Latest / MIT - Conversations with MIT Health / Getting Your Circadian Groove Back | Interview with Zan Barry, Manager of Wellness Education

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Getting Your Circadian Groove Back | Interview with Zan Barry, Manager of Wellness Education · MIT - Conversations with MIT Health

0:02
Emily Wade: We are entering cozy season here in Massachusetts, which means we're
0:07
all doing stuff like curling up with a mug of something warm or wrapping up in
0:13
a blanket or researching soup recipes.
0:18
But it also means that the time is changing and the days are getting
0:22
shorter, and pretty soon we're gonna blow past the winter holidays and we're
0:30
going to end up in slushy, sloppy, oh my God, I need this to be done season.
0:38
So what are we gonna do?
0:41
Today, I'm welcoming an actual bonafide MIT celebrity, the voice of the sleep
0:48
line to this podcast, Zan Berry.
0:51
She's the manager of wellness education here at MIT Health, and she's an expert
0:56
in sleep and stress management, and she's gonna help us navigate the months ahead.
1:02
Welcome, Zan
1:04
Zan Barry, PsyD: Hey, Emily.
1:04
Thank you
1:05
Emily Wade: we've talked about this a little bit in our planning for this
1:08
episode, but we're about to head into the time of the year where it gets dark like
1:15
the second you get out of work or school.
1:18
And so suddenly everybody's feeling a little sleepy and cranky.
1:23
is there a real biological response going on there?
1:26
Or are we just being like dramatic New Englanders who must suffer?
1:31
Zan Barry, PsyD: Excellent question.
1:32
And if you think about it, if you live in New England, you may notice that the
1:37
longest day of the year, right around June 21st, is over 15 hours of daylight.
1:43
And then the shortest day of the year, right around December
1:45
21st, is nine hours of daylight.
1:48
And we have to adapt our circadian rhythm, our biology has to adapt to that
1:53
enormous over six-hour swing between the long days and the short days.
1:58
And so this does create some difficulty with regulation.
2:03
You know, it may be a melatonin, serotonin regulation issue, but it will create
2:09
feelings of drowsiness during the day or the feeling that sleep is not quite as
2:12
restorative or, you know, for some people it's intense food cravings, carbohydrate
2:18
cravings, wanting to take more caffeine.
2:21
There are lots of ways in which the body's trying to biologically
2:24
adapt to this huge swing
2:27
Emily Wade: what is our circadian rhythm actually doing when
2:30
that daylight is decreasing?
2:32
Zan Barry, PsyD: We need daylight as a rhythm setter, a time setter for
2:38
every part of our biological rhythms.
2:41
And we need light to go into the retinas.
2:43
For sighted people, we need light to go into the retinas, to go into
2:47
the master clock in the brain.
2:48
And when there's less, relatively less light and people, let's say, are getting
2:53
up in the dark and then coming home in the dark, it's not that it's a lost…
2:59
We're not a lost cause, but we do need to make the most of those middle hours
3:03
when the sun is the most overhead.
3:05
So when the sun is highest in the sky, let's say 11:00 to 1:00, or 10:00 to 2:00
3:11
PM, we need to be, getting some of that light into our retinas in order to be
3:18
setting partially, you know, resetting those, disequilibrated, hormones.
3:23
And also we need to be getting light early in the day as a way to set the clock off.
3:27
We need…
3:27
You know, whenever, we get up, we need to turn on some light or we need to
3:31
get that first sunlight of the day.
3:33
And this will, impact when we secrete melatonin at night, which
3:38
impacts the quality of our sleep and can impact mood and other things.
3:43
Emily Wade: So I think, I feel like it's b- it was a trend a while ago, and it's
3:48
probably still a trend, but, you know, it feels like sometimes everything gets,
3:52
like, flavor blasted with mel- melatonin.
3:55
Like, there's, like, melatonin gummies and, like, melatonin breakfast cereal.
3:59
Like, i- is that, is that a legit way to supplement your melatonin, or is,
4:06
is getting outside and getting into the s- the sun or, like, exposing
4:11
yourself to light the preferred delivery format for melatonin?
4:17
Zan Barry, PsyD: Well, if the brain already has a natural pharmacy of
4:20
melatonin, let's make the most of the natural pharmacy first and foremost.
4:24
So that means light in the morning.
4:27
And for some people, they may use a brighter light or full spectrum light.
4:31
You can talk to your clinical provider about perhaps light therapy, something
4:36
called light therapy boxes that you could use in the morning, which is
4:40
both for mood and for melatonin.
4:42
Or to suppress melatonin, right, and get the brain alert.
4:45
but let's make the most of the natural pharmacy using light.
4:48
We have this incredible system that, naturally sets a beautiful pattern,
4:53
a beautiful rhythm where we're meant to be awake for about 16 hours and
4:57
asleep for about eight hours, and the melatonin pattern looks in that,
5:01
you know, looks like that curve.
5:03
so first and foremost, let's start there.
5:04
And then if you wanted to talk to a provider about supplementing melatonin,
5:09
if you look at the research, most melatonin research is on things like
5:13
jet lag, so more adjusting to a new time zone as opposed to an ongoing situation.
5:19
and most of the dosages in that research are rather small.
5:24
It's usually a low, start with the lowest effective dose kind of thing.
5:27
but talking to a provider about supplemental melatonin
5:30
could be, one avenue to take.
5:33
I always say start with the natural pharmacy first
5:36
Emily Wade: I'm gonna use a grad school word, to problematize this moment,
5:42
when we are supposed to be outside is right at the same convenient
5:46
time when we have these super fun things called work and school.
5:52
And, I think that that's kind of what-- I'm gonna blame that for the reason
5:58
that I'm not going outside enough.
6:00
I'm sure there's other, other excuses I could use.
6:02
But what do you-- what advice do you have for someone who is
6:07
feeling like, "I, I have a plan.
6:10
I'm gonna get outside," but then, you know, they're getting dumped
6:14
into like six meetings or, you know, their class or their research
6:18
project is, is running right up against that valuable sunlight time.
6:22
What are, what are some strategies that you recommend to kind of head that off?
6:27
Zan Barry, PsyD: Mm-hmm.
6:28
Well, what I really like about, expanding the window of time, let's
6:33
say 10:00 to 2:00 is your window.
6:37
If, at all humanly possible to manage the expectations of the outside world to
6:43
get recess, lunch, a walking meeting, an outdoor chore, a little outdoor errand.
6:50
And let's not let the perfect be the enemy of the good.
6:52
If it's 20 minutes, it's, you know, that's great.
6:54
Go to the, you know, take a walk, a loop around your building and come back.
6:58
But, but if your window is that nice wide range, 10:00 to 2:00, somewhere in that
7:03
four hours, and of course, it's always helpful to have a bit of social support.
7:09
So if you're meeting someone, you're probably not gonna blow it off.
7:12
it's a little sometimes harder to keep our dates with ourselves, but often
7:16
if there's a social motivator or some social expectation, we'll be there.
7:21
so if people are willing to do walking meetings.
7:23
Of course, this involves putting on mittens, right?
7:25
And being prepared to, be, you know, ready for the weather, finding some outdoor
7:31
spot where you can enjoy time outside.
7:35
I'm not asking people to love the winter, but, to, you know, dress
7:38
appropriately and get outside.
7:39
And one of the things that we have at MIT is the tunnels.
7:43
We have the tunnels which run under all the buildings, so you can get from
7:45
point A to point B, never going outside.
7:48
And people take the tunnels when the weather starts to get bad.
7:51
And I would say, unless it's a blizzard, try to walk outside.
7:56
Even on a cloudy day, you are getting so much beneficial light,
8:00
from being outside instead of being down under the, in the tunnels.
8:04
that try to, you know, get the outdoor time if you can
8:08
Emily Wade: Oh my God, I, I love that because I, I am such a mole person.
8:14
And like the second that, you know, the days get a little shorter, I'm
8:18
just like, "I'm gonna walk through all of the tunnels to get-- to like
8:23
go get underground sushi somewhere."
8:26
You know?
8:27
I'm getting that sushi at the coffee shop at the fr- you know, front of the Infinite
8:33
Zan Barry, PsyD: go one floor up.
8:34
Yep.
8:34
Get above.
8:35
Yeah
8:36
Emily Wade: Yeah, yeah.
8:37
Okay, okay.
8:39
All right.
8:40
I'm gonna, I'm gonna change my ways.
8:43
I think that's good.
8:44
MIT, you heard it here first.
8:47
Maybe, maybe take that next, next meeting.
8:50
Don't take it on Zoom.
8:52
Take it outside.
8:53
You know, go on a little adventure, you know?
8:55
S- try out one of the million new restaurants that has opened in our area.
9:02
so let's talk a little bit about the other thing that happens at
9:07
this time of year, the time change.
9:11
Everybody's favorite, spring forward, fall back.
9:14
this thing destroys my life every year.
9:16
I know that daylight savings time is supposed to be the one that's
9:19
worse, I know, technically, but this is the one that it just…
9:25
I can't, I can't function the second I have to fall back.
9:30
I'm just curious, you know, what, what's going on biologically that
9:36
makes this, like, seemingly little change just blow everything up?
9:43
Zan Barry, PsyD: Well, it is a little bit of jet lag.
9:45
You know, the sort of imposed jet lag that we suddenly are in an hour different
9:49
time zone the very next morning.
9:51
This is, an unusual circumstance for the body for sure to go an hour's
9:57
difference in, the blink of an eye.
10:00
However, we are…
10:01
We do have some flexibility.
10:03
People do adapt circadianly and, That's not a real word, but, you know.
10:08
Circadian.
10:08
People have circ- circadian a- adaptivity, and we can adapt to that
10:12
one hour probably in a day or two, as we would adapt to going to Chicago,
10:17
you know, within a day or two.
10:19
but it's the surprise of that darker nighttime when you know, dark comes
10:26
quickly at night and it really catches…
10:28
It's almost like a biopsychosocial phenomenon where people just aren't
10:33
used to driving in the dark, they aren't used to getting out of work in the
10:36
dark, and all of a sudden it's dark.
10:38
if we can reframe this, I'm big on reframing.
10:41
If we can reframe this as, "Oh, boy, I get an extra hour of sleep,"
10:45
first of all, this fall change.
10:47
Second of all, "Oh, boy, if my sleep schedule has gotten really messed up
10:51
and it's gotten very erratic or all over the place, this is a really good chance
10:55
to reset it because I'll naturally be inclined to wake up a bit earlier,"
10:59
'cause again, the clock has shifted and the body may be ready to wake up an hour
11:03
earlier on the clock than the day before.
11:06
So if I've been wanting to start getting up earlier, getting more
11:09
morning light, this is my opportunity.
11:12
use it as a little springboard if you've been wanting to
11:15
be more of a morning person.
11:18
and just getting, again, making sure you're not getting into that
11:24
vampire mode where you're sleeping in past some of the good daylight, and
11:29
then the, sun, set happens at 4:30.
11:34
If you've missed the entire lightest part of the day, that's where people
11:38
start to get really, really, ugh, you know, just in the doldrums.
11:43
So, it's really important, again, to plan ahead.
11:47
Use it as a springboard if you wanna be getting up earlier.
11:50
Enjoy the extra hour, and make sure at least that first couple days you
11:54
get out in the middle of the day to get all that good overhead light.
11:59
Emily Wade: Are there any things we can do ahead of the time change to
12:02
just like sort of prepare ourselves?
12:05
Zan Barry, PsyD: I mean, this is the one that people tend to, I'm
12:08
sorry, Emily, enjoy more because they are getting this extra hour of
12:11
sleep, and it feels like sort of a, you know, a little, treat inserted.
12:15
But, for sure, if you've been wanting to get up earlier and adjust your
12:20
time more th- by more than an hour, adjust your schedule by more than
12:24
an hour, it's a great idea the f- three or four days before to start
12:28
shifting 15 minutes at a time.
12:31
If you want to shift 15 minutes earlier to bed, and then you'll be
12:35
getting even more kind of, ahead of that time change and, and getting
12:40
even more extra sleep that night.
12:42
or getting, you know, your s- your sh- clock, your circadian clock will
12:45
have shifted even more by the night that the time change rolls around.
12:48
so if you wanted to use, again, use it as a springboard, usually 15
12:51
minutes at a time is a good amount of time to shift your body clock.
12:55
It's gentle.
12:56
It's not like trying to wake yourself up three hours earlier.
13:00
but little 15-minute increments each night or 20 minutes every
13:03
couple days is a good way to start, shifting your clock if that's
13:08
something that you're wanting to do.
13:10
Emily Wade: If you're, if you're someone like me who for, for some
13:13
reason just really resents that extra hour of sleep, I guess.
13:20
so we've, successfully gotten through the time change, and we're, you know, we're
13:28
trying to go outside and occasionally, I th- I think I used the phrase in my
13:32
la- last one of these, touch grass.
13:35
I guess we're gonna try and touch frozen grass
13:37
Zan Barry, PsyD: Touch, furs, and grass
13:39
Emily Wade: touch frozen grass.
13:40
there-- are a lot of gadgets that I feel like even, you know, it's like
13:45
if you walk past the MIT, museum gift shop, I feel like they have a lot
13:51
of like light gadgets in there right now, and sometimes I'm like, "Oh,
13:56
maybe these would transform my life."
13:58
But are there, are there kind of things that we can buy or use to
14:04
kind of fix this and jumpstart it?
14:08
Zan Barry, PsyD: Well, the first thing I would say is if you're interested
14:12
in a light therapy type gadget, a light therapy box that has specific
14:17
regulations around what would be a therapeutic dose of light and how much
14:21
time to spend in sitting in front of it.
14:23
You don't have to stare at the light.
14:24
You could sit and read, you know, but the light is close.
14:27
talk to a clinician about that.
14:28
Talk to a clinician about anything that's like light therapy because
14:32
you wanna make sure it's appropriate for your situation, appropriate for
14:35
your eye health, appropriate for other, you know, kinds of conditions.
14:39
That's light therapy.
14:40
And then there's just getting a good, you know, full spectrum light bulb that
14:46
you can Google that and, you know, find some good full spectrum light bulbs.
14:50
You might wanna get a programmable bulb.
14:52
Doesn't have to be fancy, but something that will go on when your alarm goes off.
14:56
So in the morning, as your alarm is starting to…
14:59
I wake up to this bird sound, you know, and I have a light bulb that starts to
15:02
come on, feels a bit like a sunrise.
15:05
And I have to say, that is a very pleasant addition during the dark, dark days.
15:10
it's, really nice to have it right at eye level or, you know, just
15:13
above eye level maybe with no sh- it doesn't have a shade on it.
15:17
So it's just an additional alerting signal in the, dark days of winter
15:23
that can be something to try
15:26
Emily Wade: Oh my gosh, I love that.
15:27
I think, I think our community can get behind programmable light stuff
15:34
and probably, probably make a very satisfying and exciting option.
15:39
I l- So everybody get, get creative
15:42
Zan Barry, PsyD: Yes.
15:44
Send me your i- your, interesting ideas.
15:47
Emily Wade: Yeah.
15:47
Send, send us, send us photos of your, of your interesting light setups.
15:54
we wanna see them.
15:55
We want, we want to, we want these for…
15:58
We can include them in the patient newsletter.
16:00
It'll be awesome.
16:01
so I'm holding it right now, my big honking muv- mug of coffee.
16:07
What should be- we be doing?
16:10
This is inevitably the time when, you know, our…
16:14
Well, it's out in Massachusetts, so everybody's getting the giant
16:17
iced coffee and, and, everybody's upping their caffeine intake.
16:23
when is this like you should, you should stop and, and move to something else?
16:28
Like, i- is it something where it's like, can you continue to drink, you
16:32
know, the two cups a day of coffee that, that you're drinking, or is,
16:39
is increasing that gonna be bad?
16:42
Like, you know, when, when is it too much?
16:46
Zan Barry, PsyD: the way that coffee or caffeine gets, craved, let's say,
16:52
during this time of year is because people are feeling groggy all day long.
16:55
They never quite feel like they wake up.
16:57
That's one issue that can sometimes have with, have with these
17:00
shorter days with the melatonin, serotonin dysregulation that could
17:04
happen during this time of year.
17:06
So people will be craving that feeling of wanting a stimulant all day long.
17:10
that's one situation.
17:12
And the other is just, "I need something to, you know, me going in the morning."
17:16
the problem with caffeine is that it has to go through several half-lives as it
17:21
leaves the body, and the average half-life
17:24
No one is the average person, but the average half-life, let's say,
17:27
is between five and six hours.
17:29
And the rule of thumb is that you wanna go through two half-lives
17:32
before you're ready to go to bed.
17:34
You want two cycles of half-lives before, you know, the body
17:38
may be, ready to go to bed.
17:40
So that's why you often hear this advice, no coffee after lunch or after noon,
17:44
because we are thinking if it's still in the body five hours later, and then
17:48
again another five hours later, it's gone through another half-life, then
17:51
by 10:00 or midnight we'll assume it's, it's gone through its two half-lives.
17:55
that's one rule of thumb.
17:56
But the other, I think, personal experience, if it's making your heart
18:00
beat fast and making you feel anxious, if it's fragmenting your sleep, if
18:05
it's just making you feel more jittery than anything else, or if it's not
18:09
even doing its job anymore because we've developed tolerance, and then
18:14
we're taking in more and more just to stave off withdrawal, but not really
18:17
getting any- anything out of it, there
18:20
The other s- you know, ways to increase energy, first of all, are to let's work
18:24
on the quality of your sleep to make it as robust, as consolidated, as good quality
18:29
as it possibly can be, which means, again, keeping that caffeine way earlier.
18:34
getting exercise will definitely strengthen sleep, and definitely,
18:39
create the kind of sleep drive and fatigue that the body loves in order
18:43
to be able to fall asleep more easily.
18:45
So exercise is a much better idea, let's say.
18:48
but there are upper limits to, you know, the amount of caffeine, and people
18:51
start, start getting tolerance and stop feeling the boost of it after a while.
18:57
So, so the two, you know, downsides would be either you don't feel any
19:00
boost or you're getting jittery, anxious, or, fragmented sleep.
19:05
And we want to avoid those things.
19:08
And I think the rule of thumb about keeping it toward the morning is
19:12
a, is a good one, and then adding exercise and light, and use those
19:17
as your natural stimulation.
19:18
Emily Wade: Well, I love that.
19:19
It's also, I feel like those are, cheaper.
19:22
These, these coffees, they add up after a while
19:25
Zan Barry, PsyD: They do.
19:26
And I'll tell you another secret because I s- started life as a yoga teacher.
19:30
I do dynamic breathing, which is sometimes called chicken breath,
19:33
which has no downsides at all in terms of caffeine, stimulation.
19:38
It's just pure energy, and it means pumping your arms and bouncing up and down
19:42
like a chicken a little bit if you want to, in, out, in, out through the nose.
19:46
Keep your mouth closed.
19:47
Just do a few of those to kind of pump the lungs like a bellows
19:50
and, and you will find that you get energy without jitteriness.
19:56
Chicken breath, there you go, from me to
19:57
Emily Wade: Okay.
19:58
Okay.
20:01
That's, that's awesome.
20:02
We have a town hall today.
20:03
I feel like you should I feel like you should model chicken breath at our,
20:10
at our MIT Health to- town hall today.
20:12
All right.
20:13
we've, covered a lot today, and this is, I think, I think people are gonna come
20:18
away, I know I'm gonna come away, with a lot of, a lot of strategies to try.
20:25
so say someone has, you know, they've tried going outside.
20:31
They've-- they're avoiding those tunnels.
20:33
They're no longer a mole person, and they're trying to get out in the light,
20:37
and they're improving the re- routines and working on, you know, doing those
20:43
workouts, and they still feel just like, "I am just made out of doldrums.
20:49
I'm just still feeling, the blahs."
20:53
When is, when is the moment to contact MIT Health or your, your, you know,
21:00
clinician, and what's the right door?
21:02
Where, where do you-- where should you go first?
21:06
Who should you ask?
21:07
Zan Barry, PsyD: Well, there is no wrong door because any primary care provider
21:13
will be able to help you find a behavioral health or a mental health provider.
21:18
Vice versa, any mental health provider will be able to answer
21:21
questions about seasonal pattern blues or seasonal mood, pattern mood
21:25
problems and get you, the, the full complement of care that you might need.
21:30
So we're all, networked together.
21:34
I will say if you're trying things on your own, I really recommend putting
21:39
something on the calendar to look forward to each month of the dark
21:43
months, November, December, January, go all the way through March, something
21:47
on the calendar to look forward to.
21:49
Start, as you say, you know, putting some of the, the behavioral things into
21:54
practice and if you, if you know what you wanna do and all those clinicians
21:58
can help you figure out what, what do I wanna do to get through these months?
22:02
But you're having a hard time putting it into place and putting where the
22:06
rubber meets the road, making it, actionable, I can help you with the how.
22:12
Like how can I fit this into my busy schedule?
22:14
How can I make this realistic and bite-sized?
22:17
How can I, make this work for me?
22:20
That's where something more like a wellness consultation with
22:24
someone like me who's trained as a health coach, could help.
22:27
You know, the clinicians will help with the what and then I'll help with
22:30
the how and then together, you can
22:34
flourish
22:36
Emily Wade: this, has ha- been great.
22:38
And the other thing is I wanna say is, Zan, you have quite a
22:42
few different wellness workshops and classes that are coming up.
22:48
so if you go to health.mid-
22:50
mit.edu/thrive,
22:54
not only can you submit a question to office hours, but you can also go through
22:59
and find out all of the really great programming that Zan has cooked up for
23:04
the next few months, 'cause there's, there's things about stress and time
23:11
and s- time changes and management and sleep and, and just every possible,
23:18
class that you can use to improve all of these different conflicting situations.
23:25
You know, it-- you don't have to just cling to your blanket and
23:28
your, your cozy cup of coffee.
23:30
You can, you can also get, get some help here at MIT Health
23:35
Zan Barry, PsyD: I would love to see everybody there
23:38
Emily Wade: Yes.
23:39
Yes.
23:41
That would be awesome.
23:43
well, this has been a wonderful episode.
23:45
Zan, I'm probably gonna invite you back when we switch over to the t- new
23:48
time again because, you know, I-- even though I-- this is the one I don't
23:54
like as much, I-- they both mess me up.
23:56
What can I say?
23:57
So we- we'll have you back for, for daylight saving.
24:03
and thank you so much for being on the show.
24:07
All right, listeners, I have a challenge for you.
24:10
I need questions.
24:12
I need you to go to health.mit.edu/thrive,
24:18
send us those questions.
24:19
We really love hearing from you.
24:21
All right.
24:22
Have a cozy, cozy time out there, folks, and we'll see you next time