Shelby Harris Quotes

#1. For some people they say, it's about wish fulfillment, it's about the things you are never able to do in your day you are actually fulfilling at night. There are other people who will say that it's actually telling you something.

Shelby Harris

#2. Really, a nightmare just really has to evoke some sort of, we call it, dysphoric emotion or something uncomfortable. You could be sad, you could be unhappy; you could be scared, anxious. But traditionally, the definition is you have to awaken from this nightmare.

Shelby Harris

#3. In general, there are patients with insomnia who - many patients with insomnia will actually over report the lack of sleep that they are getting.

Shelby Harris

#4. Honestly, 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 Harris

#5. There are some that are - REM Behavior Disorder, we'll see some court documented cases. And they really need to have a thorough evaluation with a sleep specialist.

Shelby Harris

#6. Decrements in attention and concentration, being able to learn more efficiently, that's just not as good. Also, there are motor vehicle accidents, workplace accidents, we see that a lot.

Shelby Harris

#7. Narcolepsy is a disorder that affects many different areas of life. So in typical patients with narcolepsy, they have something called "excessive daytime sleepiness." So, they're very sleepy during the day. Yet, at night, they're still sleepy, but their sleep is very broken.

Shelby Harris

#8. So you have Sleep Stage One, Two, and then Three/Four. One is a little bit lighter stage of the quiet, non-REM sleep and then Three/Four is really deep, deep sleep. And what you want is, you actually want a number of - you want to go through all of these stages throughout the night.

Shelby Harris

#9. Jet lag depends on which direction you're going and it can be a little complicated, but there are a few different treatments. So one would be if you're going somewhere - sorry it's hard to think about it.

Shelby Harris

#10. Now there's some night terrors that happen in adults. And if it starts as an adult and you've never had them before, then there might be other things that are happening; it might be anxiety, depression, stress. And that's when you might have more of a thorough psychological evaluation.

Shelby Harris

#11. Really if it's an hour or two after you've fallen asleep because you're in such a deep sleep at that point.

Shelby Harris

#12. So there's a few different ways that we treat insomnia. The first thing that we always do is we look at the cause.

Shelby Harris

#13. So, sleep deprivation, and sometimes an insomnia, which is a little bit of a different form, but just getting a lack of sleep, can lead to a number of different decrements.

Shelby Harris

#14. There are some patients who just have insomnia and they've had it since they were a kid and we don't quite know why. So when we look at the cause, we definitely want to treat whatever else is going on, but insomnia often because it becomes its own diagnosis and that requires its own treatment.

Shelby Harris

#15. We actually don't know the function of sleep all that well yet, but sleep is a time of quiescence in the brain.

Shelby Harris

#16. So when it comes to circadian rhythms, it's a clock that's basically programmed in our body. So if you think back to times when people lived on farms and we didn't have electricity.

Shelby Harris

#17. So when you go to sleep at night, if you're someone who hasn't had any sleep deprivation, you have a very normal sleep pattern, what we tend to see is that, in adults, they go to bed and they start off by going into the deeper stages sleep.

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#18. Some patients are still having insomnia, but it's seems worse to them than actually it is. So, if they say they're sleep deprived, they haven't slept at all in three days; if we actually take them into a lab, most of the time we actually do see they're sleeping on and off here and there.

Shelby Harris

#19. So you have it, you awaken from it and you can recall, in detail, what just happened, that's a nightmare. So it's very different from a dream where you generally don't wake up from it and you don't have this dysphoric emotion.

Shelby Harris

#20. So someone who is a child usually goes to bed about 8:00 or 9:00 at night, but then when they have a circadian rhythm shift, it shifts later. And this is natural. And they start to go to bed at 11:00, 12:00, 1:00 and they want to sleep later. So we see this a lot in teens.

Shelby Harris

#21. So, 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 Harris

#22. When it comes to the reason why we have nightmares, we're still debating that. It's a new area of research, nightmares. And the way I like to think about it is, our brain - we have stress during the day and our brain needs to learn to process this stress.

Shelby Harris

#23. We haven't really - it's harder for us to set those rhythms. So it's really important to keep a steady bedtime and wake time to really lock in those rhythms.

Shelby Harris

#24. So the deeper stages of sleep are really those times of quiescence, you're really restoring your body and we have a few different stages of sleep.

Shelby Harris

#25. So when you're in REM sleep, your brain is very active, our body is quiet, but your brain is really processing a lot of things, a lot of emotions; we dream the most in REM sleep. And then you go back down in the deep stages, and so on and so forth.

Shelby Harris

#26. Well, the actual function of the brain, not so sure yet. There's a lot of different theories about it, but when you talk about psychologically in your brain, a lot of people with insomnia, though not all, report that they can't turn their minds off.

Shelby Harris

#27. Workplace accidents with people who are sleep deprived or people who work shifts and they don't get the right amount of sleep during the day or at night.

Shelby Harris

#28. When they [people with insomnia] start worrying about not sleeping, I'll say, "Say the mantra to myself; if I don't sleep tonight, I'll likely sleep tomorrow, and if not tomorrow then definitely the third" because our body has a way of naturally catching up.

Shelby Harris

#29. There's a problem for them [teens] when they have to get up and go to school in the morning, they're very sleepy, yet on the weekends, they'll sleep 12 hours, they'll sleep late and then go to bed late and wake up late. And on vacations, it's not a problem.

Shelby Harris

#30. People tend to remember their dreams in the morning a little bit better and if earlier in the night, when you're in a lot of deep sleep, if someone wakes you, or the phone rings or something, you're really confused.

Shelby Harris

#31. So we go through in the beginning of the night, we go into the really deep stages of sleep and we actually cycle through. So, when you go down to the deep stage, then you go back up and you actually come into something called REM sleep, which is after about 90 minutes.

Shelby Harris

#32. So people only focus on getting the really deep sleep, but in reality, we spend almost 60% of the night in the stage two sleep.

Shelby Harris

#33. Some patients will report that they have sleep paralysis. If we see sleep paralysis alone and nothing else, we don't really think all that much of it, but if we see other symptoms, then it might be a red flag for something else that's going on.

Shelby Harris

#34. There are other people that think that dreams actually do serve a purpose. But what that purpose is, we're not really sure. So some people believe that it actually does have some psychological representation of what's going on in the day, but there's no need to sit and really analyze it.

Shelby Harris

#35. There's a new line of research showing that people who don't get enough sleep, they're body doesn't metabolize as well. And so they actually - it leads to weight gain. So if you're not getting enough sleep, you might have difficulty losing weight.

Shelby Harris

#36. 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 Harris

#37. So the older models, when you look at Freudian, when you look at Jungian thought, and there's still people who really - who really use the Jungian thought of dream analysis, is really that you would analyze the dreams. The dreams are there for a purpose.

Shelby Harris

#38. When you are more awake at nights, they'll toss and turn, they'll think more, they get frustrated. And when that starts to happen, you really don't sleep even more because you're making your body tense and your mind is getting more and more active.

Shelby Harris

#39. We try not using medications initially, and we use something called behavioral therapy for insomnia. This changes behaviors people do in bed, none of the tossing and turning.

Shelby Harris

#40. The other option we have are medication treatments. So you'll have the treatments such as Ambien, Lunesta, Sonata, and we'll also have Rozerem and for some patients we use Benzodiazopine/Clonazepam. Things like that to help with anxiety.

Shelby Harris

#41. Now circadian rhythms become very interesting and problematic for patients because when you become a teenager, your rhythms actually tend to naturally shift.

Shelby Harris

#42. And you cycle throughout so that you do about five to six cycles throughout the night. And we spend more time in REM later on in the night than we do earlier on.

Shelby Harris

#43. Night terrors are very different from nightmares. A lot of people will think they're the same, but they're really not. Night terrors - you want to look at the time of night when you're having the problem. Night Terrors happen in deep sleep. Nightmares tend to happen in a lighter REM sleep.

Shelby Harris

#44. So, more times than not, but not every time, it can be linked to a medical problem, such as menopause, cancer, chronic pain, it can be linked to anxiety and depression. Those are the more common causes.

Shelby Harris