Latest / Talking FACS / Sleep for Wellbeing

Transcript

Sleep for Wellbeing · Talking FACS

• 0:01
  Welcome to Talking FACS, what you need to know about family,
• 0:04
  food, finance, and fitness.
• 0:08
  This nationally recognized, award-winning podcast is hosted by the University
• 0:12
  of Kentucky Family and Consumer Sciences Extension Program.
• 0:15
  Our educators share research knowledge with individuals, families,
• 0:20
  and communities to improve quality of life.
• 0:24
  Hello, and welcome to Talking FACs. I'm your host, Dr.
• 0:29
  Courtney Luecking, Extension Specialist for Maternal and Child Nutrition,
• 0:33
  and I am thrilled to have my guest with us today, Dr. Rachele Yadon.
• 0:38
  She is an assistant professor and psychiatry residency training program director
• 0:43
  at the University of Kentucky College of Medicine.
• 0:46
  She earned her medical degree from Duke University. We won't hold that against her.
• 0:51
  She completed her psychiatry residency training at Vanderbilt University Medical Center. Dr.
• 0:57
  Yadon is a certified by the American Board of Psychiatry and Neurology.
• 1:02
  She is licensed by the Kentucky Board of Medical Licensure.
• 1:05
  And Dr. Yadon specializes in perinatal psychiatry.
• 1:09
  Welcome, Dr. Yadon.
• 1:11
  Thank you. Thank you so much for having me. I am so excited to talk with you
• 1:16
  today about sleep for well-being.
• 1:19
  So let's just jump right into it. I think we've been hearing more and more about
• 1:25
  the importance of sleep, but I'd love to hear straight from the expert.
• 1:28
  Why is sleep so important?
• 1:30
  Well, so it's crucial for our physical and our mental health.
• 1:34
  And it serves a lot of essential function. So we need the physical restoration,
• 1:38
  but it really also helps us to maintain our brain health.
• 1:42
  It's where we consolidate our memories through the day. It's where we get the
• 1:46
  bandwidth to regulate our emotions.
• 1:48
  And we really need it to perform cognitively. You know what it's like when you
• 1:51
  haven't slept for a whole day, a whole night.
• 1:55
  It's hard to drive. It's hard to do basically anything well.
• 2:00
  So sleeping not only helps us to kind of recharge physically,
• 2:03
  but it also just gives us the capacity to be able to navigate during the day.
• 2:07
  And we do know that chronic sleep deprivation is linked to a lot of serious health problems.
• 2:11
  So it's one of the things that we can really do to impact our health,
• 2:15
  protect against risk factors for diabetes and heart disease and depression and
• 2:20
  weakened immune system.
• 2:21
  So the quality really matters in how we're sleeping. We want it to be deep and
• 2:25
  uninterrupted and the most restorative that it can be.
• 2:28
  Oh my gosh, you're speaking to me.
• 2:32
  I laugh because I'm like, oh, I feel like I had a better tolerance for that
• 2:35
  sleep deprivation as a young kiddo.
• 2:37
  And as I've gotten older and added children of my own, I have found that I am
• 2:42
  more sensitive to when I don't get added to sleep.
• 2:45
  You can feel it all day. You just want to take a nap. And I think sometimes
• 2:49
  you don't realize it, you were missing it until you get it again,
• 2:53
  you know, like once I finally started sleeping again.
• 2:56
  But so let's talk about that. What gets in the way?
• 2:58
  Sleep has all these benefits, but we know that most of us aren't getting enough sleep.
• 3:03
  Yeah. Well, so it's kind of funny to think about it, but all of our electricity,
• 3:09
  so the artificial light.
• 3:11
  I mean, we need it to get around our house in the evenings and to be able to
• 3:14
  keep, you know, working.
• 3:17
  And we don't have to like write letters by candlelight anymore.
• 3:20
  But that artificial light kind of tells our brain that the sun is still out.
• 3:24
  And so honestly, that's why screens are so tough on our sleep.
• 3:28
  The light is hitting our retinas directly.
• 3:30
  So our brain is getting the signal that it's daylight and that there's still
• 3:33
  things to do. Like, why don't be sleepy? be.
• 3:36
  So a lot of us don't have a lot of time to sleep either.
• 3:42
  There's a lot of demands of life and caring for kids and other family members and work demands.
• 3:47
  A lot of people work shifts, so they're having to switch back and forth between nights and days.
• 3:53
  So yeah, and honestly, for people who do have time to sleep,
• 3:56
  we carry the stress into the nighttime. It makes us wake up.
• 4:00
  We don't sleep as deeply.
• 4:01
  And sometimes we do things to try to make us sleep that actually work against us in other ways.
• 4:09
  So honestly, there's a lot that kind of goes against our sleep.
• 4:12
  Aging can affect the way we sleep too. So older adults don't sleep as deeply.
• 4:17
  Their sleep isn't as efficient. And then we kind of notice earlier sleep times.
• 4:22
  So there's like medical factors. There's a lot going on that kind of can work
• 4:26
  against our sleep if we're not careful.
• 4:28
  Wow. So can you give an example of something you were talking about that we
• 4:31
  try to do to help ourselves that might actually be getting in the way?
• 4:35
  Some of us will turn the TV on, right? We think, okay, well,
• 4:40
  the white noise will help me settle down and I'll sleep.
• 4:43
  But the light is signaling to our brain that it's not time to sleep.
• 4:46
  The noise can affect how deeply we're going to sleep.
• 4:49
  So that can be really hard. having pets in the room a lot of us find comfort
• 4:55
  in that but then the pets are moving or they're wanting to get out of the room
• 4:59
  and waking us up in ways that we don't even realize.
• 5:03
  I mean I'm guilty of this I will be on my phone I'll like play solitaire on
• 5:07
  my phone just to help me wind down or I'll read books on a screen and again
• 5:12
  like it's maybe that's helping something but it's definitely not maybe the best
• 5:17
  thing to do to help us sleep well.
• 5:20
  Oh, gosh. Yeah, these are just like how I fell asleep last night was reading all my tablets.
• 5:25
  Yeah. Okay, so here's the worst thing that we do. Okay.
• 5:29
  When we cannot sleep, we stay in bed.
• 5:33
  That doesn't make sense to me. Help explain this. Yes. Okay.
• 5:37
  So when we can't sleep, we say, okay, well, I need to try to sleep.
• 5:41
  So I'm going to lay here and try to sleep. and it doesn't work, right?
• 5:47
  It teaches our brain that when I am in bed, I lie awake.
• 5:52
  Oh, so it's counterproductive. Yeah, good intentions. We're trying to stay in
• 5:57
  bed and eventually get sleepy, but it actually works.
• 6:01
  That's like one of the worst things that we do.
• 6:04
  Actually, what we're supposed to do, and this is what cognitive behavioral therapy
• 6:08
  for insomnia teaches us, and I can tell you more about that.
• 6:11
  It's like a special therapy for sleep disorders.
• 6:14
  But what it tells us to do is when we can't sleep, we've been lying there for
• 6:19
  20 minutes, not sleepy, get out of bed.
• 6:22
  Okay. Go do something else, something that's not very stimulating,
• 6:26
  Sudoku puzzles, reading a newspaper, something.
• 6:29
  If people still have newspapers, I don't even know.
• 6:33
  And then when you are actually sleepy, then you go back to bed.
• 6:36
  But trying to sleep doesn't work. Sleep has to come to us.
• 6:41
  Okay. Oh, okay. So maybe let's talk about how we can help sleep come to us or
• 6:48
  some tips to help get that deeper, better quality of sleep that you're saying we so desperately need.
• 6:53
  Okay. So I've got a nice little list, like less than 10 things that you can do. Okay.
• 7:00
  First is setting a standard wake-up time. That can be whatever time works for you.
• 7:05
  Some folks, that's 5 in the morning. That's when they wake up.
• 7:08
  Some people, it's 10 in the morning, 5 o'clock in the evening, whatever time it is.
• 7:13
  Keep that time even on your days off, even on holidays if you can.
• 7:18
  But having that consistency really helps to set your sleep rhythm. Okay.
• 7:24
  Only use the bed for intimacy and sleep.
• 7:28
  Okay. Not reading, not eating, not watching TV, in bed. because anything we're
• 7:35
  doing in bed, a lot of our sleep.
• 7:38
  We learn from association. Our brain just starts to associate our bed with sleep.
• 7:43
  But if it starts to associate it with working on our laptop late at night,
• 7:47
  it starts to detach that association from sleep and it gets harder to sleep.
• 7:52
  You lay in bed and that's all your brain knows to do. Okay. Okay.
• 7:56
  Okay. This is helpful and resonates with like nutrition. We always tell people
• 7:59
  the same thing about eating. Pick a place where you eat, right?
• 8:02
  So that you're not associating.
• 8:04
  So that's my second one. The third one is get up when you can't sleep.
• 8:07
  So we talked about that. So if you can't sleep, get up, go to another room until
• 8:10
  you feel sleepy enough to fall asleep quickly before returning to bed.
• 8:15
  And then get up again if sleep doesn't come to you quickly. I know it sounds
• 8:18
  counterintuitive, but it works.
• 8:21
  And number four, easier said than done. Don't worry or plan or ruminate in bed.
• 8:28
  If those are automatically happening in bed, get up and stay up until you return
• 8:33
  to bed without those mental activities interfering with your sleep.
• 8:36
  Because again, we don't want our brain to just associate when I lay down, I can't stop thinking.
• 8:41
  Okay. Oh, gosh, that's one hits home to me. It's natural because a lot of us
• 8:46
  are busy through the day and we are just trying to get through it all.
• 8:50
  And the moment that we slow down, that's when our brain is like,
• 8:55
  okay, well, now I'm going to process the day I just had and get ready for the next day.
• 8:59
  That's usually when we're trying to sleep. mm-hmm so the
• 9:04
  one of the things that we can do is if we know we're
• 9:07
  one of those people where the only time we have to do that
• 9:10
  worrying and planning is in bed we do it outside of bed before we go to bed
• 9:14
  okay we set a separate time so that some sleep therapists will call it like
• 9:19
  a worry time earlier in the day after dinner where we can just like focus on
• 9:25
  those worries Like, I'm going to think it all out now.
• 9:28
  Use that fuel up so that when I lay down, I'm really worrying.
• 9:32
  And if it doesn't work, you lay down and you notice I'm thinking and thinking and thinking. Get up.
• 9:36
  Go do some mindfulness or something else. Okay. Come back when you're ready.
• 9:41
  Okay. Okay. So a couple tips on like getting away, calming, relaxing,
• 9:46
  however you want to think about it, and then try again.
• 9:49
  Okay. And then I've got a mean one. Don't take naps. Oh, okay.
• 9:55
  Yeah. So especially in the late afternoon or the early evening,
• 9:59
  it can really interfere with your sleep at night. Even if you're sleeping at
• 10:03
  night, you might not be sleeping as deeply because that nap takes away what
• 10:07
  we call like our sleep debt.
• 10:09
  Okay. If you are someone who the way you sleep at night works fine for you,
• 10:15
  you love taking your afternoon nap, take a nap.
• 10:18
  But if you are someone who struggles to sleep, struggles to wind down,
• 10:22
  wakes up in the middle of the night, wakes up, you would wake up and you're
• 10:25
  tired, don't take naps during the day because then that just starts working against you.
• 10:29
  Okay. Okay. And if you do take a nap, like, short, 20 minutes, cat nap.
• 10:36
  Truly a cat power nap. And ideally early in the day. Okay.
• 10:42
  But the naps are not our friend when we can't sleep at night. Okay.
• 10:46
  Yeah, I don't think it's mean. I think it's just a little tough love,
• 10:49
  right? Like, we've got to push through it so that we can better at night.
• 10:53
  And then the sleep debt kind of accumulates. And then a lot of people have heard
• 10:56
  this one, but scheduling a wind down time for about an hour before bed.
• 11:02
  Okay. That might be putting your phone up, finding something relaxing to do,
• 11:07
  doing some stretching, whatever feels right to you.
• 11:11
  But kind of giving yourself a good hour to settle your brain down and transition into sleep.
• 11:17
  That sounds really luxurious. Right. I know.
• 11:22
  Okay. So those are my like big tips. I've got a couple of helpful practices. Okay, let's hear them.
• 11:28
  So limiting caffeine, marijuana, nicotine, and alcohol, especially in the afternoon and the evening.
• 11:35
  Okay. Nicotine is stimulating.
• 11:39
  Caffeine has what they call a half-life of five hours.
• 11:43
  So five hours after you drink that cup of coffee, half of it is still in your system.
• 11:48
  So if you have a soda or a pop at dinnertime, five hours later,
• 11:54
  half of the caffeine is still in your system. And some people can fall asleep.
• 11:58
  With caffeine in their system, but the sleep is not as deep or as restorative.
• 12:03
  So I tell people one of the first things you can do is kind of cut back on the
• 12:07
  caffeine, maybe don't have that later one, and try to consolidate it to the evening.
• 12:11
  And if you can't sleep, you might want to just cut it out, which again is kind
• 12:16
  of mean to say, but it works.
• 12:19
  But maybe there's caffeine-free alternatives if it's a flavor thing,
• 12:24
  right? That's true. Okay.
• 12:26
  The other thing that is a little counterintuitive is to avoid using sleeping pills.
• 12:30
  Oh, okay. Yeah. So some of them are okay to use short term, but again,
• 12:36
  it kind of teaches our brain, you need this to sleep.
• 12:40
  Okay. But our body knows how to sleep. We were sleeping when we were babies.
• 12:46
  It took us a while to learn how to sleep, but we learned how to do it.
• 12:49
  Yes. Start to believe that we need a certain set of conditions or we need to
• 12:54
  have the TV on or we need to take this medicine to help us sleep.
• 12:57
  So starting to pull back on that dependence gives our brain the confidence to
• 13:02
  realize like, oh, I can sleep on my own.
• 13:04
  And then exercising can help us sleep, but not right before bed.
• 13:08
  And again, like not trying to sleep, not exerting a bunch of effort to sleep
• 13:12
  because the exertion, that effort wakes us up.
• 13:17
  You know, it's so funny to think about this because it is a good chunk of our
• 13:21
  day or we would like it to be a pretty sizable chunk of our day.
• 13:26
  And yet, yeah, it's I guess I hadn't really thought about kind of the prep that
• 13:31
  it takes to get our bodies in that space and really a practice,
• 13:34
  just like anything else that we do. It's a practice.
• 13:37
  Yeah. Yeah, it gets easier. And again, like there's so many demands.
• 13:40
  It's so easy to find other things to do besides sleeping.
• 13:44
  But we feel so much better when we get to sleep.
• 13:47
  So some people will ask, like, what do I do if I can't shut off my thinking?
• 13:51
  And so there are some things that people can use to help them that are a little bit more structured.
• 13:58
  So there's like journaling and the worry time or like setting a time the next
• 14:02
  day to worry about it. But if people are like, I've been trying these tips and
• 14:06
  I'm like really struggling, there's something called CBTI Coach.
• 14:10
  It's an app that was developed by the VA system and it's free and it is very
• 14:17
  effective. And for folks who are like an app is not going to cut it,
• 14:20
  I like need to work through a program or work with someone.
• 14:23
  There's therapists who specialize in CBTI.
• 14:26
  And then through the Cleveland Clinic, they have a CBTI program that's six weeks.
• 14:31
  And I think it's only, I think last time I checked, it was $40 for folks who
• 14:35
  don't have access to that. But those are kind of some good resources.
• 14:39
  Now you say CBTI.
• 14:41
  Can you tell us what that means and how it works? Yeah. So it's cognitive behavioral therapy for insomnia.
• 14:47
  Basically, it's like the application of these sleep tips, but they also help
• 14:53
  you to do, they like monitor your sleep and you track your sleep and you set
• 14:59
  a time that you're not going to go to bed before this time.
• 15:02
  You're always going to wake up at this time. And it's almost kind of like a
• 15:04
  structured accountability sleep program.
• 15:08
  And it's time limited. So it's usually six weeks to 12 weeks.
• 15:12
  And it is the first-line treatment for insomnia.
• 15:16
  So even as a psychiatrist who's trained in prescribing a bunch of medicine,
• 15:20
  the guidelines say first try CBTI.
• 15:24
  Okay. And how effective is this approach? It's very effective.
• 15:30
  Yeah? It's very effective. I think the times it doesn't work is if somebody
• 15:34
  has something else that is non-behavioral that is affecting their sleep.
• 15:39
  So something medical, like they're on...
• 15:44
  Diuretics or medicines that make them urinate a lot. So they're up throughout the night or.
• 15:50
  They have something like sleep apnea where they have all the right sleep behaviors,
• 15:55
  but their body stops breathing in the middle of the night.
• 15:59
  So I usually tell people if you're trying these sleep tips and you're not sleeping,
• 16:04
  or if you're just excessively sleeping during the day, especially if you snore
• 16:07
  or if your partner has noticed that you stopped breathing, go talk to your doctor.
• 16:11
  You want to make sure it's not sleep apnea. You want to make sure it's not something
• 16:14
  like your thyroid or your liver that is medically making it hard for you to sleep well.
• 16:20
  Okay. Okay. So the kind of the snoring, stop breathing, are there any other
• 16:24
  signs it would be important to reach out to a healthcare provider for support?
• 16:31
  Yeah. If you notice that you could fall asleep at any time, like you are in
• 16:36
  the theater and you're falling asleep, you're watching television,
• 16:39
  and you're dozing off, that dozing is usually a sign that your sleep is not restorative.
• 16:45
  Okay, and those are kind of the questions we use to screen someone to see if
• 16:50
  they might have sleep apnea.
• 16:51
  So excessive daytime sleepiness, falling asleep at a red light,
• 16:56
  or honestly, it just kind of feels like.
• 16:59
  They could fall asleep at any moment. And it feels a lot like ADHD.
• 17:03
  It's hard to focus. It can be hard to manage anxiety.
• 17:07
  So, yeah, I think if somebody has tried the other sleep tips and they're just
• 17:11
  still so sleepy, they're probably not getting restorative sleep.
• 17:16
  And that's a good time to go talk to a doctor.
• 17:18
  That's so helpful to know. I so appreciate it. Now, you also mentioned some resources.
• 17:24
  Are there any resources that you want to plug? and we can be sure to link these
• 17:28
  in our show notes as well. Yes. Okay, yeah, I jumped the gun on that one.
• 17:31
  So the CBTI app, the Cleveland Clinic website, those are the big ones. Okay.
• 17:38
  And then, yeah, I think those would be the first ones I would go to.
• 17:41
  And then if someone is looking for a therapist, psychologytoday.com is a great
• 17:46
  resource where folks can put in their zip code and what they're looking for
• 17:49
  and they could say that they're looking specifically for treatment of insomnia or CBTI.
• 17:54
  And then it'll give them therapists in their area that take their insurance
• 17:58
  that can do that for them. Oh, wonderful.
• 18:00
  What a great resource. Thank you so much. Yeah, of course.
• 18:03
  Thank you for listening to Talking FACs. We deliver programs focusing on nutrition,
• 18:08
  health, resource management, family development, and civic engagement.
• 18:13
  If you enjoyed today's podcast, have a question, or a show topic idea,
• 18:17
  leave a like and a comment on Facebook at UKFCSEXT or send us an email at UKFCSEXT@UKY.EDU.
• 18:30
  Visit us online at fcs.uky.edu to learn more about the University of Kentucky
• 18:36
  Family and Consumer Sciences Extension Program or contact your local extension
• 18:41
  agent for Family and Consumer Sciences.
• 18:44
  We build strong families. We build Kentucky.
• 18:46
  Music.