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In a new partnership with Twinlab, "The Sleep Doctor" Michael Breus hopes to inspire a new way of thinking about nutrition and sleep.

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What the nutrition industry and consumers get wrong about sleep
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With 39 appearances on “The Dr. Oz Show,” Michael Breus has brought education on sleep to millions of Americans. Sleep also gets no shortage of media attention. And yet, Breus is convinced we are losing more sleep than ever.

From caffeine and alcohol to bright screens and irregular schedules, the patterns of modern life lay traps for the sleep deprived. Working with Twinlab on a set of supplements formulated to address different sleep issues, Breus hopes to help influence a new way of thinking about nutrition and sleep. Education and nutrition are both important, he insists, and getting enough sleep can be tied to every other piece in the wellness puzzle.

There is so much talk about sleep; are Americans getting any better about it?

Michael Breus: I would suggest we are getting a bit worse. Looking at the data generated each year from the National Sleep Foundation, they created a Sleep Index, which can be very helpful looking at sleep quantity, quality, etc. They also produce the Sleep in America Poll, which has great data this year on sleep and next day effectiveness.

What is the nutrition industry’s biggest misconception about sleep?

MB: The biggest misconception I see, in the current state of the nutrition industry, is the predominance of melatonin as a sleep supplement. Looking at the chemical makeup and functionality of this hormone, it is simply being used incorrectly. Melatonin is a sleep regulator, not a sleep initiator. It does not make you feel sleepy; it tells your brain it's bedtime. Those are two very different things. In addition, most melatonin is sold in an over dosage format (data out of the Wurtman Lab at MIT suggest 0.3-1.0 mg is enough to show effectiveness), so consumers are taking too much. This could interact with medications, can have negative effects and can even cause nightmares in some people.

In addition, we see that consumers are also not instructed about when to take this hormone. It takes a good 60 to 90 minutes after ingestion for it to begin to be effective. Finally, as I have written already, melatonin is a hormone, and needs to be considered as one. You would not wander down to the store and pick up testosterone or estrogen. Why can you do that with melatonin? This ingredient is good for helping manipulate our circadian rhythm, which is only a small part of the challenge for most people. 

If you could change one thing about America’s sleep habits, what would it be?

MB: Only one? Making a consistent wake-up time the most important aspect of sleep, including waking up on the weekends, would be my No. 1 choice. The more consistent our wake up time, the more our internal biological clock knows when to wake up and subsequently when to go to sleep. Once that falls in line, we see sleep drive (sleep initiation) come back as well.

My other suggestions would include:

  • Getting 15 min of sunlight each morning. This too helps reset your circadian rhythm.

  • Stopping caffeine by 2 p.m., so that at least half of it is out of the system by 10 p.m. for bed.

  • Stopping alcohol three hours before bed to allow for proper digestion.

  • Exercising daily (20 minutes) but not within four hours of bed.

How would you describe your approach to formulating the Twinlab sleep series?

MB: Research-guided, clinically relevant and practically based. I see patients every week and have been doing that for 19 years. I have noticed a few things along the way, and I wanted to incorporate my observations into the formulation process. I wanted to help formulate something with real research behind it, so we are conducting a clinical trial. I wanted a formula that was differentiated based on the many types of sleeplessness I see in clinic, so we have different formulas for different types. Finally I wanted something practical, so we are including a 10-night video program with me for every customer. That way they can learn about sleep, incorporate my supplement into their nightly routine seamlessly, and not just “take a pill” but actually get better sleep.

For both pharmaceuticals and nutraceuticals, sleep seems to be approached as a one-size-fits-all proposition. What are they getting wrong?

MB: If I had to guess, they never talk with sleep doctors who specialize in sleeplessness. There are so many “flavors” of sleeplessness, it’s amazing to me how companies have never personalized sleep issues. I have patients who have trouble falling asleep, staying asleep, waking up too early, but I also have patients who have sleep issues associated with different health issues that have different “rules for engagement.” For example, women who are going through menopause can have either primary sleeplessness (where they would have sleep issues with or without menopause) or secondary sleeplessness (where their sleep may be affected by hot flashes for example). If we do not understand the type of sleeplessness and adjust the ingredients for it, we are doing a disservice to our customer and never really helping them.

What are some of the health benefits that people don’t realize come with better sleep, and can the nutrition industry sell sleep better with more education?

MB: The list is quite long: Sleep affects every organ system and every disease state. You simply cannot come close to wellness without sleep. Historically, the nutrition industry has targeted areas like weight loss, daytime energy, muscle building, general health and mental health. I can show you data (10+ studies or more) in each of these areas where sleep is not just a contributing factor but, when fixed, could change the underlying issue. Could the industry sell better sleep with more education? I would say yes, if it were accurate, in the right voice and easy to follow.

How can the nutrition industry avoid the “just take this pill” approach to sleep and make products part of a more holistic approach?

MB: I am not convinced that historically anyone wanted to do so. The nutrition industry has been plagued with pseudoscience and non-validated claims for years. While some companies are getting better at quality, they still think in product categories and not how can this product affect health across the human system. I think companies would be well served to get sleep, weight loss, energy and muscle building people in the room, see how they can create profiles and programs for people, and look at total health.

Within a category, companies need to look at the rituals people use around their supplements and medications. As an example, my program (that comes with every bottle) teaches customers about sleep, about how sleep affects all of their systems, engage them in better health practices as a whole, and then get them feeling better. To be honest, it seems so basic to me, because that is what we do in doctor’s offices all over the world.

This article originally appeared in the Condition Specific Issue of Nutrition Business Journal. Email Cindy Van Schouwen, [email protected], to learn more about the report.

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