’ve got this world that we’re living in and whether there’s an angst over the season we’ve come through, politics, who knows what it is. Any disruption can upset the applecart and lead us to an inopportune night of sleep. Are the things, you’ve mentioned melatonin, are the things that we’re now seeing in the world, smartwatches that track your sleep, melatonin, CBD oil. Are there any of these that really do work or is some of it just placebo? We think it works, we go to sleep better so I guess it works.

Dr. Angela Seabright:
Right. Sleep is a billion dollar industry and there’s so many companies that promote products that are guaranteed to fix your sleep problems and give you the best night’s sleep. But we know that sleep is so complicated and there’s unfortunately no quick fix or easy solution. So I’m very careful in what I recommend to patients, because a lot of these products aren’t necessarily studied or proven. There are different things you can use, different tools, but I think what’s more effective is to determine the root cause of your sleep problem and go from there as far as what you can do to create solutions.

Dr. Angela Seabright:
So if you want to add melatonin, okay, but why are you adding the melatonin? Is it because you’re a shift worker and your whole schedule is off? Is it because you can’t fall asleep? Are you taking it because you’re waking up several times in the night? There’s different reasons for why you should be taking these things. And so you really have to investigate the why and that’s going to help you solve the problem.

Chuck Gaidica:
So in the case of melatonin directly though, it’s an over the counter thing. Can it hurt you? In other words, if you know the why, you just can’t sleep. I mean, that’s about as much as you want to get into it and you take an over-the-counter melatonin and it seems to help you, is that just there, you have your answer, bada bing bada boom, and it’s all done. Can you get hurt by taking melatonin over the counter?

Dr. Angela Seabright:
Well, melatonin’s very popular and it’s important to remember that it’s a supplement. It’s not a medication. So because of that terminology, it’s not FDA regulated. And so buyer beware, you may not know exactly what you’re getting. For the most part, yes, it’s been kind of popular and it can be safe, but because it’s not FDA regulated, there may be some inaccuracies in the dosage or some other impurities in it. And so we do recommend that you exercise caution if you use that and you should probably always ask your doctor ahead of time, if it’s right for you. And with any of these sleep aids and even melatonin, it’s best to be used in the short term. And melatonin works best for people who have those circadian rhythm disorders. So those night owls or people who just really have difficulty falling asleep due to jet lag or other issues. But as far as a long-term solution, I would not recommend that.

Chuck Gaidica:
Yeah. And you know, it’s funny, I was in our local pharmacy the other day and just walking in there to pick up some other stuff. And it’s amazing. They’ve redone the pharmacy, the layout, and the whole thing. I saw it ongoing over the past month. And now you walk past the vitamin area. The end shelves are very bright, kind of white layout, like an Apple store and I was amazed at how many products were related to sleep with melatonin included. It was obviously thought out and they know what they’re going after. I saw the headline, $432 billion market, the sleep market. So you’re right. It’s crazy off the charts.

Dr. Angela Seabright:
Right. And like we said, there’s other things that you can do. You can use these products as tools, but you really should be working on healthy habits and lifestyle changes to correct the underlying issue.

Chuck Gaidica:
So what are some of those, if we want to attack this in a healthful way. Give us some takeaways, things we can do now.

Dr. Angela Seabright:
So some of it, a lot of people know some of these healthy habits, they may think it’s somewhat common sense. In the medical field, we refer to it as sleep hygiene. So some of these things are sleeping in a cool, dark environment that doesn’t have a bunch of loud noises or distractions. You could sleep with a good pillow and mattress that doesn’t cause our back to ache. Those are things that’s probably going to promote good sleep, but other healthy habits that you may not be aware of, keeping the same sleep schedule, which is really hard to do. You mentioned earlier how Saturday morning, you want to sleep in, but actually that’s not a great idea because that really can throw your body off. So the more consistent of a schedule you have as far as your bedtime and your wake up time, that’s going to promote the best sleep.

Dr. Angela Seabright:
Also, we mentioned exercise. So that actually improves your sleep quality and helps you fall asleep. Avoiding caffeine, especially in the afternoon. You may not realize that that cup of coffee that you have at noon is actually still in your system when you go to bed at 10 o’clock at night, and that can definitely affect your ability to fall asleep. Minimizing alcohol, that’s another big one. People think that a glass of wine or a nightcap can help them unwind or make it easier to fall asleep. And while that’s true, you may fall asleep quicker, it actually can disrupt your normal sleep cycle and so the quality of sleep is not great, not to mention the possible hangover the next day, which is nobody wants to feel groggy. That’s the whole reason why we’re trying to get good sleep.

Dr. Angela Seabright:
And then bright lights, avoiding bright lights. That’s the other thing is that blue light. So a lot of us are staring at our computer screens or our cell phones and we really recommend limiting bright lights from electronics about an hour before bed, which I don’t know how many people could admit to doing that. It’s really hard to do.

Chuck Gaidica:
And you know, you’re saying some things that I think for a lot of people, their average day may not include a cup of coffee short of the morning if that’s their wake up call, but it may include the diet Coke or otherwise at lunchtime, which has caffeine. It may include that one glass of red wine that we’ve heard is healthful. Not that you’re going to get schnockered, but that, well, I’m just going to have a glass of wine every once in a while. You’re not going to have it at noon. For most of us that probably will occur after dinner time. So when you have that normal kind of rhythm, how do you judge, you just try to listen to your body better. If you’re not getting sleep, you can start to subtract some of these things at certain times just to see if that has an impact?

Dr. Angela Seabright:
Right. Yeah. And these are recommendations. So maybe just work on one or two at a time and see if it helps. Ideally, if you could use all of these recommendations, that would be the best, but I know it’s very difficult. So you kind of have to individualize it to your lifestyle and maybe pick out what could be the culprit.

Chuck Gaidica:
And lot of this does seem to be individual, like weighted blankets are one of these things that I’m sure that pops up in this multi-billion dollar market for sleep aids. And yet, for me, I want like the least amount of blankets. I do like it cool. And so whether it’s some kind of new mattress topper, we had one of these for a small RV for a while when we were into the camping thing, and I noticed that it actually held my heat. It actually made me feel warmer than I’d like to, and trust me, the camper was not like the warmest place in the world to be. So sometimes we get these things thinking they’re going to help. And I think, sadly we realize after we’ve purchased them, maybe they weren’t the best buy to begin with.

Dr. Angela Seabright:
Right. And you definitely don’t want to be sweating while you’re sleeping. ideal sleep temperature is at 65 to 67 degrees. And weighted blankets, the thought with that isn’t so much, as far as the warmth, it’s more of that gentle pressure that they provide kind of like swaddling a baby. They say maybe it could alleviate anxiety and promote sleep. Unfortunately, there really isn’t sufficient evidence to recommend them. However, like you said, if you’re someone who tends to be more anxious or you like having that kind of closeness, then you can certainly try that. Again, just another tool in the toolbox,

Chuck Gaidica:
Any other natural remedies that you’ve seen that may not be FDA approved, anything that really jumps off the charts to you, even as a reflection from various patients, aroma therapy, anything else that seems to have an effect?

Dr. Angela Seabright:
Well, I mean, aroma therapy probably doesn’t hurt anything. Again, just like the weighted blankets, we don’t really have studies to prove that it works, but we do know that lavender and chamomile may have calming effects. So whether that comes in like an oil or an aroma therapy or teas, I’ve seen people drink teas before bedtime that maybe have some of these herbal remedies. So those are fine to try. We just don’t know for sure. And then, the thing is, is you have to use these in conjunction with those healthy habits because you could be someone who’s drinking an afternoon espresso and staring at the blue light on your cell phone, into the wee hours of the night, and smelling lavender oil probably isn’t going to fix your problem at that point.

Chuck Gaidica:
Yeah. And you know, the world has shifted for so many people working from home, that the idea of how shall I put it ritual, the usual, the waking up at a certain hour, even if you had to drive to work, back in the old days, meaning early this year, now all of a sudden your rhythms of life have changed as well. And you don’t really have those rituals of time to start, time to end time to go home, time for dinner. So for a lot of us, just that life rhythm has shifted so much. That’s got to have an impact for a lot of people.

Dr. Angela Seabright:
You’re right. The lines are definitely blurred. And I know people that, if they have their work computer in their bedroom, you’re trying to get to bed and wind down for the night and that computer’s just staring at you in the corner. And you think, well, maybe I’ll just get a head start or I’ll just check a work email. And the next thing you know, an hour has gone by and your whole relaxation has been sabotaged by work.

Chuck Gaidica:
Yeah. Well, and to be fair, you can also drift into the news of the day or here comes a bulletin on your phone or the weather’s changing. So you’re in the midst of just trying to do something that should only take 10 minutes. And like you’re saying, it could turn into an hour and you’ve been staring at that laptop screen.

Dr. Angela Seabright:
Right. And not only is the blue light affecting you, but also just the stress of your body and the overthinking and the cognitive. We’re trying to shut things down for the night and you’re increasing your alertness and riling yourself up, so to speak.

Chuck Gaidica:
So we’ve tried to talk about some of the natural things. As a physician, you must have people that you see who come to you and say, I’ve tried everything, doc. I mean, I’ve tried changing this and changing that. And when it’s time to really deal with this as a physician, with the help of medication, what do you say to those patients and how do you determine what could be helpful for them? And really, what are we seeing in trends that you’re seeing from your side of the lens as a doctor?

Dr. Angela Seabright:
Right. Well, one of the most commonly used medications are the over the counter sleep aids. So as far as sleep aids, there can definitely be a role for them as far as short-term treatment for people who have maybe not had success with more holistic options or lifestyle changes like we talked about, but you should always talk to your doctor before you use any type of sleep aid, even if it’s available over the counter. One of the most common ones that patients use are anti-histamines like diphenhydramine or more commonly known as Benadryl. And so these are found in formulations over the counter, and sometimes they’re found in combination with a pain reliever like Tylenol. So you’ll see Tylenol PM or Advil PM. And so a lot of patients will go to that because they trust those brands, but I would caution people. Don’t take a pain relieving sleep aid just to sleep if you don’t have any pain, because basically you’re taking an additional unnecessary medication that could have effects on your liver or your kidneys.

Dr. Angela Seabright:
And if you’re going to take just the plain anti-histamine, there are some risks with that. There are some unpleasant side effects from anti-histamines like dry mouth and constipation. It also can cause daytime sleepiness and for older people that daytime sleepiness can increase the risk of falls as well as confusion. So we really don’t recommend anti-histamines, especially in the long-term. And you can develop a tolerance, even though it’s over the counter. A lot of people think of developing a tolerance with only prescription medications. Tolerance means that you need higher dosages to achieve the same effects. You can still develop that with anti-histamines. So there are some risks and in general, we don’t recommend, and you’ll be surprised, the science doesn’t even show that they’re that effective.

Chuck Gaidica:
That’s interesting. And it’s also interesting how it’s been coupled with the aspirin or the acetaminophen or whatever it is for the something, something PM. Because to your point, if you don’t have arthritis or the bad knee or something that’s giving you pain, giving you trouble to sleep at night, just taking that something PM may not be good for you, may not be good for your stomach and now you’ve got a whole new reason you’re staying up at night because of an irritated stomach.

Dr. Angela Seabright:
Right. Yeah. It’s an unnecessary use of a medication and there’s always side effects with that.

Chuck Gaidica:
So as you look toward the future, which is kind of now, because this hundreds of billions of dollars of sleep market looks like it’s just going to keep increasing. What do you see as the near and long term future for best practices and best advice when it comes to sleep, a good night sleep?

Dr. Angela Seabright:
Yeah, well, obviously the sleep habits are going to be huge and practicing those sleep hygiene techniques. And then also before medication, we really recommend therapy, something called cognitive behavioral therapy, which is one of the first-line treatments for insomnia. And that’s basically a series of sessions with the therapist that kind of focus on not only teaching some of those sleep hygiene techniques, but also behavioral training and rewiring of the brain to recognize the bed as a stimulus for sleep and maximizing your sleep efficiency. So that’s really something that as a physician, we try to use that first and foremost before medications, as well as counseling and education to people on those healthy habits.

Chuck Gaidica:
Well, and it seems like that can be such a challenge. I remember I just watched, I don’t know, maybe a month ago, this documentary on Robin Williams’ life and in there, his wife was speaking about the fact that toward the end of his, just before he took his own life, that he started sleeping in a different room. And I’ve read a line before a sleep divorce where spouses literally separate because one of them can’t sleep well or snores. And one of them sleeps fine, but they’re like, well, we just have to break apart for a good night’s sleep. And it seems like that’s such a sad therapy to have to get to when you have some of these other options to just say, I’m going to take hold of this and whether it’s cognitive therapy or something else that you could direct us toward. There are so many other options that we can look to. And I think that’s a hope when I hear what you’re saying today. It’s filled with a lot of hope. There are a lot of things we can naturally attack to really help us get a good night’s sleep.

Dr. Angela Seabright:
I would think the best thing is just trying to figure out the root cause and work with your doctor, your clinician, and practice these changes and just know that it takes time. It’s not going to happen overnight, so to speak. It’s going to take several days, several weeks, maybe months to kind of retrain yourself how to sleep.

Chuck Gaidica:
Yeah. Well do me a favor. We’ve gone through a lot of great material, a lot of great input from you, but if I wake up first thing in the morning, take me through a day. Give me maybe the top five things I can do that you think will have the greatest impact on my sleep starting with when I wake up in the morning. What should I do?

Dr. Angela Seabright:
When you wake up, well, hopefully you’re waking up at the same time every day. That’s very important. So try to make sure that you have that routine and then sunlight, getting adequate light, go outside, get some fresh air, get the sun if it’s out. I know in Michigan, we don’t always see it, but if the sun is out, go outside, enjoy the sunlight. If it’s not sunny outside, turn up the lights in your house, make it kind of a bright environment that signals to yourself, hey, it’s daytime, I’m awake. It’s a new day. And then exercise. Make sure that you’re getting your heart rate up, that you’re having cardiovascular exercise. You’re breathing. That body temperature goes up. That kind of gives you an increased alertness throughout the day. And then making sure that you’re eating healthy, you’re fueling your body throughout the day. You’re not just eating processed foods or carbohydrates.

Dr. Angela Seabright:
We want natural foods, foods that provide fuel to give you the energy throughout the day. And then also that makes it easier for you to wind down at night. And in the evening, kind of shut out some of the distractions. So back to those electronics, all the distractions from our cell phones or computers. Try to unwind, give your body a chance to settle, not only your body, but your mind. You don’t want to be maybe watching the news too late at night and get yourself worked up. And just kind of keep to a routine, I think that’s the best thing we could do for our bodies. And that’s going to promote the best sleep at night.

Chuck Gaidica:
Lots of great advice. I thank you so much for sharing your wisdom with us, Dr. Seabright, who is a Medical Director Care Management with Blue Cross Blue Shield of Michigan. It’s so great to have you on the podcast today.

Dr. Angela Seabright:
Thank you.

Chuck Gaidica:
Be well. We’re glad you joined us as well. Thanks for listening to A Healthier Michigan Podcast. It’s brought to you by Blue Cross Blue Shield of Michigan. If you like the show, you want to know more. You can go online, you can check it out at ahealthiermichigan.org/podcast. You can get all of our previous episodes as well. This is episode 66 so you’ve got a treasure trove of stuff from people who have forgotten more about the topic than I know. So it’s just a pleasure to be able to learn from so many bright people like Dr. Angela Seabright. And if you will want to leave us a review or a rating on Apple podcast or Stitcher, feel free. You can get new episodes on your smartphone or tablet and be sure to subscribe to us on Apple podcasts, Spotify, or your favorite podcast app. I’m Chuck Gaidica, have a good night’s sleep.