Menlo Park Psychiatry & Sleep Medicine, Alex Dimitriu, M.D.

10/06/2025

The 10-3-2-1 sleep method is a simple countdown that aligns with how the brain and body prepare for sleep: 10 hours before bed, stop caffeine; 3 hours before, finish your last meal; 2 hours before, stop work; 1 hour before, screens off. I often simplify this to "tech off at ten," because a firm cutoff for screens and work is the single biggest lever most people can pull for better sleep.

Why it works: caffeine has a 6-hour half-life, so a 20 oz coffee at noon is still like 5 oz in your system at midnight, and it also lightens deep sleep. Alcohol feels sedating but fragments sleep once it wears off 3–4 hours later, disrupting slow-wave sleep. Large meals keep your body busy digesting when you want it resting. Late, intense workouts can also raise body temperature and adrenaline, making it harder to wind down.

Professional tip: treat 10-3-2-1 like training. Commit for 2–4 weeks, set reminders, dim lights, swap the phone for a paper book, take a warm shower, and keep a brief sleep log to track progress. The method is effective, but it’s not a magic bullet—consistency is what makes it work. If you’re still struggling, or if there’s loud snoring, waking up gasping, or persistent insomnia, consider a professional evaluation.

I contributed to this piece in PROVOKED: https://bit.ly/4gWEWGH

No gadgets, no apps, no supplements—just a back-to-basics formula that might finally help you sleep through the night. 2:47 a.m. Wide awake again. My husband snores peacefully next to me (after taking a full three minutes to fall asleep, I might add) and I lie awake mentally reviewing next week’...

09/18/2025

Sleep "mocktails" are making the rounds, and some can be helpful—if we stick to what the research supports. My take: tart cherry juice and magnesium have evidence for improving sleep quality and duration, while lettuce water does not. Tart cherry juice contains small amounts of melatonin and tryptophan and has antioxidant properties; studies have tested up to 200 ml twice daily. Magnesium can improve sleep and mood; the form is worth knowing—threonate tends to reach the brain more readily, while citrate and glycinate are also useful. Powder vs capsule doesn’t matter much.

Safety matters. Keep elemental magnesium well below 350 mg per day. Read labels carefully: a supplement may list a larger compound dose but deliver far less elemental magnesium. For example, about 2000 mg of magnesium threonate provides roughly 140 mg elemental. Too much magnesium can cause nausea, diarrhea, cramping, and at very high doses can affect heart rhythm. Seltzer is fine for fizz; avoid sugary or caffeinated drinks before bed. Lettuce water has very little evidence and no human trials supporting a sleep benefit.

Practical plan: build a solid routine first—consistent bed and wake times, dim lights, and no screens for two hours before bed. If you want to try a mocktail, consider 4–8 oz tart cherry juice diluted with sparkling water 1–2 hours before sleep, plus a magnesium glycinate or threonate providing 100–200 mg elemental magnesium (staying well under 350 mg/day). Valerian root or chamomile can be added and have supportive data. And any time you see a new trend, search "term + PubMed" to check the science.

I contributed to this piece in Popular Science: https://bit.ly/46vwn0N

Should we all be drinking magnesium and lettuce water before sleep? Experts weigh in.

09/11/2025

Many people chase eight hours every night, but time in bed and time asleep are not the same. In middle-aged and older adults, about seven hours of actual sleep tends to align with better brain and mood outcomes. Because most of us sleep a little less than the window we give ourselves, I suggest an eight-hour opportunity for sleep — lights out to alarm — which usually yields a healthy seven hours. Overshooting with nine to ten hours can fragment sleep and reduce efficiency.

Quality matters as much as quantity. Deep sleep is front-loaded in the night; REM sleep clusters toward morning. Late-night emails, doomscrolling, alcohol, and caffeine all chip away at these stages. Some medicines do too: benzodiazepines can reduce deep sleep, and antihistamines like diphenhydramine can cut into REM.

Practical steps I share with patients:
Keep consistent bed and wake times.
Slow down two hours before bed — "turn tech off at ten."
Avoid alcohol and large meals for 3–4 hours before bedtime; skip late exercise.
Keep the bedroom cool, dark, and quiet.

If you wake at 2 a.m., do not reach for your phone. Try 3-4-7 breathing, and if you are not sleepy after ~20 minutes, get up and read a paper book in dim light.
Short-term melatonin can help while you rebuild habits, but lifestyle changes do the heavy lifting. Afternoon slump? A 10–15 minute rest or a small late-morning coffee can help; avoid caffeine after noon. Hormonal factors, including estradiol and progesterone, also play a role — check levels and work with a specialist.

I contributed to this piece in US News & World Report:
https://bit.ly/47BgxnG

08/25/2025

Have you ever learned a new word, recognized a specific trend, or started thinking about a certain car—and suddenly it seems to appear everywhere? This is what we call the Baader-Meinhof phenomenon, or more simply, the 'frequency illusion.' It’s not that the world suddenly changed, but rather your brain is now more tuned into that concept.
This is driven by selective attention and confirmation bias. Your mind filters for what it expects or values based on recent exposure, allowing some information in while ignoring the rest. Once you become aware of something new, your brain becomes hyper-aware of it and starts identifying it more often, reinforcing the perception that it's suddenly everywhere.
This cognitive loop can influence how we perceive ideas, behaviors, and even larger cultural trends. Recognizing how our minds work in this way can help us better understand what’s real versus what’s simply more noticeable to us at a given time.
I contributed to this piece in Verywell Mind, where I dive deeper into why this happens and how to stay aware of this cognitive bias: https://bit.ly/3V0ICNu

The Baader-Meinhof phenomenon, AKA the frequency illusion, happens when we notice something and it suddenly seems to be everywhere. Learn why it happens.

08/21/2025

Middle-of-the-night wakeups can be frustrating—often leading to more stress and even less sleep. While many reach for their phone (which only makes things worse), simple calming techniques can help you fall back asleep faster.
One approach gaining attention is based on eye movements similar to those used in EMDR therapy—a research-backed method for calming the nervous system by moving the eyes left to right repeatedly. These movements may activate the parasympathetic nervous system, which is responsible for relaxation and recovery.
I often suggest pairing this with controlled breathing (like box breathing: inhale for 3 seconds, hold for 4, exhale for 7) or progressive muscle relaxation. These physical techniques shift focus from the racing mind back to the body, helping ease the transition back to sleep.
The key? Keep your mind clear, direct attention away from screens, and use physical relaxation methods. It doesn’t have to be complicated—just consistent.
I contributed to this piece in the New York Post, which breaks down the concept further:
https://bit.ly/4opylbo

“I’ve tried it a couple of nights in a row and it literally works — like it’s the best trick I’ve ever tried,” Jenna Coak said in a video on TikTok.

08/18/2025

Methylphenidate, commonly known as Ritalin, is a stimulant prescribed to improve focus, attention, and impulse control. But combining it with alcohol can send mixed signals to your body. One stimulates your system, the other sedates it. This conflicting effect can mask the sensation of intoxication—making a person drink more without realizing how impaired they truly are. That increases the risk of overconsumption, impaired judgment, and cardiovascular stress.

If you're prescribed methylphenidate and choose to drink, consider lower doses (1-2 drinks max) and possibly skipping or switching to a shorter-acting version on those days. Being informed helps prevent unintended harm.

I had the chance to speak with MedShadow about how alcohol interacts with Ritalin, and what safer strategies might look like.

Read the full interview in the first comment.

Use caution when drinking alcohol with methylphenidate (Ritalin, Concerta), as the combination may result in unintended side effects

08/14/2025

A new study has linked certain sleep traits with the risk of developing a wide range of diseases—and the findings are an important reminder that sleep quality goes far beyond just how many hours you get each night.
What struck me most as a sleep specialist is how the study emphasized the importance of consistency, timing, and fragmentation during sleep. It's easy to overlook these subtler factors in favor of tracking sleep duration alone. But how deep your sleep is, whether you wake during the night, and how regular your sleep schedule is can all significantly impact overall health.
One key takeaway: Good sleep loves rhythm. Regular sleep and wake times, especially getting to bed before midnight, matter more than many realize. A cool, dark, and quiet environment, along with a supportive mattres,s can go a long way in improving both the quality and rhythm of your sleep.
There’s also great value in using objective tools like sleep trackers to assess patterns over time—it helps move the conversation toward both sleep quality and consistency.
I contributed to this piece in Fox News Online: https://fxn.ws/45vuWz3

Researchers analyzing UK Biobank data reveal that poor sleep patterns double the disease risk for 42 conditions, with sleep regularity more important than duration alone.

08/11/2025

Many people try supplements for depression before seeing a mental health professional. While this isn’t always ideal, it’s helpful to understand which ones may truly offer support. A recent study reviewed dozens of supplements and found that four stood out: St. John’s wort, saffron, probiotics, and vitamin D. These have been studied for years and may help ease symptoms of depression—especially when used for mild cases.
However, quality and dosage matter a great deal. Not all supplements are created equal, and mixing several at once can make it harder to figure out what’s working. I encourage patients to start with just one at a time from a trusted source. And always involve your healthcare provider in the conversation—especially if symptoms are more severe or persistent.
For more insights into how supplements may fit into care for depression, I shared some thoughts with Everyday Health. Read more in the first comment.

08/07/2025

Words matter—especially when we talk to ourselves. In my interview with HuffPost, I discussed a unique anxiety hack: giving your anxiety a silly or ridiculous name. While it might sound unusual, there’s real benefit to this approach. Naming anxiety something lighthearted, like "Wacky Wanda," can help put distance between you and the feeling, making it less overwhelming. It reduces stigma, shifts perspective, and creates space to manage it more constructively. But there’s a caveat—minimizing symptoms with humorous names shouldn't replace clinical attention if anxiety is affecting your daily life. If your emotions are getting in the way of how you function, always consult a mental health professional. Read more about this technique and how to apply it mindfully in HuffPost's article in the first comment.

08/04/2025

Taking vitamin B12 in the evening? It might be hurting your sleep. B12 is energizing and can shift your internal clock, causing early wakeups or restless nights. Before supplementing, consider a blood test to check your levels. Read more in the first comment.

07/30/2025

Most people should fall asleep within 10–20 minutes of turning off the lights. But with phones in hand right up until bedtime, it’s no wonder insomnia is on the rise. When you’re scrolling late at night, your brain stays active—too active for sleep. The overstimulation from screens delays your natural wind-down and leads to poorer sleep once you finally close your eyes.
If it’s taking you significantly longer to fall asleep, and this struggle happens more than three times a week for over three months, it could be a sign of sleep-onset insomnia. But you're not alone—about a third of adults experience trouble sleeping occasionally.
The good news? There are simple ways to reclaim your sleep: start with "tech off at ten," say no to caffeine after noon, and create a quiet, dark sleep environment. Prioritize downtime and make room to unwind before bed.
For more practical tools on improving sleep and breaking the cycle of nighttime restlessness, check out this article:
https://bit.ly/4kZpLwI

07/30/2025

One of the biggest traps for people struggling with anxiety is impatience. When you're in a constant state of worry, the mind wants quick answers and rapid relief. But most effective treatments—whether therapy, lifestyle changes, or medication—require time and consistency.

In a recent interview with HuffPost, I shared insights on how anxiety narrows our perception, forcing an all-or-nothing mindset: situations feel either completely threatening or totally safe; solutions are either perfect or useless. This lack of nuance often leads anxious individuals to give up on potential solutions too soon, believing nothing will help.

The takeaway? Stay the course. Whether it’s a new routine, medication, or therapy, give it time—at least 2 months—and take notes. Tracking your progress can offer clarity and motivation that anxious thinking alone may not.

Read the full article here: https://www.huffpost.com/entry/4-ways-to-identify-and-escape-your-anxiety_l_68768c89e4b0ad34794f5ebb?o5

There's actually a pattern to the chaos.