I'll work on patient's thoughts about sleep, "So I must get eight hours of sleep tonight or I won't sleep tomorrow." That sometimes - or "I won't function tomorrow." That sometimes makes it very difficult for you to sleep at night
Shelby HarrisThere's some debate as to whether you need to awaken from them because there are some patients who are actually starting to say, "I had these horrible nightmares, but I never woke up from them." But they can still recall them when they get up in the morning. So there's still some debate in the field.
Shelby HarrisSo, it's not every patient that I see, but I'd say a good 70% to 80% of the patients when they go to bed it's like a stereo is playing at an 11 or 12 and they can't turn it down, at all. So it makes it very hard for their body to down regulate to be able to go to bed at night.
Shelby HarrisIt's uncommon, but there are some people who just have a delayed circadian rhythm and they just - they sleep better during the day then they do at night. So they've - a lot of those people with delayed sleep phase disorder they start to work in bars, they work some of the late night shifts, they sort of adjust to doing it more and more as time goes on.
Shelby HarrisHonestly, what we use a lot is melatonin. So we use lower dosages of melatonin, taking it at different times, depending upon where we are traveling and that can really help adjust the body's rhythm to wherever you are going.
Shelby HarrisIf you're going somewhere East from here, generally what you want to do is you want to try to have your bed time earlier and earlier so what we'll do is I'll have someone adjust for a week or two by going to be 15 minutes earlier and getting up 15 minutes earlier every night. So that can be a really simple thing.
Shelby Harris