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Integrative Psychiatry

Functional Medicine Approaches to Sleep By Ashwin Mehta, MD

By August 31, 2020No Comments

In medicine, we have this preconceived notion that to do anything or to accomplish anything of importance we really have to strive and work hard for it.

Interestingly enough sleep is more about the process of letting go. The harder we try to get to sleep, that effort, that concern leads more to diminishing sleep quality.

During sleep one of the most important thing that happens is reversing damage we incurred during wakeful hours alongside repleting energy stores and a cooling of the brain and body.

Sleep is a multidimensional process in nature and is very much growing science where it is more behavior based rather than organ based of study.

Studies have shown that incurring sleep loss actually decreased the efficacy and the development of the immune system upon receiving the flu vaccine.


Sleep has always been a subject that’s very near and dear to my heart because I was always fascinated by how much we can achieve in terms of good health, without any real conscious input from our heart. Conversely, sleep is a letting go. Sleep is a surrender. And interestingly enough, the harder we try, the harder we strive to sleep, oftentimes that effort, that anxiety that worry, that concern actually lends itself to diminishing sleep quality.

Why is sleep important? Culturally, we actually denounce the importance of sleep. You hear it all the time “I’ll sleep when I’m dead”.

Sleep is somehow considered or the requirement for sleep or sound sleep is somehow seen as a weakness.

Now what happens during sleep? One of the most important things that happens during sleep is reversing damage that we incurred during wakeful hours, reversing oxidative stress, repeating energy stores, very importantly, there’s a brain and body cooling. And this happens also during REM sleep. Also, there’s a tremendous amount of brain development that happens between you know from birth to age 25 that a large majority of that brain development happens during REM sleep.

Now, nobody really explained to me why the AASM the American Academy of Sleep Medicine adopted the Chinese Yin & Yang as their as the as their symbol. But the way that I explain this, especially to those individuals who are experiencing insomnia, is that there is emerging evidence for a biphasic, a biphasic sleep model, a sleep routine in human beings biphasic, meaning during every period of nighttime sleep, it’s okay to have a brief period of wakefulness. Conversely, during every period of daytime wakefulness, it’s okay to have a little bit of rest, a little bit of sleep. And, you know, we can only we only need to look at the wisdom of ancient cultures and traditions the world over perhaps besides ours, that have recognized the importance of a siesta in the middle of the day.

Common sleep concerns, include insomnia. We are a society of poor sleepers, especially with our race to introduce as many screens, electronic devices with bright screens in front of our eyes. Obstructive sleep apnea is also incredibly common 26% in the general population and 70% if obese, Clock watchers oftentimes fall into this category of insomnia/sleep state misperception which is, you’re actually sleeping better than you think you are it’s just that when you do wake up, you have such profound anxiety that that mitigates a lot of the restfulness that you would subjectively otherwise experience from good quality sleep. We also use things like Magnesium, Valerian, Lavender, meditation, melatonin, yoga and acupuncture.

Yoga is also really important to treat insomnia. This study looked at the effects of mindful yoga on sleep in pregnant women, It’s a pilot study of a small sample size of 15 healthy women. And they used hatha yoga classes for seven weeks and they measured sleep using actigraphy, which is basically a band that you wear on your wrist and it’s a scientifically validated measure of demonstrating how well someone is sleeping using motion detectors. What they found was that women who began the intervention in the second trimester had significantly fewer awakenings, and less wake time during the night and less perceived sleep disturbance than in baseline. So therapeutic yoga, prenatal yoga, can be useful in addressing sleep concerns that are often common in pregnant women.

Frederick Barrett is a cognitive neuroscientist with training in behavioral pharmacology, and the Associate Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Dr. Barrett has been conducting psychedelic research at Johns Hopkins University since 2013, and his research in healthy participants and in patients with mood and substance use disorders focuses on the psychological and neurological mechanisms underlying the enduring therapeutic and other effects of psychedelic drugs. In 2017, he received an NIH “R03” grant as Principal Investigator to investigate biological mechanisms of psilocybin effects, the first federally funded research since the 1970s administering a classic psychedelic to people with psychedelic effects as the primary focus. He has developed measures of subjective effects of psychedelic drugs, and has also published first-in-human studies characterizing the acute and enduring effects of psilocybin on the brain. He is currently leading clinical trials to investigate the use of psilocybin to treat patients with major depressive disorder and co-occurring alcohol use disorder, and he is leading a number of ongoing studies aimed at better understanding the psychological, biological, and neural mechanisms underlying therapeutic efficacy of psychedelic drugs.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.