Latest / Clearly Hormonal / Ep 32: Mastering Your Sleep with Irina Macare

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Ep 32: Mastering Your Sleep with Irina Macare · Clearly Hormonal

• 0:02
  Dr. Komal Patil-Sisodia: Welcome to Reset Recharge, the podcast where women's health takes center stage.
• 0:07
  Dr. Komal Patil-Sisodia: I'm your host, Dr.
• 0:08
  Dr. Komal Patil-Sisodia: Komal Patil-Sisodia, a triple board certified endocrinologist and women's health expert.
• 0:13
  Dr. Komal Patil-Sisodia: This show is all about empowering you with the knowledge to understand your metabolic health, navigate hormonal changes, and feel confident in the conversations you're having with your healthcare provider.
• 0:24
  Dr. Komal Patil-Sisodia: Whether you're managing symptoms, exploring treatment options, or just want to feel more in tune with your body, you're in the right place.
• 0:31
  Dr. Komal Patil-Sisodia: As a physician, my goal is to educate on this podcast.
• 0:34
  Dr. Komal Patil-Sisodia: The content shared here is for informational purposes only and should not replace personalized medical advice.
• 0:41
  Dr. Komal Patil-Sisodia: If something we discuss resonates with you, please talk to your healthcare provider at your next visit.
• 0:46
  Dr. Komal Patil-Sisodia: Now let's dive in and help you reset, recharge, and take control of your health.
• 0:55
  Dr. Komal Patil-Sisodia: Hi everyone.
• 0:56
  Dr. Komal Patil-Sisodia: Welcome back to Reset Recharge.
• 0:58
  Dr. Komal Patil-Sisodia: I'm your host, Dr.
• 0:59
  Dr. Komal Patil-Sisodia: Komal Patil-Sisodia.
• 1:00
  Dr. Komal Patil-Sisodia: Today I am very excited for our special guest Irina Macare is a sleep coach, and I met her through a local group of female entrepreneurs and we have a lot of.
• 1:13
  Dr. Komal Patil-Sisodia: Overlap in what it is we're trying to do for women's health and just health in general.
• 1:18
  Dr. Komal Patil-Sisodia: And sleep is a huge part of health and is hugely disrupted in midlife.
• 1:23
  Dr. Komal Patil-Sisodia: So I wanted to invite her onto the podcast to talk about her background and then this and her sleep coaching business and a framework that she's come up with to help people feel like they can get to sleep in a better way.
• 1:37
  Dr. Komal Patil-Sisodia: Welcome, Irina.
• 1:38
  Dr. Komal Patil-Sisodia: Thank you so much for being here.
• 1:40
  Irina Macare: Thank you so much, Dr.
• 1:41
  Irina Macare: Komal, for inviting me and allowing me to have a voice on your platform.
• 1:46
  Dr. Komal Patil-Sisodia: Oh, it's my pleasure.
• 1:46
  Dr. Komal Patil-Sisodia: I think that all the good information that we can put out there for our listeners so that they have tools to be able to make their quality of life better is so important.
• 1:56
  Dr. Komal Patil-Sisodia: Irina, can you tell us a bit about your background and what brought you to sleep Coaching?
• 2:02
  Irina Macare: Yeah, that's a interesting story because my background is actually, I'm an IT engineer and I've been working in IT for 16 years, and the IT space, it's very competitive and very hardworking.
• 2:16
  Irina Macare: So I burnout out multiple time and burnout came of course with insomnia.
• 2:22
  Irina Macare: So I've struggled with insomnia for years and initially when it happened there was like a night here and there.
• 2:29
  Irina Macare: But then as life went on, challenges got harder and harder, my stress level increased.
• 2:36
  Irina Macare: So it got to, the point was it wasn't a matter if I wake up in the middle of the night.
• 2:41
  Irina Macare: So I was waking up in the middle of the night and couldn't fall back asleep until morning.
• 2:46
  Irina Macare: So at some point it wasn't about, if I wake up, it was about like at what time will I wake up and for how long will I be awake?
• 2:54
  Irina Macare: And.
• 2:54
  Irina Macare: Initially, I pushed through this being tired and the sleep deprivation and the effects of it through with coffee and willpower, but everything changed when I got into a car accident because I didn't have reactions fast enough to avoid a collision.
• 3:12
  Irina Macare: So that was my wake up call, literally, and fig, figuratively.
• 3:18
  Irina Macare: So that was the point when I realized that I have to do something otherwise, like I will literally die.
• 3:25
  Irina Macare: But back then I was in Ireland and honestly like the medical system there is not great either.
• 3:32
  Irina Macare: So I knew for sure that I didn't want to go to a sleep doctors or to even like to my gp first to go to the GP and then you go to a specialist.
• 3:40
  Irina Macare: I knew that they're going to prescribe medications.
• 3:43
  Irina Macare: I was always passionate about health, personal development, and personal improvement, so I start reading every book, every blog that I could put my hand on.
• 3:53
  Irina Macare: So over the years, I experimented with a lot of things, some work, some didn't, and it took me some time until I was able to fix my sleep or to feel better.
• 4:05
  Irina Macare: Because I was so passionate about what I was doing.
• 4:07
  Irina Macare: I was always talking about this at work and a lot of people like was were listening to me and trying some of the things that I was sharing and they were like days or weeks after, it's oh, Irina, I tried your whatever you said, and it worked and I feel so better.
• 4:23
  Irina Macare: And that fueled me so much.
• 4:26
  Dr. Komal Patil-Sisodia: Yeah.
• 4:26
  Irina Macare: And fast forward after I moved here in US and I burn out again.
• 4:32
  Dr. Komal Patil-Sisodia: Yeah.
• 4:33
  Irina Macare: I was like, so I got into a depression.
• 4:35
  Irina Macare: I was starting to ask like existential question.
• 4:38
  Irina Macare: I was like, what's life like?
• 4:40
  Irina Macare: What?
• 4:40
  Irina Macare: My work didn't bring any joy.
• 4:42
  Irina Macare: So I wanted to go into coaching and to help people.
• 4:47
  Irina Macare: And just at the same time, precision nutrition.
• 4:50
  Irina Macare: I don't know if you're familiar with precision nutrition.
• 4:53
  Dr. Komal Patil-Sisodia: I've heard the name, but I don't.
• 4:54
  Dr. Komal Patil-Sisodia: Yeah,
• 4:54
  Irina Macare: it's a very good and famous company that provides nutrition certification and they just launched their sleep stress management and recovery certification for the first time, and I felt like that was a sign and that was my entry into the sleep world.
• 5:11
  Irina Macare: It was by accident and everything like.
• 5:16
  Irina Macare: Conspired to get me there.
• 5:18
  Irina Macare: And that was like the beginning of my sleep coaching education.
• 5:21
  Irina Macare: After that, like I took more courses because there were so many gaps.
• 5:26
  Irina Macare: I feel like right now there is not one single course that covers everything that a sleep coach should know.
• 5:32
  Irina Macare: Initially I wanted to help people that I was seeing around me, especially in the IT world.
• 5:38
  Irina Macare: Sleep was not seen as something that you should be proud of.
• 5:42
  Irina Macare: Actually the opposite people were wearing as a badge of honor.
• 5:45
  Irina Macare: The fact that they were sleep deprived is like, my code is the best when I'm writing it at 2:00 AM with a beer in hand.
• 5:52
  Irina Macare: Or like, I slept only five hours.
• 5:54
  Irina Macare: I'm so busy, I'm so, so important.
• 5:57
  Irina Macare: You know, so it felt like.
• 5:59
  Irina Macare: Sleep is a waste of time.
• 6:01
  Irina Macare: And I was like so frustrated because like I knew what it means to be sleep deprived.
• 6:05
  Irina Macare: Yeah.
• 6:06
  Irina Macare: So my initial initiative as a coach, I wanted to, I had a motto, let's make sleep sexy again.
• 6:12
  Dr. Komal Patil-Sisodia: Yeah.
• 6:14
  Irina Macare: But.
• 6:15
  Irina Macare: With time and that was trying to make people understand the benefits of sleep and how they actually can use sleep as a productivity tool and how they are better engineers when they are sleeping well.
• 6:30
  Irina Macare: And while starting taking clients and working with people, I realized that.
• 6:34
  Irina Macare: Those people, honestly they are not so open to hear the message, but they are the other people who are actually struggling with sleep.
• 6:43
  Irina Macare: They're trying to do everything in their power to sleep, but they can't.
• 6:48
  Irina Macare: And while trying to help those people, I realize I learned that the gold standard for treating insomnia is cognitive behavior therapy for insomnia.
• 6:58
  Irina Macare: So I got myself educated in that field and.
• 7:02
  Irina Macare: Start applying CBTI practices and start helping people and while working with people, I realize that there are some cases where CBTI, while it's evidence-based, there are so many studies, it's proven to work.
• 7:17
  Irina Macare: There are situation with CBTI does not work because of its rigidity and.
• 7:23
  Irina Macare: So I looked in acceptance and commitment therapy applied to insomnia, and that's how.
• 7:30
  Dr. Komal Patil-Sisodia: Yeah,
• 7:30
  Irina Macare: my evolution as a sleep coach and how I introduce gradually different knowledge and tools in my coaching practice.
• 7:38
  Irina Macare: So yeah, that I'm,
• 7:40
  Dr. Komal Patil-Sisodia: yeah, that's an incredible story.
• 7:42
  Dr. Komal Patil-Sisodia: First and foremost, I'm so glad you're okay from that car accident.
• 7:45
  Dr. Komal Patil-Sisodia: That sounds terrifying, right?
• 7:47
  Dr. Komal Patil-Sisodia: Yeah.
• 7:47
  Dr. Komal Patil-Sisodia: To be behind the wheel and not have control, I'm sure that was.
• 7:51
  Irina Macare: Yeah.
• 7:52
  Irina Macare: Yeah.
• 7:52
  Dr. Komal Patil-Sisodia: I can understand how that was your wake up call.
• 7:55
  Dr. Komal Patil-Sisodia: It
• 7:55
  Irina Macare: took four years to have the courage to drive back on the highway, especially here in the us.
• 7:59
  Irina Macare: Really?
• 8:00
  Irina Macare: Oh
• 8:00
  Dr. Komal Patil-Sisodia: my gosh, right?
• 8:01
  Dr. Komal Patil-Sisodia: Yeah.
• 8:01
  Dr. Komal Patil-Sisodia: That's just such a clear example of like how not getting enough sleep can be so detrimental, right?
• 8:07
  Dr. Komal Patil-Sisodia: So I love that you are taking something from your personal experience and that's what's driving your.
• 8:13
  Dr. Komal Patil-Sisodia: Passion for this type of work.
• 8:15
  Dr. Komal Patil-Sisodia: So for our listeners, Irina, can you explain the difference between a CT and CBT?
• 8:22
  Dr. Komal Patil-Sisodia: Like I, I've known what CBT is, but when we first started talking, that was the first time I heard about a CT and I really wanted to understand a little bit more.
• 8:31
  Dr. Komal Patil-Sisodia: I'm sure that if, I don't know, there's probably.
• 8:34
  Dr. Komal Patil-Sisodia: Some other people who may not know either.
• 8:37
  Irina Macare: Absolutely.
• 8:38
  Irina Macare: And I feel like though there are some practitioner who are using shortly, it's act, ACT and CBTI, so it's easier to pronounce.
• 8:45
  Irina Macare: There are practitioner who are using ACT in their treatment for insomnia, but it's not as popular.
• 8:50
  Irina Macare: And I would say it's relatively new because CBTI was such, had such good results that people were training only in CBTI and that was it.
• 9:00
  Irina Macare: So the difference is that the CBTI focusing on changing the thoughts and the behavior that interfere with sleep while ACT focuses on changing the relationship with those thoughts and feelings, especially with the struggle around not sleeping.
• 9:16
  Irina Macare: So with act, we change the relationship of towards wakefulness.
• 9:22
  Irina Macare: And we are not challenging, like with CBTI, you are challenging the thoughts like, I'm not going to sleep tonight at this night, so tomorrow I'm going to be exhausted and it's going to be ruined.
• 9:33
  Irina Macare: So with in CBTI, we are actually challenging those thoughts.
• 9:36
  Irina Macare: Is it true?
• 9:37
  Irina Macare: Have there been situation in the past where you haven't slept well and you actually perform well?
• 9:43
  Irina Macare: So that's the CBTI approach on the act.
• 9:46
  Irina Macare: Is it not?
• 9:48
  Irina Macare: Necessary fighting against it.
• 9:50
  Irina Macare: We are not looking at the thought.
• 9:51
  Irina Macare: Is it true or not?
• 9:53
  Irina Macare: More like is it helpful?
• 9:55
  Irina Macare: Like what is the goal that I'm trying to have right now?
• 9:57
  Irina Macare: Is it to sleep?
• 9:59
  Irina Macare: Is the thought of or the worry of being awake, is it helping you to achieve the goal that you're having?
• 10:05
  Dr. Komal Patil-Sisodia: Yeah, so
• 10:06
  Irina Macare: we're not questioning the thoughts.
• 10:08
  Irina Macare: We are creating like some psychological flexibility.
• 10:12
  Irina Macare: And that allows you to do what matters, even when the mind is nosy, noisy, and even if your sleep is not perfect.
• 10:20
  Irina Macare: So you don't let the thoughts control your action.
• 10:23
  Irina Macare: You're actually diffusing away from your thoughts and taking, and not let your thoughts dictate your action.
• 10:30
  Dr. Komal Patil-Sisodia: Interesting.
• 10:31
  Dr. Komal Patil-Sisodia: Okay.
• 10:32
  Dr. Komal Patil-Sisodia: Yeah.
• 10:32
  Dr. Komal Patil-Sisodia: The whole premise of.
• 10:34
  Dr. Komal Patil-Sisodia: CBT is that your thoughts drive your actions, right?
• 10:38
  Dr. Komal Patil-Sisodia: So it's focused on the changing of your thoughts, but sometimes those are difficult for people to change and this is where a CT comes in and
• 10:45
  Irina Macare: yeah, because that, I think act is used in many, many, many places, especially with addiction.
• 10:53
  Irina Macare: But I feel like it's such a good fit for insomnia because
• 10:57
  Dr. Komal Patil-Sisodia: yeah.
• 10:59
  Irina Macare: You are feeling tired.
• 11:01
  Irina Macare: You are.
• 11:02
  Irina Macare: It is hard.
• 11:03
  Irina Macare: It is hard.
• 11:04
  Irina Macare: And we are not actually, we are not trying to invalidate your experience.
• 11:09
  Irina Macare: And the thing with insomnia.
• 11:11
  Irina Macare: It feels so lonely is being awake in the middle of the night, in the dark when everybody else sleeps and you feel like guilty.
• 11:19
  Irina Macare: It's something wrong with me.
• 11:21
  Irina Macare: Why am not sleeping?
• 11:22
  Dr. Komal Patil-Sisodia: It's extremely isolating.
• 11:24
  Irina Macare: So it feels sometimes that people who are trying who are telling us like, try harder.
• 11:29
  Irina Macare: It's like they're invalidating us.
• 11:31
  Irina Macare: Acceptance.
• 11:32
  Irina Macare: It doesn't mean that you are denying what's happening.
• 11:36
  Irina Macare: Yeah.
• 11:36
  Irina Macare: It's just allowing to be and go through it with even when things are harder and there are techniques to help you to detach from those thoughts.
• 11:46
  Irina Macare: To allow them to be Yeah.
• 11:48
  Irina Macare: And to go forward with.
• 11:51
  Dr. Komal Patil-Sisodia: That's a very powerful thing and I like how you have framed this.
• 11:55
  Dr. Komal Patil-Sisodia: In the context of insomnia?
• 11:57
  Dr. Komal Patil-Sisodia: Yeah.
• 11:57
  Dr. Komal Patil-Sisodia: Specifically right with,
• 11:59
  Irina Macare: and the biggest problem with sleep is that sleep does not reward effort.
• 12:04
  Irina Macare: So the harder you try, the more anxious you become and the more anxious, the more hyper aroused and the harder it is to sleep.
• 12:12
  Irina Macare: So trying more sleep is a situation when trying more actually backfires.
• 12:17
  Irina Macare: I see.
• 12:18
  Dr. Komal Patil-Sisodia: I see.
• 12:19
  Dr. Komal Patil-Sisodia: That makes sense because I know the nights that I've tried to fall asleep, it's almost like your thoughts race more if I happen to wake up in the middle of the night.
• 12:27
  Dr. Komal Patil-Sisodia: Now I, just so our listeners know, what is, how do you define sleep wellness versus just getting more hours of sleep?
• 12:35
  Dr. Komal Patil-Sisodia: Because quality of sleep matters, right?
• 12:37
  Dr. Komal Patil-Sisodia: And the hours can be a little different from person to person, but I'd love for people to hear what your take is on that.
• 12:44
  Dr. Komal Patil-Sisodia: And then also like sleep hygiene in general.
• 12:47
  Irina Macare: Yeah.
• 12:47
  Irina Macare: What I like to say is that when it comes to sleep more doesn't mean better.
• 12:52
  Irina Macare: Better is better.
• 12:53
  Dr. Komal Patil-Sisodia: Yeah.
• 12:54
  Irina Macare: And when it comes to better sleep, it means like better quality and all the stages of sleep because there's so some people who are focusing so much, I want to get more deep sleep, or I want to get more rem sleep.
• 13:08
  Irina Macare: Each stage of sleep has its purpose and you should have like a balanced ratio of it.
• 13:14
  Irina Macare: So when it comes to quality sleep, it means how not to be fragmented.
• 13:19
  Irina Macare: So it should be like.
• 13:21
  Irina Macare: In one bout.
• 13:23
  Irina Macare: And of course we sleep in 90 minute cycles and we wake up every around 90 minutes.
• 13:29
  Irina Macare: But we do not remember often.
• 13:30
  Irina Macare: We do not remember those awakening, but one metric that we track quality of sleep is the sleep efficiency.
• 13:38
  Irina Macare: And it measures the times in bed versus time asleep.
• 13:43
  Irina Macare: Oh, okay.
• 13:43
  Irina Macare: So a good efficiency is between 85 and 90.
• 13:48
  Irina Macare: And again, sleep does not, you don't have to be perfect asleep.
• 13:52
  Irina Macare: If you have a sleep efficiency of a hundred, that means you're sleep deprived.
• 13:57
  Irina Macare: So it takes around like 15 to 30 minutes to fall asleep.
• 14:02
  Irina Macare: Like it's totally normal.
• 14:03
  Irina Macare: Yeah.
• 14:04
  Irina Macare: And if you fall asleep as soon as your head hits the pillow, that's an indicator that you don't get enough quality sleep that your body needs.
• 14:12
  Irina Macare: So
• 14:13
  Dr. Komal Patil-Sisodia: That's so interesting.
• 14:14
  Dr. Komal Patil-Sisodia: I never thought of it that way.
• 14:15
  Dr. Komal Patil-Sisodia: Because all of us, like we have that type A, especially those of us who are type A are like, yeah, a hundred percent that means I'm better.
• 14:22
  Dr. Komal Patil-Sisodia: That's such an interesting thing that a hundred percent actually means quite the opposite.
• 14:27
  Irina Macare: And see, that's why a lot of the people who have a struggle with sleep, with insomnia.
• 14:33
  Irina Macare: Yeah.
• 14:33
  Irina Macare: They're like the perfectionist, the A typers.
• 14:35
  Irina Macare: Yeah.
• 14:36
  Irina Macare: Because like they try to do everything perfect, but as I was saying, sleep does not reward effort.
• 14:44
  Irina Macare: So yeah it's about, and again, the sleep quantity differ from person to person, from stages of life, like.
• 14:54
  Irina Macare: Across lifespan, the needs for sleep changes, and even for the same person.
• 15:00
  Irina Macare: The sleep needs can vary from day to day.
• 15:03
  Irina Macare: So for example, if you are sick, you might require more sleep.
• 15:08
  Irina Macare: So to allow your body to, and your immune system to fight the.
• 15:12
  Irina Macare: Disease.
• 15:13
  Irina Macare: You should not be so fixated on the number of hours you're asleep.
• 15:18
  Irina Macare: Of course, there is a range where it's not good.
• 15:23
  Dr. Komal Patil-Sisodia: Yeah,
• 15:24
  Irina Macare: less than six hours, let's say.
• 15:26
  Irina Macare: It might be too little and it can be too much as well.
• 15:30
  Irina Macare: If you sleep more than nine hours, that.
• 15:33
  Irina Macare: I don't know if you've done that, but like when I was young and I had like summer vacation often I was sleeping 10, 12 hours and I remember those days I was like so groggy.
• 15:44
  Dr. Komal Patil-Sisodia: Yeah.
• 15:45
  Irina Macare: So if you sleep too much, you don't feel well.
• 15:49
  Irina Macare: So sleep, wellness, I would measure it if, how do you feel during the day after asleep?
• 15:56
  Irina Macare: Do you feel rested?
• 15:57
  Irina Macare: And of course this can be impacted by so many other things.
• 16:02
  Irina Macare: Food can be impacted by many other biological system in your body, but how do you feel if you had like a full night of sleep?
• 16:11
  Irina Macare: Yeah.
• 16:11
  Irina Macare: Do you feel rested?
• 16:12
  Irina Macare: Do you feel emotionally balanced?
• 16:15
  Irina Macare: So yeah that's how I would define quality of a sleep ness.
• 16:19
  Irina Macare: Yeah.
• 16:20
  Dr. Komal Patil-Sisodia: I think that is.
• 16:22
  Dr. Komal Patil-Sisodia: Fantastic.
• 16:22
  Dr. Komal Patil-Sisodia: And it gives people some tangible idea of what that would be.
• 16:26
  Dr. Komal Patil-Sisodia: Yeah.
• 16:26
  Dr. Komal Patil-Sisodia: With the wiggle room that it is different for each person.
• 16:30
  Dr. Komal Patil-Sisodia: Exactly.
• 16:30
  Dr. Komal Patil-Sisodia: And really you have to pay attention to it.
• 16:32
  Dr. Komal Patil-Sisodia: It's interesting.
• 16:33
  Dr. Komal Patil-Sisodia: My husband and I laugh because I think that I need much less sleep than he does.
• 16:38
  Dr. Komal Patil-Sisodia: And I will get up early in the morning.
• 16:40
  Dr. Komal Patil-Sisodia: I'm like a morning person.
• 16:42
  Dr. Komal Patil-Sisodia: I have lived like a whole day before he, before like on the weekends before he gets up, he's just like, what have you been doing?
• 16:49
  Dr. Komal Patil-Sisodia: I was like, I don't know.
• 16:49
  Dr. Komal Patil-Sisodia: I've been up since six and you know, I did this and this and this and this and so it's interesting and I look at my sisters and their spouses and there's always one that.
• 16:59
  Dr. Komal Patil-Sisodia: Goes, okay.
• 17:01
  Dr. Komal Patil-Sisodia: A little bit of sleep and the other one who needs much more sleep.
• 17:04
  Dr. Komal Patil-Sisodia: So there's a little bit of sleep disparity there.
• 17:06
  Dr. Komal Patil-Sisodia: So let's shift gears and talk a little bit about your dream sleep coaching method, right?
• 17:13
  Dr. Komal Patil-Sisodia: I'm interested in how you develop that and what each of the pillars means for your coaching style.
• 17:19
  Irina Macare: Right?
• 17:20
  Irina Macare: So working with people and over the years.
• 17:23
  Irina Macare: I found myself saying the same things and trying to use different methods and to use different levers.
• 17:31
  Irina Macare: And this made me realize that when people were coming to me, they were so overwhelmed they didn't know where to start improving their sleep.
• 17:40
  Irina Macare: So I.
• 17:42
  Irina Macare: Understanding the sleep, how sleep works, and what are affecting sleep.
• 17:46
  Irina Macare: I created like this framework to explain the five pillars where we can see if you have to, you have any problem and if you have to do improvements and each pillar you have different levers that you can use.
• 18:00
  Irina Macare: So the dream, it's an acronym actually, and the first pillar is sleep drive.
• 18:07
  Irina Macare: And sleep drive is basically.
• 18:10
  Irina Macare: Our body's desire for sleep.
• 18:14
  Irina Macare: The moment you wake up, you start building the sleep drive and when you are asleep, you are actually removing that sleep drive.
• 18:21
  Irina Macare: So think about is like when you're hungry, when you wake up, you're hungry, you eat, and then as you go through your day, you become more hungry.
• 18:29
  Irina Macare: So it's similar with sleep stands for rhythm from the circadian rhythm, so sleep drive and circadian rhythm.
• 18:36
  Irina Macare: There are two system that work together.
• 18:38
  Irina Macare: Circadian rhythm is also responsible for.
• 18:41
  Irina Macare: The timing of sleep, like telling you when to be asleep and when to be awake, and also is responsible with alertness, light.
• 18:49
  Irina Macare: It's a huge factor to tell your rhythm when it's day and when it's night.
• 18:55
  Irina Macare: And there are some other things like temperature and timing.
• 18:59
  Irina Macare: B, it's environment, but basically it's a umbrella for all the sleep hygiene, like I put in there, all the sleep hygienes when it comes to your temperature or bedroom temperature.
• 19:12
  Irina Macare: The noise, the light timing, like when to eat and when not to eat coffee.
• 19:17
  Irina Macare: Yeah.
• 19:17
  Irina Macare: And alcohol consumption.
• 19:19
  Irina Macare: So I'm looking to see if you have any behavior that could disrupt your sleep that falls into this category.
• 19:27
  Irina Macare: And a and m basically is the ACT and CBTI part of it.
• 19:31
  Irina Macare: Yeah.
• 19:31
  Irina Macare: So a is the automatic or the behavior and cognitive loops.
• 19:36
  Irina Macare: First I'm looking at are there any behavior that are affecting your ability to sleep?
• 19:42
  Irina Macare: And the thoughts as well as I was saying, is like, I have the thought that is I'm not, I'm a bad sleeper and this makes me more anxious.
• 19:49
  Irina Macare: So looking at those and re restructuring the thought, the behavior, and the thoughts.
• 19:55
  Irina Macare: And the M is the mind body connection where we are looking at your stress level and how can we work you with your body to help your mind Because like sometimes you can influence your mind by influence, by working on the body, and you can work on.
• 20:10
  Irina Macare: Relaxing your body by working with your mind.
• 20:13
  Irina Macare: Yeah.
• 20:13
  Irina Macare: So it's a bidirectional connection.
• 20:16
  Irina Macare: Some people, some books are saying there is no mind body connection, there is unity.
• 20:21
  Irina Macare: It's just one thing.
• 20:22
  Irina Macare: It's hard to, yeah.
• 20:24
  Irina Macare: So when I'm working with people, I'm looking at.
• 20:27
  Irina Macare: Each pillar to, and we assess.
• 20:30
  Irina Macare: Dream sleep.
• 20:31
  Irina Macare: Sleep is my method.
• 20:32
  Irina Macare: So basically we study first what's happening in your life, in your body.
• 20:38
  Irina Macare: So we are tracking things without.
• 20:40
  Irina Macare: Trying to change anything.
• 20:43
  Irina Macare: And that gives us insights and understanding what's going on.
• 20:47
  Irina Macare: And then we start removing all the barriers and start building, supporting foundation for sleep.
• 20:53
  Irina Macare: Yeah.
• 20:53
  Irina Macare: And at the end we focus on sustaining the progress and improving resilience because life happens.
• 21:00
  Irina Macare: Yeah.
• 21:00
  Irina Macare: And sleep is like weight loss.
• 21:02
  Irina Macare: Like you do all the work, you lose the weight.
• 21:05
  Irina Macare: But then your work doesn't stop there.
• 21:07
  Irina Macare: You have to continue to do all the things to keep the weight.
• 21:11
  Irina Macare: It is the same with sleep.
• 21:13
  Irina Macare: Once you have a better sleep, that doesn't mean like we stop there.
• 21:16
  Irina Macare: You have to continue with all these patterns and when life happens, what can you do to bounce back?
• 21:23
  Irina Macare: You know?
• 21:23
  Irina Macare: Yeah.
• 21:23
  Irina Macare: That's the resilience.
• 21:25
  Dr. Komal Patil-Sisodia: I love that you used weight as an analogy because I know we've talked about this and I do a lot of weight management in my practice as well.
• 21:33
  Dr. Komal Patil-Sisodia: It's so interesting that the habits are really the important thing, right?
• 21:37
  Dr. Komal Patil-Sisodia: Even when people are going through weight loss plateaus, I will tell them it's.
• 21:42
  Dr. Komal Patil-Sisodia: The consistency of the effort through the plateau.
• 21:44
  Dr. Komal Patil-Sisodia: So you're saying the same thing.
• 21:46
  Dr. Komal Patil-Sisodia: It's the consistency of the sleep habits.
• 21:48
  Dr. Komal Patil-Sisodia: And I will tell you that on the nights that I do all the things that I'm supposed to do, I sleep like a rock.
• 21:53
  Dr. Komal Patil-Sisodia: On the days that I am not great about it.
• 21:57
  Dr. Komal Patil-Sisodia: My sleep is terrible and so I, you are a hundred percent spot on and I love.
• 22:01
  Dr. Komal Patil-Sisodia: Part of your coaching is teaching people how to maintain those habits because it can be really hard.
• 22:07
  Dr. Komal Patil-Sisodia: That is a whole other skillset in and of itself, is the maintenance arm of it.
• 22:12
  Irina Macare: The brain and body likes to have routine.
• 22:16
  Irina Macare: Yes.
• 22:16
  Irina Macare: And anticipate, and that's like one of the things that I like to work with my clients is that to create routines, including weekends and a sleep schedule, including weekends, because your body will start reacting in anticipation of sleep.
• 22:31
  Dr. Komal Patil-Sisodia: Yeah.
• 22:31
  Dr. Komal Patil-Sisodia: So
• 22:31
  Irina Macare: ideally, once you have started your routine, your mind and body knows that it's sleep time and.
• 22:40
  Irina Macare: Start preparing the nervous system, all the hormones that are needed.
• 22:44
  Irina Macare: Yeah, that when you go to bed, you're ready for sleep.
• 22:48
  Dr. Komal Patil-Sisodia: For listeners who are ready to start working on their sleep, what are a few actionable mini steps that they can take tonight based on your framework?
• 22:59
  Irina Macare: My number one recommendation is to create a consistent sleep schedule, because as I was saying, our body likes routines.
• 23:07
  Irina Macare: And you can start with a wake up time because you have more control when you wake up than when you fall asleep.
• 23:15
  Irina Macare: So you start with a wake up time to the po.
• 23:19
  Irina Macare: Usually what I do is like I look at the schedule for the entire week and I find out like, where do you wake up the earliest?
• 23:26
  Dr. Komal Patil-Sisodia: Yeah,
• 23:27
  Irina Macare: and that's like the starting point.
• 23:29
  Irina Macare: And you can vary plus minus 30, 30 minutes, and that's your wake up tab for the entire week, including days.
• 23:37
  Irina Macare: Let's say you wake up at 6:00 AM.
• 23:40
  Irina Macare: You'll wait.
• 23:40
  Irina Macare: That's the hardest part.
• 23:42
  Irina Macare: And sometimes I do make some adjustment depending on the people's schedule.
• 23:46
  Irina Macare: And often, you know what, like I had clients who wanted to wake up at 6:00 AM but their chronotype was not an early bird.
• 23:55
  Irina Macare: So
• 23:56
  Dr. Komal Patil-Sisodia: Interesting.
• 23:56
  Irina Macare: Yes.
• 23:57
  Irina Macare: We haven't talked about chronotype, but chronotypes, no.
• 24:01
  Irina Macare: Is a biological and genetically predisposition for a specific time of the day when you're asleep.
• 24:09
  Irina Macare: And basically you have the late the night owl, the early bird, and in between.
• 24:16
  Irina Macare: And the in between can be earlier or a little bit later in the morning.
• 24:21
  Irina Macare: So sometimes people are trying to create a sleep schedule to fit that doesn't fit their chronotype, and that often can lead to sleep issues, including insomnia, because like if you're a night owl and you go to bed at nine.
• 24:36
  Irina Macare: Pm your body is not ready to sleep.
• 24:39
  Dr. Komal Patil-Sisodia: Yeah.
• 24:39
  Irina Macare: And you toss and turn into bed and then your brain will start associating bed with wakeful wakefulness.
• 24:46
  Irina Macare: And then that's, that's the equation for insomnia.
• 24:51
  Irina Macare: And I had clients where I actually shifted their sleep schedule later and fit better to their lifestyle, but they were trying to wake up early because they were thinking.
• 25:00
  Irina Macare: If I wake up early, I am like more productive or people appreciate more the early birds and they, there is a stigma with night owls.
• 25:10
  Irina Macare: So there is some shame about like going to bed late or waking up late.
• 25:15
  Irina Macare: So I'm trying to reframe that, that way of thinking.
• 25:20
  Irina Macare: So then we look at, it's like, how many hours do you think you can sleep or do you want to sleep?
• 25:25
  Irina Macare: And then we look at the, that's, that would be like the time to be asleep.
• 25:29
  Irina Macare: And then we count 15, 30 minutes for you to fall asleep.
• 25:34
  Irina Macare: And that's time in bed.
• 25:36
  Dr. Komal Patil-Sisodia: Yeah.
• 25:36
  Dr. Komal Patil-Sisodia: And
• 25:36
  Irina Macare: then the previous hour would be a wind down.
• 25:40
  Irina Macare: So that's how I would structure Okay.
• 25:42
  Irina Macare: A sleep schedule.
• 25:44
  Irina Macare: And if you can do that regularly over time, you will fall asleep easier and wake up easier.
• 25:52
  Irina Macare: There are so many people who have like a consistent sleep schedule and they wake up without alarm.
• 25:58
  Irina Macare: That's the best.
• 25:59
  Irina Macare: Another thing that I recommend is getting light exposure.
• 26:04
  Irina Macare: So we are bombarded with information about blue light and blue light blockers.
• 26:10
  Irina Macare: Yeah.
• 26:10
  Irina Macare: But there is not enough talk and discussion about how important light exposure throughout the day it is for our circadian rhythm.
• 26:20
  Irina Macare: And the problem is that we are sleep deprived, a flight during the day, and we have like too much light at night.
• 26:28
  Irina Macare: We live in indoor most of our time, and even if you have a window, the light that it's coming through the window, it's not enough.
• 26:35
  Irina Macare: And then your brain doesn't have a strong signal that it was day and at night.
• 26:41
  Irina Macare: When we turn on the lights, it's things that it's day.
• 26:45
  Irina Macare: So by getting bright light exposure in the morning, the first 30 minutes after you wake up.
• 26:52
  Irina Macare: It tell, gives your brain like a strong signal that it's day and that's like a countdown starter.
• 26:59
  Irina Macare: And the brain knows that around 16 hours after that signal, it has to start producing melatonin.
• 27:06
  Dr. Komal Patil-Sisodia: Yeah.
• 27:07
  Irina Macare: And by also getting light exposure throughout the day in enhances that signal.
• 27:13
  Irina Macare: And even if you get light exposure at night, it inoculates that signal saying it is like, we know that it was day.
• 27:20
  Irina Macare: So even if you get light exposure at night, your circadian rhythm knows that it's nice.
• 27:25
  Irina Macare: So getting light exposure early in the morning, the first 30 minutes, you can get a sad lamp, especially now that it's so dark outside.
• 27:33
  Irina Macare: I was just going
• 27:33
  Dr. Komal Patil-Sisodia: to ask that, right?
• 27:35
  Dr. Komal Patil-Sisodia: Yeah.
• 27:35
  Dr. Komal Patil-Sisodia: Like being in the Pacific Northwest, we don't get quite as much light.
• 27:39
  Dr. Komal Patil-Sisodia: So the sad lamps help then?
• 27:41
  Irina Macare: Yes.
• 27:41
  Irina Macare: Especially in the morning.
• 27:42
  Irina Macare: Okay.
• 27:42
  Irina Macare: So they help with mood, but also with the circadian rhythm.
• 27:46
  Dr. Komal Patil-Sisodia: Yeah.
• 27:46
  Irina Macare: So get light exposure from that.
• 27:48
  Irina Macare: If it's possible and you can go outside at lunch, during lunch break, movement and light exposure would help.
• 27:55
  Irina Macare: And sometimes it's like 15 minutes.
• 27:58
  Irina Macare: It's enough.
• 27:59
  Irina Macare: Yeah.
• 28:00
  Irina Macare: 'cause if you measure the light outside, it is like.
• 28:03
  Irina Macare: Thousands of locks while inside is just hundreds.
• 28:07
  Irina Macare: Yeah.
• 28:08
  Irina Macare: So it is a huge difference even on a cloudy day like today.
• 28:13
  Dr. Komal Patil-Sisodia: Yeah, that's fantastic.
• 28:14
  Dr. Komal Patil-Sisodia: And I know when we were chatting yesterday, I mentioned.
• 28:18
  Dr. Komal Patil-Sisodia: One of my friends had written a book on circadian rhythms, so I'm gonna give her a quick shout out Lynne Peoples The Inner Clock, if you haven't read it.
• 28:25
  Dr. Komal Patil-Sisodia: It's a great book.
• 28:26
  Dr. Komal Patil-Sisodia: She spent well over a year researching and writing this book, but it talks all about the chronotypes and the things that you were saying.
• 28:32
  Dr. Komal Patil-Sisodia: So I, I love when my worlds collide like this.
• 28:35
  Dr. Komal Patil-Sisodia: When you said chronotype, I was like.
• 28:37
  Dr. Komal Patil-Sisodia: I know where that registered.
• 28:40
  Dr. Komal Patil-Sisodia: So from your perspective, Irina, how can someone know when their sleep issues are beyond just behavioral coaching and when they might need a medical evaluation?
• 28:48
  Irina Macare: That's a good question.
• 28:50
  Irina Macare: So the most underdiagnosed sleep disorder is obstructive sleep apnea.
• 28:57
  Irina Macare: Yeah.
• 28:57
  Irina Macare: Especially in women and especially in women at menopause.
• 29:01
  Dr. Komal Patil-Sisodia: Yes.
• 29:02
  Irina Macare: And that's because like when they.
• 29:05
  Irina Macare: One of the criteria for diagnosing sleep apnea without the actual test in the lab is the stop bank questionnaire, and basically the stop bank is like the acronym and they're looking at the circum circumference of the neck, the body mass index and the weight, and
• 29:23
  Dr. Komal Patil-Sisodia: correct.
• 29:25
  Irina Macare: That captures a lot of people, especially men, but it excludes a lot of cases where the obstructive sleep apnea happens for other reasons.
• 29:36
  Irina Macare: So when we entering menopause and our estrogen goes down and progesterone goes down, so estrogen.
• 29:44
  Irina Macare: Impacts muscle elasticity.
• 29:46
  Irina Macare: And with the estrogen being low, the muscles are not so elastic.
• 29:50
  Irina Macare: So they collapse on our throats, on our airwaves and progesterone a huge role in sleep respiration.
• 29:57
  Irina Macare: So the signal between brain and the lungs.
• 30:01
  Irina Macare: So a lot of women that don't fit the stop bank criteria they struggle with obstructive sleep apnea.
• 30:08
  Irina Macare: Some of the symptoms might be overlooked as other symptoms from menopause.
• 30:13
  Irina Macare: Like we've talked yesterday about the fact that you can.
• 30:17
  Irina Macare: Wake up during the night and too many times, and to go to bathroom, a frequent urination.
• 30:22
  Irina Macare: It is a sign of obstructive sleep apnea.
• 30:25
  Irina Macare: You wake up with headaches you feel you fall asleep as your head hits the pillow.
• 30:31
  Irina Macare: Yeah.
• 30:32
  Irina Macare: A lot of people look at like their spouses and things like why do I don't, I have like their sleep.
• 30:37
  Irina Macare: But basically what's happening, they are like chronically sleep deprived.
• 30:41
  Irina Macare: Yeah.
• 30:41
  Irina Macare: Because they have epileptic sleep apnea and they not breathe during.
• 30:44
  Irina Macare: And that's my number one recommendation is to get tested.
• 30:49
  Irina Macare: So overall is like you've done everything.
• 30:52
  Dr. Komal Patil-Sisodia: Yeah.
• 30:53
  Dr. Komal Patil-Sisodia: You still, it's still not working.
• 30:54
  Dr. Komal Patil-Sisodia: Yeah, not
• 30:55
  Irina Macare: working.
• 30:56
  Irina Macare: There are some sleep disorders that are so hard to diagnose.
• 30:59
  Irina Macare: Yeah.
• 30:59
  Irina Macare: And people get diagnosed very late.
• 31:01
  Irina Macare: I've been recently, I've been at the Idiopathic Hypersomnia conference, which was here in Seattle this summer.
• 31:07
  Irina Macare: And I've talked with so many people out there who were like patients and some took like 13 years to be diagnosed and basically there is like a.
• 31:18
  Irina Macare: A need to sleep more and more and more.
• 31:21
  Irina Macare: And they sleep so much.
• 31:22
  Irina Macare: There is narcolepsy as well that it's, if it doesn't come with cataplexy, so there are two types of narcolepsy, narcolepsy type one and type two.
• 31:32
  Irina Macare: And the type one covers cata, like you have cataplexy.
• 31:35
  Irina Macare: So it's just some degree.
• 31:37
  Irina Macare: Still hard to diagnose, but to some degree it's easier to pinpoint in that direction.
• 31:43
  Irina Macare: But the ones who don't have cataplexy, yeah, like they're just having the sleep issues.
• 31:48
  Irina Macare: So if you're struggling with your sleep, you're, you have a hard time to sleep or you are doing everything, you're sleeping a lot, but you're still feeling very tired, then.
• 31:59
  Dr. Komal Patil-Sisodia: Yeah.
• 32:00
  Irina Macare: Go to medical
• 32:00
  Dr. Komal Patil-Sisodia: evaluation.
• 32:01
  Dr. Komal Patil-Sisodia: Yeah.
• 32:01
  Dr. Komal Patil-Sisodia: And
• 32:02
  Irina Macare: I do a very deep assessment in my intake process because as a coach I have to be very careful with my scope of practice.
• 32:10
  Irina Macare: Yeah.
• 32:10
  Irina Macare: I do not diagnose, I do not treat.
• 32:13
  Irina Macare: Yes.
• 32:13
  Irina Macare: So if I'm seeing any red flags, I am trying to my best to refer them to the right specialist.
• 32:20
  Dr. Komal Patil-Sisodia: That's really lovely to hear.
• 32:22
  Irina Macare: Yeah.
• 32:22
  Dr. Komal Patil-Sisodia: It's nice to hear that you are taking all of that into account.
• 32:26
  Dr. Komal Patil-Sisodia: So Irina, how has your own relationship with rest and sleep kind of evolved since you started this framework?
• 32:33
  Irina Macare: Honestly, when it comes to sleep problems, it's not like you are cured.
• 32:39
  Irina Macare: I'm still having nights of bad sleep, especially when I'm having some stress happening in my life.
• 32:46
  Irina Macare: That what change is my relation with sleep and how do I react?
• 32:52
  Dr. Komal Patil-Sisodia: Yeah.
• 32:53
  Irina Macare: When I'm having sleepless nights and.
• 32:57
  Irina Macare: I remember like even in the past when I was still working as an IT engineer, I was like so busy that I didn't have time for anything.
• 33:06
  Irina Macare: I love listening audio books, so sometimes when I was waking up in the middle of the night, I was actually excited because I was having some time to catch up.
• 33:17
  Irina Macare: So it seems like it's a way of changing your relationship with anxiety.
• 33:23
  Dr. Komal Patil-Sisodia: Okay.
• 33:24
  Irina Macare: I knew that I'm going to, yeah, it's going to be hard, but I've done this many time and I know that I can handle things without, like less hours of sleep.
• 33:35
  Irina Macare: So as soon as like the stressor is removed, then my sleep is back to normal.
• 33:40
  Irina Macare: And that's the problem with insomnia because.
• 33:43
  Irina Macare: That's how it starts.
• 33:44
  Irina Macare: People start having some sleep problems because of an event or something happening in their life, and they start engaging in compensatory behaviors like going to bed too early or staying too late, or drinking alcohol or taking sleep meds and.
• 34:01
  Irina Macare: Then even if the stressor is moved, their loop of insomnia continues and they get to be in a chronic insomnia.
• 34:09
  Irina Macare: So this is very important on how do you think about it and
• 34:14
  Dr. Komal Patil-Sisodia: yeah.
• 34:15
  Irina Macare: How that affect you.
• 34:17
  Irina Macare: And the other thing is like I am very careful with my light exposure.
• 34:21
  Dr. Komal Patil-Sisodia: Yes.
• 34:22
  Dr. Komal Patil-Sisodia: You know it's interesting, I was at the eye doctor yesterday and she was asking me if I wanted contacts with like blue light blocking, and I know.
• 34:31
  Dr. Komal Patil-Sisodia: And I said yes.
• 34:32
  Dr. Komal Patil-Sisodia: So now I'm gonna call back and say, no, put me back for the non blue light blocking ones.
• 34:38
  Dr. Komal Patil-Sisodia: Because listening to you now, I'm thinking, oh my gosh, I put my contacts in when I go to walk in the morning.
• 34:43
  Dr. Komal Patil-Sisodia: And if it's blocking all that blue light, well that's going to be bad.
• 34:47
  Irina Macare: Yeah, because we need that blue light in the morning.
• 34:50
  Irina Macare: And you know what's interesting to think about it?
• 34:54
  Irina Macare: So with age, you know that our eye changes.
• 34:59
  Irina Macare: Yes.
• 34:59
  Irina Macare: You can
• 34:59
  Dr. Komal Patil-Sisodia: develop It's the lens.
• 35:01
  Irina Macare: So with age, that becomes more yellow.
• 35:04
  Irina Macare: And that yellow actually blocks the blue light to enter your eyes.
• 35:10
  Irina Macare: Really and older people beside the fact that their melatonin production reduces.
• 35:17
  Irina Macare: Also their circadian rhythm is affected by the light that enters their eye.
• 35:23
  Irina Macare: So I know people who got surgery for cataract.
• 35:27
  Irina Macare: And dear Sleep got better after that because
• 35:31
  Dr. Komal Patil-Sisodia: that is fascinating.
• 35:32
  Irina Macare: Yeah, so it is fascinating.
• 35:35
  Irina Macare: It's so interesting.
• 35:36
  Irina Macare: That's why like I'm so stoked about the circadian rhythm.
• 35:40
  Dr. Komal Patil-Sisodia: Yeah.
• 35:40
  Irina Macare: You can improve your sleep just using some of the levers and it's a low hanging fruit.
• 35:47
  Irina Macare: And I'm not saying that if you have insomnia, just fixing those.
• 35:51
  Dr. Komal Patil-Sisodia: Yeah.
• 35:51
  Dr. Komal Patil-Sisodia: Yeah.
• 35:52
  Dr. Komal Patil-Sisodia: It
• 35:52
  Irina Macare: will improve your sleep and.
• 35:54
  Irina Macare: I would like to mention that a lot of people dismiss the sleep hygiene advices when they have insomnia, but you know, it is like when you have a cavity, you don't stop brushing your teeth because you have a cavity.
• 36:09
  Irina Macare: If you have insomnia, you should not stop taking care of your, sleep hygiene practices.
• 36:16
  Irina Macare: So don't underestimate if it doesn't fix your insomnia, it doesn't mean it doesn't matter.
• 36:21
  Dr. Komal Patil-Sisodia: That's so good.
• 36:23
  Dr. Komal Patil-Sisodia: I was just gonna ask you if you could leave our listeners with a takeaway, but I think it has to be that, yeah.
• 36:28
  Dr. Komal Patil-Sisodia: So can you repeat that again?
• 36:30
  Irina Macare: If you have insomnia and your sleep hygiene doesn't fix your insomnia, it doesn't mean those behavior doesn't matter.
• 36:39
  Dr. Komal Patil-Sisodia: Ugh.
• 36:39
  Irina Macare: They still matter.
• 36:41
  Dr. Komal Patil-Sisodia: Yes.
• 36:41
  Irina Macare: Just you have to do other things on top of that.
• 36:45
  Irina Macare: In addition.
• 36:46
  Irina Macare: Yes.
• 36:46
  Irina Macare: In addition.
• 36:47
  Irina Macare: Yeah,
• 36:47
  Dr. Komal Patil-Sisodia: in addition.
• 36:48
  Dr. Komal Patil-Sisodia: So I think that is.
• 36:49
  Dr. Komal Patil-Sisodia: Fabulous advice because, and it goes back to what we were talking about before, which is like that maintenance, right?
• 36:55
  Dr. Komal Patil-Sisodia: Those that the habits that you build around sleep hygiene are going to matter quite a bit.
• 37:00
  Dr. Komal Patil-Sisodia: Yes.
• 37:01
  Dr. Komal Patil-Sisodia: Irina, thank you so much for your time.
• 37:04
  Dr. Komal Patil-Sisodia: How can our listeners who are tuning in, how can our listeners find you and where can they find you?
• 37:10
  Dr. Komal Patil-Sisodia: Can you give us your.
• 37:12
  Dr. Komal Patil-Sisodia: Social handles and your website and I will post them all in the show notes so that we can get that out to everyone.
• 37:18
  Irina Macare: Definitely.
• 37:19
  Irina Macare: And thanks for asking.
• 37:21
  Irina Macare: They can find me on my website, irinamacare.com.
• 37:24
  Dr. Komal Patil-Sisodia: Okay.
• 37:25
  Irina Macare: That's where they can find more details of my coaching program, where I'm describing actually the dream sleep, the method and the framework and the method.
• 37:34
  Irina Macare: Also, I am on Instagram at Irina Macare and on LinkedIn the same Irina Macare.
• 37:42
  Dr. Komal Patil-Sisodia: Yeah.
• 37:43
  Dr. Komal Patil-Sisodia: Perfect.
• 37:44
  Dr. Komal Patil-Sisodia: So I will link all of that in the show notes and as a coach you have more of a reach, so you're not limited to just people in Washington state.
• 37:52
  Dr. Komal Patil-Sisodia: No.
• 37:52
  Dr. Komal Patil-Sisodia: So for any listener, even if you're not in the state of Washington, you can work with Irina and I.
• 37:57
  Dr. Komal Patil-Sisodia: Again, I will post everything down in the show notes.
• 38:00
  Dr. Komal Patil-Sisodia: Irina, thank you so much for the time you took today to share your framework and share how you look at sleep.
• 38:06
  Dr. Komal Patil-Sisodia: It's, I think this is going to be a really valuable episode for people who are tuning in.
• 38:11
  Irina Macare: Thank you so much for inviting me.
• 38:12
  Irina Macare: It was my pleasure.
• 38:14
  Dr. Komal Patil-Sisodia: My pleasure.