Pillow TalkⓇ - Questions and Answers About Sleep

Questions and Answers About Sleep

Dr. Barry Krakow
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  • Albuquerque
  • United States
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Latest Sleep News

GAMA: Message from the President - Embracing Change

With little urging Dr. Barry Krakow, a 35 year member of our medical community, enthusiastically brought forth some constructive and thought provoking observations after our annual meeting in January. As a Sleep Medicine specialist, Dr. Krakow is always on the alert for effective ways to solve his patients’ sleep problems as well as his own. A strong advocate for positive airway pressure, his own use of a PAP device for nearly 15 years gives him more than enough juice to push away any retirement thoughts. “I love working and sleeping; both are quite rewarding and energizing” – hence an optimism about the future.

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New Research

by Barry Krakow, MD | PubMED

Prevalence of sleep breathing complaints reported by treatment-seeking chronic insomnia disorder patients on presentation to a sleep medical center: a preliminary report.

PURPOSE: Few studies have examined the co-morbidity between insomnia and sleep-disordered breathing in the clinical setting. This study evaluated treatment-seeking insomnia patients and their self-report of sleep breathing complaints.

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7 Signs You're Overstressed: Learn the Truth Behind Hives, Memory Loss, Pain, Fatigue, and Painful Periods: Crazy, Surreal Dreams

Crazy, Surreal Dreams When your mind gets overloaded with anxiety and doesn't know how to process it, a bad dream can be its way to work through the stressful experience so it becomes less threatening, explains Barry Krakow, MD, medical director of the Maimonides Sleep Arts and Sciences in Albuquerque, New Mexico. Nix It: Think of the dreams as free psychotherapy, a possible clue to what's making you tense, and a suggestion on how to deal with it. Focus on how you felt in the dream. If you were afraid or embarrassed, consider why. Then ask yourself what makes you feel the same way in real life. For example, you might realize you've said or done something embarrassing at work and need to apologize to someone or be more careful. If bad dreams are starting to interfere with your sleep, occur nightly, or are truly disturbing, you may need professional help to sort things out, says Dr. Krakow.


Feature - Spooky dreams may be just what the doctor ordered

11/4/2011 - WASHINGTON (AFNS) -- Ghoulish figures, demonic clowns, man-eating zombies and vampires. There was enough frightening stuff out there this Halloween that even the most fearless may have been spooked this year. So which of these nightmares are still keeping you up at night? For some individuals out there, Halloween was not their only nightmare of the year. As many as 25 percent of the adult population will wake up after an intense and fearful vision brings them out of their rest. In fact, almost three percent of adults were reported to have nightmares frequently to always, based on the "Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR." The Wilford Hall Clinical Health Psychology Center at Lackland Air Force Base, Texas, which specializes in behavioral sleep medicine, defines a nightmare as a frightening and complex dream that may lead to being awakened from sleep. These dreams are often a lengthy, elaborate dream sequence that is highly anxiety-provoking or terrifying. They may also become a beneficial habit after a traumatic event that leads to post-traumatic stress disorder and a way of processing the event. After time, these nightmares actually are reduced to being just a bad habit and involve the individual reliving the traumatic event multiple times over again. "Many people do not realize that frequent nightmares may be able to be treated at one of our behavioral sleep clinics," said Capt. (Dr.) JoLyn Tatum, a Wilford Hall Clinical Health Psychology Center fellow. "We treat nightmares as a behavioral problem and use a form of treatment called 'imagery rehearsal therapy' in our 'Nightmare Class' offered at the clinic." The Nightmare Class was developed from the studies of Dr. Barry Krakow, the Maimonides International Nightmare Treatment founder and a board certified sleep disorders specialist. Dr. Krakow developed the technique of imagery rehearsal therapy, which basically consists of educating the individual on how to change the frightening imagery through techniques of rescripting the nightmare.


REM Sleep State Takes Edge Off Painful Events

When a physician at a U.S. Department of Veterans Affairs hospital in the Seattle noticed a blood pressure drug was preventing recurring nightmares a UC Berkeley researcher got interested in why. Turns out the drug suppresses the neurotransmitter norepinephrine and that during REM sleep norepinephrine goes down so that the brain can process painful memories in order to take the edge off them the next day. So in the REM sleep state it appears the brain processes emotionally difficult experiences to enable you to better handle these memories the next day.

They say time heals all wounds, and new research from the University of California, Berkeley, indicates that time spent in dream sleep can help.

UC Berkeley researchers have found that during the dream phase of sleep, also known as REM sleep, our stress chemistry shuts down and the brain processes emotional experiences and takes the painful edge off difficult memories.

The findings offer a compelling explanation for why people with post-traumatic stress disorder (PTSD), such as war veterans, have a hard time recovering from painful experiences and suffer reoccurring nightmares.They also offer clues into why we dream.

"The dream stage of sleep, based on its unique neurochemical composition, provides us with a form of overnight therapy, a soothing balm that removes the sharp edges from the prior day's emotional experiences," said Matthew Walker, associate professor of psychology and neuroscience at UC Berkeley and senior author of the study to be published this Wednesday, Nov. 23, in the journal Current Biology.

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Profile Information

How many hours of sleep do you get at night?
6 hours
About Me:
Dr. Barry Krakow - Author of "Sound Sleep, Sound Mind."

Barry Krakow, M.D.

Barry Krakow, MD is a board certified internist and sleep disorders specialist, who has spent 25 years in medicine in the fields of internal medicine, emergency medicine, addiction medicine, and sleep medicine. Currently, he is medical director of two sleep facilities in Albuquerque, NM:

  • Maimonides Sleep Arts & Sciences, Ltd, a community-based, sleep medical center
  • Sleep & Human Health Institute, a non-profit sleep research institute

Dr. Krakow's research team has established many firsts in the field of sleep medicine, including:

  • The first randomized controlled study to demonstrate that a cognitive-imagery technique can successfully decrease chronic nightmares without medication or psychotherapy
  • The first studies to show that trauma survivors suffer inordinately high rates of sleep breathing problems that worsen their insomnia, anxiety, depression, and posttraumatic stress symptoms.
  • The first studies to link sleep breathing problems to insomnia complaints among psychiatric patients
  • The first case series showing that treatment of sleep breathing problems decreases insomnia problems in many different types of insomnia patients
  • The first study to show that a large proportion (50%) of sleep center patients with sleep apnea also suffer from clinically significant insomnia symptoms, which may interfere with their efforts to treat their sleep breathing problems
  • The first study to show that evidence-based sleep medicine treatments could help crime victims with sleep problems
  • The first study to show that evidence based sleep medicine treatments could help disaster survivors with sleep problems
  • The first randomized controlled study to demonstrate that nasal dilator strips can reduce insomnia symptoms in patients with likely sleep-disordered breathing.

Dr. Krakow's research group is one of the most published on the evaluation and treatment of sleep disorders in mental health patients, including more than 30 peer-reviewed papers and abstracts in this field. In addition, he has authored or co-authored four books on this topic as well.

Dr. Krakow's research teams have consistently shown that insomnia and mental health patients frequently suffer from undiagnosed physical sleep disorders, which prevent them from resolving their sleep complaints, and which therefore often prevent them from improving their mental health.

With the publication of Dr. Krakow's new book, Sound Sleep, Sound Mind, he aims to spread the word that an enormously large number of insomnia patients and mental health patients can benefit a great deal by completing a full sleep evaluation and receiving evidence-based sleep treatments. In his view, sleep medicine needs to be thoroughly integrated into the fields of psychiatry and psychology in order to provide mental health patients the opportunity to rapidly recover their sleep health. We believe that aggressive treatment of sleep disorders in these patients will markedly improve their chances to improve their mental health.

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Dr. Barry Krakow's Blog

Sound Sleep Sound Mind - 4.5 stars out of 5.

Sound Sleep, Sound Mind has been getting a lot of great reviews! We encourage you to rate the book, too!

Posted on January 19, 2010 at 2:30pm

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At 4:00pm on October 12, 2009, Jan said…
Hopefully I will be moving back to Albuquerque in the near future and it's nice to learn about the NM Sleep Center. I see that you have addressed several aspects of sleep disorders on other medical conditions. I recently posted a discussion questions regarding the affects of elevation on the severity of sleep apnea. I was wondering if you could point me to some literature or articals which may address this question. All I know is that my life dramatically change when I moved up here to the Grand Canyon, and I'm still looking for answers. -- Thanks
At 8:03am on October 25, 2008, Noel said…
Dr. Krakow,

Could you please respond to my blog or directly to me on "Turning Nightmares into Dreams?"

Noel A. Cuff
At 12:13pm on June 4, 2008, Danielle said…
Dr. Krakow,
It is good to know that someone is addressing the issue of sleep with regard to mental health, although the issue is so potentially treacherous. I fear another stigma on the horizon, if this isn't handled with care. And from the perspective of a narcoleptic, I can assure you that I have had times when I have suffered from insomnia that has crippled me in every aspect of judgment until I resolved it.

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