with Dr. David Hilden


The Sleep Episode of Your Dreams

Dr. Hilden taking a breakEpisode Six of The Healthy Matters Podcast is no snoozer. I’m joined by sleep expert Dr. Ranji Varghese from the Minnesota Regional Sleep Disorders Center, located at Hennepin Healthcare. We uncovered so many interesting facts about the mysteries of sleep in this episode, including a few frightening ones that would keep me up at night – but thankfully he offered tips for insomnia as well.

He kindly answered some basic questions about why we sleep, how much sleep we need, and then we went a little deeper. Like what happens when people chronically do not get enough sleep?  The answer was nightmarish.

“Sleep deprivation can have a diminishing effect on our immune system: our brains will not function optimally, and bone and muscle repair will go haywire,” he said. “And in the past few years, we’ve discovered something called the glymphatic system, which is basically the sewer system for our brain.”

Since I missed the “glymphatic system” lesson in medical school, I asked him to explain, and you’ll have to hear for yourself why it’s even more important to get a good night’s sleep and why your brain’s future memory health may depend on it.

So what else is going on when we sleep? Dr. Varghese suggests that we may not be completely “offline” when we’re catching z’s.

“I look at it as not completely unconscious, but maybe just an altered state of consciousness, where there is some processing of information to make us again more optimized the next day,” he said. “There are two stages of sleep, non-REM (Rapid Eye Movement) sleep and REM sleep. During REM sleep we have vivid memories and vivid dreams. They are emotional. What does that suggest? It means that the brain is actually processing information during this period. We’re consolidating memories when we’re sleeping.”

What about dreams?

“Everyone dreams,” explains Dr. Varghese. “They may not remember them, but when they’re going through REM sleep dreams tend to be the most vivid, technical and emotionally laden. We think the dreams may be this playground for our brains to practice out the things we learned in the previous day.”

A caller also asks about the benefits of dreaming, and why we sometimes dream of those who have died.

Sleepwalking, sleep eating, melatonin, insomnia, sleep apnea – we cover all of these topics with Dr. Varghese – and I deliver a personal parasomnia story as well. Relax, listen to this episode, and enjoy a new appreciation for your next night of sleep.


Has anyone ever died of a broken heart?

Heart and mind connecting

There’s definitely a connection between the heart and mind, and in this Healthy Matters episode I’ve brought together two of the best minds to talk about the relationship between our mental health and physical health. Dr. Eduardo Colon chairs our Psychiatry Department and Dr. Steven Goldsmith is a cardiologist and nationally recognized expert in heart failure.

“You can die from a broken heart,” said Dr. Steven Goldsmith. “Fortunately, most of the time this is diagnosed in the context of other significant physical illnesses, such as an acute episode of lung disease, exacerbation or pancreatitis – but it can definitely occur.”

So where does the mental health connection come from? (Spoiler alert: it’s related to that thing between your shoulders.)

“When I was a kid, I borrowed a book that was called ‘The Body has a Head,’” said Dr. Colon. “It’s something I that I think about pretty often, because when we have this discussion about your emotions or your psychological wellbeing, people think about the mind, and we tend to forget that we have this incredible organ in our body – our brain – that’s connected to every other organ and regulates a lot of function.”

Dr. Colon shared what he learned about a guy who’s written a paper on “voodoo death,” (yes, it’s as creepy as it sounds) as well as how the need for mental health care has grown dramatically in recent years due to the pandemic.

“The isolation that we’ve all experienced, and certainly the narrowing down of the level of activity. I sometimes say that we were stuck on Groundhog’s Day in terms of the routines: fear of getting ill, the acknowledgment of the impact of the pandemic and people around you in your sense of vulnerability.” Dr. Colon also acknowledged that there has been a loss of sobriety for people with substance use disorders, and he’s seen people who have been struggling with preexisting mental health illnesses such as depression. These of course can lead to other concerns.

“Physical or mental stress can cause a form of heart disease called stress cardiomyopathy,” explains Dr. Goldsmith. “And what that means is that the heart suddenly – for no other reason – seems to not work very well, and it’s usually not fatal. It’s usually reversible, but you can die from it.”

The convergence of stress, inflammation, hormones and even genetics can create just the right conditions for heart failure. But there are ways to reduce some of these risk factors, and the doctors offered a few great suggestions including yoga, meditation and mindfulness – something that I mention I may need to practice, too.

We round out the episode with a couple of questions from listeners: one who’s experiencing heartache and another who’s concerned about his family’s history of heart issues. Healthy Matters of the heart that matter to you on Episode Five – enjoy!


Addiction creates the “perfect storm of perfect storm badness”

Did you know that one in 100 people in the U.S. is experiencing an addition to opiates? Have you wondered how some people can become addicted to something when others do not?

In Episode 4 of The Healthy Matters Podcast I’m joined by my friend and colleague Dr. Charlie Reznikoff – an addiction medicine expert who’s going to help us break down some of the myths and offer insights on how addiction can be treated.

“Addiction is many things,” he explains. “It can result from an untimely exposure to drugs, trauma in childhood mixed with, a little bit of bad genetic luck.”

We also talked about the most addictive drugs and the top one may surprise you. It’s on the “fastest track from outside your body to inside your brain.” Can you guess what it is?

So why do some of us struggle with addiction while others do not? We go into more detail about this and how most of us can simply have one drink or one painkiller and not give it another thought, while others will have concerns or are at a higher risk for addiction.

Dr. Reznikoff also talked about COVID-19’s effect on the opioid crisis and fentanyl’s connection to Wuhan, China. Yes, that Wuhan, China where COVID-19 was first reported.

“Fentanyl is an illicit, highly potent synthetic opioid that is cooked in China, or at least produced in China and shipped to America,” he said. “So when traffic to and from Wuhan was shut down in 2020, the shipments of fentanyl also became limited and those addicted to it had to find other sources, which created the ‘perfect storm of perfect storm badness.’”

Episode 4 of The Healthy Matters Podcast also covers addiction questions about alcohol, nicotine and even caffeine – as well as a brief discussion about the best and most expensive cup of coffee we’ve ever had.