In our last episode, we talked about Adrenal Fatigue / Adrenal Dysfunction and how to test for it. In the next three episodes, we are going to focus on three main types of Adrenal Dysfunction that we see.
Three main types of Adrenal Fatigue:
- The Vampire
- The Ghost
- The Zombie
Adrenal Fatigue is quite real and can seriously impact someone’s life. We are not trying to make light of the effect that Adrenal Dysfunction can have. But we find by putting some easily remembered descriptions; this medical condition will resonate with people. And it will be more easily understood.
Symptoms of the Vampire:
- Cannot wake up in the morning: these are the people that press the snooze button a lot. Often Vampires will have several alarms to help them get up in the morning
- They might not be drinking your blood, but will drink a lot of caffeine to get going in the morning. Even with copious amounts of coffee but are still tired.
- Morning and daytime brain fog
- Weight gain
- Sugar and carbohydrate cravings mainly in the late afternoon and evening. They will say their diet is perfect during the first half of the day. But come later in the day and evening time, they cannot control the sugar cravings. Even if they are full from dinner, Vampires still find themselves snacking in the evening.
- Fatigue: mental and physical fatigue
- Cannot sleep at night. These are the people that will lie in bed for hours, unable to fall asleep. They were so tired in the morning but come evening, wide awake.
- Feels more awake in the evening. This type of commonly seen Adrenal Fatigue will get all their chores done in the evening.
- More energy at night, especially mental energy. This is when they are getting projects, emails done.
The adrenal glands secrete cortisol in a diurnal curve. In a perfect world, you will see the cortisol being highest in the morning and will slowly decline, being lowest at night.
With the Vampires, you will see what is called a ‘reverse diurnal curve.’ With very low cortisol levels in the morning, it makes it very difficult to wake up in the morning. The cortisol can continue to stay reduced in the afternoon, also causing afternoon fatigue.
Come evening time, cortisol levels rise. This makes it difficult to fall asleep. The rise in cortisol in the evening can disrupt insulin and blood sugar. This can cause sugar and carb cravings, which are almost impossible to resist.
I am sure you are asking: How Do I Correct Cortisol Levels in a Vampire? I have Adrenal Dysfunction Vampire type, what can I do about it?
Before we answer this, we have to put out the disclaimer: All content found in this blog, including text, images, audio, video, or other formats were created for informational purposes only. The purpose of this website and blog is to promote consumer/public understanding and general knowledge of various health topics. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition and before undertaking a new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concern regarding this topic, then it is time to find a new doctor.
Now that we have the disclaimer out of the way let’s get on with helping the Adrenal Fatigue Vampire type. We are going to break it up into Nutritional, Lifestyle, Supplementation and prescription medication
Nutrition: The best way nutritionally is to balance your blood sugar and insulin. Cortisol can really disrupt your blood sugar and insulin levels. One of the best ways to do this is to implement a lower carbohydrate diet. That is easier said than done. Trying to restrict your carbs but having intense craving at the same time do not go hand in hand. One helpful trick is to do a ketogenic diet while cycling in carbs in and out on a schedule. We have a manual written that will explain hormones and weight gain/loss. It will also help guide you on a program to balance your blood sugar and insulin levels. If you are interested in downloading our free guide is called ‘Keto-Carb-Cycling-Program’ (which abbreviate KCCP), go to progressyourhealth.com/kccp.
Lifestyle: There lots of options for good sleep hygiene. More than you will read here. But one of the main points we want to get across is to reduce light as much as you can in the evening. I know that it can be difficult because we want to relax and watch a TV show, movie or work on the computer at night. One thing you can do to reduce the blue light burden is to get blue light blocking glasses. And you can get a blue light blocking screen for your computer. Use the blue light blocking screen for your computer during the day. It will help you sleep better at night. These are easily found online.
Supplementation: Supplementation can be incredibly important for Adrenal Dysfunction Vampire type. But this is where what works for the Vampire will not work for other types of Adrenal Fatigue.
You can find all these products on our website. As a Progress Your Health podcast listener, use the free shipping code: VAMPIRE to get free shipping.
Cortico-B5-B6: by Metagenics. This formula contains Vitamin C and B5 (Pantothenic Acid), which both have an affinity for the adrenal glands and helps with the production of cortisol.
We love using licorice solid root extract to help raise cortisol levels for the Vampire. Licorice increases the half-life of cortisol. So it helps to keep cortisol levels in the blood around longer. But if you have high blood pressure, do not take licorice. As it can raise the blood pressure. Commonly in Adrenal Fatigue, there is low blood pressure so the licorice can help with this. But in the cases of high blood pressure, do not take.
Licorice Solid Root Extract: by Wise Woman Herbals: ½ teaspoon in the morning for the Vampire Type Adrenal Fatigue. Optional 1/8th teaspoon in early afternoon or lunchtime for energy.
Glandulars: Using an adrenal glandular can be really helpful for the Vampire. Cortisol is made from the adrenal cortex. Taking a glandular with adrenal cortex can help upregulate low cortisol levels in the morning.
We really like using a product by Thorne called Adrenal Cortex: two capsules in the morning to help with energy. With an optional capsule early afternoon to help with energy. By helping the energy and adrenals in the morning can help drop the cortisol at night for sleep.
‘I’m vegetarian/vegan and do not want to take anything that has animal product, let alone an animal organ’: There are Non-glandular Supplementation (no animal products) that the Vampire can take if they do not want an animal product.
Adrenal Response: by Innate Response, Formulas has no glandular and can help the Vampire with morning energy. Take two tablets in the morning. Optional one tablet in the early afternoon for energy.
As mentioned above, as being a Progress Your Health Podcast listener, use the code: VAMPIRE for free shipping.
Hydrocortisone: (Cortef) Hydrocortisone raises cortisol levels. Cortisol itself doesn’t exist outside of the body. Taking hydrocortisone orally will convert into cortisol in the body. The Vampire has low levels of cortisol in the morning. By prescribing hydrocortisone in the morning, it will help raise the cortisol levels. Raising cortisol levels in the morning will help the adrenals drop the cortisol in the evening to help with sleep. We like using a low dose of sustained-release hydrocortisone. That way, you can take one capsule of hydrocortisone in the morning and not have to take any later in the day.
PYHP 068 Full Transcript:
Dr. Maki: Hello, everyone. Thank you for joining us for another episode of the Progress Your health Podcast. I’m Dr. Maki.
Dr. Davidson: And I’m Dr. Dr. Davidson.
Dr. Maki: So, we are rapidly approaching fall here in the Pacific Northwest. The leaves are changing. The leaves are falling off of the trees and changing colors and you can definitely tell that the temperature is dropping a little bit. The mornings are a little bit brisk. So, this is a blog post that you wrote actually, I don’t know what, probably almost a year ago this time. The three types of adrenal fatigue so we thought it’s appropriate considering Halloween. This actually is going to probably post it like a right around Halloween and we thought that it would be kind of– it would be congruent with the time of the year.
Dr. Davidson: Yes, because the three types of adrenal fatigue. Now with adrenal fatigue or adrenal dysfunction which is what we really like to call it, that we’ve seen, there are so many different types. The three main types that we’ve seen over the course of being in practice since what, 2003 to 2004, is we’ve called– we’ve named them, the vampire, the ghost, and the zombie. So, that’s why Dr. Maki was saying it would seem appropriate because we’re coming around Halloween because we have given them these names. Now, we definitely don’t want to make a light of adrenal fatigue because adrenal fatigue, adrenal dysfunction is serious. It’s real and it can cause a lot of symptoms for people, affect their quality life. But in some regards, it’s easier to help you understand it if we can kind of have some fun names to go along with it.
Dr. Maki: Yeah, it’s a little more memorable than calling it some kind of medical term and in honesty, for adrenal fatigue as we talked about on the last couple of episodes, that’s not a real diagnosis. Some people certainly, in our view of the world, in our view of medicine and physiology and our experience working with people, as you just said, we feel that it’s a completely illegitimate diagnosis. Conventionally, not so much and that’s as we’ve talked about it a few different times, this huge divide between having low adrenal function which is Addison’s disease and too much adrenal function which is Cushing’s disease. There is really nothing in between and we just find that to be very silly because cortisol, as we’ve talked about, which is our primary stress hormone which is also important in blood sugar balancing, how can that not have an impact on the way we look and feel on a day-to-day basis?
Dr. Davidson: Exactly. So, as we talked about with testing, the previous episode prior to this one, is we talked about testing for adrenal fatigue or adrenal dysfunction. We talked a lot about, like Dr. Maki said, cortisol and the way cortisol is secreted in a diurnal curve of a 24-hour period. Now, the reason we separated into types is because if one person falls into the vampire type of adrenal fatigue, their options on what would we do to help correct that, help manage that, would be completely different than somebody that fell into the zombie type.
Dr. Maki: Yeah, right. And maybe there might be a little bit more similarity between the zombie and the vampire, which we’ll get into on the next two episodes. But certainly, the difference between the ghost and the zombie or the ghost and the vampire, that’s where you would approach those situations completely differently. So, just like PCOS, there’s three different types of PCOS. We’ve kind of classified it just to simplify, now we’ve came up with these interesting monikers for the three types of the most common or let say it that way, the most common types of adrenal fatigue. Now, remember there’s probably subsets and more subsets and we can keep dividing, everyone might not follow into each one of these three. There might be– and we’ll talk about the ghost on the next episode. There’s actually two types of ghost and we’ll talk about that as well.
But this helps to at least in your mind, you should be able to– if you are dealing with fatigue issues or you think you have an adrenal problem, you should be able to identify with at least one of the three to some extent. That’s our goal or our hope from these three podcasts.
I think it’s a very memorable way for people to kind of conceptualized. Then if you’re going to do testing, right, if you’re going to do either blood test, looking up pregnenolone, DHA testosterone or if you’re going to do a saliva test from ZRT labs or maybe even a Dutch test, each one of these categories or each one of these types is going to have a certain, their test is going to look a certain way. You can almost predict that based on which profile you fall into.
Dr. Davidson: Yeah, just for example like we were talking about the cortisol secretion from the adrenal glands. So, in a perfect world, which we know we don’t live in a perfect world, but in that perfect Utopian world is that cortisol is high in the morning so you’re bright-eyed bushy-tailed and then that slowly comes down over time, over the day and then it comes down at night so that we can go to sleep and stay asleep all night. So, this is the three types that we see where that cortisol dysfunction or that secretion of cortisol from the adrenal glands gets dysfunctional and you’ll see the cortisol come in. Like for example, the vampire, you’ll see the high cortisol at night and then a low cortisol in the morning.
Dr. Maki: Yeah, right. And I think that right there, that diurnal curve you’re talking about, so the cortisol helps us maintain our circadian rhythm. We wake up with the sun, we go to bed with the moon and that is, we’re not meant to be nocturnal mammals, right? We are very much regulated by a light-dark cycle. However, we’ve all probably known somebody in our lifetime that falls into that night owl category, hence the night owl and the vampire kind of the same thing. I know back in my 20s when I was going to college and working or whatever, I used to have some trouble sleeping like a lot and I was definitely a vampire for sure, 100%.
Dr. Davidson: Because that’s what you would see is that vampire can not go to sleep at night. I mean a lot of them, they’ll say, “I’m wide awake, staring at the ceiling, why lay in bed staring at the ceiling? I might as well get up and do things.” A lot of times the vampires just cannot go to sleep, fall asleep before 2:00 a.m.
Dr. Maki: Yeah, right. And you’ll notice that with the vampires, they are the ones that tend to be shift workers or working the graveyard shift. I used to work actually at a hospital in college. I used to be a cardiac monitor technician in a hospital in Duluth Minnesota and I used to work graveyard. They couldn’t get anybody to work graveyard shift. Everybody hated the graveyard shift. It was boring but I’ve had sleep trouble anyways. I would try to go to bed at a reasonable time and I’d be up, like you said, for hours. So, I used to, not volunteer but I would work night shift a lot just because it was easier just to stay awake than trying to sleep when I couldn’t sleep. Since now, we’ve been in practice for over 15 years, we’ve seen lots of people that fall into that vampire category.
Dr. Davidson: Yeah, same thing and then, of course, come morning time, so the thing with the vampires is like we mentioned that cortisol’s high at night so you’re actually bright-eyed bushy-tailed at night, so they’re awake. By the time they do fall asleep and that cortisol drops, it’s almost impossible to wake up in the morning.
Dr. Maki: Yeah, right. Yeah, so if you have a traditional 9 to 5 kind of a job, you have to get up, you maybe went to bed somewhere between midnight to two in the morning. You have to get up early. The vampires are the ones that just no matter what, they can not get out of bed. I remember back when I was going to college at that time, I would have such a hard time making it to my 8:00 class. Like I could not do it. I had to drive across town and go over the bridge and it was kind of far and long ways away and I’ve hardly ever made it to that on time to the 8:00 class. It was so difficult. But now, it’s interesting. Now 20 years later, 25 years later, my sleep patterns are completely different than they were when I was in my 20s.
Dr. Davidson: Yeah, so you can’t beat yourself up and I actually have a lot of patients who bring in maybe a family member or something and say, “Why can’t they wake up in the morning?” I even have some patients that set alarms around their bedroom because they will without even consciously be aware, turn off their first alarm and go back to sleep and forgot they even turned it off which is why they have to have one across the room and they have to have one on the other side of the room. Their pressing snooze and it’s not, in some ways, you can’t say, “Oh, well, why can’t you just wake up?” It really has to do with that adrenal dysfunction. In some ways, you don’t want to point a finger and make them feel shameful about it because it’s that biology that’s at work here.
Dr. Maki: Yeah, right. And especially if your cortisol’s been up all night long, right? Which in this particular subset, your cortisol is low all day and then evening time is when they finally start to feel alive. It might be 7:00, 8:00, 9:00, and all of a sudden, they’re finally awake and now it’s really hard to turn that off because now the cortisol is peaking when they should be sleeping. Then of course, when it comes for them to wake up again in the morning, their cortisol is plummeting. That right there I think is probably the most common of the three, to some extent. There’s subtle vampires and then there’s some kind of really obvious vampires. I think most people, what we just said, hard time waking up and difficult time going to bed. I think that affects– I don’t have any real statistics because I don’t think anyone really pays attention to. But I would imagine that that’s probably affects a third if not more of the population. Everybody has that problem.
Dr. Davidson: Then, like you had mentioned, they, like you said, they’re awake at night. Like patients will tell me, “I feel really good at night. I don’t want to go to bed. I want to you know, this is the first time all day long that I actually felt like a normal human being. I want to stay up and enjoy my time,” especially when everybody else in the house might be asleep. They want to enjoy their time. Vampires are the people that are doing laundry at 10:00 at night and ordered– checking their emails and writing and being creative because they actually feel alive at night. But come morning time, they are sucking down the coffee, drinking the caffeine.
Dr. Maki: Yeah, they need that, the caffeine boost just to keep going. Now caffeine as we have said, probably in another podcast in the past, caffeine’s kind of have a double-edged sword because too much caffeine consumption kind of just magnifies that adrenal dysfunction because now you’re using a central nervous stimulant that raises your catecholamines, your epinephrine, norepinephrine dopamine, but then also raises your cortisol. So, you’re doing that kind of an artificial way so that the more caffeine you drink, the usually the more tired you’re going to become eventually.
Dr. Davidson: Also with vampires, you see waking. It’s very common to have waking that they can’t really– in some ways attribute to, because I’ll have patients with this kind of reverse diurnal curve of a cortisol mostly say, “I’m great in the morning. I don’t even eat anything in the morning. I’m not hungry for lunch. I can have a salad for lunch. I have no cravings.” But come late afternoon or even at especially evening time, after dinner they’re full but they have the sugar cravings.
Dr. Maki: Yeah, right. Carb and sugar cravings. Whether it’s salty carbs or sugary carbs, it’s like they– and it’s also in the floodgates open and they just can’t stop eating. I mean, maybe not with that much of lack of self-control but there’s a certain component that where they just– their appetite, they kind of they wake up, their appetite wakes up, their body kind of sense, “Hey, if you’re going to be awake then you need to find some food”. Partially, because they have been hungry all day and now, this the first time they’ve actually had an appetite and their body is kind of– their body and their mind is kind of making it up for lost time in some respects.
Dr. Davidson: Like you had mentioned, cortisol has a direct effect on glucose which also has a direct effect on insulin.
Dr. Maki: Yeah, right. And that we talked about that in other episodes, right? So, all the time, the more impact that we have, that’s why stress sometimes, I don’t know how many people– I just talked to someone last week that was going through a really stressful time. Of course, her cortisol is elevated and she was hardly eating or drinking anything, right, during out the day and she gained like 30 pounds over the course of a few months. But she knows that there was many nights where she didn’t eat anything. Like she has to remember if she ate anything or not but she still gain some weight because of the impact of that very powerful hormone has on other hormones that contribute to fat storage. So, when you’re in that stressful moment like that your cortisol goes up, it really kind of shuts off your appetite temporarily but then it comes back with a vengeance later.
Dr. Davidson: Like we had said, of course, if you’re not getting enough sleep at night, you’re going to be tired in the morning. But with the vampires and with the way this cortisol secretion is, it’s different. It’s not just that they’re tired like, “Oh, I didn’t get enough sleep last night, I’m tired.” Sure, we all have a night like that or day like that where we didn’t get a lot of sleep last night, but with the vampires, they are physically and they’re mentally tired especially in that morning and that afternoon. Like even mentally tired trying to fill cognitive or being able to do their work or their emails or meetings. They will say, “I feel like I’ve got like a towel over my head or I just can’t think. I can’t see. It’s just not enough processing.”
Dr. Maki: Yeah, right. So, if you’re like trying to go to work and trying to do your job and it’s going to be really a struggle to even use them fairly basic mundane tasks if your brains not working the way that it supposed to. Then like you say, then comes 7, 8, 9, 10:00 o’clock, all of a sudden there– it’s like they got this little surge, literally, they have this surge of energy because their cortisol is finally rising and they feel like– I don’t know how many people had said, “Yeah, come 10:00 o’clock and I feel alive”. They finally feel fairly good but it’s just not necessarily conducive to the typical 9 to 5, Monday through Friday works schedule that so many people have. Vampires don’t fit into that type of schedule very well.
Dr. Davidson: No, I mean you got to get the kids to school. You got to do things in the morning. Morning comes early. There’s a lot of vampires out there that are just– that’s why the coffee comes in because you got to have a crutch because you got to get through the day but at the same time, it is a little bit like a credit card where you’re borrowing the energy and you got to pay it back later. So, one thing with the vampires, these people think, “Well, what do I do now or why did this happen?” It does happen from chronic stress over time that kind of degrades that diurnal curve or that secretion of the cortisol. But there definitely are options to be able to help people kind of readjust this.
Dr. Maki: Yeah. Now, granted, I think this happened because we live in a very artificial world, right? There’s lots of stimulus coming out us all the time. TV and computers and I mean even more now than there ever used to be but for the last hundred years basically since– this might sound weird, but really since the invention of the light bulb, which was that Thomas Edison invented the light bulb, what, a hundred years ago, hundred and some years ago? Maybe at the turn of the century, and now we’re able to control the light in our environment where before it was all sun and the moon. I mean, we’ve all been camping before and you go camping, you will have a campfire, no external stimulus, people get tired relatively, really. You’re going in the woods for a week, your insomnia, your vampire status is going to slowly dwindle because now there is not this ambient light that’s going to affect your hormones drastically over time.
Dr. Davidson: It’s easy to say, “Turn off your light or turn off your TV or turn off your phone a couple of hours before going to bed.” That can be really difficult, but there are other options that you can do as well. You don’t all have to go camping and then come back to reset.
Dr. Maki: Yeah, right. I mean that like I said, that’s kind of an extreme example. That’s not really practical that you’re going to go in the woods for a week at a time. That just to– that’s what we’re kind of design for, as that kind of environment, and the world we live in now which is normal to us, as our current society, but hormonally, it doesn’t match with our biology very well and I think that the vampires tend to be kind of the sensitive ones, right? They are the ones that the external stimulus that’s coming at us are the ones that are really affected by that and which is why they end up that way because they’re just maybe genetically predisposed to respond in those ways. Then you throw some others, pressures on top of that and it really just puts a lot of pressure on that, on that circadian rhythm in that as you said, that diurnal curve.
Dr. Davidson: Yeah, definitely that degraded curve is exacerbated over time. So, one thing with vampires that we want to do is we want to try to bring down that cortisol at night to help them fall asleep so then also bring up the cortisol in the morning without coffee. We want to do in a way we were basically sort of helping those adrenal glands be able to get back to that circadian rhythm of bringing up that cortisol earlier. Somebody that can’t wake up before 10:00, you can’t all of a sudden overnight, help them wake up at 6:00. It’s a progression of, “Hey, 10:00 and then we work for– let’s get you wake up at 9:00. Let’s work at 8:30,” and then we work away back. Same with sleeping, if you can’t go to bed until 2:00 in the morning, we don’t try to make them go to bed the next day at 10:00. It’s just not going to happen. You’re just slowly resetting that over time and there’s definitely ways to do that. Lifestyle, like Dr. Maki had talked about. Nutrition-wise and definitely exercise-wise, there’s supplementation. There’s even prescriptions you can use to kind of help change this diurnal curve of the cortisol or the degraded curve.
Dr. Maki: Yeah and we were looking at someone’s adrenal status and granted it’s kind of a grey area because there’s no actual diagnosis. These things that we’re talking about are just kind of fun little terms that we had kind of developed for us to be able to compartmentalize and we can spot them in a second. We ask a couple of questions like, “Oh, yeah, you’re the vampire. Opp, you’re the ghost. Opp, you’re the zombie”. So, it helps us kind of help categorize. We’re hoping it’ll do the same thing for you. But then what that translates to is how we are going to be able to help them? When it comes to adrenal function, there’s basically like 5 tiers of treatment options here. Like you said, there is a prescription option which should be like hydrocortisone.
Then there’s glandulars, adrenal glandulars which can be very helpful but some people don’t tolerate them very well just like the hydrocortisone. Then you get into the herbs and then the next your down would be vitamins and minerals and then lifestyle and diet lifestyle. So, those different tiers kind of help depending on which category they fall into. The severity of their symptoms help to determine where on that tier. Now, you might combine a couple of those tiers together. You might notice the vampire for sure is potentially an easy candidate for hydrocortisone. Maybe a low dose, maybe morning and noon, something like that. But maybe someone, maybe that isn’t initiated or tried and maybe they can’t tolerate. So that now, as a practitioner, it gives us an idea where their adrenal status really is, right? So now, we can look at those other tiers and adjust accordingly depending on how they respond.
Dr. Davidson: Exactly. One thing when we’re looking at this, so we’re going to go onto the next episode with the ghost and then the next episode after that, we’ll talk about the zombie. It’s not a progression. It’s not like a vampire turns into a ghost which turns into a zombie. Like Dr. Maki said, the vampires, they might be predisposed that way. I think honestly, I think the zombies are the more sensitive ones. They’re the ones that are less common but they’re the ones that have more of a tremendous effect on their quality of life and their health with the way their cortisol is being secreted. So, but you don’t– you know, one doesn’t turn into another but you can see over time like Dr. Maki said, he was a vampire in the past and working on lifestyle and nutrition and supplementation able to kind of reverse that and change that. So, one thing we have kind of talked about is, you might resonate with this and say, “Oh my gosh, you know what? I think I’m a vampire. It’s not my fault that I can’t get up and get the kids to school because my cortisol just isn’t coming up.” It really isn’t your fault but we had talked about maybe having some options that might be able to help you.
Dr. Maki: Yeah, right. Really when you’re trying to– especially for these vampires, you’re trying to bring the cortisol down at night but a really good way to do that is to raise it in the morning. So again, this is, like I said, the vampire I think is probably one of the more common ones that we see you often. So, if you want to go to the show notes, right, so an easy way to find us, we’ll have a few more resources on the show notes for this episode. Go to progressyourhealth.com/vampire. The show notes will be there. There’ll be some other information that we didn’t share in this podcast but it’ll help give you some ideas as far as what can be done to kind of get you going in the right direction.
Dr. Davidson: Yes. So, progressyourhealth.com/vampire, we’ll have a short little description of what we talked about on this episode and then also below that we’ll have a little bit of some options with disclaimer, disclaimer, disclaimer, educational purposes about whatever, whatever, but it will have some options that you might be able to help facilitate right now to be able to help you go to sleep a little earlier, wake up a little earlier like you feel like people tell me, “I just want to feel like myself. I want to feel like a normal human being at 9:00 o’clock in the morning and not have to fake it.”
Dr. Maki: Yeah, right. And like you said too, that process, you can’t expect to have huge change. Like if you’re having a really hard time waking up by 8:00 in the morning or 6:00 in the morning or whatever it is, don’t expect you’re going to change that by a few hours. You just start working on 15, 20 minutes, a half an hour at a time and then of course over a three-month period or a little bit shorter or a little bit longer, now you’re going to be able to start making a lot of progress and then be able to re-establish a proper diurnal curve. Your cortisol rises in the morning like it’s supposed to between 5:00 and 8:00 in the morning and then it’s going to start to go down in the evening, appropriate time. We would like most of our patients to be in bed preferably sleeping right around 10:00. There’s one hour window, 9:30 to 10:30, that’s kind of your goal window. So, you’re still able to get a few hours of sleep prior to midnight, that’s really important, and then have enough hours of sleep before you wake up for the day, the following morning. That can be a challenge. We work with people of all different age ranges and they all have their sleep challenges as we have been talking about. It’s really difficult in our very artificial world. So, Dr. Davidson, do you have anything else to add?
Dr. Davidson: No, this is great.
Dr. Maki: Okay. So, on the next episode, we’re going to talk about the the ghost which has a couple of subsets. We’ll get into that, in the next one but until next time, I’m Dr. Maki.
Dr. Davidson: I’m Dr. Davidson.
Dr. Maki: Take care. Bye-bye.