Circadian Rhythms, Sleep Hygiene, and Well-Being: An Insightful Q&A With Thrive Wellness Reno Primary Care Physician, Internal Medicine Lorrie Oksenholt, D.O.
Thrive • May 26, 2022
When working optimally, the body’s circadian rhythms cause individuals to feel sleepy around bedtime and refreshed upon waking. When disturbed by external or internal factors, circadian rhythms don’t function correctly, which can contribute to inadequate sleep. Mental, emotional, and physical health challenges can then arise. Below, dive into the topic of circadian rhythms in an insightful Q&A with Thrive Wellness Reno Primary Care Physician, Internal Medicine Lorrie Oksenholt, D.O.
What are circadian rhythms?
All living beings have internal clocks called circadian rhythms that regulate sleep and wakefulness. Just as pets tend to wake up earlier than their owners and many flowers curl their petals toward their buds in the evenings, humans instinctively follow natural sleep and wake patterns triggered by circadian rhythms. Circadian rhythms work at a cellular level in accordance with changing light throughout the day.
How do circadian rhythms function?
Changes in light signal the body to produce certain hormones that are helpful for sleeping and waking. The eyes and brain work together to initiate this hormone production. The suprachiasmatic nucleus located in the brain’s hypothalamus responds to light and dark indicators from the eye’s retinal nerve. These fluctuations in light and dark trigger the body to produce cortisol in the mornings and melatonin in the evenings. Cortisol helps increase energy, heart rate, and body temperature which benefit waking. Melatonin serves as the body’s sleep-inducing hormone and promotes relaxation, although its exact mechanisms are not fully understood.
How do circadian rhythms change over a lifetime?
Circadian rhythms change during infancy, adolescence, and elderly years.
- Infancy: When babies are born, they don’t have consistent sleep and wake patterns. Instead, they sleep up to 18 hours a day at various intervals. When they reach around four to six months old, babies begin to develop circadian rhythms that allow them to sleep more throughout the night.
- Adolescence: Many adolescents develop “sleep phase delay” which occurs when their bodies produce melatonin later in the evening than typical. This physical phenomenon might help explain why many teenagers tend to stay up late and have difficulty waking up.
- Elderly years: During the aging process, circadian rhythms become less reliable. In general, elderly people tend to experience both sleepiness earlier in the evening and wakefulness earlier in the morning. Additionally, hormonal changes associated with aging, such as menopause in women, can frustrate sleep.
How can circadian rhythms become disrupted?
In a perfect world, circadian rhythms would allow individuals to rise in the morning with energy to perform daily tasks and then wind down as the evening darkens so that falling asleep occurs easily at bedtime. Without disruption, this process would repeat daily. However this is, of course, not always the case. Instead, circadian rhythms can become interrupted by external circumstances. Some interferences to circadian rhythms include:
- Changes in daylight: Daylight savings time, traveling through time zones, and seasonal weather oscillations can affect the body’s responses to light and dark. These disturbances can cause irritability, daytime sleepiness, and difficulty concentrating.
- Alternative schedules: Any work, school, or other obligatory schedules that fall outside the hours of 7 a.m. and 6 p.m. can impact circadian rhythms. This is especially the case for those who work shifts in the early mornings or late nights. Because these schedules don’t align with the body’s biological fluctuations, they can cause trouble sleeping and impede individuals’ ability to perform tasks effectively.
- Artificial light: Urban light pollution, light from screens and electronics, and light from inside individuals’ homes can impact sleep quality by confusing the body’s responses to natural daylight and darkening cadences. Those who experience insomnia may be highly sensitive to artificial light. These individuals as well as anyone with sleep struggles may consider removing electronic devices from their bedrooms, dimming their lights inside the home in accordance with the darkening sky, and refraining from screen time during the evening.
- Stress : As part of the body’s instinctual fight-or-flight response, it shuts down the circadian rhythm sleep signal when stressed. While this mechanism is helpful if survival is threatened, stress from daily life can cause unnecessary sleep issues and resulting sleeplessness.
How can discordance in circadian rhythms impact well-being?
After losing only a single night’s sleep, it’s common for individuals to be less effective at carrying out physical activities, completing cognitive tasks, and regulating their emotions. When circadian rhythms are upset and sleep quality consequently suffers for extended periods of time, the effects of inadequate rest on physical, mental, and emotional health are magnified. A prolonged inability to achieve good sleep can lead to heart and immune system problems, trouble concentrating, and increased irritability, as well as symptoms of depression and anxiety .
How can individuals maintain their circadian rhythms?
Practicing good sleep hygiene and sleep-promoting self-care strategies can help one avoid many sleep disruptions while reinforcing their natural circadian rhythm. Some ways to incorporate these into your routine include:
- Going to bed and waking up at the same time every day. Adhering to a regular schedule for going to sleep and waking up can help regulate circadian rhythms.
- Exposing yourself to sunlight. Sunlight can help promote wakefulness by reinforcing the body’s light signals to stimulate cortisol production. When the sun begins to set, the body is able to easily contrast the previous sun exposure with the darkening evening, so that it readily begins producing melatonin.
- Making time for daily movement: Thirty minutes of physical activity daily can help release pent-up energy that may contribute to restlessness. Physical activity does not have to be rigorous exercise to be beneficial. Mindful movement can promote a healthy circadian rhythm among many other perks.
- Practicing mindfulness : Meditation, gentle yoga, and breathing practices can help reduce stress and tension that may be impeding your ability to sleep well.
- Avoiding certain substances leading up to bedtime. Limiting caffeine and alcohol intake in the afternoon and evening can promote restful sleep.
- Considering the time that you take any medications. Discuss with your medical provider whether any medications you’re taking might impede your sleep and would be better to take in the morning rather than at night.
- Seeking primary care support. Speaking with your medical provider about struggles with your circadian rhythm can help determine whether there are any underlying medical conditions, such as sleep apnea or thyroid problems .
- Seeking mental health support: Attending therapy can provide insight on whether any mental health conditions may be contributing to upset in your circadian rhythm. Mental health providers can implement evidence-based therapeutic interventions, such as cognitive behavioral therapy (CBT), which can be beneficial for reducing sleep-interfering thoughts and behaviors before bedtime.
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By obtaining clinical support, individuals can reset their sleep and wake cycles, improve their sleep quality, and boost their daytime effectiveness. Thrive Wellness’ interprofessional team provides integrated care for physical, mental, and emotional health concerns. Our specialists can help you uncover the roots of sleep-related challenges and improve your health holistically so you can embrace your full potential every day. Reach out to learn more about our outpatient services as offerings vary by location.
About the Contributor
Thrive Wellness Reno Primary Care Physician, Internal Medicine Lorrie Oksenholt, D.O.
After earning a bachelor’s degree in foods and nutrition at Walla Walla College in Washington state, Dr. Lorrie Oksenholt attended medical school at the University of Missouri-Kansas City where she obtained her medical degree as a doctor of osteopathic medicine. She completed her internal medicine residency through the University of Nevada, Reno where she also served as a clinical professor of medicine in both inpatient and outpatient settings. Additionally, Dr. Oksenholt worked as the chief of staff and acting medical director at Nevada Mental Health.
Dr. Oksenholt has been practicing internal medicine for over thirty years and has significant experience treating general health concerns as well as issues specific to women’s health and men’s health, respectively. Throughout her career, she has worked closely with clinical specialists to treat mental and behavioral health issues, including eating disorders. She is passionate about a whole-person approach to health care that addresses the mind, body, and heart for overall well-being. As an internal medicine physician at Thrive Wellness Reno, Dr. Oksenholt finds fulfillment in working alongside caring clinicians to foster holistic health for patients. She strongly believes in the power of preventative medicine and is committed to collaborating with those in her care to achieve optimal health.
Outside of her practice, Dr. Oksenholt enjoys taking advantage of the abundance of outdoor activities that Northern Nevada has to offer. She and her husband enjoy spending time together as well as with their children and grandchildren as often as possible. Dr. Oksenholt has many hobbies including glasswork, jewelry making, and quilting.
Coming out is a deeply personal, courageous, and in many cases, life-changing act. Whether you're sharing your sexual orientation or gender identity, coming out is about embracing authenticity and sharing an essential part of who you are. During the process of coming out, prioritizing your mental health at every stage is crucial. In this blog, we'll discuss insights and strategies to support your mental health before, during, and after coming out. Wherever you are in your journey, know that your experience is valid and you are not alone. Understanding the Mental Impact of Coming Out Coming out can bring about a lot of big feelings, including fear, relief, joy, anxiety, grief, and hope, sometimes all at once. Know that heightened emotions during this time are completely normal. Sharing such an integral part of yourself with the world can feel intense, but even with the ups and downs, being authentically you is worth it. Because LGBTQIA+ individuals face added mental health burdens due to stigma and discrimination, taking care of yourself during this time is more important than ever. You might experience increased anxiety, mental exhaustion, or avoidance ahead of coming out, so don’t be afraid to reach out for support. At its core, coming out is about authentic self-expression and showing your truest self, which can feel both exciting and scary at the same time . The self-acceptance and community gained from coming out is a vital part of finding long-term strength and joy. Still, it’s okay if you feel uncertain or conflicted, and these feelings are just part of the process. Before Coming Out: Emotional Preparation Coming out starts with reflection. Remember that there’s no rush when it comes to figuring out who you are. It’s okay to take time to understand your identity and what coming out might mean for you. Here are a few questions to consider: What do I hope to gain by coming out? Who feels emotionally safe to talk to? What are my fears, and how can I manage them? Mental wellness tips before coming out: Journaling can help you better understand your feelings and fears and explore different ways to share your truth. Talking through your feelings and different scenarios with a therapist , especially one who is LGBTQIA+ affirming, can help you to feel more supported and ready to come out. Practice grounding techniques like deep breathing, meditation, or visualization to ease anxiety ahead of sharing your identity. Helpful resources for coming out include: Trevor Project Lifeline (1-866-488-7386) TrevorSpace (an online community for LGBTQIA+ youth) OurCenter (a local community center for the LGBTQIA+ community in Reno) During the Coming Out Process: Staying Grounded The act of coming out can feel intimidating, as you’re sharing such a vital part of who you are. You might experience fear, panic, or doubt. While these feelings are real, know that you don’t have to navigate them alone. Tips for emotional resilience: Practice conversations ahead of time with a therapist or supportive friend so you feel ready when the time comes to share. Choose a time and place where you feel safe and in control. Use affirming statements, like, “I deserve to be loved for who I am.” Coping with negative responses: Set emotional boundaries with people who aren’t supportive. Create an emotional safety plan: know who you can call, where you can go, and what can help soothe you in moments of distress. After Coming Out: Processing and Healing Coming out, no matter how it went, deserves to be celebrated. An act of strength and authenticity like coming out is no small feat, so be proud of yourself for sharing who you are. Even so, the emotional aftermath can be complicated. You might feel joy and empowerment or loss and grief, especially if relationships shift. Healing strategies: Acknowledge your courage . Even difficult conversations are acts of strength. Rebuild your safety if you've experienced rejection. This might mean changing your environment or seeking new support systems. Release guilt or shame. Being who you are is never something you should feel ashamed or guilty for. Support networks can make a huge difference. Seek out different forms of support like: LGBTQIA+ support groups (in-person or online) Peer mentors or community leaders Allies, friends, or family who affirm and respect your identity Therapeutic options to deal with stress, grief, or isolation associated with coming out: EMDR (Eye Movement Desensitization and Reprocessing) can help process trauma. Narrative therapy helps you rewrite your story in your own empowering voice. Coming Out More Than Once: Navigating the Long Game Coming out isn’t just a single milestone, it’s a recurring process. You might come out again and again: to a healthcare provider, a neighbor, a partner, or a friend. It can feel exhausting or unfair to have to come out more than once, but each time, you’ll continue to find more strength, confidence, and understanding for yourself. Other tips for coming out: Focus on cultivating a strong inner identity that doesn’t rely on external validation. You know who you are, and you don’t need to prove yourself to anyone. Create a personal toolkit of coping and grounding strategies to deal with stress or burn-out associated with coming out. Thrive Wellness offers a free breathing exercise guide to help relieve anxiety and calm the nervous system. Download it here . Find affirmation and support through community. This can look like finding a chosen family, looking up to queer role models, attending events that celebrate the LGBTQIA+ community and its history, and working on embracing authenticity and having pride in who you are. Remember, there’s no one-size-fits-all approach to coming out, and it’s never too late to share who you are. Whether you're preparing to come out, in the midst of sharing your truth, or processing what came after, know that you are worthy of love, safety, and joy. Your truth is worth celebrating, today and everyday! For support during the coming out process and beyond, reach out to our team of affirming, inclusive, and compassionate mental and physical health care providers. We're here for you.
Taking steps to protect and maintain good mental health is key to living your best life. Whether it's managing stress, building emotional resilience, or simply finding a moment of peace during your busy day, developing a set of strategies to protect your mental health is essential. This Mental Health Awareness Month is all about turning action into awareness, so why not take action today to care for yourself and improve your mental health? This guide outlines ten impactful activities you can incorporate into your daily routine to boost your mental health starting today. By incorporating these activities into your days, you can take control of your mental health journey, grow personally, and improve your relationship with yourself and others. Why is Taking Action for Your Mental Health Important? Understanding the significance of proactive mental health care can change how we treat ourselves and move through our everyday lives. Taking action for yourself not only improves your overall well-being but also helps prevent existing or potential issues from becoming more severe. When you prioritize your mental health, you’ll feel a greater sense of happiness and productivity, paving the way for stronger relationships and a fuller, more enjoyable life. Focusing on your mental health is not just about problem-solving, but about living in a balanced and fulfilling way that supports your overall well-being and ability to thrive. 10 Effective Activities for Improving Your Mental Health It’s essential to have a repertoire of activities on hand that can boost your mental health. Simple activities like sleeping enough, meditating, spending time with a friend, or seeing a therapist can have huge impacts on your overall mental wellness. Prioritizing your mental health doesn’t have to be complicated or difficult, it’s just about doing activities that make you feel joyful, relaxed, or energized, fueling a better outlook on life overall. Here are 10 activities you can do today to help your brain and body to feel their best: 1. Mindful Practices Practicing mindfulness is a simple yet impactful step you can take in improving and protecting your mental health. Mindfulness practices include activities like meditating and mindful breathing to calm the mind and reconnect with the body. Meditation and breathing exercises are shown to reduce stress, improve focus, and grow your self-awareness. For more breathing exercises for anxiety relief, download our free guide “Breathe Easy” . 2. Eating Intuitively Eating intuitively is a powerful way to boost your energy and mood and reduce stress around food, helping to improve your overall mental health. This approach encourages a healthy relationship with food by promoting balance, variety, and pleasure without guilt. Intuitive eating helps you recognize and respond to your body's signals, leading to more mindful and satisfying eating experiences. By focusing on how foods make you feel, both physically and emotionally, you can make healthier choices that nourish your body and mind. Adequate nutrition has been shown to support brain function, improve mood, and reduce the risk of mental health conditions. 3. Sleep Hygiene Practicing good sleep hygiene is essential for maintaining overall health and wellbeing. Establishing a consistent bedtime routine helps regulate your sleep patterns, ensuring you get the deep sleep your body needs. Aim to go to bed and wake up at the same time each day if possible. Quality sleep is vital for cognitive function, emotional stability, and physical health, making good sleep hygiene a key component of wellness. 4. Mindful Movement Doing movement that you enjoy can have massive impacts on your mental health. Exercise reduces stress by triggering the release of endorphins, which have mood-lifting and pain-relieving effects. It also helps regulate hormones like cortisol, improving the body's ability to handle stress. By simply incorporating enjoyable movement into your routine a few times a week, you’ll see improvements in both your mental and physical health. 5. Go Outside Spending time outside can support physical, mental, and emotional well-being. It allows you to disconnect from everyday stressors, reconnect with the natural world, and experience a sense of tranquility and peace. Spending time in nature has been linked to reduced anxiety, improved mood, and increased mindfulness. Make time to explore outdoor environments such as parks, forests, beaches, or gardens. Practice mindfulness while in nature, focusing on the scenery and sounds that surround you. Incorporating nature into your daily routine can provide a refreshing break from everyday life, improving your mental health. 6. Make Time for Creative Pursuits Creative activities can be a great outlet for self-expression and reducing stress. Creativity allows you to explore new ideas, solve problems, and connect with your inner self. Even dedicating just 10 minutes a day to creative pursuits can have a positive impact on your mental health. Activities like drawing, painting, journaling, or crafting can help you unwind and stimulate your mind. Creative expression can also improve mood, enhance cognitive function, and foster a sense of accomplishment. 7. Practice Positive Self-talk Positive self-talk is a powerful habit that involves speaking to yourself in a kind, supportive, and encouraging manner. It's about cultivating a positive mindset and nurturing self-compassion. By shifting negative thoughts and beliefs to positive affirmations, you can boost your self-esteem and overall well-being. Practice acknowledging your strengths, accomplishments, and perseverance, even in challenging situations. 8. Practice Social Wellness Social wellness is about nurturing meaningful connections with others and fostering a supportive network of relationships. It involves engaging in positive interactions, building trust, and offering and receiving support. Cultivating social wellness contributes to emotional resilience, reduces feelings of isolation, and promotes overall happiness. Take time to connect with friends and family members regularly, whether through phone calls, video chats, or in-person gatherings. 9. Do Something for You Making time for yourself is crucial for maintaining life balance and preventing burnout. This involves setting boundaries, practicing self-care, and prioritizing activities that bring you joy and relaxation. Taking time for yourself allows you to recharge, reflect, and reconnect with your inner needs and desires. Self-care can take many forms, from indulging in a hobby to simply enjoying a quiet moment alone. Regularly dedicating time to yourself helps reduce stress, improve mental clarity, and enhance overall well-being. 10. Visit a Mental Health Professional Sometimes, we need professional support for our mental health, and that’s okay! Knowing when it’s time to see a therapist shows strength and self-awareness. No matter where you are in your mental health journey, getting guidance from a therapist can be a helpful tool in living your best life. Our team of mental health professionals are ready to support you now, don’t be afraid to reach out and open up. When Should I Seek Professional Help for My Mental Health? It's important to know when it's time to reach out to a mental health professional. Persistent feelings of sadness, anxiety, or emotional distress that interfere with your daily life are clear indicators for seeking professional help. If your coping mechanisms and self-care activities fail to alleviate your mental health concerns, reaching out can offer valuable support and interventions. Nurturing Your Mental Well-being Through Action Investing time and effort in your mental health can make positive differences in your everyday life. By understanding the importance of mental health practices and incorporating proactive strategies, you lay the groundwork for feeling better and staying mentally strong over time. Whether through improved sleep hygiene, mindful practices, or seeking professional help when needed, these efforts can bring more joy, emotional stability, and peace into your life. Make these activities a regular part of your day with a focus on self-growth, and you'll be on your way to a healthier mind and a fuller life.
Romantic relationships can be one of the most joyful parts of life, but they can also stir up deep fears, especially for those living with obsessive-compulsive disorder (OCD). When OCD takes shape around your relationship, it’s known as Relationship OCD (ROCD), a lesser-known but deeply distressing form of OCD that centers on obsessive fears and doubts about your partner or the relationship itself. Have you ever found yourself spending hours analyzing how you feel, seeking reassurance that your partner is “the one,” or constantly second-guessing whether you’re truly in love? If so, you’re not alone. ROCD is real, and with the right tools and support, healing is possible. Let’s break down what Relationship OCD really looks like, how it affects interactions, and how to find more peace, connection, and presence in your relationship. What is Relationship OCD? Relationship OCD is a subset of obsessive-compulsive disorder that fixates on doubts, fears, or perceived flaws within romantic relationships. Unlike the normal ups and downs that every couple experiences, ROCD involves a preoccupation with intrusive thoughts that feel impossible to stop thinking about, like whether you’re really attracted to your partner, or if they’re “good enough” for you. These thoughts can feel distressing, uncontrollable, and all-consuming. What sets ROCD apart is the compulsive mental checking that follows. You might replay interactions, examine your partner’s every word, or repeatedly ask friends or family members, “Do you think we’re good together?” These rituals, designed to bring relief, often do the opposite. They intensify the anxiety and begin to erode the connection you’re trying to protect. Relationship OCD Examples: What It Can Look Like in Real Life ROCD doesn’t always look the same for everyone. For some, it shows up as intense anxiety about having children with their partner: “What if they’re not going to be a good parent?” For others, it might revolve around analyzing every interaction or feeling jealous of a past relationship their partner had. Here are a few common presentations of ROCD: “Do I love them enough? ” spirals, even when nothing’s wrong. Feeling distressed if your partner doesn’t respond the “right” way during a conversation. Constantly seeking reassurance from others about your relationship. Comparing your partner to idealized versions of relationships you see online. Avoiding important conversations or decisions (like parent-child planning) because of underlying doubts. The key thing to remember? These thoughts are symptoms of OCD, not reflections of reality. How OCD Affects Relationships ROCD can strain even the strongest partnerships. When someone is stuck in a cycle of obsessions and compulsions, it often leads to emotional distance, communication breakdowns, and frustration on both sides. A partner might feel like they’re walking on eggshells or like they’re being constantly evaluated. Meanwhile, the person experiencing ROCD may feel ashamed, misunderstood, or exhausted by their own mind. Many individuals report feeling like they can’t be fully present during time with their partner because their mind is so busy analyzing, comparing, or worrying. And over time, these patterns can impact the health of the relationship itself. That’s why relationship-centered, mental health-informed approaches are so vital. How to Treat Relationship OCD Thankfully, ROCD is treatable. But the most effective treatments don’t just focus on the relationship, they focus on the OCD. At Thrive, our therapists often use Cognitive Behavioral Therapy (CBT) and a specialized approach called Exposure and Response Prevention Therapy (ERP) . These modalities help people face their fears without performing compulsions. Over time, this rewires the brain’s response to uncertainty. Therapists may also incorporate experiential techniques like eye movement desensitization and reprocessing, which engage both the body and mind to help clients process intrusive thoughts and emotional pain. For some, prescription medication like SSRIs may be helpful as part of a treatment plan. For couples navigating ROCD together, couples counseling can support healthy communication and connection without reinforcing compulsions. How to Support a Partner with Relationship OCD If your partner is experiencing ROCD, your role is crucial. It's not about "fixing" them though, it’s about being a safe, steady presence. Here are a few ways to support your partner with ROCD: Educate yourself about OCD and ROCD so you can identify symptoms versus your partner’s true feelings. Avoid reassurance loops . It’s tempting to soothe their fears, but constant reassurance can reinforce the cycle. Encourage professional support with a therapist or psychologist experienced in OCD. Focus on building a relationship where uncertainty is tolerated, not feared. Practice empathy. Remember that these thoughts are distressing and involuntary. With the right tools and support, both of you can learn how to thrive even in the midst of mental health challenges. Final Thoughts: Healing Together ROCD can feel isolating and confusing, but you don’t have to face it alone. Whether you’re the one struggling or the one supporting, healing happens through community, compassion, and the right care. At Thrive Wellness, we believe in compassionate, holistic care, and we’re here to walk alongside you. Whether you need individual therapy, couples counseling, or a dedicated treatment plan, we’re here to help you find your way back to connection, peace, and presence. Need support? Reach out today and begin your journey toward healing together. For tools to help you cope with anxious thoughts, download our free breathing exercises guide "Breathe Easy" .
