circadian & ultradian rhythm - dr. leslie...

LeslieKorn,PhD,MPHLMHC,ACS,RPP,NTP,NCBTMB

CopyrightDr.LeslieKorn,2018

Circadian & Ultradian Rhythm

Copyright,LeslieE.Korn,2018


Psychobiological Rhythms Stress & Well-being


Balance Circadian Rhythm Amajorfoundationofmentalhealth

Mood,sleep,stress,pain,depression

Human rhythmicity • 24-hr.light/darkcycle/• Sleep/wake/• Cortisolcycle

• BiPolar,Depression,Insomnia,Stress,PTSDallreflectdisruptionoftherhythm

• Ongoingdisruptionofrhythm-drivenbehaviorsreinforcesmentaldistress

Major PsychoBio Rhythm Circadian 24 hour Sleep/Wake Cycle

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• Humanrhythmicitydependsuponinternalpacemakers

• Lighttravelsthroughtheretinaoftheeyesviatheretino-hypothalamictracttoSuprachiasmaticnuclei(SCN)inthe

hypothalamussignal➔thepinealgland

• Thepinealrespondstothepacemakerbysecretingmelatonin

• Genetics,Lifestyle&StressinfluenceCircadianrhythm

Circadian Rhythm

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• Transmissionoflightviatheeyesto

stimulatethebrain&hormones

• Disruptionsoccurwithalterationsof

exposuretolightanddark;Jetlag

• LightinAM&darkatnight;shiftwork

increasesuntilpuberty

• Hencewakeuptimeforteens

• Melatonindecreaseswithage,related

insomnia

• Sleepdisruptionindementia(useoflight

therapytoregulatesundowning)

Circadian Rhythm

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• Disruptedcircadianrhythm➔

• Dysregulatedcortisolrhythm➔

insomnia,depression,glycemic

dysregulation,mooddisorders,

BiPolar,bulimia,PMS,dementia

• Test:24hr.diurnalcortisoltoconfirmcurrentstory&history

• TheCSrhythmcanreflect

differentstagesofstress

response.Adaptive/maldaptive

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Stress, Trauma & Circadian Rhythm


• RegulateCircadianRhythm,toregulatemoodandhealth

• Whyiscircadianrhythmsoimportanttomentalhealth?

• Selfregulationiscentraltomental&physicalhealth

• Stressunderliesmentalillnesssymptoms

• Stressandtraumadisruptcircadianrhythm➔

• Disruptedcortisolrhythm➔insomnia,depression,bloodglucose

handlingissues,mooddisorders,BiPolarADHD,bulimia,PMS,

diabetes2,diabetestype3akaAlzheimers

Stress, Trauma & Circadian Rhythm

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• LithiumisbelievedtoworkbyregulatingrhythminBi-Polar

• 24hr.awaketherapytobreakdepressioncycle• LighttherapyforSeasonalAffectiveDisorder• BlueLightblockingglassesforinsomnia

• Schoolshavelaterstartingtimesforteens

• Lighttherapytoreducesundowningindementia

• Light/Dark&NutritiontoregulateinPTSDandTBI• ChronoNutrition:thetimeyoueatisasimportantaswhatyoueat

Applications of Circadian Rhythm Therapies

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Pineal Gland as Spirit Center

The“Third”Eyeof

consciousnesspractices;Hindu

traditionajna,orbrow,chakra

_________

DMT“spiritmolecule,”N,N-Dimethyltryptamine

Inthebrain&inAyahuasca

__________

Dr.RickStrassman’sresearch&

theoriesonmystical

experiences;

visual&auditoryhallucinations,

and(DMT),aserotonin/

melatoninanalogue

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• Descartesbelievedthepinealglandwas

theseatofthesoul

•Manyreptiles,likethe

lizard,haveactual3rd

eyeswhichfunction

astheircompass

Pineal Gland as Vestigial Third Eye

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• Twointertwinedsnakesaresymbolofthenervoussystem

• Sympathetic/Parasympathetic

• Thesnakesjoinatthe"thirdEye,thepinealgland,the“seatof

consciousness

Symbol of Medicine Caduceus

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Caduceus & Third Eye of Yoga

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• Umbrellatermformooddisordersthatfollowaseasonalpatternof

recurrence

•Recurrentfallandwinterdepressiveepisodeswithfullremissions

• (Or)switchtohypomaniaormaniainthespring&summer

• PeoplewithSADexhibitthe“atypical”vegetativesymptomsofdepression,

including:

•Hypersomnia

• Increasedappetite•Carbohydratecraving•Weightgain

Seasonal Affective Disorder Circadian Rhythm Disruption

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Major influence on Stress, Sleep & Mood

1. Earlylifetraumacandisruptsleepfromchildhood

2. EarlyLifetrauma(adversechildhoodevents;ACE’s)isarisk

factorforsleepdisruption&mooddisorders

3. Chronicstressexacerbatesmoodateverylifestagechange➔

PMS➔peri&menopausaldepression,anxiety,insomnia

4. Trauma&chronicstressdisruptcircadianrhythm

5. Trauma&stressdisrupt&latercortisolrhythmofadrenal

glands

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PhysicalSymptomsof(Adrenal)Stress•Premenstrualtension•Cravingsforsweets&carbohydrates•Headaches•Sternocleidomastoid/trapezius musclepain&spasm

•Alcoholintolerance•Indigestion•Vertigo•Poormemory

•Palpitations•Ligamentlaxity

•Sensitivityto(sun)light

Stress As Disrupted Rhythm

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Insomnia • Irritability,nervousness,

frustration

• PoorConcentration

• Excessivefatigue

• Confusion

• Depression

• Weakness

• Lightheadedness

Adrenal Stress: Many Symptoms

Food allergies, airborne allergies • Asthma

• Hives

• Dermatitis

• AutoImmune

• Posturalhypotension

• LowBasalBodyTemp

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Adrenal Stress Visual Assessment

• Darknessontheeyelidsmay

denoteexcesscortisol

• Puffinessundertheeyes• Hyperventilation• Grittingteeth/TMJ

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• Initialinsomnia• Difficultyfallingasleepand/orfrequentawakeningswith

difficultyfallingbackasleepor

subsequentsleepthatis

restless&unsatisfying

• Earlymorningawakeninginsomnia

ormaintenanceinsomnia

• Sleeplatency:Theaverageamountoftimetofallasleep

Insomnia & Disruption of Circadian Rhythm

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• 30%ofthepopulationwillexperienceinsomnia

• 92%ofactivedutypersonnelwithPTSDreportinsomnia

• PTSD:Individualswithinsomniapriortotraumaexposurearemorelikelyto

developPTSDfollowingexposure

• 4-6millionpeopleayearreceiveprescriptionsforsedative/hypnotics

• BenzodiazepinesalterREMsleep;someevidencefor⬆dementiarisk

• Ambien(sedative/hypnotic)isexcretedataslowerrateinwomen:amaccidents

• Agingdoesnotdecreasethetotalamountofsleepneededhoweversleepis

morerestless

Insomnia

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• Anxietyortension• Circadianrhythm

• Environmentalchange

• Emotionalarousal

• Fearofinsomnia

• Sleepphobia• Disruptiveenvironment

• Painordiscomfort

• Caffeineoralcoholingestion

Causes of Initial Insomnia

Wewillexploreinsomniatreatmentinmoredetailinafuturemoduledevotedtoinsomnia&differentcircadianrhythmdisorders

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•First Steps: reset the ‘clock” • Nutritional Therapies • Reducestimulants

•Healthysubstitutionsforstimulants

• Assess&addressreactivehypoglycemia

• Smallsnackbeforebed

Integrative Circadian Rhythm and Sleep

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• Regulate Circadian Rhythm • CBT-Insomnia • Chrono-therapies • BlueLightblockingglassesatnight •Sleepincompletedarkness&inacoolroom

(60-65degrees)

•Brightamlight(before10am)

•Reducesunglassuse•Eliminatenightshiftwork

•HerbalMedicine

•Nutrition•RelaxingBodywork•ParasympatheticYogaasanas

Integrative Treatment Circadian Rhythm & Sleep

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• Threesupplementsresettherhythmoftheclock

• Melatonin.0.5-.75mg

• Methylcobalamin,(vitaminB12)enhanceslight

sensitivityofthe“clock”&regulatescortisol“peak”

• Lithium:5-20mg/day

• (Lithium-richmineralsprings)

Nutrients to Help Reset Circadian Rhythm

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• Melatoninlevelsdropasweage

• Melatoninonlyaidssleepbyre-settingCircadianRhythm

• *Sideeffects• Gastrointestinaldisturbances• Lethargy• “Hung-over”feeling• Exacerbationofsymptomsindepressedpatientsisalsoaconcern

*Philp,Richard.Herbal-DrugInteractionsandAdverseEffects.2004.

Melatonin: Adverse Effects

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• Sunlight• Limitsunglassuse

• 10,000LuxLightBoxes• Fullspectrumlightbulbs

• Deliveredfor20-30minutesmorning

• Contraindications:bi-polar?

• BlueLightBlockingGlassesatnight

Chrono-Therapies

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• Lactium:milkbiopeptide• De-Stress:sedativeeffect;actsonGABAreceptors• Dose:150-450mg.BID/TID

• Decreasecortisol;stressresponseatnight;cortisolis

oftenhighatnightin

depression

Nutrients for Initial Insomnia

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• Differentiate type • Assessforlowbloodsugar• Eataprotein&carbsnackbeforebed

• Magnesium • Epsomsaltbaths

• OralMagnesiumtoboweltolerance

• GABA precursors • Lactium

• Bioidenticalprogesteronein(pre)menopausalwomen

Hydrotherapies & Before Bed Protocol

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• Herbal Medicine• Valerian,Hops,Passionflower(GABAsupport)• Timed Exercise• Aerobicexercisebefore3pm• Balance Hormones• Progesteroneinperi&postmenopausalwomen;

testosteroneinmen

• Medical issues • Sleepapnea;prostateissuesinmen

• Hydrotherapies • Magnesiumsulfatebath

• Neurofeedback • Cranial Electrical Stimulation

Integrative Circadian Rhythm & Sleep

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• Valerian/Hops/Passionflower(VHP)

• Decreasessleeplatency,lengthenssleepduration

• LicoriceRoot• RegulatesHypothalamic/

Pituitary/AdrenalAxis(HPA)

Herbal Medicine for Insomnia

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Make this smoothie as a natural stimulant for a morning beverage. Remember Coffee is a drug, not a beverage. A little, lifts mood and resets circadian rhythm, The Cocoa supports dopamine and focus and has polyphenols which reduce inflammation. The Matcha has theanine, a natural anxiolytic. This recipe is very forgiving, so feel free to experiment.

Ingredients• 12 oz. fresh brewed organic coffee, hot • 1/2. c. full- fat, unsweetened coconut milk • ½ tsp. Organic Matcha powder (or strong tea from 3 matcha tea bags) • 4 tbsp. unsweetened organic cocoa powder (for drinking) • 5-10 drops liquid stevia (or to taste) • Vanilla extract (optional) • Coconut cream, unsweetened (optional)

Directions Combine all ingredients in a blender at medium speed for a few minutes until frothy. Pour into a mug and top with coconut cream, if desired. For children I substitute berries and almond milk for the coffee.

This recipe makes four servings.

AM RECIPE

Mocha Matcha Smoothie

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Make this smoothie an hour or two before you want to go to sleep. Cherries and chamomile tea help induce sleep; Cherries stimulate melatonin release. The mangos, seeds, and coconut will support blood sugar and brain function throughout the night so you can rest peacefully. Blueberries or frozen bananas make a good substitute for mangos.

Ingredients• 1 cup almond or coconut milk • 1/2 cup Strong, cold chamomile tea • 1 cup frozen (or fresh) cherries • 1 cup frozen mangos • 1 tsp. flax seeds (or flax seed oil or lemon flavored fish oil) • ó tsp. chia seeds • 1 Tbs. coconut cream or coconut oil • 3 drops liquid stevia • 1 drop vanilla extract (optional)

DirectionsPlace all ingredients in the blender and blend until smooth. Keep a quart of strong chamomile tea in the fridge or make “chamomile tea ice cubes” to add to evening smoothies.

Cherry Chamomile SmoothiePM RECIPE

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• 90-120minutecycle

• Contra-lateralassociationwithhemisphericdominance

• Yogacorpsepose,sitting&lotusposefacilitateneutral,naturalshift&renewal

• Lyingontherightsidecongeststherightnostril&quietsdowntheleftbrain

• Payattentiontoshiftwhenitoccurs• Siesta/Naps/restperiods/daydream

states

Ultradian Rhythm

ErnstRossi:TheUltradianRhythmandThePsychobiologyofMindBodyHealing33


• Helpclientsidentifytheirultradiancyclestobuildinselfcareduringtheday&reframebeliefsaboutcognition&focus

• Signsofshifting:“antsy”yawning,bathroom,spaceyetc.

• Shiftdominancebasedongoal:children&adultswithfocusactivateleft

braindominance/creative,sleepy,relaxedsideactivaterightbrain

• OCDactivaterightbrain/Focusactivateleft

• CulturallyCompetency:

• Mosttraditionalculturesadheretocircadian&ultradian-drivenschedules

• Askclientsabouttheirtraditionalpractices

Applications

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• Closeofftheleftnostrilplacingyourfingeralongthesideofyournose.Breatheintotherightnostril

• Closeofftherightnostril,breatheintotheleftnostril• Repeatthisseveraltimes

• Onenostrilwillbemore"open"orfreeflowing,&theotherwillbemorecloggedor

congested

• Themorefreeflowingdenotesgreaterdominanceontheoppositehemisphereof

thebrain.Soifyourleftnostrilismoreopen,yourrighthemisphereismoreactive

Ultradian Rhythm Exercise

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Automated Morningness-Eveningness Questionnaire (AutoMEQ)

• This19-questionassessmentprovidesinformationaboutsleephabits

andyourcircadianrhythmtype

http://www.cet-surveys.com/index.php?sid=61524

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• Circadianrhythmisthe24hoursleep/wakecycle:majorpsychobiologicalrhythm

• Stressdisruptscircadianrhythmandtherebydisruptssleep

• PTSD,Complextraumadepression,bipolar,seasonalaffectivedisorder

symptomsofcircadianrhythmdisruption

• LightandDark,Nutrition,HerbalMedicine&Hydrotherapyallprovidemethods

tobalancecircadianrhythmandimprovesleep

• SomeNutrientsincludeVitaminB-12whichshouldbeusedasmethylcobalamin

orhydroxocobalamin(notcyanocobalamin)

• Melatoninisahormonethatregulatescircadianrhythmitdoesnothelpone

sleepperse

Summary


Thank you!drlesliekorn.com [email protected]

circadian & ultradian rhythm - dr. leslie...

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