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How is Sleep Linked to Cancer? August 27, 2015

Posted by Dreamhealer in Cancer, Chemotherapy, Sleep.
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Written By: Dr. Adam McLeod, ND, BSc

Everyone knows the importance of a good nights sleep. It is no secret that your physical and mental health is negatively impacted when you do not get adequate sleep. Is lack of sleep actually linked to the formation of cancer? The short answer is yes and the reasons are obvious when you take a closer look at the science of sleep.

The circadian rhythm is a natural cycle in our brains that tells our cells whether it is day or night. This is a biological process that is present in virtually all forms of life and it helps to synchronize our biochemistry with the position of the sun. This internal clock obviously would be of great importance to our ancestors, however with our modern lifestyle we have become disconnected from the sun. There is a growing body of evidence that shows a link between disruptions in the circadian rhythm and the formation of cancer. In fact, some studies suggest that a circadian rhythm in chaos is a signal for a high risk of breast cancer even in the absence of mammographic evidence of neoplasm1.

People who work irregular shifts will naturally have disrupted circadian rhythms3,4. The reason is obvious; in what natural environment would anyone work at such irregular times and disregard their own internal clock. The effect is so dramatic that some researchers have called for shift work to be labeled a carcinogen2. It is also interesting to note that individuals who have mutations in genes related to this cycle have an increased risk of developing cancer6. The bottom line is that if your natural circadian rhythm is disrupted then you are more likely to develop cancer3,5.

What can be done to restore the health of your circadian rhythm? There are several key molecules that directly influence this delicate rhythm. Perhaps the best documented molecule is melatonin8,9. Melatonin is responsible for the generation of at least 40% of the amplitude of the circadian core body temperature rhythm7. Manipulation of melatonin levels are clinically useful to resynchronize the circadian rhythm under conditions of rhythm desynchronization. In other words, melatonin helps to restore the circadian rhythm when it has become disrupted.

Everyone has heard about melatonin and how it can be used to promote restful sleep. Melatonin is a critical component of the circadian rhythm, and it is one of the molecular signals that tells our cells whether it is day or night. I have seen countless times where cancer patients were prescribed melatonin by another Naturopathic doctor, but the patient discontinued it because they thought their sleep was fine. This suggests a misunderstanding between the patient and some of my colleagues regarding the reason for prescribing melatonin in the context of cancer. Whether the patient is sleeping well or not is secondary. They should be taking this supplement because of melatonin’s potent anti-cancer properties.

Melatonin triggers cell death in cancerous cells and it has several properties that make it useful as an adjunctive cancer therapy10,11,12. The conclusion from a paper in the prestigious journal “Cancer Research” stated that:

“Physiologic and pharmacologic concentrations of the pineal hormone melatonin have shown chemopreventive, oncostatic, and tumour inhibitory effects in a variety of in vitro and in vivo experimental models of neoplasia. Multiple mechanisms have been suggested for the biological effects of melatonin. Not only does melatonin seem to control development alone but also has the potential to increase the efficacy and decrease the side effects of chemotherapy when used in adjuvant settings.”

The use of melatonin is particularly indicated in cases of estrogen positive breast cancer. For those who are taking tamoxifen or letrozole as a long-term therapy, it is helpful to add melatonin into the treatment plan. The cancer prevention properties of melatonin appear to be mediated through the estrogen response pathway18.

When used appropriately, melatonin not only decreases side effects from chemotherapy, it also significantly enhances its effectiveness. In one randomized study, lung cancer patients were treated with chemotherapy alone or chemotherapy with melatonin. The melatonin group lived significantly longer with a reduced side effect profile14. This is just one example of many clinical trials. Melatonin can be used during chemotherapy or radiation, and the antioxidant effect is considered supportive of these conventional therapies15.

In my experience, the high doses of melatonin (20mg) are well tolerated when they are used properly. The most common complaint that I hear from patients is that they feel groggy the next morning. Upon further questioning, it becomes clear that they did not use the melatonin correctly. You must take it before bed; but after you take the melatonin, you must avoid light! This means no television, no iPads and no reading.

When light touches your eyes, it inhibits the activity of melatonin. This makes sense considering how connected melatonin is to the circadian rhythm. Think about it for a second. A thousand years ago when our ancestors went to sleep, they would not have encountered light again until the sun rose. When you are exposed to light after taking melatonin, it sends mixed messages to your brain and disrupts the circadian cycle. This often results in a sensation of grogginess the next morning. It is critical that after you take melatonin, you immediately go into a dark room and sleep.

One other interesting note about melatonin is how its metabolic effects are easily disrupted by magnetic fields13. The clinical significance of this disruption is unclear, but this is not surprising given how delicate the circadian rhythm is. What is also interesting is that magnetic fields appear to disrupt the positive benefit from tamoxifen as well16. This does not mean that everyone should panic and avoid all sources of magnetic fields since this is virtually impossible to do in modern day society. The threshold for this inhibitory effect is not well established, however, it is worthwhile to point out this interaction. Perhaps people wanting to prevent cancer should reduce their exposure to excessive magnetic fields when possible17.

Melatonin certainly can be helpful in an integrative cancer setting but you must have professional guidance when developing a cancer treatment plan. A Naturopathic Doctor can help you to develop a safe and effective treatment plan. Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative cancer care .http://www.yaletownnaturopathic.com

References:
1) Keith, Louis G., Jaroslaw J. Oleszczuk, and Martin Laguens. “Circadian rhythm chaos: a new breast cancer marker.” International journal of fertility and women’s medicine 46.5 (2000): 238-247.

2) Stevens, Richard G. “Light-at-night, circadian disruption and breast cancer: assessment of existing evidence.” International journal of epidemiology 38.4 (2009): 963-970.

3) Megdal, Sarah P., et al. “Night work and breast cancer risk: a systematic review and meta-analysis.” European Journal of Cancer 41.13 (2005): 2023-2032.

4) Hansen, Johnni. “Risk of breast cancer after night-and shift work: current evidence and ongoing studies in Denmark.” Cancer Causes & Control 17.4 (2006): 531-537.

5) Hansen, Johnni. “Increased breast cancer risk among women who work predominantly at night.” Epidemiology 12.1 (2001): 74-77.

6) Zhu, Yong, et al. “Non-synonymous polymorphisms in the circadian gene NPAS2 and breast cancer risk.” Breast cancer research and treatment 107.3 (2008): 421-425.

7) Cagnacci, A., J. A. Elliott, and S. S. Yen. “Melatonin: a major regulator of the circadian rhythm of core temperature in humans.” The Journal of Clinical Endocrinology & Metabolism 75.2 (1992): 447-452.

8) Kiss, K., et al. “Disturbed circadian rhythm in ICU patients as indicated by melatonin levels: a prospective pilot study.” Critical Care 19.Suppl 1 (2015): P549.

9) Flynn-Evans, Erin E., et al. “Circadian rhythm disorders and melatonin production in 127 blind women with and without light perception.” Journal of biological rhythms 29.3 (2014): 215-224.

10) Hill, Steven M., and David E. Blask. “Effects of the pineal hormone melatonin on the proliferation and morphological characteristics of human breast cancer cells (MCF-7) in culture.” Cancer research 48.21 (1988): 6121-6126.

11) Blask, David E., Leonard A. Sauer, and Robert T. Dauchy. “Melatonin as a chronobiotic/anticancer agent: cellular, biochemical, and molecular mechanisms of action and their implications for circadian-based cancer therapy.” Current topics in medicinal chemistry 2.2 (2002): 113-132.

12) Jung, Brittney, and Nihal Ahmad. “Melatonin in cancer management: progress and promise.” Cancer Research 66.20 (2006): 9789-9793.

13) Liburdy, R. P., et al. “ELF magnetic fields, breast cancer, and melatonin: 60 Hz fields block melatonin’s oncostatic action on ER+ breast cancer cell proliferation.” Journal of pineal research 14.2 (1993): 89-97.

14) Lissoni, P., et al. “Five years survival in metastatic non‐small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial.” Journal of pineal research 35.1 (2003): 12-15.

15) Sanchez-Barcelo, Emilio J., et al. “Melatonin uses in oncology: breast cancer prevention and reduction of the side effects of chemotherapy and radiation.” Expert opinion on investigational drugs 21.6 (2012): 819-831.

16) Harland, Joan D., and Robert P. Liburdy. “Environmental magnetic fields inhibit the antiproliferative action of tamoxifen and melatonin in a human breast cancer cell line.” Bioelectromagnetics 18.8 (1997): 555-562.

17) Stevens, Richard G. “Electric power use and breast cancer: a hyptothesis.” Am. J. Epidemiol.;(United States) 125.4 (1987).

18) Sarkar, Fazlul H., and Yiwei Li. “Using chemopreventive agents to enhance the efficacy of cancer therapy.” Cancer Research 66.7 (2006): 3347-3350.

What You Need to Know About Sleep August 20, 2015

Posted by Dreamhealer in Healing, Health, Sleep.
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The number one thing you need to know about sleep? It is important!

The average person spends 36% of their lives asleep and there is good reason for this. Sleep is as essential to our health and well being as diet, exercise and all the other little things you do to keep yourself healthy. As with diet it is not only quantity of sleep but also quality. The average sleep time historically was about 9 hours. Now, we average about 6.5 hours with an increasing number of us living on even less. According to Lucassen et al. (2008) “Chronic sleep disruption can be regarded as a physiological stressor”. The knock on health effects of both short term and chronic lack of sleep mean we should all be making sleep as much of a priority as going to the gym or eating our 5 a day.

Why is Sleep so Important?

While there are many different theories about the purpose of sleep, it is widely acknowledged that sleep is a time of restoration and rebuilding within the body.

Sleep is Needed for Your Brain to Rebuild

One example of this is in the brain where flushing of the fluid around the brain throughout the brain cells removes waste products. This process mainly occurs during sleep. Therefore without sleep your brain basically cannot properly rid itself of waste products including amino acids. These include substances such as amelyoid beta – a chemical involved in alzheimer’s. Other brain processes such as memory consolidation and processing are carried also out during sleep. Studies have shown that students will retain more information if they sleep on it.The 5 hours after learning is the critical time for memory consolidation and it is sensitive to sleep deprivation (Hagewoud et al. 2010). Have you ever had a problem and then slept on it and figured it out the next morning? This is because problem solving ability increases during sleep because neural connections increase.

Sleep Helps with Weight Loss 

As we all know obesity is one of the most biggest health challenges facing us today. Contributing factors include sedentary lifestyle and poor diet. Another possible factor (and therefore another weapon in the fight against obesity) is sleep. When you don’t sleep enough your body craves stimulants such as sugar, carbohydrates, caffeine and nicotine to help it sustain itself. Lack of quality sleep can lead to poor diet and lifestyle choices as your body is simply too tired to cope without some sort of additional help. Quality sleep will not only reduce your risk of relying on these stimulants but sleep also decreases the production of grelin- the hormone responsible for hunger. So getting a good night’s sleep can also help you stay on track with maintaining a healthy diet throughout the day.

Lack of Sleep Can Impair Your Body’s Ability to Heal Your Brain!

Sleep deprivation undoubtedly puts the body under stress.  Lack of sleep impairs our brain functionality and can cause damage to the brain. Studies on rats have shown the antioxidant glutathione decreases in some parts of the brain when the rats are deprived of sleep. This chemical is essential for the protection of cells from damage by free radicals, heavy metals and other harmful chemicals in the body. One part of the brain that was found to be particularly vulnerable was the hypothalamus and the study hypothesizes that this could be a factor in the impaired functionality experienced as a result of sleep deprivation. Sleep deprivation also effects the stress hormone systems of the body. Meerlo, Sgoifo and Suchecki (2008) state that sleep deprivation may have a direct activating effect on these systems and long term, could affect the reactivity of these stress systems to to other challenges and stressors. This means that long term lack of sleep may inhibit your body’s ability to cope with challenges such as stress and illness.  Increases in blood pressure caused by lack of sleep can potentially contribute to cardiovascular disease. Elevated glucose and insulin levels which are known side effects of sleep deprivation are contributory factors in diabetes. These are just some of the ways sleep physically affects the body.

What Affects our Ability to Sleep?

Many different facets of modern life interfere with the natural rhythm of our body clock also known as circadian rhythm. Circadian rhythm is the internal system that regulates our wake/sleep pattern. It is seen throughout the natural world in plants, animals, fungi and bacteria. This rhythm is controlled by light. In the natural world this would mean daylight. Nowadays, we are surrounded by lights from electric light bulbs, computer screens, televisions and cellphones at all hours of the day and night. This can interfere with this natural rhythm which evolved over thousands of years in a world dominated by sunlight as the main source of light. Overstimulation by unnatural light sources is thought to be one of the contributory factors to the decline of sleep quality in modern life.

Another factor affecting sleep which researchers have identified is our work. Åkerstedt et. al (2002) identified some of the major aspects of work that affect our sleep in different ways. High work demands, physical effort at work, work related stress and the social situation, feelings of support at work all contribute to sleep disruption. The study also identified other factors such as obesity, lack of exercise, age, gender and even martial status as predictors of sleep deprivation. Perhaps unsurprisingly, having a good social support indicated a lower risk for sleep disturbance and poor sleep patterns while being over 45, female, a smoker and overweight increased that risk.

How Do I Know If I am Getting Enough Quality Sleep?

As previously mentioned it is not simply a case of time yourself to sleep for 8 hours of sleep a day (though that does work for many people). The quality of sleep is also crucial as is recognizing that different people have different sleep patterns at different times in their lives. Teenagers internal body clock predisposes them to stay up late at night and wake up late in the day. As we age, people become less capable of sleeping in a large block of time. Older people do not need less sleep but napping is a more effectual way for them to rest. The key things to think about in terms of sleep are- Do you wake up feeling rested or is it very difficult for you to get out of bed in the morning? Do you wake up during the night? Do you experience a slump in your energy during the day? Do you find you rely of coffee, nicotine or sugar etc to wake you up or get you through the day? Do you rely on pharmaceuticals or alcohol to help you get to sleep at night? If so then you may need to take control of your sleep pattern and adopt some simple practices to improve your sleep.

What is Sleep Hygiene?

Sleep Hygiene is is term used to describe practices and habits which are conducive to sleep. Getting a good nights sleep sometimes requires a little bit of planning not just before bed but throughout your day. As previously discussed the circadian rhythm or body clock is regulated by light. Avoiding bright light late at night (at least thirty minutes before you plan on going to bed) can help your body to switch to sleep mode. As previously mentioned the body’s circadian rhythm is controlled by light. Even staring at a TV, computer or phone before bed can interfere with this. Bright lights in the bathroom before bed or when you wake up in the middle of the night should be avoided. Switch to softer, more gentle lights to aid sleep.

How do I get Better Sleep?

Exercise is a fantastic tool to help aid sleep. Vigorous exercise in the morning or early afternoon can help you sleep better at night because it decreases stress levels. It should be avoided right before bed as it will stimulate the body to be more wakeful. Gentle exercise like walking, or yoga are helpful as part of an evening unwinding routine.

Caffeine, nicotine sugar and other stimulants should be avoided close to bed time. Experts vary as to the length of time you should stop consuming these before bed. Some sources say about 6 hours others say more or less. You will find the right balance yourself but it is a good idea to err on the side of caution. Many people advocate the use of alcohol as a “night cap” to help induce sleep. However these should be used with caution. While alcohol may help you to get to sleep in the first place, overall it decreases the quality of your sleep throughout the night as your body works to break it down. Avoiding drinking a lot of liquids for 2 hours before bed is also helpful. Waking in the middle of the night to go to the bathroom has a detrimental effect on the quality of your sleep.

A light meal can be helpful to induce sleep. You should avoid going to bed hungry. However, heavy or spicy meals have the opposite effect and as your body works to digest these food it disturbs the normal processes you should be going through during sleep. Milk has been shown to have properties that are conducive to sleep but not everyone tolerates dairy well so this may not be an option for everyone.

Creating an environment in your bedroom that is conducive to sleep is crucial. Apart from the absence of bright light the temperature should be right for sleeping, noise even background noise will effect your sleep so if necessary use earplugs. Avoid to other activities such as eating or working in your bedroom. This will help your mind to associate this room with sleep and aid in moving your body to the sleep stage.

Avoid going to bed when you are not actually tired. Lying in bed thinking about work or the fact that you are not asleep yet will not induce sleep. Don’t look at the clock and count how many hours you have left before you get up. This can lead to stress and anxiety which only further inhibits your sleep. If you are having trouble sleeping get up and go into another room and do something restful (not looking at a screen!). This may include reading a book, listening to soothing music or meditation.

Maintaining the circadian rhythm will help to improve your sleep quality. This means going to bed and waking up at the same time each day as much as possible (yes even on weekends). Napping, though useful for some people should be avoided for those who find it difficult to sleep at night. If you are a person who must nap then avoid napping later in the day (at least 5 hours before bed). Establishing this routine helps your body to learn when it’s time to wake up and when it’s time to sleep.

Bright lights in the morning will help to stimulate the body into wakefulness mode. going outside in the light or opening up the blinds in your room will help to rid you of that early morning grogginess.

Are there Natural Supplements that can Help with Sleep?

There are many supplements that can be beneficial to aid your sleep. Melatonin is a hormone secreted by the pineal gland in the brain which controls the sleep/wake cycle. Lack of this hormone is what causes people to be poorer sleepers as they age. The darker days of winter cause the body to produce it at different times in winter and it has been linked to seasonal affective disorder. It has been found to be useful in the treatment of cluster headaches and in high doses it has also been shown to be an effective adjunctive treatment for cancer. It can be used as a supplement to aid sleep with minimal side effects and it is often used to help control the sleeping patterns of shift workers. Magnesium and vitamin D also have a role in sleep. Making sure you are getting enough of these essential vitamins and minerals is helpful in the quest for a restful night’s sleep. Avoiding side effects such as grogginess involves finding the right dose. This varies from person to person and you should consult your naturopathic doctor or health care professional to find the right dose for you.

Non-pharmacological interventions for patients suffering with insomnia were found to be beneficial for 70-80% of patients. (Morin et. al 1999). These could include things like homeopathics, acupuncure, mindfulness and the other techniques previously mentioned. There are many health issues such as sleep apnoea, nervous system issues and abnormal hormone levels which can contribute to poor sleep. Talking to your naturopathic doctor may help to uncover or rule out these issues and help you catch those much needed zzzzz.

If you have any questions about sleep and how you can improve your sleep quality feel free to contact our clinic at info@yaletownnaturopathic.com.

References

1. Restricted and disrupted sleep: Effects on autonomic function, neuroendocrine stress systems and stress responsivity. Peter Meerlo, Andrea Sgoifo, Deborah Suchecki. Sleep Medicine Reviews. June 2008

2. Sleep disturbances, work stress and work hours-A cross-sectional study. T Åkerstedt, A Knutsson, P Westerholm, T Theorell, L Alfredsson, G Kecklund. Journal of Psychosomatic Research: February 2002

3. Sleep deprivation induces brain region‐specific decreases in glutathione levels

D’Almeida, Vânia1,2; Lobo, Letícia L.1; Hipólide, Débora C.1; de Oliveira, Allan C.2; Nobrega, José N.3; Tufilk, Sérgio1,4

4. Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review. Morin CM, Hauri PJ, Espie CA, Spielman AJ, Buysse DJ, Bootzin RR

Sleep. 1999.

5. Coping with Sleep Deprivation: Shifts in Regional Brain Activity and Learning Strategy

Roelina Hagewoud,1,† Robbert Havekes, PhD,1,†§ Paula A. Tiba, PhD,2 Arianna Novati,1 Koen Hogenelst,1 Pim Weinreder,1 Eddy A. Van der Zee, PhD,1 and Peter Meerlo, PhD1. Sleep. 2010.

6. Regulation of adult neurogenesis by stress, sleep disruption, exercise and inflammation: Implications for depression and antidepressant action. P.J. Lucas, P. Meerlo, A.S. Naylor, A.M. Van Dam, A.G. Bayer, E.Fuchs, C.A. Women, B. Czeh. European Neuropsychopharmacology. 2010

Sleeping It Off: How Alcohol Affects Sleep Quality March 15, 2013

Posted by Dreamhealer in Alcohol, Experiments, Health, Research, Sleep.
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drinking affects sleep dreamhealer

Having a drink (or two) is one way to nod off more quickly, but how restful is an alcohol-induced slumber?

The latest research, published in Alcoholism: Clinical and Experimental Research, shows that while a nightcap may get you to doze off, you’re more likely to wake up during the night and may not feel as rested following your sleep.

Scientists reviewed 20 studies that included 517 participants who were tested in 38 sleep laboratory experiments. The volunteers drank varying amounts of alcohol, ranging from a low of one to two drinks, a moderate amount of two to four drinks, to a high of four or more drinks. While some experiments examined the results of only one night of drinking, others extended into several consecutive nights. Most of the participants were healthy young adults, and none had drinking problems.

“This review confirms that the immediate and short-term impact of alcohol is to reduce the time it takes to fall asleep,” lead author of the study Irshaad Ebrahim, director of the London Sleep Center, said in a statement. “In addition, the higher the dose, the greater the impact on increasing deep sleep.”This helps explain why so many people rely on alcohol to fall asleep, despite warnings from experts that it merely postpones and can worsen insomnia. “The effect of consolidating sleep in the first half of the night is offset by having more disrupted sleep in the second half of the night,” Ebrahim said.That presents a more complicated picture of how alcohol affects sleep, and the trade-off may have implications for understanding how sleep can impact overall health as well. At all doses studied, alcohol increased deep or so-called slow-wave sleep (SWS) during the first part of the night. This type of slumber is associated with healing and regeneration of bones, muscles and other tissues, as well as maintaining a strong immune system.“SWS or deep sleep generally promotes rest and restoration,” Ebrahim said, cautioning, however, that alcohol increases in this stage can worsen sleep apnea and sleepwalking in people who are prone to those problems.

In contrast, drinking has long been known to reduce REM sleep, the deepest sleep stage in which most dreams occur and during which memories are likely stored and learning occurs. And the current review suggests that it’s the amount of alcohol people drink that may have the biggest effect on their sleep quality. One or two drinks, for example, can increase slow-wave sleep while not affecting deeper REM sleep. But more alcohol can cut into the time spent in the REM stage. So that nightcap may be helpful in getting you to doze off, while a wild night of heavy drinking is likely to make you more restless. Moderation, it seems, is the key to a good night’s sleep.

Article retrieved from: http://www.healthland.time.com
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