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Speaker 1: Okay, as we always do say mornings, it's a medical

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Speaker 1: news segment with doctor Jim Kinney, chief medical officer for

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Speaker 1: Dignity Saint Mary Medical Center in Long Beach, and a

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Speaker 1: board certified.

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Speaker 2: Er doc who has wonderful stories to talk about in

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Speaker 2: the er.

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Speaker 3: Morning Jim, Morning Bill.

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Speaker 1: Okay, let's get right to it because we have a

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Speaker 1: lot to talk about. Poor sleep con trigger a vicious

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Speaker 1: cycle that your brain simply can't break. Most of us

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Speaker 1: do have poor sleep in the sense we wake up,

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Speaker 1: wake up in the morning. During the night, I always

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Speaker 1: wake up to pee, and most people do once in

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Speaker 1: a great while. I'll sleep through the night, and then

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Speaker 1: of course I'll notice that I have very wet sheets

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Speaker 1: because I have wet the bed.

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Speaker 2: What happens and what is poor sleep? Right?

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Speaker 3: So, I mean lots of people wake up through the night.

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Speaker 3: That's not normal to go through cycles in our sleep

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Speaker 3: deep sleep and then light or sleep the later and

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Speaker 3: they eat. In the sleep cycles, we get rem sleep,

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Speaker 3: and that's when your your brain actually gets to kind

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Speaker 3: of clean out the toxins and everything else. So you know,

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Speaker 3: it's it's not unusual to wake up, but when you

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Speaker 3: wake up unrested and sleepy and tired. That's your best

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Speaker 3: indicator that you got poor sleep. And what this really

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Speaker 3: shows is there's a link between mental health. You know,

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Speaker 3: how you feel, how you're doing, and sleep. Uh And

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Speaker 3: and it's been well documented right that that lack of

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Speaker 3: sleep or poor sleep results in mental health issues and

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Speaker 3: vice versa. Mental health issues seem to be associated with

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Speaker 3: poor sleep. So we don't know, you know, chicken in

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Speaker 3: the egg, probably both are impacting each other. But sleep

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Speaker 3: is that important that you know you need to get

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Speaker 3: that to maintain good mental health. The problem is that

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Speaker 3: not everybody does that. There's a lot of issues that

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Speaker 3: feed into sleep, like whether you're getting you know, bright

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Speaker 3: lights in your eyes before at bedtime when you're trying

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Speaker 3: to go to sleep, a lot of people are scrolling

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Speaker 3: on their phone checking things, really amping up their anxiety

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Speaker 3: and not producing melatonin. This shuts off your pineal gland

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Speaker 3: when you see bright light, and that's the gland in

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Speaker 3: your brain that produces melatonin.

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Speaker 1: When you talk about poor sleep, are you supposed to

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Speaker 1: wake up refreshed and ready to go and bounding out

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Speaker 1: of bed Because I know very few people that do that.

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Speaker 1: I mean every morning I wake up sometimes your alarm

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Speaker 1: goes off. Usually I wake up before the alarm and

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Speaker 1: it takes me about an hour to kick in and

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Speaker 1: be normal.

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Speaker 2: That has to be what happens to most people. Yeah,

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Speaker 2: it is.

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Speaker 3: That's about right. You know, you wake up and your

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Speaker 3: cortisol level and you're in the temperature kind of what

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Speaker 3: tends to wake you up. So if you can control

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Speaker 3: your environment, ideally you go to bed with the room

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Speaker 3: cooler and darker, and then in the morning when you

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Speaker 3: wake up, you should be getting sunlight in the room

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Speaker 3: or light, and then you also get a warmer temperature,

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Speaker 3: and those two together will trigger all the natural kind

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Speaker 3: of things in your body to wake you up. And

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Speaker 3: then our brains are set to see that morning lighting.

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Speaker 3: You know that low in the horizon, the wavelengths of

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Speaker 3: light that come across on the low horizon, early morning light,

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Speaker 3: those are actually set to wake you up. So if

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Speaker 3: you can get outside and see some of that, this

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Speaker 3: will help you wake up, and then your cortisol level

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Speaker 3: starts to rise, and that's what and you want that

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Speaker 3: early morning high elevation of cortisol so that you wake

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Speaker 3: up in the morning and then all day long that

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Speaker 3: tends to drop off. And you want it to be

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Speaker 3: low at night. And then again, that's why behaviors that

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Speaker 3: spike your cortisol at night are not good, because then

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Speaker 3: you're not gonna be able to go to sleep.

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Speaker 1: So people will work on night shifts, and those of

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Speaker 1: us here in this show who have no chance of

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Speaker 1: waking up to light other than artificial light, we are,

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Speaker 1: I won't say in trouble, but.

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Speaker 2: Part of this vicious cycle. Is that fair to say?

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Speaker 3: Yeah? Absolutely, shift workers and I was one for many,

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Speaker 3: many years. You know, it definitely attacts your health. It

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Speaker 3: affects your mental health, your physical health, risk factors for

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Speaker 3: cardiovascular disease and everything else. But you can mitigate it

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Speaker 3: by doing certain things. And if you're going to adjust

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Speaker 3: your timing of when you sleep, you can do that

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Speaker 3: again by getting artificial lights that simulate that morning light

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Speaker 3: and then avoiding light in your eyes in the evening.

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Speaker 3: A lot of people wear those blue blocker lights and

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Speaker 3: things like that. If you're going to have to be

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Speaker 3: up and about when it's when it's bright light or

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Speaker 3: sunny just before you go to bed, wearing those kind

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Speaker 3: of devices will help reduce those those wavelength of light

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Speaker 3: that stop the production of melatonin and then don't allow

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Speaker 3: you to go to sleep. So it takes real intention.

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Speaker 3: And if you're going to try and alter your sleep

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Speaker 3: cycle away from the normal daily variations of light and

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Speaker 3: sun and everybody else being awake and asleep, you're going

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Speaker 3: to have to do it very intentionally.

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Speaker 1: Got it, Jim. Over the years, and we've been talking

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Speaker 1: for decades. Now we're talking about the magic bullet for

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Speaker 1: weight loss, and it looks like we're pretty close. If not,

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Speaker 1: we're there with the GP GLP one drugs. Now. I'm

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Speaker 1: reading what you have written as a topic. There is

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Speaker 1: a strategy that is five times more effective than just

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Speaker 1: simply taking the drug.

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Speaker 2: And a lot of people want to know about that one.

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Speaker 3: Yeah, so okay, I don't know that that's not exactly

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Speaker 3: what it is. So here's the deal. Glts have a place.

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Speaker 3: They are very effective in helping people lose weight. And

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Speaker 3: in a study environment, you know, people are losing like

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Speaker 3: twenty percent of their body weight, but then in real

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Speaker 3: life they seem to be losing closer to five or

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Speaker 3: six percent of their body weight. And that's because it's

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Speaker 3: you know, you're not getting all the support of a study.

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Speaker 3: And over time, either people stop taking it or you know,

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Speaker 3: it plateaus and it stops working for them. So it

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Speaker 3: is an effective strategy, but long term it doesn't seem

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Speaker 3: to be as effective as at the weight loss surgery itself.

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Speaker 3: So either the gastric sleeve or the gastric bypass surgery,

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Speaker 3: those are lifelong commitment. So now as you know, because

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Speaker 3: you've done this, it changes your body forever, so there's

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Speaker 3: no option to go back and overall, and again this

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Speaker 3: study was was presented at a bariatric surgery conference, so

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Speaker 3: definitely this is more there's some bias here potentially, but

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Speaker 3: what they showed was long term loss from gas bypass

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Speaker 3: surgery is about twenty five percent of your body weight

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Speaker 3: and GLPS it's about five percent. Where they're getting the

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Speaker 3: five times more effective. But the real answer is there's

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Speaker 3: probably a strategy in between where maybe you use the

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Speaker 3: GLPS at first, see how they do, and if you're

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Speaker 3: able to maintain that weight loss, then you keep going

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Speaker 3: with GLPS. If not, then you need to go potentially

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Speaker 3: to weight loss surgery and re law surgery. By the way,

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Speaker 3: is it's still not you know, it should be at

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Speaker 3: this point considered kind of a standard treatment for obesity,

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Speaker 3: and it still really is just kind of a boutique service.

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Speaker 3: You know that it shouldn't be that. It just like

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Speaker 3: the GLPS, where we recognize obesity as a serious health

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Speaker 3: problem and we address it using all the tools that

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Speaker 3: we have.

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Speaker 2: Well, what do you call it?

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Speaker 1: Weight loss surgery? And I had the ruin why? And

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Speaker 1: I weighed I was.

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Speaker 2: Three hundred and ten pounds.

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Speaker 1: And for those people that want to see what I

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Speaker 1: looked like at three hundred and ten pounds, that was

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Speaker 1: when I had the worst television show in the history

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Speaker 1: of mankind. And you can go to YouTube and look

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Speaker 1: it up Bill Handle judge for yourself, and you'll see

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Speaker 1: a couple of photos where I just I'm unrecognizable, but

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Speaker 1: I had the ruin why. I had the the most

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Speaker 1: I won't say I guess it's fair to say the

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Speaker 1: most effective, but certainly the most invasive part of the

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Speaker 1: weight loss surgery.

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Speaker 2: And it worked.

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Speaker 1: I mean I went down and I've kept the weight

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Speaker 1: off for all those years. And to your point, and

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Speaker 1: we only have a second If it is this effective

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Speaker 1: and long term, it's going to save the insurance company

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Speaker 1: buckets of money. With diabetes and cardiovascular disease. Why is

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Speaker 1: it not now simply part of normal treatment that the

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Speaker 1: insurance companies pick up.

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Speaker 3: Yeah, they do pick it up, so it is covered.

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Speaker 3: And that's what I'm saying is it is still looked

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Speaker 3: at as an extreme, you know, extreme intervention. And that's

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Speaker 3: the problem is the surgeries have gotten better, Like you said,

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Speaker 3: we do less invasive surgeries and it's not as extreme,

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Speaker 3: and it shouldn't be looked at as the last resort.

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Speaker 3: It should be looked at as an effective treatment for

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Speaker 3: obesity that hasn't resolved with diet and exercise.

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Speaker 1: All right, all right, Jim, we'll talk again next week

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Speaker 1: as we always do on a Wednesday.

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Speaker 2: You have a good win. Take care, all right, Take

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Speaker 2: care