An enlightened approach to insomnia, depressed mood, fatigue, and other sleep-related problems of everyday life, harnessing the power of light therapy to reset the natural clock.
Sleep problems and depressed mood often go hand in hand, forming a frustrating cycle. Michael Terman, PhD, has devoted his career to studying the brain functions that feed these disorders. His discoveries in chronotherapy have been widely recognized as game-changers by the medical establishment, and his 2010 New York Times op-ed, “Sleeping (or Not) by the Wrong Clock,” shot to number one on the paper’s list of most-forwarded online articles. In Chronotherapy , Terman and McMahan reveal the heart of his findings, a powerful program that recalibrates our internal clocks—our exquisitely designed, natural sensitivity to the timing and brightness of light exposure. These delicate mechanisms are often decimated by the modern demands of a 24/7 lifestyle.
Beginning with a questionnaire that pinpoints the problem areas, Terman helps readers decipher when their natural internal night begins and ends. The treatment process can then start, incorporating the power of natural light and, when necessary, supplemental light therapy. His approach has brought relief to thousands of sleep sufferers, as well as those burdened by bipolar disorder, seasonal affective disorder, depression, sleep disorders due to around-the-clock work schedules, and other impediments to vibrant health. For the first time, his findings are now available for a general audience, sharing the essential elements of chronobiology in clear, authoritative, scientifically grounded chapters that are easy to apply to a variety of situations.
Chronotherapy chapters PART TIME, SLEEP, AND RHYTHMS Chapter 1: External vs. Internal Time The clock on the wall measures twenty-four hours every day, but the clock in your brain runs a little different. How can you help them work together? Chapter 2: The Pressure to Sleep 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? Chapter 3: Owls, Larks, and Hummingbirds What kind of “bird” are you? And once you know, how can that help you figure out when best to get stuff done? PART TIME, LIGHT, AND THE BRAIN Chapter 4: Getting Light into the Brain How do your eyes pass signals to your inner clock, and what makes those signals so important? Chapter 5: Getting Light Wrong 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? Chapter 6: Geography and Time East or west, south or north, how can where you live have such a huge impact on your mood and sleep? PART INTERVENTIONS Chapter 7: Healing Light 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? Chapter 8: Nighttime Meds and Melatonin 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 brain’s inner clock holds great promise. Chapter 9: Hospitalized with Depression When someone becomes so depressed they need to go to the hospital, what promise does chronotherapy offer for a quick turnaround and continued improvement? Chapter 10: Beyond The Charge in the Air 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 wellbeing into your home? PART STAGES OF LIFE Chapter 11: The Promise of Pregnancy 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? Chapter 12: Strategies for Babies and Children When your baby or child sleeps well and feels good, you feel better too. How can chronotherapy help you reach this goal? Chapter 13: The Challenges of Adolescence 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? Chapter 14: In Later Years 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? PART CHRONOTHERAPY IN YOUR LIFE Chapter 15: Coping with Shift Work 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? Chapter 16: Racing the Clock, Racing the Sun 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? Chapter 17: Chronobiology in the Home and Workplace How will the collaboration of chronobiologists and architects transform the places you live, work, an...
The book features many case studies of individuals with different sleep problems. E.g. Some can't wake when they're supposed to; others are on shift work and find it highly disruptive; some suffer from SAD (Seasonal Affective Disorder), etc.
A large part of the book focuses on SAD and how to treat it. Didn't find this useful or relevant to me because I live in a tropical country with plenty of sunlight all year round. (SAD is primarily caused by depression brought on by too little sunlight.)
And the chapters that talked about the people doing shift work simply just presented facts (and case studies), and not a solution. It didn't say anything about how to adapt to doing this shift work at all.
What I was more concerned with was finding out how to reset the inner clock, as the book puts it, especially if one has to travel, or conform to particular sleeping/waking hours because of one's job.
The book does talk about this, but not to my satisfaction. There is much research cited, and the authors describe how they helped a few people sleep/wake when they were supposed to. One of these people was a teenage student who had problem making it to school on time because he just couldn't sleep and wake early. His cycle was to sleep around nearly dawn and wake in the afternoon. Another was a young woman who had problems waking up to get to work because she was an "owl".
(To clarify: the book classifies people as "larks", "owls", or "hummingbirds". Larks are those who favour waking earlier than most; owls are those who like sleeping/waking late; hummingbirds are what the majority of people are - those who sleep/wake at "normal" times. By the way - the book doesn't offer any "proof" that such a classification actually does exist in people; for all you know, all of us could be any one of the three if we wanted to.)
Anyway, the authors' "solution" to these people's sleep problems, is something called a "lightbox". This specially-made device emits a strong, powerful light that supposedly helps reset the body's inner clock to the desired sleep/wake time.
This is where I have a problem with this book.
Now, the people mentioned in the book who used the lightbox all had to: 1) actively want to solve their problem, and 2) force themselves to use this lightbox.
The abovementioned teenage student in particular - who had himself agreed to trying the lightbox because he recognised that his schoolwork and life in general were being adversely affected by his odd sleep cycle - said multiple times that using the lightbox "wasn't easy", and that he had to force himself to do it, and that it took a while before he got his life back on track.
So, if you had to "force" yourself to do it, why couldn't you just "force" yourself to wake up on time? Plus, his mother was at home and could wake him. She could have just dragged him out of bed and "forced" him to get ready for school and "force" him to get to bed by a certain time each night.
And if the light was the key factor in resetting his clock, why couldn't his mother have just dragged him out of bed into the sun outside? Or he could have slept in a brightly lit room with lots of windows so sunlight could pour in in the morning.
There are just so many ways, if you think of it, that he could have reset his clock without having to use the lightbox. After all, it wasn't as if the lightbox gave him instant results (as in, he could sleep/wake at the correct time the very next day after using it) or was easy to use!!!
Personally, I've faced quite a few instances in my own life where I've had to "reset" my own inner clock in order to wake up on time, or adapt to a different timezone. In all these instances, I've found that the best solution is to make sure that I don't fall asleep when I'm not supposed to, and am actively working (as in, doing something that either requires a relatively high level of cognitive activity, if not physically moving around doing stuff) during the time I'm supposed to be up - as opposed to feeling sluggish/drowsy and just sitting around doing nothing and trying not to fall asleep. This ensures that my body is tired enough to shut down at the "correct" time, even if it means having to skip sleep for a day, or do with very minimal sleep the night before. And this has always worked for me.
I picked up this book in hopes of finding out if there was a more "natural", less "painful" (as in, where I don't have to go through at least one day feeling tired/out of sorts while I'm in the process of resetting my clock) circadian-induced method of resetting one's clock, instead of using my method which I just described in the above paragraph.
Turns out, all the book offers - after citing hundreds of pages of research - is the lightbox method. And it is not cheap - the thing costs a 4-figure sum!
What use is the lightbox method, if the people who had to use it all found it tough and difficult in the beginning? At the end of the day, all had to still "force" themselves to sleep and wake at the right times! So how can it be said that the lightbox is doing the work? It's the people themselves who are making the effort to sleep/wake at the hours they want!
The silliest thing was that the lightbox didn't even "solve" their sleeping problems immediately. All took "a while" (as the individuals themselves who used it said). Apparently, your sleep cycle shifts merely an hour or two per day.
That having been said, the book isn't entirely without merit. I found reading about the various sleep studies interesting, and over the years some cases have been particularly interesting, such as the man who spent an extended period of time in a cave (with therefore no sunlight cues to alert him as to the actual time outside) and came out thinking it was one month earlier (because he had been sleeping later and later every night, until he "lost" - or rather "gained", depending on how you view the concept of time - an entire month).
Apparently, what this and other similar studies (mostly done on rats & plants) show is that most creatures' "natural" clocks actually follow a 25-hour cycle and not 24-hour one. But this is hardly new information (for me at least) - I remember reading this perhaps a decade ago or something in a science article.
Other conclusions drawn by the researchers were that: 1) pulses of light in the dark/night can cause an individual's inner clock to change (which is the basis for the lightbox treatment); 2) most of us follow a 25-hour cycle, but some people could follow up to a 26-hour or longer one, with even others following a shorter cycle at 23 or 24 hours.
Duh. Nothing new, right? I'm sure most of us knew at least point #1? And for point #2, I'm not sure I'm entirely convinced.
Pick up this book only if you're interested in reading about the studies I mention. The rest is just a huge plug for the "lightbox treatment" thing.
Happiness Help! Living in an overcast, northern state on the western edge of the eastern standard time, I'm a victim of....... winter slump. If you are concerned about SAD - seasonal affective disorder, this book explains why and what to do. Even if you are living in the Sunbelt, this book highlights research about sleep disorders, depression, adolescent bio-rhythms, aging, air quality, time zone variables, daylight savings time, etc. It also sounds a wake-up call to the medical establishment: Put Big Pharm on the back shelf. Try regulating sleep and light as a first step to treat depression, bi-polar, low energy, mood swings, etc. before prescribing pills. Compared to chronotherapy, sleeping pills are less effective, more expensive, have more negative side effects, and actually reduce life expectancy (according to several studies which control for many variables). For parents concerned about the early start times of high schools, and wondering why communities don't adjust start times to better support teenagers, this is yet another book to support your case. Check out the online resources at http://www.chronotherapy.us/resources...
Wow! I now know why staying up late is my preference and understand my kids better as they grow and reach adolescents. Lots of good information on how our internal clocks work, how to test them, and how to adjust them.
I was especially interested in their description of bright light therapy, and the use of melatonin. This type of treatment can be used for so many things, including insomnia, depression, chronic fatigue, SAD, and more. It was also interesting when they described the small amount of melatonin that occurs naturally as compared to the mega-doses available in the stores. I hope that doctors get educated and realize the benefits of this treatment with the lack of side effects compared to medications. I also hope that insurance companies will start covering this treatment once they realize that it is far less expensive than all of the prescription medications that are currently in use.
Maybe it had something to do with the fact that I finished this work as an audio book, but the entire thing seemed like an infomercial. I have been reading health-based nonfiction for a long time now and I can honestly say this has been one of the worst books I've ever picked up. Past chapter two, everything becomes repetitive and the book is simply an emphasis on one single idea: chronotherapy is an amazing treatment that can cure everything.
Don't read it. It's definitely not worth the time.
Anyone can find a chapter that interests him/her. I had bought this book by chance, but it is gradually improving my life. Even if you don't have any sleep disorders or any problem, the suggestions will make your life more qualified!
As a long-term insomniac, I hoped to learn something new about my malady from this book, and I did! I will spare you some time - you only need to read the first half of the book. The gist of this part of the book describes how you can reset your internal time clock by using bright light therapy and melatonin doses five to six hours before bedtime. There is also a discussion, and I found this to be the most interesting part of the book, on the use of "Triple Chronotherapy" to address depression. This treatment involves a) a full night of sleep deprivation followed by b) three nights of short sleep with the first night from 6PM to midnight, second one 8PM to 2AM, then a third night 10PM to 4AM, and c) including bright light therapy each morning at 7AM following the first night of no sleep for a total of 4 treatments of bright light therapy. An interesting discussion of negative ions is also included, where a disconnected negative ion generator was used as a placebo, but Dr. Terman decided to also include a functioning negative ion generator condition and found it to have significant impact on a sense of well-being. He notes that there are a lot of snake oil versions of negative ion generators and that most of them are a waste of money. I was not able to locate the model he used in his study, a 16 7.5 6 cm; JoniCare. Model 45; Sea-King AB, made in Västerås, Sweden. He is the real thing - a scientist of the first order. Truly fascinating.
So why three stars? The first half of this book was excellent. However, the Seussian filler that makes up the last half of the book was a serious disappointment: Bright light therapy works for new moms, it works for children, it works for adolescents, it works for teenagers, it works for people with dementia, it works for shift workers, it works for jet lag, I will not eat them in a house, I will not eat them with a mouse, I will not eat them in a box, I will not eat them with a fox, I will not eat them here or there, I will not eat them anywhere, I do not like green eggs and ham, I do not like them, Sam I am.
Get it from your library and read the first half of this book. It's very good. Well written and informative. You can stop when he starts talking about how to use chronotherapy when you have a new baby.
I would have liked to have more personally applicable instruction as a chronic illness sufferer of sleep problems. Others were mentioned including shift work, jet lag, etc.
Overall though, it was interesting and informative. A subject not so well-known yet shown to be effective in treating some sleep problems, depression, and bi-polar. I will take some of the general advice about learning to reset the inner clock (circadian rhythm), and put it in my arsenal in my continued quest to find relief from my many symptoms.
It was very interesting and made lots of sense. After reading this I am going to talk to my doctor and get a light-box. I am curious to see further development within the Chronotherapy field.