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- [00:00]
Tamsen Fadal
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- [00:54]
Dr. Shelby Harris
Seam.
- [00:57]
Tamsen Fadal
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- [01:13]
Dr. Shelby Harris
The thing that I think is really interesting is that I am having more and more people in my practice who are in their 20s, very late 20s, early 30s, who are coming for sleep treatment, which I never really saw before. But don't fall asleep on the couch. You're gonna start, yeah.
- [01:27]
Guest
What? Why not?
- [01:28]
Dr. Shelby Harris
Because you're gonna train yourself to start sleeping on the couch.
- [01:31]
Guest
I'm sitting down with Dr. Shelby Harris, one of the country's leading experts. We're talking about what actually works to fall asleep and also to stay asleep. More than 60% of women report sleep problems during perimenopause and menopause. But it's not just about being tired. When you don't sleep, it's nearly impossible to think clearly, to manage emotions, to make good decisions, or to even show up as yourself during the day.
- [01:54]
Dr. Shelby Harris
I always say that sleep is like the bedrock. It's not one of the pillars. It's the stuff that everything else builds on top of sleep. So if you're getting good sleep, you have a good foundation for all the other good things that are going to happen with you.
- [02:05]
Guest
If you're in perimeter menopause or menopause and you're just tired of being tired, this episode is going to give you the clarity and the answers you have been looking for.
- [02:14]
Dr. Shelby Harris
There are people who really thought that there was nothing that they could do for so long. They've tried all the sleep hygiene and then they come and we do some CBT for insomnia, maybe some other work. But now she's not on any Medication, she's sleeping so much better. And this patient. And you can just see how happy she is, like, now that she doesn't have to rely on meds.
- [02:32]
Guest
Let's do the myth bust.
- [02:33]
Dr. Shelby Harris
Yeah.
- [02:33]
Guest
Women need less sleep after 40.
- [02:35]
Dr. Shelby Harris
If you see a doctor who tells you that it's normal, sleep less as you get older, find a new doctor.
- [02:42]
Guest
Let's go ahead and get into it. Dr. Shelby, it's great to see you and have you here in the studio.
- [02:46]
Dr. Shelby Harris
It's so good to see you.
- [02:47]
Guest
So, you know, we're gonna talk about sleep, which has become one of my favorite subjects.
- [02:52]
Dr. Shelby Harris
Good.
- [02:52]
Guest
Yeah, I know, because I always wanna improve. It changes a lot. I wanna ask you this, though, and I don't know if I've ever asked you this before. What made you focus on wanting to help women in midlife with sleep?
- [03:04]
Dr. Shelby Harris
You know, it was something that I just started noticing happening more and more with my PAT over the years that I had more women who were just in midlife. So that's where I really started to focus my practice on.
- [03:15]
Guest
Mostly in midlife and then having a problem sleeping, I guess.
- [03:19]
Dr. Shelby Harris
Exactly. So I was seeing more and more patients with insomnia, and then I was like, oh, they're really in midlife. And these women were going through perimenopause, menopause, and people weren't talking about that area and that time of life as being a very distinct challenge for sleep. So that's why I started to focus.
- [03:34]
Guest
On it, and it really is. So is it true that we sleep worse after the age of 40, or do we just sleep. Sleep differently at that point?
- [03:42]
Dr. Shelby Harris
Both, I would say. So some. Some people have always had trouble with sleep, and they might develop new sleep problems. So they might develop, let's say, sleep apnea, or their insomnia might change. Other people never had sleep problems, and they just start to develop insomnia when perimenopause starts to hit. So they might notice their brain's more active than it had been. They're having hot flashes, night sweats, all of that.
- [04:05]
Guest
So let's talk about that shift that happens, because I feel like there's so many things that. That happened during it. And we blame a lot of things, right? So we blame. Maybe it was too much stress. Maybe I went to bed too late. Maybe it was caffeine. It could be everything. It could be none of those. You could be absolutely quote, perfect. So what is the shift that happens during perimenopause when it comes to sleep?
- [04:25]
Dr. Shelby Harris
So there are three different areas that I always think about when it comes to that stage of life, the first one is the biologic changes that happen. So these biological changes are those hormonal changes. Right. So the drops in estrogen, the drops in progesterone, and they happen at varying times. So you don't know it's gonna happen, like, in two weeks from now. So they start to have trouble with their sleep through that. Then there's also these psychological changes that happen. So we know that women tend to have more anxiety and depression, and we see that happen in that stage. And then finally there's social stressors that happen. So we are. A lot of women are having children later in life. They're working. They're a sandwich generation. So they're never really able to turn off the br. It's like this perfect storm of these three different areas. And that's why we start to have it at that time of life.
- [05:10]
Guest
Yeah. What do we need to do in order to go to sleep? Whether. How does that work? Because I guess that's kind of the question. Like, you've got the hormonal issues that are going on. You've got the stressors that are going on. You've just, you know, everything is kind of changing biologically at the same time. But what needs to happen when you get into bed? Cause I think you said it to me, like, we do a whole bunch of other things and we plan and prepare, and then with sleep, we're like, I'm just gonna jump into bed and fall asleep. We don't really always prepare for that.
- [05:36]
Dr. Shelby Harris
Yeah, I think a lot of people think of sleep as this on, off, switch. And if you're someone who gets in bed and you just pass right out, it's very possible you're either sleep deprived or you have something else that's going on that's making you fall asleep. You shouldn't fall asleep immediately. Should take about five minutes at least. So the goal is to really wind down a bit. So what does wind down mean? It could be 10 minutes. It could be a half hour. It could be an hour for some people.
- [06:00]
Guest
Before you get into bed.
- [06:01]
Dr. Shelby Harris
Exactly. Okay, so there's not one. Like, people are very interested in what I do to get to bed at night. Not that interesting. Like I read.
- [06:09]
Guest
Tell me about your boring routine.
- [06:11]
Dr. Shelby Harris
I literally, when the pandemic started, I said to myself, I'm gonna finally start stretching. So.
- [06:15]
Guest
Before bed?
- [06:16]
Dr. Shelby Harris
Yeah, before bed. So I did an app. I would look at it at first, and then I got used to it. So now I know what to do. And then I get in bed, I read a magazine, read a book or something, and I go to bed. It's not that interesting.
- [06:27]
Guest
And you fall asleep.
- [06:28]
Dr. Shelby Harris
I fall asleep within five to 15 minutes. But there's the occasional night where it does take me longer. I'm a human being.
- [06:35]
Guest
But that's the part that's interesting, is that you do fall asleep. Because I have to tell you, like, I could lay there sometimes 30 minutes an hour, turn over, put my phone on for a minute. I know. Not one of Dr. Shelby's rules. So let's talk about when you should consider that you have sleep issues going on. Whether or not it's a normal sleep issue or whether or not it's something that you should be trading.
- [06:58]
Dr. Shelby Harris
Yeah, I think the thing that people should do is first and foremost, always think about the sleep hygiene stuff. Right. So like we were just talking about. The screens are not always horrible, but it's like, what are you looking at on it? So are you then scrolling? Are you doom scrolling? You're getting sucked into all this other stuff that is activating. So screens, alcohol, caffeine, all that stuff that we always talk about. If you're doing that and you're still having trouble with your sleep at least three nights a week, routinely, or even if you sleep okay, but you feel horrible when you get up, then you want to see someone. So I usually say, like, do sleep hygiene for about two weeks. And if you're consistent with the same bedtime, wake time, all that stuff, you're getting enough sleep and it just. Or you're not getting enough sleep, it's not working. Then see, definitely see a specialist in.
- [07:42]
Guest
Sleep medicine because there could be something else going on.
- [07:45]
Dr. Shelby Harris
Exactly.
- [07:45]
Guest
That's beyond your control.
- [07:46]
Dr. Shelby Harris
Exactly.
- [07:47]
Guest
Let's talk about temperature in the bedroom, because I know that part of sleep hygiene is to kind of keep your bedroom cool, make sure it's dark. Can you go over what sleep hygiene is?
- [07:55]
Dr. Shelby Harris
So sleep hygiene, we often talk about it. My colleague Rachel Mamber said it was like dental hygiene. So it's brush floss every single day. And that helps to prevent a cavity. Same thing for sleep hygiene. So we think about it as like the room temperature. Right. So you want cool, quiet, dark, comfortable. Cool is usually in the 60s Fahrenheit. I know, I know.
- [08:17]
Guest
Is it really. Is it like 68? What is it?
- [08:19]
Dr. Shelby Harris
People will often say 67, but it really is not. That's not a one size fits all. But because in different parts of the country with the humidity levels, it feels very different. So somewhere in the 60s, some people like it. And like, I couldn't do this. Low to mid-60s. We keep my house at about 68. My mom, I love her dearly, but she wants to have the house at like, 78 every night. And I will not stay at their house if it's that warm. Yeah, but you want it somewhere in there.
- [08:43]
Guest
Okay. So that's your temperature. You want to make sure it's dark, try to cover up lights, anything else.
- [08:48]
Dr. Shelby Harris
So something I think about a lot with my patients right now. Because it's summertime, the sun's coming out here in New York at like, five in the morning. So when I see someone's sleep diary and they're having a lot of these 5am Awakenings, that's the first thing I often think about is dark, comfortable.
- [09:02]
Guest
What's comfortable mean?
- [09:03]
Dr. Shelby Harris
Comfortable. It's. It's so, like, personal. But people are sleeping on a Mattress Often that's 20 years old. So if your mattress, if you have the pillow, the same pillow you've had for years, that's like, so flat. If there's a dent in your mattress, get something new.
- [09:18]
Guest
Dr. Shelby, can you explain what is your circadian rhythm?
- [09:20]
Dr. Shelby Harris
So circa means about Diane. A day. So it's your body's rhythm that's about a day long. So when you go to bed at night, your body starts to have melatonin. About two hours before you go to bed, that starts to get released and you start to get sleepy. And then throughout the night, you stay asleep, and then you wake up in the morning. That's that temperature, body temperature, we were talking about. Your body temperature drops right before bed and then starts warming up in the early morning hours. And it's just night and day. So that's what we have to keep consistent. You might have little dips here and there during the afternoon, like after. After lunch. But that's why we talk about keeping a consistent sleep wake schedule, because it keeps your body's clock in check.
- [09:56]
Guest
Does that shift with everybody, or does it shift in particular for women that are in perimenopause, menopause?
- [10:01]
Dr. Shelby Harris
It shifts for everyone, actually. So when you're young, when you're a young kid, you go to bed early, you wake up early, then you become a teenager, you go to bed later, you sleep in. And then when you become an adult, it kind of goes a little earlier. And then sometimes we see, as we get older, you start going to bed early and wake up earlier again.
- [10:17]
Guest
So let's talk about some of the reasons that you would be treated for sleep or some of the different things, just so we can define what each thing is. So I want to talk about the difference between insomnia and sleep apnea.
- [10:28]
Dr. Shelby Harris
Yeah. So two totally different things, but you can have both, which is very common. So insomnia, when we have. Many people have just an episode of insomnia where they have a night of just poor sleep here and there. But real chronic insomnia, or actually diagnosable insomnia, is trouble falling asleep, staying asleep, or, and, or awakening earlier than you would like to. And it has to create some problem for you. So it's not just being a short sleeper. It's like I'm annoyed by it. I feel like I'm not focused. That. And if it's happening for at least a month, that short term, and if it's happening at least three months, for at least three nights a week, that's long term. So that is considered insomnia. Right. So a lot of people have insomnia and they don't even realize it. Cause they just think it's like, oh, I just have trouble sleeping. But it's only three nights a week. Well, three nights a week is the criteria.
- [11:17]
Guest
And insomnia is how many hours that you would or wouldn't sleep.
- [11:20]
Dr. Shelby Harris
That's a great question that I get all the time. It's really not about the number of hours or number of minutes awake. Some criteria will say 30 minutes, but really it's more about perception. So if you're bothered by it, you're probably at least a half hour that it's taking to fall asleep or wake up. So that's insomnia. Now, sleep apnea is a totally different thing. So sleep apnea is when you fall asleep at night. Your airway has muscles in it, right. And when you're falling asleep, you relax the airway. So there's different types of sleep apnea, but the most common one is obstructive sleep apnea. So once you fall asleep, the airway loosens so much that you hear you have this kind of like flapping. And then what happens is then it closes completely or partially. And that's an apnea or a hypopnea. So not getting oxygen throughout the night. So that's what happens multiple times. And then when you have not enough oxygen, your brain says. Your brain says protectively wake up. So you go and you wake up and everything tightens. And then you fall right back asleep. Most people have no idea it's happening. No idea at all. And in women, it's often misdiagnosed because the typical screener that we have for it is called the Stop Bang questionnaire. And that actually is not really great for women. For women, they'll often report that they feel tired, not sleepy the next day, maybe some more depression. They might not snore overtly. They might just have pauses in. In their breathing. So. And also it just. People don't report it because they don't feel like it's sexy. They don't want to. Like it's not very woman. Like they might say things like that. So it's really gets misdiagnosed all the time in women or missed, I should say. So if you can have sleep apnea, but you can also have insomnia on top of it. So some people will wake up from an apnea, but then they have. Their insomnia kicks in and they can't.
- [13:05]
Guest
Fall back asleep, they can't go back to sleep. Is that prevalent? Is that more. More. Do you see it more in women that are in perimenopause and menopause, or could that be at any time during your life?
- [13:14]
Dr. Shelby Harris
We apnea happen more in women once they hit perimenopause. So the rates are more in men when they're younger, but they actually start to even out more when women hit perimenopause because of the loosening of the airway. The muscles just aren't as rigid and tight. So that's what tends to happen.
- [13:29]
Guest
So is it like a lack of estrogen or lack of hormone?
- [13:32]
Dr. Shelby Harris
It can be. There are some people that are suggesting that. That it's the hormonal changes that are causing the loosening of the airway. And there are some people, this is nothing that is at all a standard. But there's some people that are suggesting, like maybe there's a role for MHT in the future because it might help to actually tighten the airway a little bit.
- [13:50]
Guest
Menopausal hormone therapy.
- [13:52]
Dr. Shelby Harris
Exactly.
- [13:52]
Guest
As part of what? As part of a solution for sleep.
- [13:56]
Dr. Shelby Harris
A possible solution.
- [13:57]
Guest
Wow.
- [13:57]
Dr. Shelby Harris
Right? Potential. No data behind it yet, but it's definitely something people are starting to think.
- [14:02]
Guest
About, which is the show we're always screaming, more data. So I.
- [14:05]
Dr. Shelby Harris
Exactly.
- [14:05]
Guest
I hear you. That. We'll just add that to the list. If you're listening to these symptoms of perimenopause and thinking, oh my gosh, I think that's me, it's time to start tracking what you may be experiencing, I created a free symptom tracker to help you do just that so you can get clear on what's happening and advocate for yourself and walk into that next doctor's appointment with confidence. Take a look in the description of this episode. The link is right there in the show notes. Let's get back to the conversation. Let's talk about a couple other things because I want to get these names, then we can kind of go into solutions. What is hypersomnia? Because I had not heard about it. And then how can it be treated?
- [14:40]
Dr. Shelby Harris
So insomnia, not getting enough sleep. Hypersomnia is the exact opposite. So you're sleeping too much. So there can be a bunch of different types of excessive sleepiness disorders from narcolepsy to even sleep apnea causes hypersomnia. So you might sleep more because the quality of your sleep isn't that great. So there's a lot of things that can cause hypersomnia. Grinding teeth at night. There's so many things I feel like.
- [15:04]
Guest
Some people would welcome, you know, sleeping too much at this point.
- [15:07]
Dr. Shelby Harris
Right.
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Guest
But it's really not healthy for you.
- [15:09]
Dr. Shelby Harris
It's not healthy. It's like people would say, oh, I'd love to get 10 hours of sleep at night. But. But for some people, they are naturally long sleepers. But if it's getting in the way of you living your life and especially if it doesn't feel restorative, that's a big problem.
- [15:22]
Guest
So you sleep a lot and then you're still exhausted. Exactly. And any of these are a reason to see a sleep.
- [15:29]
Dr. Shelby Harris
Yep.
- [15:30]
Guest
All right, let's talk about chronic sleep deprivation and how that changes.
- [15:35]
Dr. Shelby Harris
So chronic sleep deprivation, there can be different types throughout. It's not a diagnostic category necessarily, but. But people often will not get enough sleep when they're younger because they're working so much or they're out late at night. And then as they start to get older, it can now start to look more like insomnia and all these other issues that might start to take hold. So we might see some people with insufficient sleep syndrome. Then it might become like insomnia or something like that as they're getting older.
- [16:03]
Guest
So let's talk about the consequences of poor sleep, because I feel like it's one thing to be annoyed by it, it's another thing for it to really impact your metabolism, your we, your mood, your long term health. Can you talk about some of those long term consequences that you can have if you really are getting poor sleep night after night?
- [16:22]
Dr. Shelby Harris
Yeah. So sleep quantity and sleep quality are both important. So if you're not having either of those things together, then what we see is it affects so many parts of your body. So from your mood to your thought process, cognitive function, cardiovascular system. You were talking about weight. You might have issues. If you're not getting enough sleep, then you're going to actually start to eat more because your brain is not getting the full signal. And it just really balance absenteeism at work, quality of life. I always say that sleep is like the bedrock. It's not one of the pillars. It's the stuff that everything else builds on top of sleep. So if you're getting good sleep, you have a good foundation for all the other good things that are going to happen with you.
- [17:08]
Guest
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- [20:01]
Dr. Shelby Harris
So it's generally for much of the population between seven to nine hours. That's where they get the eight from. It's just in the middle. That's it.
- [20:08]
Guest
Okay, that's it.
- [20:10]
Dr. Shelby Harris
So seven to nine hours. There are people though who do better with about six and some people who do better with nine. So there are outliers, but it's really about quality as well. So I would rather someone have a little less but better quality than nine hours of broken throughout the night.
- [20:24]
Guest
And what is quality defined as?
- [20:26]
Dr. Shelby Harris
That's an excellent question. It's hard. It's like how do you feel during the day? So if you feel like it's restorative sleep, then that's a good start.
- [20:34]
Guest
Is that where we go into REM and all that? Because I've got the tracker now and I don't even know half those things on the tracker. Like I want to know all of it, but I feel like as long as I get a good score, I'm in the green, I'm doing well.
- [20:45]
Dr. Shelby Harris
Yeah, it's really about how you feel. So you don't even need the tracker. Honestly it's about how you're feeling during the day. And if you find that you're waking up a lot at night, even if it's quick, but you're having very broken sleep, that's probably not great quality. So you'd want to get that evaluated.
- [20:59]
Guest
So you want to stay asleep.
- [21:00]
Dr. Shelby Harris
Yep. Or you might have awakenings, one or two awakenings at night to use the bathroom. That's totally normal. But if you feel like it's like a lot of awakenings, that's not good.
- [21:08]
Guest
Okay, so you talk about CBTI Therapy. Can you explain that? That's a specialty and something that you focus on with people that come to you?
- [21:18]
Dr. Shelby Harris
Yeah. So CBT I, Cognitive Behavior Therapy for insomnia is really. It's the gold standard treatment. It's the first line treatment for insomnia ahead of medication, believe it or not. And that even is important for women in perimenopause and menopause. So we might sometimes use hormonal replacement. We might also use cbti. It really does work really well, even for women who are having hot flashes. We don't fully know why it works, but it does help with hot flashes in a number of women. So what it is, is it's. People often think it's sleep hygiene. It's not. Sleep hygiene is just a tiny piece of. So you start with the sleep hygiene, but then we limit the time in bed. So a lot of times people are in bed eight, nine hours a night, but they're only sleeping six hours. So I might actually limit that at first. It goes against common sense to help really make them sleepier and increase their sleep drive so that they sleep throughout the night. They might have a quick awakening and go back to sleep. I might have them go to bed later because that might actually help them fall asleep faster. And then we move it earlier once they're falling asleep faster so that they can get more sleep. We also work on what people are doing in the middle of the night. So are you getting up? Are you laying in bed, trying to force sleep to happen, all those sorts of things. Then we work on the thoughts about sleep. Like, if I don't sleep, I can't function tomorrow. And we'll challenge some of that stuff.
- [22:33]
Guest
Yeah, let's talk about. I'd like to go into it. So if somebody comes and says, like, listen, I need CBTI and I have insomnia, or I'm just not able to sleep, you can do it for a number of different things. Would you recommend that if you're a woman in perimenopause and just can't sleep. You've tried everything. Nothing else is working.
- [22:48]
Dr. Shelby Harris
It's very effective for people who have insomnia.
- [22:51]
Guest
So you come in and you adjust sleep schedule. That's the first thing.
- [22:53]
Dr. Shelby Harris
Yep. Will also talk about what they're doing in bed. So a lot of times, people never thought about sleep before, and now it's preoccupied. Like, they're preoccupied with it. So when the night comes, I often hear people say, I dread the night as it gets closer. Yeah, it's so true.
- [23:08]
Guest
I understand that for you, right?
- [23:10]
Dr. Shelby Harris
It's so true. So they might be tired, but wired at night. So they were like, I'm so exhausted, I just want to get in bed. But they're not sleepy because they're not falling asleep. So I might adjust what they're doing before bed and have them go to bed later so they're not putting as much effort into it.
- [23:24]
Guest
So what would they do instead of panic?
- [23:27]
Dr. Shelby Harris
I don't care. It really doesn't matter. There's no magic thing. It's. They can. They can watch tv, even. Believe it or not, they can do. I have. People will say, like, I'll have them go to bed a few hours later. And they were like, I don't know what to do. I'm so bored. Is there a drawer you can clean out?
- [23:41]
Guest
Wow.
- [23:41]
Dr. Shelby Harris
Right? It doesn't matter. Just stay up later and maybe unwind a little bit before, but not hours before. And so I'll have them change that. Getting up at the same time every single morning and not compensating for a bad night of sleep is super important. So we're gonna pick awake time. We're gonna pick a way that they can use an alarm clock, not their phone. Because a lot of people just use their phone as the alarm clock. So they're looking at that in the middle of the night? No. So we're gonna use an alarm clock. Maybe. And then we'll also talk about maybe if they're up in the middle of the night, what are they doing? So getting out of bed, really? There's no magic answer. It's. Some people read. I honestly, if I have a rough night, I get out of bed. If it's really bad, and I go through. I collect cookbooks. I go through my cookbook collection.
- [24:23]
Guest
You do? What do you do with them?
- [24:25]
Dr. Shelby Harris
I literally just look through them and I earmark things that. Pretty pictures and things that I want to make in the coming few weeks, months, whatever.
- [24:31]
Guest
That's your.
- [24:32]
Dr. Shelby Harris
Yeah. People laugh at me. But it works for me.
- [24:34]
Guest
And then you go back to bed.
- [24:35]
Dr. Shelby Harris
And then I go back to bed. Right.
- [24:37]
Guest
I feel like I could have had my whole house decluttered by now with the amount of sleep that I don't get. But I just lay there and panic.
- [24:42]
Dr. Shelby Harris
Right. But what happens is the less time that you spend in bed, and if you restrict. Restrict that time a little bit with the guidance of someone who. Or an app or someone who can help you, you fall asleep faster and you stay asleep more in the middle of night, so you don't have to get out of bed as much in the middle of night. Your brain is just not as active because you're spending less time in bed.
- [25:00]
Guest
So the therapy is one way to do it. Yeah. Is that work better than different sleep medications or other kinds of treatments?
- [25:08]
Dr. Shelby Harris
So it's. We consider it better in the long run because once someone starts on sleep meds. Yes, there's some people who just need it for a short time. But it's pretty unusual that someone comes through my door who's like, oh, I stopped the sleep meds and I was fine. Usually once you start them, it's hard to stop them long term. And as when we're talking about people in perimenopause and menopause. Right. We're talking about people in their 40s, 50s, who are now on sleep aids, then it becomes a real concern of ours for falls, accidents, memory problems. We don't want people to now get into later years having a sleep medication. So it's really not our preferred first line of treatment.
- [25:44]
Guest
So the therapy, CBTI is the first line of treatment. If nothing else has been working.
- [25:49]
Dr. Shelby Harris
Exactly.
- [25:50]
Guest
Where do you find the courses or a coach? Is that what you need? You know, therapist, how do you. How do you go about finding. If someone's listening now and they're like, I want to try that tonight.
- [25:58]
Dr. Shelby Harris
Right. So my book is one great place. Right. So the women's guide to Overcoming Anxiety, that's cbti. And then also we might think about apps out there. So if you're. If you're really just. You're struggling, you want to try something, there's like CBTI Coach is a great one by the VA and then finding people. So there are a lot of people who say they do it, but I really encourage. If you really want someone who knows what they're doing, go to the Society of Behavioral Sleep Medicine website and you'll find people who are actually really well.
- [26:23]
Guest
Trained in it that you can actually coach you either online or.
- [26:27]
Dr. Shelby Harris
Exactly.
- [26:28]
Guest
What do you recommend to somebody that cannot fall asleep, even if they're absolutely exhausted. Like my husband said to me two nights ago, I think I'm overly tired. Which I completely understand what that means. What do you recommend for somebody like that?
- [26:42]
Dr. Shelby Harris
Stop trying. So that's when I would say, take the effort is like. Effort is the thing that is the enemy for sleep.
- [26:48]
Guest
It's the killer, right?
- [26:49]
Dr. Shelby Harris
It's the killer.
- [26:49]
Guest
Yeah.
- [26:50]
Dr. Shelby Harris
So just get outside, do something to pass the time. Read a cookbook. I don't care.
- [26:55]
Guest
And then there's like.
- [26:56]
Dr. Shelby Harris
There's all these, like, techniques, like cognitive shuffling, where you go through the Alphabet and you say, a for apple, B for banana. I mean, they help, but they're just.
- [27:05]
Guest
Like, wait, I want to hear some of this. So a.
- [27:07]
Dr. Shelby Harris
So cognitive shuffling is something we've been talking about in psychology for years, but it had a resurgence on, like, TikTok or something, and now everyone's talking about it. It's literally just an exercise of going through. It can be in bed for a little bit, or you get out and you just want. But it's ideally in bed for, like, five minutes. You go through the Alphabet and you pick a category. So it could be A for apple. Yeah. It could be fruit. That would drive me mad because I would have letters where I couldn't think of something. But some people like that. I just think of any word that goes with that letter of the Alphabet. Okay.
- [27:37]
Guest
Okay.
- [27:37]
Dr. Shelby Harris
And what it is, is it's just. It's busy enough that it occupies you from all the worries, but it's not busy enough that it keeps you awake.
- [27:44]
Guest
Right.
- [27:45]
Dr. Shelby Harris
But if you're doing it for, like, 10 minutes and it's not working, that's when I would say, get out of bed. And then later on, when you're actually sleepy, go to bed, but don't fall asleep on the couch. You're gonna start. Yeah.
- [27:55]
Guest
What? Why not?
- [27:56]
Dr. Shelby Harris
Cause you're gonna train yourself to start sleeping on the couch.
- [27:58]
Guest
I did that for a long time. What is that? I feel better. I sleep better out there. I have no worries on the couch.
- [28:03]
Dr. Shelby Harris
It's conditioning.
- [28:05]
Guest
So let's go into that.
- [28:06]
Dr. Shelby Harris
Yeah. So that's the common thing. Right. Why do I sleep better on the couch, not in the bed? Because you have associated the bed with so much frustration and dread. And then when you're not sleeping and you go out to the couch and you allow yourself to sleep, you say, see? It's so much better here. And then you continue to fall asleep on the couch. So you have to just pick one place in your house to allow yourself to sleep, even if it's a struggle, but just really just try to keep the sleep in that one other place. Oh, that's it.
- [28:31]
Guest
Oh, gosh. I know I should have met you three, four years ago. I have a dent in the couch from where I've slept on that thing so much. Let's talk about scrolling and phones and television. And I know that you, you know, we know good and bad about doing those at night, I guess, a little bit, but I'd like to go into them, like, what your thoughts are about scrolling at night, the effects that it has on our ability to rest or fall asleep, and the reason why.
- [28:56]
Dr. Shelby Harris
So the phones are an interesting one. So the screens. There are a lot of people who still will say that the screens are not good for you before bed. There's some researchers out there that are really debating how bad the blue light is for you.
- [29:08]
Guest
Like, it might not be so bad.
- [29:10]
Dr. Shelby Harris
Yeah, I mean, I don't want to make, like, a blanket statement one way or the other, but it's interesting. It's actually there are some researchers who are debating it because the research is. Is not as strong. The original study that said, like, blue light is not good, guess how many minutes it actually delayed sleep by 11 minutes. Oh, and there are studies that come out now that show it can delay sleep. So it really does vary, but there are some that don't show it does. It delays it as much. So I'm one of those people who's like, stay away from the screens. Mostly because we get sucked into watching stuff. We get sucked into a text, an email, just. I mean, all these social media apps are meant to be addictive. So it's like, it's not even that. It's just. Yeah, it's not even that. It's the blue light. It's really like, what are you looking at? All this stuff is just sucking you in that you can't go to sleep and put it down.
- [29:56]
Guest
You think it's more the content than the actual blue light.
- [29:58]
Dr. Shelby Harris
At least in my work with people, I think the content is the bigger issue.
- [30:03]
Guest
So if somebody does that, though, and that is their habit over and over, what do you recommend in replace of that? I know there are different kind of apps out there. Do you feel okay about audiobooks or would you rather somebody read? All right, so give me some solutions.
- [30:15]
Dr. Shelby Harris
Audiobook reading. You can listen to a podcast. Some people will do meditation. I caution against getting too stuck on that to fall asleep to. Like, I want people to meditate during the day, because meditation is so good for teaching your brain to just quiet itself. Especially if you're that person who wakes up at three in the morning and you can't turn your brain off. So practice meditation during the day because you're stronger from the daily meditation practice that you can use it more at night. You can just say, let go, let it go. If you're falling asleep while meditating, you're actually not getting the practice of meditating.
- [30:46]
Guest
All right, so what are the calming rituals that you recommend for a good night's sleep?
- [30:49]
Dr. Shelby Harris
Like I said, there's no one size fits all. So for me, it's reading and stretching and also before that, I actually washed my face. I am really into like a good skincare regimen because it just, for me, it signals nighttime's coming. Other people love to read a book, other people love to listen to a podcast. It's just find something for you that, that's quiet, calm and relaxing, that moves towards the bed.
- [31:12]
Guest
All right. You get into bed.
- [31:13]
Dr. Shelby Harris
Yep.
- [31:14]
Guest
This night in particular, you've fallen asleep and you're feeling great about yourself. Then you have to pee.
- [31:19]
Dr. Shelby Harris
Yep.
- [31:20]
Guest
So you get up, go back to bed, and now you cannot fall asleep.
- [31:24]
Dr. Shelby Harris
Yep.
- [31:24]
Guest
What do you do? And is that common?
- [31:26]
Dr. Shelby Harris
Super common. So if it happens routinely, I would start saying, okay, are there things that you're doing that are making you have to pee? Right. Are you drinking a lot of liquids before bed? Sometimes even things like sleep apnea can cause women to have to pee a lot at night. But if you just can't fall back asleep, then I would suggest, like, you could try a little of that cognitive shuffling. And if nothing is working, then just get out and take the effort out of it. Pass the time. And when you get sleepy again, then go back to bed and just say the next night will be better. And don't sleep in the next morning. That's the thing that will make it harder the following night.
- [31:59]
Guest
So get up at that same time.
- [32:00]
Dr. Shelby Harris
Even if you're get up at the same time. Exactly. And then the next night, go to bed at your usual time. Don't go to bed too much early because you're going to make the problem continue to happen.
- [32:10]
Guest
So if you're going to do 11 o' clock to 7 o' clock in the morning, 11 o' clock at night, 7 o' clock in the morning. If you can stay on a schedule like that.
- [32:16]
Dr. Shelby Harris
Exactly, exactly. It's the compensating for sleep that actually throws people off.
- [32:21]
Guest
Some things happen in bed too. I Think, you know, restless leg syndrome, there's a couple of other things, like when you're in bed that really can. Can stop you from sleeping. Can you go over a couple of those that are like that?
- [32:31]
Dr. Shelby Harris
So restless leg is the biggest one. So when we think about perimenopause and menopause, there's sleep apnea, insomnia, and then the other big thing is restless leg. So restless leg, it happens more in women than men. I have it myself. It's horrible, horrible, horrible. It's just. It's uncomfortable. So what it is, is as the night gets closer, you tend to have this feeling where you have to just. Everyone describes it different, but it's like you have to stretch. You gotta move. Patients will sometimes say they feel like they have soda in their veins. And the name is a misnomer. Cause it's not just your legs that's the most common, but you can have it in your arms or your trunk.
- [33:04]
Guest
Oh, I didn't know that.
- [33:05]
Dr. Shelby Harris
Yeah, it's kind of weird. So some people will have to just constantly move. The only way you can find relief is by getting up and moving around. So it gets misdiagnosed as insomnia all the time. Because they're not reporting the sensation that's causing them to not be able to fall asleep. Or they. Or they get misdiagnosed as having anxiety.
- [33:25]
Guest
Because your whole body feels. You're restless. On high alert, right? Your body feels on high alert. So what can somebody do if they have that get. I mean, is there actual treatment aside? So what does that treatment.
- [33:33]
Dr. Shelby Harris
Yeah, so we always start with just checking your iron levels. So you get a ferritin panel. You look at that first. And you wanna see someone who knows what they're talking about when it comes to restless leg. Cause it can still be low, but within normal limits. But sometimes just iron supplementation can help for some people. If that's enough. If that's not enough, then we might start to think about medications. We do have really good medications out there. And then also we always think about, like, certain sleep hygiene things. So alcohol, caffeine, those are things. Too much caffeine can really cause restless leg to be pretty out of control.
- [34:05]
Guest
Oh, wow.
- [34:05]
Dr. Shelby Harris
Yeah.
- [34:06]
Guest
Well, I wanna talk to you about that because I think, you know, we talk about foods, we talk about caffeine, we talk about alcohol now playing a big role. I never noticed alcohol playing a big role. I thought that wine made you fall asleep. You have a little glass of wine, and that's just not the case anymore. Can we can we talk about that and if that's. Is it changed because of our age? Has it just changed because we're more.
- [34:24]
Dr. Shelby Harris
Aware of it as you get older, it does take longer and it gets harder to metabolize alcohol for sure. So it can impact us more. Like I used to be able to have a glass of wine and have no issues. And now like that one glass of wine and I'm like, why, why, why.
- [34:39]
Guest
Did I do this?
- [34:40]
Dr. Shelby Harris
But yeah, it's very dehydrating. But also what alcohol does is even though it might make you fall asleep, it causes broken sleep at night. So the sleep is not as restorative. So it actually can really disrupt your remaining that you might get at night. And also you might have more awakenings or just more shallow unrestorative sleep or non restorative sleep because of the alcohol. And essentially what happens is after a few hours you wake up because your body is in withdrawal from the alcohol and it says to you, okay, you need to have more and you're not going to be drinking in the middle of the night ideally. So it's really not an ideal thing to be doing. So you want to limit it within three hours of bed. Of course, I'm also a fan of people living life and, and enjoying once in a while you go out, you have a glass of wine, you just know that night might not be as good and that's it.
- [35:24]
Guest
So three hours before you're gonna go to sleep. Is that the same with meals? When should your last meal?
- [35:30]
Dr. Shelby Harris
Yeah, so heavy meals, like your big meal, you wanna limit that within three hours of going to bed. But some people, a light snack about an hour before is actually helpful. So for like someone like myself, the intermittent fasting thing doesn't work for me. I get migraines. So we actually recommend to some people to have a light snack about an hour before bed. That's a mix of like a whole grain carb and some sort of protein. So that kind of mix can be really helpful for some people to help settle them so they don't wake up with headaches or low blood sugar in the middle of the night.
- [35:58]
Guest
What would that snack be? What's your, what do you do?
- [36:02]
Dr. Shelby Harris
My go to is typically I like Greek yogurt. So I'll have Greek yogurt with a little bit of granola and some raspberries in it.
- [36:08]
Guest
Oh, that's like a nice dessert though, right?
- [36:10]
Dr. Shelby Harris
It's like lovely. A little cup of.
- [36:11]
Guest
So do you look forward to that every night?
- [36:12]
Dr. Shelby Harris
I do, I really do. Great. Yeah.
- [36:14]
Guest
Okay, I like that one. I always thought that you shouldn't have anything. Cause you're trying now, trying to empty out your.
- [36:19]
Dr. Shelby Harris
It really. It does vary upon the person, but some people, they need to have a little bit of something and that mix can actually be pretty sleep. Not. I wouldn't say it makes someone really sleepy, but if you haven't eaten and you're just hungry, like it can be harder to fall asleep for some people.
- [36:34]
Guest
Menstrual cycles. I know we're talking about perimenopause. So most of the time you're, you know, you're still going to have, you could have a heavy cycle, you're going to have a cycle. It's kind of all over the place. How does your menstrual cycle impact your sleep? How does your menstrual cycle impact your sleep cycle?
- [36:46]
Dr. Shelby Harris
Yeah. So when you're about to get your period, so about three, four days before, that's when some people can notice that they have disrupted sleep. So that's actually really. It's interesting in boys and girls, the rates of insomnia and any sort of sleep problem are pretty much equal. And then when girls start to actually menstruate, that's when insomnia starts to go up in women. So, yeah, because of that we don't.
- [37:10]
Guest
Get a break no matter what age. Right.
- [37:12]
Dr. Shelby Harris
So about three to five days before, you might start to see some disruption. So we talk about insomnia typically happen because of the drops in the estrogen especially, you know, some women actually will start to have hypersomnia, which is that excessive sleepiness. So we sometimes see that as well. So there. It can be one or the other, or you might just be someone that's not really bothered by it at all. And then once you menstruate, a few days into that, your sleep tends to normalize itself again.
- [37:35]
Guest
There's a lot to keep track of.
- [37:36]
Dr. Shelby Harris
I know, right?
- [37:38]
Guest
Throughout our lives, if you're sleeping with a partner, you know, that can be difficult, especially if the partner is sleeping soundly, snoring, sleeping, you know, peaceful. And you're not. I've heard of sleep divorces now where, you know, can you explain what a sleep divorce is? And is it really necessary?
- [37:56]
Dr. Shelby Harris
In some cases it can be really marriage and relationship saving because people just try to force themselves to sleep together. And it doesn't have to be just because if someone's snoring loud enough or they're having enough snoring that it's causing the other person to stay away. I would encourage that person to get evaluated for sleep apnea. But sometimes even when they're evaluated, like, you just might have different sleep time schedules that you might need, or you just might. One person might move more than the other. And so sleeping apart. But right before you go to bed, spend time together, cuddle, have sex, whatever you want, then go to sleep in your separate environments. And that can actually be very freeing because it gets rid of the resentment that a lot of people have. So. So this term sleep divorce, I always can't stand it. Cause it has such a negative connotation for some people. One of my colleagues, Wendy Troxell, talks about it as a sleep alliance. So you together come up with a plan. And it doesn't have to be every day or every night. It can be three nights a week. You sleep apart. You just come up with what works for you and your partner. And it can be really freeing for relationships.
- [38:56]
Guest
All right, a sleep alliance.
- [38:57]
Dr. Shelby Harris
Sleep alliance.
- [38:58]
Guest
So in a sleep alliance, you do what?
- [39:00]
Dr. Shelby Harris
Whatever you want. So you sleep apart. You sleep apart a few days a week, every night. But the key is, in my opinion, you both have to be on the same page. So you have to agree. And the environment where you sleep has to be equal. So it's not like one person's, like, relegated to, like, the couch, the uncomfortable futon or something. That's not fair.
- [39:17]
Guest
You're on the floor. I'm on that.
- [39:18]
Dr. Shelby Harris
That's not fair.
- [39:24]
Guest
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- [41:49]
Dr. Shelby Harris
So naps, they can be good and then they can be bad. So it really does vary. If you're someone who tends to be an okay sleeper and maybe you're just not getting enough sleep because you've been working or the kids or whatever it is that's going on, then a nap can be really beneficial. So 20 minutes, that's what we recommend. So I usually say get in. If you can do it in your bed, it's even better. Set a timer for 30 minutes so you take some time to fall asleep. So 30 minutes, 20 minutes, that's it. And try to do it before. We usually say 2pm, but that's assuming you go to bed about 10. So try to do it about eight hours before you're gonna go to bed at night. And then just experiment with it. If it tends to help you and you feel good and it doesn't impact your nighttime sleep, then you're fine. If you find that the 20 minutes is not refreshing and you just, it's like no matter what you do, you're still sleepy, then you wanna see someone and get evaluated. Or if you're having trouble sleeping at night with the nap, get rid of the NAP.
- [42:43]
Guest
Why only 20 minutes?
- [42:44]
Dr. Shelby Harris
Because if you take a longer nap, what tends to happen is you go into a deeper stage of sleep. So what a lot of people do is they take an hour and then you're waking up at a deep sleep and you're actually more groggy. So it's either 20 minutes or about 90. So you go through a whole full sleep cycle and you finish the deep sleep and then you can wake up. But most people aren't taking 90 minute naps. That's a little bit.
- [43:03]
Guest
I don't even know what time you do that exactly. And can you catch up on your sleep? I know I used to. I used to work a morning shift. So I was like, I'm just going to catch up on Saturday and Sunday and I'll be fine by Monday. Is there such a thing as catching up or is that just a misnomer and you shouldn't even go there?
- [43:16]
Dr. Shelby Harris
To some extent you can, but the reality is most people are missing out on so much more during the week that they're never able to fully catch up. You're just continuing to have sleep debt. But if you miss an hour or two throughout the week, maybe three hours, you can usually make that up on a weekend. But most people are losing way more than that.
- [43:33]
Guest
All right, I know there's a lot of tools, trackers, products, data recommendations, but I wanna get some from you. Cause I know people ask. I know everybody wants to ask you these questions and many people do. So we know you like to go to your cookbook. If you cannot sleep, you thumb through cookbooks and earmark them. You can send me a picture any night that you're doing that. I'm just curious, are there specific books, apps, or sleep products that you recommend to clients that you think are really essential?
- [43:57]
Dr. Shelby Harris
Yeah, it's interesting. I don't really think that there's any one thing that's a one size fits all, in all honesty. So if you're someone who is trying out, let's say a tracker or the ring or a watch or something like that, typically with people who have real entrenched sleep problems, they tend to make people more obsessed about their sleep and then it can backfire. So if it's helping you, I'm all for it. If it's bringing to light, like, okay, my sleep schedule is so inconsistent. I'm all over the place when I go to bed or alcohol use, caffeine, do it. When it comes to products though, I'm really like, there's not one product. But I'm a big fan of cooling products for the bed. So cooling sheets, cooling comforter, pillow, you can get even. There's like, you go up on the like cost ladder to like even the real beds that have the jets in them, all these things and then like really comfortable bedding. Right. I'm a really big fan of that and making sure your room is quiet. So a white noise machine I think can be helpful if you have noise going on. There's earplugs that you can get that are really wonderful and then blocking the light. So whether it's with really like spending the money in great shades and curtains that will block the light, an eye mask. There are really great products out there. Like I said though, there's not one size fits salt.
- [45:10]
Guest
Melatonin and magnesium are two things that you know. I know the supplementation is a very big conversation these days. I'm curious what your, your take is on those. And if you decide you're well, if you are on hormone therapy, menopausal hormone therapy, that might solve a lot, Right. For some people can be very, very helpful during that time. If you decide that's not what I want to do, but magnesium or melatonin, can you go down the list on both of those and tell us the pros and cons?
- [45:36]
Dr. Shelby Harris
Yeah. So like first of all, menopausal hormone therapy can help some people, but in all the women that I see, not all, but many, it's not always the thing that solves everything. So I want people to know there's a lot of options out there. Right? Cbti, we have options. Now. Melatonin and magnesium often get talked about as an option. There's not that much research in supporting.
- [45:57]
Guest
It on either one either.
- [46:00]
Dr. Shelby Harris
Magnesium is really good as a relaxer.
- [46:04]
Guest
Which type of magnesium? Because there's different types of magnesium.
- [46:06]
Dr. Shelby Harris
Magnesium threonate. There's like all different types. But in all honesty, all it really does is calm the body and calm the brain. So it's not really a sleep medication. It just helps to set the stage for sleep. So if you tend to feel like it can relax you, but it's not necessarily going to make you sleep. Now, magnesium is, or, sorry, melatonin is something our brains naturally make. So melatonin often gets touted as like this insomnia cure. It really is. So some people swear by it. Great. But a lot of times people are using way too much. So we actually talk about using small amounts. So like 1 to 3 milligrams. And where we use it all the time in sleep medicine is more for jet lag. For people who can sleep a full night but need to change the timing of their sleep. So they need to not be a night owl anymore to become an earlier time. Then we will use it, but very different than how most people are using it. So for insomnia, it's not always the like thing that most people hope it's.
- [46:57]
Guest
Going to be other thing, other things should take place beforehand. But if you decide you want to do that and we're going to do, we're going to do some myth busting in a, in a, in a second. So we'll see which, which things are out there on TikTok.
- [47:07]
Dr. Shelby Harris
And to add to it, melatonin has side effect. I mean, nothing is without side effect.
- [47:12]
Guest
Side effects.
- [47:13]
Dr. Shelby Harris
The most common things I see are with women. I'll. They'll say I have very vivid dreams or nightmares.
- [47:18]
Guest
And then I'll say it's melatonin.
- [47:19]
Dr. Shelby Harris
Oh yeah. I'll say, what are you taking? And I'll find out. It's melatonin. Like stop the melatonin. Very common side effect that no one talks about. And then it could also cause daytime sedation. So you might take a small amount but be really sleepy the next day. So even though you sleep at night, what good is that doing if it doesn't inform your daytime and help you feel better? What's the point of it?
- [47:39]
Guest
Do we have any idea why it causes dreams? Weird dreams.
- [47:41]
Dr. Shelby Harris
It kind of plays around with the REM sleep that's happening at night. Yeah, sure. I know it's kind of crazy.
- [47:47]
Guest
I wish somebody had said the word perimenopause to me earlier because I spent years thinking I was just stressed out. Mood swings, anxiety, weight gain I couldn't explain, and sleep. I was wide awake at 3am night after night and not one doctor brought it up. If that's where you are right now, if you're in your late 30s or 40s and you're thinking, is something off? You're not imagining it. That's why I wrote how to menopause. I interviewed 42 doctors to put everything you need to know about perimenopause, including the parts nobody talks about about. It's straightforward, it's not overwhelming. And you can get your copy right now@howtomenopause.com I wanna always give people a takeaway of some kind of change. So if there's a woman listening out there, that's like, just give me something now because I'm having just awful sleep. Or if there's something we can do. So what are three small changes people can make today to start improving their Sleep.
- [48:42]
Dr. Shelby Harris
So the first thing I always say is to really consider consistency with your sleep wake timing. So same bedtime, same wake time. So really trying to stay there will be helpful for a lot of people. The second I would say is really thinking about the compensating during the daytime. So are you someone that's trying to either exercise a lot, do a lot of things to put a lot of effort into trying to force sleep to happen at night? So maybe do a little bit of an audit of like, how much are you really trying to think about sleep? Because it's that effort that's part of the problem.
- [49:14]
Guest
Should you be thinking about it? It.
- [49:15]
Dr. Shelby Harris
I mean, you think about it a little bit, but not too much. Like, if you become really rigid with your, like, sleep routine at night, that's probably a problem.
- [49:24]
Guest
Okay.
- [49:25]
Dr. Shelby Harris
Yeah. And then the third thing I would say is if you're. Because a lot of people are doing all the sleep hygiene things, right? They're limiting the alcohol, the caffeine. They've heard about it. If that's not working after two weeks, then I would say 100%, go get an evaluation for sleep apnea or insomnia or something, and there's better treatments out there.
- [49:41]
Guest
All right, So I want to go over social media. You know, it has a lot of sleep suggestions.
- [49:47]
Dr. Shelby Harris
A lot of the interviews I do for big newspapers are, like, commenting on TikTok and Instagram trends.
- [49:54]
Guest
Okay. We're going to comment on some crazy. And if there's any other ones I want to hear, you know, that you might. You might have. But we'll see about these. Let's do the myth busts.
- [50:02]
Dr. Shelby Harris
Yeah.
- [50:03]
Guest
Women need less sleep after 40.
- [50:06]
Dr. Shelby Harris
No, no. Like a lot of. If you see a doctor who tells you that it's normal to sleep less as you get older, find a new doctor.
- [50:13]
Guest
Really? I've heard that tons of people.
- [50:14]
Dr. Shelby Harris
Oh, my gosh, it's so wrong. So, yeah, we typically get a little less sleep. We're talking like, half hour maybe, if that sometimes as we get even older, we might nap during the day. Older adults might nap, so that might be a little less, but it's within 24 hours. It's the same. You should not be getting drastically less than you ever got before. It should be the same. And if you're noticing a problem and you're really having trouble during the day, definitely get evaluated.
- [50:38]
Guest
Isn't it crazy sometimes these are just sentences that are out there and statements that are out there with no backing whatsoever that we've just repeated forever, and.
- [50:46]
Dr. Shelby Harris
It'S such a shame. It does such a disservice to so many people.
- [50:49]
Guest
Well, we're gonna. We're gonna make sure we do a service. We're working on that, Dr. Shelby. All right. Too much cardio can keep you awake.
- [50:57]
Dr. Shelby Harris
If it's close to bed, it can. So within three hours of bed, you want to try and limit really intense cardio. But in general, it's not a bad thing during the day.
- [51:05]
Guest
And you do stretching, right?
- [51:06]
Dr. Shelby Harris
I do stretching right.
- [51:08]
Guest
20 minutes of sunlight on your eyelids during the day helps you sleep.
- [51:13]
Dr. Shelby Harris
I would argue more than 20 minutes. So you should try to have some light during the day, and then you wanna keep it dark at night. Just kind of like. I always think, like, how did we live when we were in a cave?
- [51:25]
Guest
I know.
- [51:25]
Dr. Shelby Harris
That's how I always think about it.
- [51:26]
Guest
It always does go back to basics in so many different ways, doesn't it? We all need blue light glasses for our screens at night.
- [51:33]
Dr. Shelby Harris
Debatable. So I would say just stay away from the screens because we're getting sucked in. But I don't know that you necessarily always need them.
- [51:40]
Guest
I think we are, too. I have a question. Do you have any success story that has kind of stuck with you of somebody that's turned their sleep around in a really great way?
- [51:48]
Dr. Shelby Harris
Yeah, I mean, I've had so many. I mean, it's. That's what I. That's why I absolutely love doing what I do, is because there are people who really thought that there was nothing that they could do for so long, and they've tried all the sleep hygiene, and then they come and we do some CBT for insomnia, maybe some other work, and they're sleeping so much better. But I can think of someone that I saw, I just finished with maybe a month or two ago, who was on a lot of sleep medications, a lot of medications over the years, and was just on Xanax and just a combination of things. And over time, it wasn't a simple, super simple treatment because we had to do it with the prescriber and slowly kind of taper off. But now she's not on any medication. She's sleeping so much better. And it was just by making behavioral changes and changes to tolerating a bad night, which I know sounds terrible, but we fear that bad night so much that then you just keep taking medication. So getting. Helping women really sleep better without necessarily having to rely on medication. And this patient, I mean, she's doing so much better, and you can just see how happy she is. Like, now that she doesn't have to rely on meds, beds, or just is sleeping just so much better on our.
- [52:58]
Guest
Own, I wonder, do you feel encouraged by the amount of conversation that sleep is getting? I have to imagine when you started this practice years ago, and even, you know, over time, people were like, I'll come to you if I have a problem.
- [53:11]
Dr. Shelby Harris
Yeah.
- [53:11]
Guest
But really, it has been taken on a life of its own. In terms of people understanding the importance of sleep, would you say?
- [53:17]
Dr. Shelby Harris
Yeah, 100%. But I think it almost has swung sometimes a little too much in the opposite direction, where people are so obsessed with it that it's like, they don't think that they can ever have a bad night. And that's why I'm always like, once in a while, I don't sleep well. And that's completely normal. It's. How often are you having those bad nights? Right. But the thing that I think is really interesting is that I am having more and more people in my practice who are in their 20s, very late 20s, early 30s, who are coming for sleep treatment, which I never really saw before, because people are starting to really recognize the importance of sleep and good sleep and how it can really build over time to help just with health in general. So that. That, I think, is really important.
- [53:57]
Guest
I think it's great. I'm seeing younger people all the time that want to have these conversations in a bigger and a better way. What is it that they. What is it that they take away most of all from? Everything is usually being able to do the CBT therapy that helps them.
- [54:11]
Dr. Shelby Harris
Yeah. A lot of them don't want to go. Even start to go down the medication route. There's just a different. I don't know, there's a different. Different flavor to some of these patients and the younger population, too. A lot of the people I'm seeing are like, I want to start having a. Maybe getting pregnant or. And we know that sometimes insomnia and sleep deprivation can actually change or actually make it harder to conceive and make pregnancy harder. So these people, a lot of these patients are thinking more proactively. I don't want to have to rely on medication when I'm pregnant or when I have a baby and all that sort of stuff, which I think is.
- [54:41]
Guest
Really interesting parting words for people that say, okay, I want to sleep. I want to get a good night's sleep. I don't want to rely on meds. But, you know, it's been hard for me.
- [54:50]
Dr. Shelby Harris
Yeah.
- [54:50]
Guest
What do you say to them?
- [54:52]
Dr. Shelby Harris
Talk to people who know what they're talking about and don't just get brushed off. So really like try like we talked about the sleep hygiene stuff, but if it's not enough, we have there are really amazing providers out there and there is a lot of help and a lot of treatments that we have available for different sleep disorders. So definitely get evaluated because it's not worth going through life just like not sleeping well when we can actually help you.
- [55:15]
Guest
Dr. Shelby, thank you. I'm still looking forward to this conversation. I'm sad it's over.
- [55:18]
Dr. Shelby Harris
I always love talking sleep with you. Thank you.
- [55:20]
Guest
I feel the same way. Thank you. I really hope Dr. Shelby's advice helps you walk away with a little more clarity and a lot less guilt about what it really takes to get better sleep. Trust me, it's going to take some time at least though. These are some of the tools that you can get started using today, tonight, and please give yourself permission to put yourself first. You can find all of our resources in the show. Notes if you love this episode and got anything from it, please do me a quick favor and leave a review or share it with somebody who's up at 3am thinking she's the only one. I'm Tamsen Fadal and I'll see you next Wednesday. The Tamsen show is an original production by Authentic Wave executive producers Scott Weinberger, Kevin Bennett and Rebecca Grierson Brand Director Johanna Ofsnik. Our line producer is Sabrina Sarre. The views and opinions and information shared by guests on the Tamsen show are their own and do not necessarily reflect the views of Tamsen, Fadal or the production team. This podcast is for informational purposes only and is not a substitute for professional medical, legal or financial advice.