Michael Terman Ph.D. - Reset Your Inner Clock: The Drug-Free Way to Your Best-Ever Sleep, Mood, and Energy

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First trade paperback edition copyright 2013

Previously published in hardcover as Chronotherapy

Copyright 2012 by Michael Terman and Ian McMahan

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Library of Congress Cataloging-in-Publication Data

Terman, Michael.

[Chronotherapy]

Reset your inner clock : the drug-free way to your best-ever sleep, mood, and energy / Michael Terman,Ph.D., Director, Center for Light Treatment and Biological Rhythms, Columbia University Medical Center, Ian McMahan, Ph.D., City University of New York.First paperback edition.

p. cm.

Revision of authors Chronotherapy. 2012.

Includes bibliographical references and index.

ISBN 978-0-698-14824-6

1. Circadian rhythmsTherapeutic use. 2. Sleep deprivationTherapeutic use. 3. SleepPhysiological aspects. I. McMahan, Ian. II. Title.

QP84.6.T448 2013 2013028919

612'.022dc23

While the authors have made every effort to provide accurate telephone numbers, Internet addresses, and other contact information at the time of publication, neither the publisher nor the authors assume any responsibility for errors, or for changes that occur after publication. Further, the publisher does not have any control over and does not assume any responsibility for author or third-party websites or their content.

Version_1

What our book does and doesnt offer

O ur goal in writing this book is to help readers make informed decisions about their health and the health of their loved ones. It should not be seen as a substitute for treatment by, or the advice and care of, a professional health care provider. We the authors and our publisher have done our best to make sure that the information we give you here is accurate and up-to-date. We are not engaged in rendering professional advice or services to the individual reader, and shall not be liable or responsible for any adverse effects or consequences that might be seen as arising from information or suggestions herein.

To JANE, JIUAN, and SELENA

Contents

The clock on the wall measures twenty-four hours every day, but the clock in your brain runs a little differently. How can you help them work together?

The longer you stay awake, the more pressure you feel to sleep. But what if your inner clock says it is not yet ready for sleep?

What kind of bird are you? And once you know, how can that help you figure out when best to get stuff done?

How do your eyes pass signals to your inner clock, and what makes those signals so important?

Seeing light and being in darkness are basic daily experiences. But what happens when they come at the wrong times, and why does that have such negative consequences for mood, alertness, and sleep?

East or west, south or north, how can where you live have such a huge impact on your mood and sleep?

How can light help you solve your sleep problems, have more energy, and feel more positive about life? Why do the details matter so much?

Do you rely on pills to get to sleep? They may not work, and they may be bad for you. But a new approach based on the brains inner clock holds great promise.

When someone becomes so depressed that he or she has to go to the hospital, what promise does chronotherapy offer for a quick turnaround and continued improvement?

What is it about spending a day at the beach that gives you such a lift? And how can you use new technology to bring that feeling of well-being into your home?

You are going to have a baby! You are thrilled, but a little apprehensive, too. How can chronotherapy help you through the next nine months?

When your baby or child sleeps well and feels good, you feel you are doing the right thing as a parent. How can chronotherapy help you reach this goal?

As a teen, why do you feel the need to stay up so late and sleep so late? What are the consequences for your mood, health, and schoolwork? What simple steps can you take to put your life on a smoother course?

Does getting older have to mean being tired, sleeping badly, and feeling down? How can you or someone you care about reverse these trends by using light?

What if your job puts you on duty when your inner clock says you should be asleep? How can chronotherapy help you stay awake, alert, and in a decent mood?

You are traveling across the world and you need to be in high gear tomorrow. How can chronotherapy prepare you for the trip and help you recover from jet lag as quickly as possible?

How will the collaboration of chronobiologists and architects transform the places where you live, work, and learn?

Why is mainstream medicine so slow to put the insights of chronotherapy into practice?

Foreword

John F. Gottlieb, M.D.

Feinberg School of Medicine

Northwestern University

O ur current understanding of mental health is being challenged and enlarged by groundbreaking approaches. One of the most promising is psychiatric chronotherapy. This book offers both a thorough exposition and a new synthesis of this advance. But to understand how it emerged and why it is so important, we need some background.

Modern psychiatric research, training, and clinical practice are heavily influenced by the pharmaceutical industry. Complaints about the effect of Big Pharma can be found from within and outside the medical establishment. From the subtle effects of publication biases and journal sponsorship to the more overt pressures found in research funding directives, medication-based treatment algorithms, and industry-supported training, the hand of Pharma casts a broad shadow over the current practice of psychiatry. To be fair, the interests of this economic sector have also dramatically moved our field forward. New medications have been developed, treatments have become more effective, and our understanding of the neurobiology of mental illness has exponentially increased. Despite, or perhaps even because of, these advances, our field continues to lean toward neurotransmitter and receptor theories of dysfunction that can be corrected with new psychotropic agents. We live in an age of pharmacotherapy.

Against this background, the new field of chronotherapy is shouldering into view, offering a different set of ideas about what goes wrong in emotional and behavioral problems and what can be done to address it. Chronotherapy, in turn, owes its existence to the basic science of chronobiologythe study of circadian rhythms. Chronobiology is itself a relative newcomer. As recently as fifty years ago, circadian biologists hotly debated whether internally generated rhythms even existed in humans. It was thought that we had evolved past these ancient timing structures and that the ebb and flow of our cognitive, behavioral, and emotional processes was all socially determined. Through painstaking research and novel experimental methods, humans were found to share a circadian heritage with the rest of the biological world. Like all living organisms, we have an internal clock that sets the timing of our daily behavior and physiology. Also shared is our sensitivity to the environmental fluctuations of light and darkness.