Why Sleep Is Vital for Your Health and Hormones

Why Sleep Is Vital for Your Health and Hormones, The Healthiest You podcast, May 2023

Steph Wells (00:00):

Do women need more sleep than men?

Mike Kelly (00:03):

How can hormones affect sleep?

Steph Wells (00:06):

Is a bedtime snack good or bad?

Mike Kelly (00:08):

All that and more on this episode of The Healthiest You.

Steph Wells (00:12):

Women are twice as likely compared to men to have insomnia or have trouble falling asleep and staying asleep at night. That's why a solid bedtime routine is important. Now, Mike, in our business, bedtime is what it is. You get as many hours as you possibly can.

Mike Kelly (00:30):

Usually, it's while you're at work.

Steph Wells (00:31):

While you're at work. And so, my bedtime routine typically is, I go to bed whenever my kids do, it's anywhere between 9:00 and 10:00, and then I get up in the morning depending on what I have to get accomplished.

Mike Kelly (00:42):

I don't know about you, but I notice like a certain amount of time if I get past 9:00, I'm up till 11:00.

Steph Wells (00:47):

Yes.

Mike Kelly (00:47):

But if I go to sleep at 9:00, I wake up around 3:00 or 4:00. I kind of have to jog that in there. Make sure I can get enough sleep, at the same time getting a good sleep because that's very important.

Steph Wells (00:57):

But do you have a snack or like a glass of water or something [inaudible 00:01:00] need to?

Mike Kelly (01:00):

We're already on food.

Steph Wells (01:01):

Well, I mean they asked if a bedtime snack was good or bad.

Mike Kelly (01:04):

Already.

Steph Wells (01:04):

OK, moving on.

Mike Kelly (01:05):

No snack for me.

Steph Wells (01:06):

So we'll be focusing on women's health and wellness in this new season of The Healthiest You podcast. Whether you're on your way to work or enjoying a cup of coffee, take this time to focus on your health. Here to talk about women's sleep health is Dr. Aileen Love, pulmonologist and sleep medicine specialist with Lehigh Valley Health Network. Dr. Love, welcome to the show.

Aileen Love, MD (01:28):

Thank you so much for having me.

Mike Kelly (01:30):

Hey, on average, how many hours of sleep should women get every night?

Aileen Love, MD (01:36):

So the American Academy of Sleep Medicine recommends that individuals get at least seven hours of sleep per night. Typically, people want to aim somewhere between seven and nine hours of sleep. Now, if you're getting non-restorative sleep, having episodes where, for instance, you're pulling all-nighters, whether you work in medicine or you work in radio, then in those circumstances you may need to get more sleep than seven to nine on those occasions. But seven to nine is a goal to strive for on a daily basis.

Steph Wells (02:07):

Do women need more sleep than men and how much?

Aileen Love, MD (02:10):

So women do sleep a little bit longer than men do. There have been data demonstrating, for instance, in a study looking at over 50,000 people that women slept, on average, 11 minutes longer. But the question really is why are women needing more sleep? And that really has to do with the types of lives that women live. Their sleep can often be more fragmented because they are caregivers for children and as we get older, parents. And we also struggle between balancing the paid work we do at our day jobs and the unpaid work that we do when we're at home with our families.

Steph Wells (02:50):

Mm-hmm.

Mike Kelly (02:50):

And why is sleep essential for a woman's health?

Aileen Love, MD (02:53):

So I think it's important to think of sleep as being essential for everybody's health, but particularly for women, we know that we are in increased risk for having depression and anxiety, as you noted earlier on the show. We also know that sleep deprivation can be associated with increased risk for motor vehicle accidents, poor daytime performance, and also cardiovascular disease. There's a growing body of research looking at the glymphatic system, which is basically the circulating cerebrospinal fluid. I think of it as the street-cleaning system of our brain. And when we get enough sleep, it helps to kind of usher up all these harmful proteins and get them out of the cerebrospinal fluid. When we don't get enough sleep, those harmful proteins can potentially build up, and over the long run may be associated with some cognitive issues down the road. And so sleep is really imperative, not just for how we feel today or tomorrow, but how we may be feeling 10 or 15 years from now.

Steph Wells (03:54):

Wow. What are some ways women can improve their sleep?

Aileen Love, MD (03:58):

So I think the essential part of getting a good night's sleep is in part having a good bedtime routine. So you want to really try to aim to go to bed and wake up at the same time every day. Which can certainly be a challenge when you're juggling a job and a family, but it's certainly something to strive for. Regular exercise is really key to getting a good night's sleep. There's data that shows having 30 minutes of high-intensity exercise three times a week can really make a difference in terms of offering neuroprotection. And then finally, finding ways to wind down at night. So I'm counseling patients frequently about stopping the doom scrolling at night. Don't dive into the Facebook, the TikTok. Put your phone down, turn off the TV, try mindful meditation. It can be really, I think, challenging to do, but if you are able to lie still and focus on your breathing and relaxation techniques for 10 minutes, it can really make a difference.

Mike Kelly (04:59):

Dr., you mentioned some great tips on how to get a better sleep. What is a good bedtime routine?

Aileen Love, MD (05:04):

So you really want to try to go to bed at the same time every day and wake up at the same time every day. Now, most of us have a typical circadian rhythm where we're going to fall asleep at around 9:00 or 10:00 at night and want to wake up somewhere between 6:00 or 7:00 in the morning. Our bodies are intimately tied with the sun rising and the sun setting, but there are those of us who have advanced sleep phases. Particularly as we get older, we may want to go to bed earlier and wake up earlier. And then anybody who has teenagers knows, they like to stay up late and sleep late. At the end of the day, what you really want to get is that seven to nine hours of sleep.

(05:41):

If you are working a shift work job where you have to get into work early or if you have to go into work late, then you have to develop coping mechanisms for that. For instance, if you have an early shift, you might really want to try to limit your exposure to light at night so that you're not sending signals to your brain that the sun is out and that you should stay up. Similarly, if you're working night shift, there may be a role for strategic napping before you go into work and also potentially even napping before you come home to reduce the risk of motor vehicle accidents.

Steph Wells (06:14):

I clearly have not developed that coping mechanism yet myself. What are the stages of sleep and their purpose, and which one is most important to a woman's health?

Aileen Love, MD (06:24):

So there are four stages of sleep that we'll typically score on in laboratory sleep study. Stage one is early sleep when you're sort of drifting in and out. Stage two is where we spend the majority of our night. And stage three is really this restorative sleep. It's called delta sleep. It's slow-wave sleep. It's that stage of sleep where you lift the baby from the car seat to the crib and they don't really stir. And then finally, there's rapid eye movement sleep, which sometimes people mistakenly think is deep sleep, but it's actually closest to wakefulness. However, it's the stage of sleep where we do our most vivid dreaming, and it can be associated with memory consolidation. All of this, having typical sleep architecture where you cycle through stages of rapid eye movement sleep, is really critical to a good night.

Mike Kelly (07:08):

Dr., I've heard that drinking tart cherry juice can promote better sleep. Is that true?

Aileen Love, MD (07:15):

So I think there's limited data that demonstrates that cherry juice can potentially be helpful in treating insomnia. But with any supplement, I think it's important to keep in mind that none of them are regulated by the FDA and that they certainly do not take the place of what have been tried-and-true evidence-based practices for improving sleep, which include maintaining a good sleep schedule. And for individuals who suffer from insomnia, cognitive behavioral therapy for insomnia.

Steph Wells (07:45):

I'm glad I got this next question. Is eating a snack before bed good or bad? And are there healthy snacks you recommend?

Aileen Love, MD (07:53):

So there are some patients for whom taking a snack at night may be beneficial. For instance, there are diabetics who may suffer from low blood sugar on the middle of the night, and so they're counseled to have a complex carbohydrate or a protein snack close to bedtime to prevent their sugar from dipping. For most of us, however, a bedtime snack is not necessary, and it really does prompt us wading into some dangerous territory. When we reach for snacks at night, we'll sometimes reach for the ones that aren't particularly healthy, the salty, fatty, or delicious bowl of ice cream, which tastes great going down but may not really help your waistline. There is a growing body of literature that demonstrates that our eating habits should really be tied to our circadian rhythm. And then if we limit our eating really more to 9 or 12 hours a night, we'll be better off than sort of grazing over the 16 to 18 hours that we could potentially be awake.

Mike Kelly (08:50):

What foods or drinks should be avoided before bedtime?

Aileen Love, MD (08:53):

So we would definitely counsel against eating heavy, fatty foods at night. It's not a time to have a T-bone steak. Similarly, I would really advise patients against drinking alcohol close to bedtime. Patients will often say to me, "But my grandmother always had that nightcap of blackberry brandy." Don't do it. Alcohol will help you fall asleep, but it's not going to help you stay asleep. So you're really better off potentially having a cup of chamomile tea than having the alcoholic beverage.

Steph Wells (09:28):

Side sleeping or sleeping on your stomach or back, which is healthiest, and are there sleep positions you should avoid?

Aileen Love, MD (09:37):

So you really want to sleep in a position that's going to be comfortable for you. So as we get older, we get aches and pains. If you have a bum shoulder or a bad knee, you really want to sleep in a position that's not going to aggravate that pain. That's probably the most important step in finding a good night's sleep because if you're suffering from pain because of your joints hurting, well, your sleep will be fragmented. There is a group of patients who have obstructive sleep apnea, and their sleep-disordered breathing tends to be worse when they're on their back. You've got gravity working against you and your upper airway is collapsing in on itself when you're on your back. And for some patients whose sleep apnea is positional, sleeping exclusively on their side can occasionally be a reasonable treatment option for them. I'll advise them to get a fanny pack, put tennis balls in it, turn it around so the balls are on their back, and every time they go to roll, they'll hit a tennis ball and that will push them back onto their side.

Mike Kelly (10:33):

Now, I love a good nap in the afternoon, but the question is, is it healthy for you?

Aileen Love, MD (10:43):

So for certain patients, napping can be helpful. I think for young mothers who are having frequently fragmented sleep at night, whether they're nursing for a baby or getting up with young children who have fragmented sleep, you're really talking about survival. And so if you're napping when the baby naps or when your kids nap so that you can function and drive safely, I think that's reasonable. Shift workers will sometimes need to nap. And then there are patients who have certain rare sleep disorders, such as narcolepsy, where we talk about strategic napping as a way of coping and getting through their day. But for most of us who are able to maintain a regular sleep schedule, there shouldn't necessarily be a role for napping. And you can run into trouble with napping.

(11:24):

So you come home from work, you sit on the couch, you doze for an hour between 5:00 and 6:00, and the next thing you know, you've delayed your ability to fall asleep at night. You're going to bed at midnight instead of maybe going to bed at 10:30, but you still have to get up at 6:00 or 6:30 in the morning. And so you're ultimately truncating the total amount of sleep you're getting at night and contributing to sleep deprivation.

Steph Wells (11:46):

This next question describes me. Some women may experience tiredness during the day, but then get a boost of energy at night when it's time to be going to bed. Why does this happen?

Aileen Love, MD (11:59):

So it's very natural for all of us to feel a dip in the midday. Part of it has to do with the fact that there's a drop in the circadian rhythm and there's a rise in our homeostatic drive for sleep, which is basically our internal clock saying, "Please go to bed." And it just keeps ticking upward as the day marches on. Once we sort of get past that little bit of a dip, then our energy may rise. And oftentimes in the evenings, we're faced with stressors that have the potential to raise our cortisol levels. So you're dealing with family stress, trying to sort of get kids to bed or deal with elderly parents who you may be taking care of, and all of that can contribute to sort of a second wind.

Mike Kelly (12:41):

I have two questions for you here. What sleep problems affect women the most, and then how are they diagnosed?

Aileen Love, MD (12:48):

So insomnia is a very common problem among women, and the risk of it increases as we get older. And in fact, a lot of women will develop insomnia as they go through perimenopause and menopause, and it can be triggered by a variety of reasons. One may be that they start to develop hormonal changes that result in hot flashes, so they'll have an increase in night sweating that fragments their sleep. Women can also develop sleep apnea when they begin to go through that hormonal shift as their estrogen levels drop and their rise of follicular stimulating hormone goes up, they're at increased risk for developing upper airway obstruction.

(13:30):

And then, finally, women can develop restless leg syndrome. It's something that we sometimes see in women who are going through their first pregnancy. So suddenly their iron stores drop and their legs feel restless. We know that there's an intimate connection between iron deficiency and restless leg syndrome. And so maintaining a good iron store can really be a key to that. Medications can also trigger restless legs. And since women are more apt to develop anxiety and depression than men, they're often put on medications that can aggravate leg movements of sleep.

Steph Wells (14:04):

When is it time to consider having a sleep study done?

Aileen Love, MD (14:09):

So, certainly, if you have a bed partner who tells you that you're snoring or witnesses you stop breathing at night, that would be a good indication for seeing your primary care doctor or sleep specialist and being evaluated for a sleep-disordered breathing. The majority of sleep testing that we do here is to look for obstructive sleep apnea. We can do the testing at home. We can also, on occasion, do the testing in our sleep lab. What the sleep studies do if we're looking for sleep apnea is, we're looking at respiratory effort and the flow of air in the upper airway and oxygenation, and whether or not your oxygenation is dropping in response to obstructive events. And it's important to really diagnose sleep apnea because we know that untreated sleep apnea can be associated with poor daytime performance and sleepiness and is also, in severe cases, associated with cardiovascular disease. And so getting a jump on that can really be helpful in potentially primary prevention down the road.

Mike Kelly (15:10):

I am learning so much new information here. I've got to ask you though, why do women struggle more than men with insomnia or falling asleep, and then staying asleep?

Aileen Love, MD (15:20):

I think a lot of it may have to do with the fact that women are juggling paid and unpaid work, and so their time is more limited, and often are facing different stressors than our male counterparts are. I also think that women have more fragmented sleep that starts from a relatively young age. Often from the time we become pregnant, we start to develop fragmented sleep. We're carrying a baby, we can't get comfortable. We're getting up in the middle of the night to go to the bathroom, and then we have the baby, and then we're getting up in the middle of the night to nurse the baby. And then the baby is not sleeping because they're not a baby anymore, but they're still not sleeping at 3:00 or 4:00 and they come to mom, and you have to go back and help them get back to bed.

(16:06):

And so we get into this cycle of having fragmented sleep from our 20s and 30s. And unfortunately, when we think about insomnia, there's sometimes a genetic predisposition, but then there's often a precipitating event, and it could be the onset of motherhood, and then it perpetuates bad sleep habits. So what I often try to advise patients is, "Yes, you're in a period of survival right now and we have to get through it. But as soon as you can get your child on a regular sleep routine, this is your opportunity to do the same thing for yourself."

Steph Wells (16:37):

So the key is to get men to do more unpaid work? Well, strike that from the comments, thank you very much. Does interrupted or broken sleep affect women more severely than men and how so?

Aileen Love, MD (16:50):

So I think the bigger issue is that it happens to women potentially more often than men. And so as a result, they're going to be more symptomatic from it.

Mike Kelly (17:02):

What triggers restless leg syndrome, and what are the signs a woman may have this?

Aileen Love, MD (17:07):

So one of the more common reasons women develop it is because of iron deficiency. And so in my practice, I'm frequently checking ferritin levels that look at your underlying iron stores to see whether or not they're low. Women in pregnancy will suddenly find that their legs have this creepy-crawly sensation. They just can't get comfortable, they constantly have to move them, and the symptoms get worse as the night wears on. You replete the iron stores and their symptoms may get better, or they have the baby and their iron stores get repleted and their symptoms get better.

(17:37):

There can be other reasons, however, why patients develop restless leg. Medications can certainly trigger them, particularly antidepressants. And then there are a group of patients who develop restless legs, we call it idiopathic. But there are certainly treatments out there for it. Particularly if the RLS symptoms are disrupting your ability to fall asleep, we'll treat those symptoms with either gabapentin, which is a neuropathic pain medication. We'll sometimes also prescribe certain Parkinsonian drugs such as Mirapex, which would also be helpful.

Steph Wells (18:12):

You sort of already answered this question, and I'm going to ask it again only because I think this is something that my mom is dealing with. Ways in which to prevent or treat restless leg syndrome, you had mentioned some of them just moments ago. An iron supplement, something like that, is that also...

Aileen Love, MD (18:27):

So I think the first step is checking your iron stores. So you certainly don't want to be taking iron supplementation if your iron stores are, for instance, a ferritin level greater than 75 because there's always the risk of iron overload. So it's essential that your iron be checked first before you indiscriminately start taking the supplement. But that is one of the key tests that I will order as part of a workup for restless leg. I'll also make sure that patients aren't bleeding. So in younger women, we associate iron deficiency with menstruation. As we get older, you can have other sources of bleeding, including from the gastrointestinal tract. And so frequently in my sleep clinic, I'll be screening patients on whether or not they're up to date in their colonoscopy.

Mike Kelly (19:10):

Should women be concerned about snoring?

Aileen Love, MD (19:13):

So certainly snoring can be a symptom of obstructive sleep apnea. And so if it's relatively new in onset, and if it's associated with weight gain, if you have a bed partner who tells you that you stop breathing, then it's probably worth investigating it further and seeing whether or not you may have obstructive sleep apnea by talking to your primary care doctor or seeing a sleep physician.

Steph Wells (19:33):

What is mouth taping? Is it safe and a good idea for those who snore?

Aileen Love, MD (19:39):

So I do not recommend mouth taping. It has been used to help treat asthma by encouraging breathing through the nose, and some people have used it to potentially treat snoring. There's no great data to support its use. The tape has potential to be irritating to your skin.

Steph Wells (19:57):

Oh, so you're taping your mouth closed.

Aileen Love, MD (19:59):

Correct.

Mike Kelly (19:59):

Yes.

Steph Wells (20:00):

Oh!

Mike Kelly (20:00):

Can you do that at work with a fellow co-worker?

Steph Wells (20:03):

Only on selected Wednesdays.

Mike Kelly (20:05):

Selected hypothetical question.

Steph Wells (20:06):

OK.

Aileen Love, MD (20:06):

If you try it out, let me know how it works.

Steph Wells (20:09):

Unbelievable.

Mike Kelly (20:10):

Dr., how common is sleep apnea in women? What treatment can help?

Aileen Love, MD (20:14):

So when women are premenopausal, the rates of sleep apnea are lower. When we go through that hormonal change and our estrogen levels drop, our rates of sleep apnea match our male counterparts. And so the estimate rate of sleep apnea among women in North America is between 10% and 15% of all women.

Steph Wells (20:34):

Can magnesium help women sleep better? And do you recommend a magnesium supplement or magnesium drink mix?

Aileen Love, MD (20:42):

I do not typically advocate for supplemental treatment. There's not great data that supports their use. There are small studies looking at these supplements, and I always keep in mind that these supplements are not regulated by the FDA. And generally speaking, a supplement is not going to replace the tried-and-true evidence-based guidelines that have been put forth by the American Academy of Sleep Medicine on good sleep hygiene and in cases of insomnia, cognitive behavioral therapy for insomnia. And in cases where that doesn't work, occasionally hypnotic medications.

Mike Kelly (21:22):

Now, you said you didn't like the magnesium supplement, but are there other supplements you recommend for women to get a more restful night of sleep?

Aileen Love, MD (21:29):

So there are other supplements that people have tried, and again, like the tart cherry juice, people will try chamomile tea. There's a limited amount of evidence to support all of this. What I usually tell patients is that, "It really requires a careful review with your primary care doctor just to make sure that whatever you're taking isn't going to interact with the medications that you've already been prescribed."

Steph Wells (21:52):

How do hormones affect sleep in women?

Aileen Love, MD (21:56):

So as we get older, our estrogen levels will drop when we're going through menopause and that can certainly increase our risk for sleep apnea. It can also increase our risk for insomnia as we develop hot flashes potentially and other vasomotor symptoms of menopause. The other thing to keep in mind is that women are often juggling a lot of stressors. We have, oftentimes, jobs that we get paid for and then we have unpaid jobs at home, whether we're caring for children or caring for parents. And that can cause, sometimes, a dysregulation of cortisol, which is our flight-or-fight response hormone. As a result, that can lead us to crave unhealthy foods. And those cravings for unhealthy foods can lead us to reach for those bed night snacks that aren't necessarily healthy. And we can often get ourselves into a bit of a vicious cycle.

Mike Kelly (22:52):

Does hormonal birth control, such as the pill, impact your sleep?

Aileen Love, MD (22:57):

So there's really mixed data on whether or not oral contraception is helpful or harmful in terms of sleep. I certainly wouldn't choose a hormonal contraception because I think it's going to either improve my sleep or not. The choice of birth control that you use as a woman should be determined based on a conversation with your doctor and your partner.

Steph Wells (23:18):

Women go through so many changes throughout their lifetime from menstruation, to pregnancy, to menopause and beyond. How does sleep change throughout a woman's life, and are there tips to adapt to each new phase of life and the sleep challenges that may come with them?

Aileen Love, MD (23:35):

So I think one of the biggest challenges to sleep for women is when they have their first baby. It's probably one of the biggest traumas that women go through in life. And there's extreme sleep fragmentation that can come from that and the stresses of trying to nurse and feed your baby. And children, first six weeks don't even have a circadian rhythm that they follow, their sleep is utterly erratic. And so during those first few years when you're caring for young children, you really want to focus on trying to get sleep when you can. And when you can get your child on a more regular sleep routine, try to get yourself on that regular sleep routine as well, so that the erratic sleep that you may be experiencing early on in motherhood doesn't carry through when your child is 6, 7, 8 years old.

(24:29):

As we get older and we hit middle age and experience the hormonal changes of menopause, again, maintaining a regular sleep routine is really important. And exercise can really be key as a stress management tool and also improving sleep. By exercising, we can reduce our cortisol levels, and it can help us to sort of burn off that nervous or anxious energy. I talk to a lot of patients at their change of life about making worry lists. So if you have racing thoughts at night because you have so much on your plate, write down everything. Sit at your kitchen table at 8:00 at night, write it all down, get it all out. It'll be there for you tomorrow morning when you wake up, but you're not taking it to bed with you.

Steph Wells (25:13):

That's a great idea.

Mike Kelly (25:15):

This is the worst, when you wake up and you are just sweating for no apparent reason. What causes night sweats and is there anything that can help?

Aileen Love, MD (25:25):

So in women, probably the most common reason for night sweats is they're going through menopause, and they have an increase in a dysregulation of their hypopituitary axis and some thermal dysregulation associated with it. Now, night sweats can be quite disruptive to sleep. And if they are significantly impacting your quality of sleep, there are treatments available. So if you find that the night sweats are really disruptive for you, it's worth a conversation with your doctor about whether or not you would be a candidate for hormone replacement therapy. And even if you're not, there are other drugs that are available that may be effective, including some antidepressants and even neuropathic pain meds like gabapentin.

(26:13):

For others, night sweats can be a sign, however, of other disease processes. And so I think it's important to keep in mind not to attribute every night sweat to necessarily menopause, particularly if you're 10 years out from going through that change in life. There could be other reasons why you're experiencing night sweats, including infections and sometimes more serious illnesses such as cancer.

Steph Wells (26:37):

And the next question kind of falls into that. How does poor sleep affect the immune system?

Aileen Love, MD (26:43):

So we know that not getting enough sleep can cause dysregulation of the immune system and put you at increased risk for developing cardiovascular disease. There may even be an association between decreased sleep and cancer. The key is trying to get those seven hours of sleep at night, which can really be challenging.

Mike Kelly (27:02):

Now, I'm guilty of scrolling my phone, binge-watching more TV prior to bedtime. Do blue light glasses help prevent sleep disruption or is it time to toss the TV out of the old bedroom, put down my phone, and do that at least one hour before bedtime?

Aileen Love, MD (27:17):

So it would be my recommendation that you turn off the TV, move it out of your bedroom and put down your phone. I never recommend blue light screens for patients because if you need to use a blue light screen, you probably shouldn't be using your electronic equipment at all. And I think that a lot of the social media that we use and the light that it's admitting can really be disruptive to our ability to relax, clear out our minds, and try to go to sleep. The only time I will recommend that patients consider using their phone is if they're going to be using it for a mindful meditation app.

Steph Wells (27:54):

Can sleep habits or a lack of sleep affect a woman's weight?

Aileen Love, MD (27:59):

So, yes. We know that if you're not getting enough sleep, you can sometimes have a rise in some of our stress hormones and then that leads us to binge-eating or craving unhealthy foods. And as a result, we reach for those unhealthy snacks and that's not good for our waistline. Certainly, there's a growing body of research that suggests that timing what we eat plays an important role in terms of maintaining a healthy weight.

Mike Kelly (28:29):

Dr., I'm sure you've done this. Being a doctor, you've probably pulled all-nighters at one point or another. I think everyone I know has pulled an all-nighter, or some are just natural night owls. What happens to your body or brain after staying up all night?

Aileen Love, MD (28:46):

So I think that there are two separate questions here. The first is what happens if you have to do the all-night shift, or you spend 30 hours up because your kid's sick and you just can't get any rest? In those circumstances, you'll eventually crash and fall asleep, and that is normal. You'll likely have a rebound of rapid eye movement sleep, and that is normal. Generally, when people are up for 24 hours, they'll recognize that their ability to function, their reactivity time, is diminished, and that is normal. That is not the time to get behind the wheel of a car and drive. It's probably best to just try to get some sleep. You could probably fall asleep with the sun shining out because your homeostatic drive for sleep is so strong at that point in time.

(29:37):

There are some people, however, who by nature are what we call night owls. The official term in sleep medicine is delayed sleep phase syndrome. And there's nothing wrong with that. There's this sort of natural curve of where people shake out. Most of us want to go to bed at 10:00 and wake up at 7:00, but there are those who are early birds and those who are night owls. The only time being a night owl becomes an issue is if it doesn't jive with what your day job is. So if you are a night owl but you have to get to class at 7:00 or 8:00 a.m., or you have to be at work at 7:00 a.m., that's when you're going to run into problems.

Steph Wells (30:13):

Is a regularly late bedtime harmful to a woman's health?

Aileen Love, MD (30:19):

So I think the problem with the late bedtime is that the wake time doesn't shift accordingly. So we stay up late because we have to get the kids' lunch ready, because we have to prepare for that meeting tomorrow. Because we just feel like we need a little time for ourselves, and the only time to do it is between 11:00 and midnight because everybody wants something from us before that. But we still have to get up at 6:00 in the morning to get everybody ready for school and for work. And as a result, we're truncating our total sleep time. So you're probably better off trying to go to bed a little earlier and get at least that seven hours of sleep at night.

Mike Kelly (30:55):

Now, you were saying earlier, seven hours of sleep, but when is the best time for women to go to bed for optimal rest?

Aileen Love, MD (31:03):

So for most of us, our circadian rhythm wants us to go to bed between 9:00, 10:00 in the morning, excuse me, at night, and then wake up around 6:00 or 7:00 in the morning. But there's going to be natural variation and there will be some who like to go to bed a little bit earlier, and there's some who go to bed a little bit later. I think it also is going to be dependent on what your job is as well. So for most of us, the sleep schedule that I laid out, 10:00 to 7:00 is probably going to work, but for some of us a little later, OK as long as you're getting those seven hours.

Steph Wells (31:37):

What are your best tips to get quality sleep and have sweet dreams instead of nightmares?

Aileen Love, MD (31:42):

So I think “A.,” having a regular sleep schedule is really important. “B.,” exercising, really important. Get 30 minutes, three days a week of high-intensity exercise if you can. If you can't do that, then find other ways to incorporate walking into your daytime routine. Park far away from where your office is so you get a 10-minute walk in and out. Go for a walk with your family now that the weather is getting warmer after work, or take the dog for a walk if you have a pet at home. And then finally, stress management is going to be really important in terms of getting a good night's sleep. So making worry lists of the things that are on your mind so that you'll leave them there on the table, you're not going to take them to the bedroom with you.

(32:26):

And then finally, I think finding ways to relax your mind, whether it's a hobby, crochet, jigsaw puzzles. Turning off the phone, turning off the social media, and finding activities that don't involve blue light, that can be relaxing for you. Mindful meditation can really also be helpful. I've done it with my own daughter, and it's remarkable how kids are really able to be in the moment, and it's contagious. Do the activities with your children if they're open to it. Treat it as a family activity; it helps everybody get a better night's sleep.

Steph Wells (32:59):

That's fantastic. Dr. Love, thank you so much for joining us today.

Aileen Love, MD (33:02):

Thank you for having me.

Steph Wells (33:04):

To schedule a sleep study, visit LVHN.org/sleepstudy, or learn about more services offered at Lehigh Valley Health Network at LVHN.org/pulmonology. Remember to subscribe or follow The Healthiest You wherever you get your podcasts, so you never miss an episode.

Mike Kelly (33:20):

And remember, be safe, be smart, be the healthiest you.