Tag Archives: sleep

Your Device Is Killing Your Sleep – The Blue Light Backlash

Using digital tablet

Oxygen, water, food, sleep. These are the four requirements for life. Without them (in varying lengths of time) people die. Sleep is an important factor as it heavily influences our performance at work, our risk for chronic disease, and our overall quality of life. Sleep researchers, however, aren’t clear on the exact reason why humans even need to sleep. From an evolutionary perspective sleep would certainly have left primitive humans vulnerable to attack so it must offer some great advantage. Generally speaking, sleep is thought to allow our brains and our bodies to heal and repair from the damage of the day; synaptic plasticity is managed, brain pathways that are not being used are pruned, muscles are repaired, and energy stores are replenished.

America is Tired

Short sleep duration (defined as less than 7 hours of sleep per night) is common. In the United States 24% – 48% of people report it. If you are obese, a smoker, consume excessive alcohol, or are physically inactive you are more likely to report short sleep duration.1 Sleep is an active process. In other words, you don’t fall asleep simply because your brain is tired. Sleep is actively maintained throughout the night. Disruption of this careful balance between arousal and sleep results in, what else, disrupted sleep.

Circadian Rhythm is Important

Humans display a 24-hour circadian rhythm. This rhythm is endogenous meaning it is maintained even in the absence of environmental cues. Human beings placed environments with no light, no time cues, no social cues, etc., will still display a 24-hour rhythm. However, external timing cues do modulate and adapt the rhythm to the environment. For example, sunlight, in humans, is a powerful cue to have the waking phase of our 24-hour cycle during the day. Other mammals, like rats and mice, have most of their waking phase at night. These rhythms were created through many years of evolutionary pressure. Light cues, which modulate our circadian rhythm, are extremely powerful. Circadian rhythm is endogenous so an internal pacemaker is necessary. The suprachiasmatic nucleus in the hypothalamus is a major part of the internal pacemaker of humans. This part of the brain is connected to the retina via the retinohypothalamic tract.2 This direct and powerful connection shows just how important light is for controlling circadian rhythm.

Stages of Sleep

Sleep is divided into two forms – non-REM and REM. Non-REM sleep is further subdivided into 4 stages, each with its own properties. During non-REM sleep neuronal activity is low, metabolic rate and brain temperature are at their lowest, heart rate decreases, blood pressure lowers, and muscle tone and reflexes are intact. Contrast this with REM (rapid eye movement) sleep where brain activity is similar to that of the awake brain. For this reason, it is sometimes referred to as paradoxical sleep. In REM sleep brain temperature and metabolic rate rise and there is complete loss of muscle tone with the exception of the diaphragm (so you can breathe), the eye muscles, and some muscles within the inner ear.

The Adverse Effects of Blue Light

A recent study of about 1,500 Americans found that 90% of adults use an electronic device within 1 hour of bedtime at least a few times per week. Devices may be an important contributor to insomnia because of the short-wavelength-enriched light that is emitted from them. Exposure to light in the evening and the early part of the night, even at low intensity, has several sleep-disturbing effects. First is suppresses melatonin delaying the onset of sleep. It shifts the circadian clock to a later time making it harder to fall asleep at a regular hour. Finally, it increases alertness and arousal.3

In one interesting study, 12 adults were randomly assigned reading from a light-emitting eBook for 4 hours before bed or reading from a print book for 4 hours before bed for 5 consecutive evenings. They found that those reading an LE-ebook displayed decreased subjective sleepiness, decreased EEG delta/theta activity, suppressed melatonin secretion, lengthened sleep latency (increased time to fall asleep), delayed and reduced REM sleep, and impaired morning alertness.3 

Why does blue light have this effect? Human eyes have rods, cones, and intrinsically photosensitive retinal ganglion cells. Rods and cones are mostly responsible for image-forming vision. Intrinsically photosensitive retinal ganglion cells are responsible for regulating circadian rhythm and other biologic functions. Retinal ganglion cells form the beginning of the retinohypothalamic tract which transmits light data from the retina to the hypothalamus to regulate circadian rhythms throughout the body. Retinal ganglion cells respond powerfully short-wavelength light like the blue-colored light emitted from most devices and LED televisions. This blue light will cause a high rate of fire from the eyes to the hypothalamus, which will change hormonal and circadian rhythms.4 Blue light also has the ability to stimulate other areas of the brain which are responsible for producing norepinephrine, a neurotransmitter that has potent arousal properties.5

With the knowledge that the blue light emitted from almost all devices and LED TVs is disruptive to the foundational pathways for sleep, it’s important to take steps to remedy this if you’re having trouble sleeping. First and foremost, do not use your device in bed. At all. In fact, you should avoid using it at least an hour before you plan to go to bed. Do not watch TV in bed either. If your symptoms are severe, avoid TV for at least an hour before you plan to retire. If you have to use a device for some reason, avoid long exposure. You should also consider wearing red-colored lenses for about an hour before bed. The red-color of the lens blocks the blue light from reaching the retina. Blue-light blockers that are clear also exist. You could consider purchasing a pair of these and using them in the evening and while you’re using your device. I’ve recommended a pair from this website: www.blepeyewear.com. As devices age, they tend to emit more blue light. If possible, consider getting a newer device. Finally, many devices come with a night-shift mode. This mode shifts the hue of the screen to a warmer, redder tone. This has been studied to see if it offset the negative effects of the light from a device. Unfortunately, it did not. Melatonin levels were still reduced when using night shift mode.6

In the end, if you suffer from insomnia, reducing your device exposure is likely to have a measurable effect on your sleep. Our devices have become extensions of our lives so it may be difficult to completely eliminate exposure, however, your brain (and your boss) will thank you for the better sleep.




2Kandel, et al., editors. “Sleep and Dreaming .” Principles of Neural Science, 4th ed., McGraw-Hill, 2000, pp. 936–947.

3Proc Natl Acad Sci U S A. 2015 Jan 27;112(4):1232-7.

4Molecular Vision 2016; 22:61-72.

5Blue-Light Therapy following Mild Traumatic Brain Injury: Effects on White Matter Water Diffusion in the Brain. Front. Neurol. 8:616.

6Sleep, Volume 40, Issue suppl_1, 28 April 2017, Pages A290.


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Nutrition and Health Guidelines

Last month was national nutrition month and we posted some staggering statistics on the health of the nation. Today we’d like to give you some guidelines to help improve those statistics.

Nutrition and Health Guidelines

It’s not enough to just change your diet. It’s important to get out and move your body too. In addition, if you are under a lot of stress either emotional or physical it can affect your health. Lack of sleep is often overlooked when people are struggling to meet their health goals. If you would like more information on how these affect you, don’t hesitate to contact Dr. Court in the office.



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Time Change Gotcha?

A couple of guys sleeping near the Kiosko Alfo...

Image via Wikipedia

Every year around this time people start coming into my clinic complaining of sleep disturbances.  They find themselves not being able to get to sleep at night and then feeling groggy and unrested in the morning.  This phenomenon is interesting and shows us just how sensitive humans are to changes in our schedules and changes in light.

As a matter of fact, there are research papers that show that traffic accidents increase up to a week after the changes both in the fall and spring.

Every fall we set our clocks back one hour and daylight savings ends for all of us.  For a select few, this change can affect how they feel greatly.  And it’s not just psychological.  This shift in time means that it will be lighter in the morning and darker in the evening.  While this may not seem like such a big deal, peoples’ body clocks don’t always adjust right away and this can affect how we feel.

For instance, many hormones that we secrete are timed with our body clocks.  If our body clocks shift out of balance, our hormone balance may shift as well.  Two great examples are melatonin and cortisol.


Cortisol is highest in the morning and lowest at night.  With a shift in sleep habits, this rhythm is thrown off as well.  Symptoms may include fatigue, changes in blood sugar and feelings of a foggy mind.  For most this is a temporary condition and once the body adapts to the time change, the natural circadian rhythm of cortisol production returns as well.  If it does not or the symptoms are particularly annoying one thing you can do is make sure you eat regularly.  Cortisol helps elevate blood sugar when it begins to drop to low so eating regularly will take the strain off of your cortisol system and allow it to focus on re-regulating itself.


Melatonin is particularly interesting.  Melatonin is secreted by the pineal gland in the brain.  It is secreted during darkness.  Thus, with the increase in light in the early morning hours your melatonin levels are likely to drop off quickly and wake you earlier than you’d like.  This is problematic because it is often hard to get back to sleep once melatonin levels have dropped.  On the flip side, melatonin levels are likely to rise too early in the evening making you feel like it is time to sleep when it’s not.  A great way to combat this physiological mix up is to take melatonin just before you go to bed (30-60 minutes prior).  I recommend taking a very small amount because research has shown that large amounts can have the opposite effect.  Take about 1.5mg before bed.  This will temporarily increase your melatonin levels and allow you to get better quality sleep and signal your body that it needs to re-regulate its melatonin production.

It should only take about a week for your body to adapt to the change.  If it takes longer, you might have a true sleep disorder and should consider having it evaluated.  Try these helpful hints first though!

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11 Natural Ways for a Better Night’s Sleep

Sleep is an essential part of our lives.  Most of us don’t think about just how important it is until we experience sleeplessness.  The effects can range from annoying to down right life altering.  They include anything from feeling foggy headed and grumpy to hallucinations if the sleep is disturbed long enough.  I came across an interesting article online with 8 natural sleep remedies. I’ve listed them below with some others that were not mentioned.

1. Magnesium and calcium

Magnesium and calcium are both sleep boosters, and when taken together, they become even more effective. Plus, by taking magnesium, you cancel out any potential heart problems that might arise from taking calcium alone. Take 200 milligrams of magnesium—lower the dose if it causes diarrhea—and 400 milligrams of calcium each night.

2. Wild lettuce

If you’ve suffered anxiety, headaches, or muscle or joint pain, you might already be familiar with wild lettuce. It’s also effective at calming restlessness and reducing anxiety—and may even quell restless legs syndrome. When using a wild-lettuce supplement, take 30 to 120 milligrams before bed.

3. Hops

Beer fans will no doubt be familiar with the calming effect of hops, the female flowers used in beer making. For sleep purposes, though, this extract has been widely used as a mild sedative for anxiety and insomnia. Take 30 to 120 milligrams before climbing under the covers.

4. Aromatherapy

Lavender is the trick here, as studies have proven that it aids in sleep. It’s also a cheap, nontoxic way to slip into a peaceful slumber. Find a spray with real lavender and spritz it on your pillow before bedtime. Or buy a lavender-filled pillow.

5. Melatonin

Melatonin is the hormone that controls sleep, so it’s no wonder that it naturally induces sleep. Although some experts recommend taking higher doses, studies show that lower doses are more effective. Plus, there’s concern that too-high doses could cause toxicity as well as raise the risk of depression or infertility. Take 0.3 to 0.5 milligrams before bed.

A note from Dr. Court – Taking melatonin keeps your brain from making it.  Because of this, I don’t recommend people take it for long periods of time.  If you need it in a pinch or for a week or two of high stress it’s ok, but you should look for something else if you think you will need assistance for longer than that.

6. Yoga or meditation

Choose gentle yoga or stretching, not vigorous power or ashtanga yoga, which could energize you instead. Try easy yoga stretches in bed followed by simple meditation. Close your eyes and, for 5 to 10 minutes, pay attention to nothing but your breathing.

A note from Dr. Court – When I can’t sleep I like to use something called square breathing.  Tip your head back and breath in for two seconds then tip your head forward and breath out for four seconds.  Repeat until you are asleep.  It works wonders for me.

7. L-theanine

This amino acid comes from green tea and not only helps maintain a calm alertness during the day but also a deeper sleep at night. However, green tea doesn’t contain enough L-theanine to significantly boost your REM cycles.  You will have to take a theanine supplement to get enough of the stuff to help you sleep. Take 50 to 200 milligrams at bedtime.

8. Valerian

Valerian is one of the most common sleep remedies for insomnia. Numerous studies have found that valerian improves deep sleep, speed of falling asleep, and overall quality of sleep. However, it’s most effective when used over a longer period of time. One caveat? About 10% of the people who use it actually feel energized, which may keep them awake. If that happens to you, take valerian during the day. Otherwise, take 200 to 800 milligrams before bed.

9. 5-HTP

This substance is an amino acid that is used to make serotonin in the body.  Serotonin is critically important for being able to get to sleep and stay asleep.  5-HTP or 5-hydroxytryptophan is a derivative of the amino acid tryptophan.  While tryptophan is readily available in the diet in such things and turkey and milk, 5-HTP is not.  I usually recommend people supplement with about 100-200 mg before bed.  The supplement is readily available through any health care practitioner who specializes in functional medicine.

10. GABA

GABA is technically another amino acid, but it is not so in the traditional sense.  It is not incorporated into proteins like other amino acids.  GABA is one of the main inhibitory neurotransmitters in the brain and deficiencies in GABA can lead to anxiety, insomnia and even seizures.  GABA can be taken orally as a supplement to help you sleep.  As a matter of fact most of the pharmaceutical aids for sleeping act on GABA.  To obtain a supplement with GABA in it you should definitely see a qualified doctor who specializes in functional medicine.  I routinely recommend this for my patients and it works great.  I recommend 600-800 mg before bed.

11. Hydrolyzed Milk Proteins

Remember when Mom would give you a glass of warm milk to help you sleep?  As it turns out there is some science behind why that was so effective.  Many nutrition companies use products with these proteins in them as sleep aids.  I use a product from Biotics Research call DeStress. It works wonderful for sleeplessness.  I don’t know of any available over the counter but ask your health practitioner if they have any sources they are aware of.

This list is by no means all inclusive, but it’s a good start.  There are many reasons that you might not be sleeping, but I would certainly try a natural remedy before resorting to more powerful pharmaceuticals which have a high rate of dependency.  Here’s to a better night’s sleep!


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Napping Improves Brain Function!

Bring back the siesta.

It turns out that toddlers are not the only ones who do better after an afternoon nap. New research has found that young adults who slept for 90 minutes after lunch raised their learning power, their memory apparently primed to absorb new facts.

Other studies have indicated that sleep helps consolidate memories after cramming, but the new study suggests that sleep can actually restore the ability to learn.

The findings, which have not yet been published, were presented Sunday at the annual meeting of the American Association for the Advancement of Science in San Diego.

“You need to sleep before learning, to prepare your brain, like a dry sponge, to absorb new information,” said the lead investigator, Matthew P. Walker, an assistant professor of psychology and neuroscience at the University of California, Berkeley.

The study recruited 39 healthy young adults and divided them into two groups. All 39 were asked to learn 100 names and faces at noon, and then to learn a different set of names and faces at 6 p.m. But 20 of the volunteers who slept for 90 minutes between the two learning sessions improved their scores by 10 percent on average after sleeping; the scores of those who didn’t nap actually dropped by 10 percent.

via Vital Signs – Afternoon Naps Can Increase Ability to Learn, Study Suggests – NYTimes.com.

Dr. Court’s Comments

This truly is good news!   The fact that napping is good for the brain was something Dr. Carrie and I were sure was true while we were in chiropractic school.  We had class from roughly 7 AM until 3 or 4 PM with an hour for lunch and an hour for club meetings.  These meetings were generally academic in nature, so the class load was quite high.  We took every chance we had to get some extra sleep because we were often up late studying and needed to get up early to be at class by 7.  We did not, however, have 90 minutes to sleep.  More like 20….or 30.

The naps did help when we had the chance to get them and know we know why.  This study shows that neurons in the brain need rest just like a muscle needs rest to function at its best.  This is something I routinely tell my patients when they are rehabbing their brains.  I specifically tell them not to perform their exercises when they’re tired or hungry.  Neurons that are fatigued or do not have enough energy supply are more apt to fail and cause more problems.

Obviously, not all of us have time to take a 90 minute nap in the middle of the day.  The best way to get the most out of our brains is to sleep well at night.  This means keeping good sleep habits.  These include:

  • Getting to bed at a regular hour every night and waking at a regular hour every morning.  This helps to maintain the natural circadian rhythm of many of the hormones in the body.  Sometimes when these hormones are disturbed, sleep becomes difficult.
  • Keeping at much light out of your bedroom as possible.  No one should have a television in their room.  I know many patients use it to “fall asleep” but it is not an effective tool for most.  Even the light from your alarm clock is enough to stop the production of the neurotransmitter melatonin.  My suggestion is to take a magazine or a small piece of cardboard and cover up the light coming from the clocks in your room.  The darker the room the better.
  • Avoiding things that might disrupt sleep like alcohol and caffeine before bed.  Caffeine is a stimulant and there’s a reason people drinking it when they wake up.  Alcohol, a depressant that usually makes people sleepy, has a rebound effect that can actually wake you 2-4 hours after you go to sleep.  It is not an effective way to manage insomnia as some people use it for.
  • Lose weight if you need to.  Being overweight increases the risk of sleep apnea, a sleep disorder that causes a person to stop breathing at night.  This cessation of breathing can cause a person to wake up unknowingly, sometimes hundreds of times per night.  If you know you have sleep apnea, get a CPAP machine.  CPAP stands for Constant Positive Airway Pressure.  Basically the machine keeps you throat open so air can pass uninterrupted into your lungs.

Of course if you need to take a nap and you have the time, indulge yourself!  It is good for your brain.  But remember the nap should supplement your positive sleep habits and should not serve as a replacement.

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How Your Body Clock Regulates Your Metabolism

Not getting enough sleep?  It could be why you’re not losing weight, or worse yet, why you’re gaining weight.

Scientists have discovered that your circadian rhythms regulate the energy levels in your cells. In addition, the proteins involved with circadian rhythms and metabolism are intrinsically linked and dependent upon each other. This finding has far-reaching implications, which could include new ways to treat cancer, diabetes, obesity and a host of related diseases.

24-hour circadian rhythms govern fundamental physiological functions in almost all organisms. These circadian clocks are the essential time-tracking systems in your body. Disruption of these rhythms can profoundly influence human health.

In a new study, researchers showed that an enzyme protein which is an essential molecular gear of the circadian machinery interacts with a protein that senses cell energy levels and modulates aging and metabolism.

This suggests that proper sleep and diet may help maintain or rebuild the balance between your circadian clock and your metabolism, and could also help explain why lack of rest or disruption of normal sleep patterns can increase hunger, leading to obesity-related illnesses and accelerated aging.

via How Your Body Clock Regulates Your Metabolism.

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