The Livy Method Podcast - Let's Talk Psychology of Sleep with Dr. Beverley David - Fall 2024

Episode Date: October 1, 2024

In this episode, recorded on October 1st, 2024, Gina talks about the psychology of sleep with Dr. Beverley David. Dr. Beverley is a Clinical Psychologist registered with the College of Psychologists of Ontario. She also holds a Ph.D. in Sleep Research (Insomnia) and a Master's in Health Psychology.You can find the full video hosted at:https://www.facebook.com/groups/livymethodfall2024Topics covered:How does sleep factor into your weight loss journey? Introducing Dr. BeverleySleep is the pillar of wellbeingConsistency and regularity: What does good sleep look like? Sleep and mortality and the connection to health conditionsSleep as a "luxury" and self-medicationThe impacts of being sleep-deprived on memory, impulse control & hormonesStages of sleep: Give yourself the opportunity to get 7-9 hours of sleepCan you catch up on sleep you have missed?What is your body doing when you are sleeping?The Livy Method and how it can support creating routine and improve your sleepDon't chase sleep and using a worry journal Hypervigilance on sleep - Stop trying to sleep! Paradoxical IntentionGood sleepers don't worry when they have a poor night's sleep. Defining insomnia versus being sleep-deprived and sleep apnea Building in more sleep opportunity Bathroom visits at night: strategies and training your bladderHave a cool bedroom; Peri-menopause and giving off heat at nightUsing devices to monitor your sleep perpetuates worry Menopause and Sleep: Getting back in touch with your sleep clockWhat is Cognitive Behavioural Therapy (CBT)?  Where to find Dr. Beverley DavidFind Dr. Beverley:https://www.yourpsychologycentre.ca/@drdrbeverleyTo learn more about The Livy Method, visit www.ginalivy.com. Hosted on Acast. See acast.com/privacy for more information.

I'm Gina Livy and welcome to the Livy Method podcast. This is where you'll have access to all of the live streams from my 91 day weight loss program. With a combination of daily lives, guest expert interviews and member stories, there is something new almost every day. Miss the morning live? Want to re-listen to one of our amazing guest experts? Well, this is the place. This podcast is hosted on Acast, but it's available on all podcast platforms, including the one you're listening to right now, Spotify, Apple,

and Amazon Music. This is an opportunity to become curious. And then some things, how do we help you feel less overwhelmed so you can continue on your journey? Keep believing in yourself and keep trusting the process. Just be patient. Everybody talking about sleep these days, probably because we're not getting enough sleep. But today I want to talk about how does sleep factor into your weight loss journey? And joining me today is the perfect guest to discuss this clinical psychologist, Dr. Beverly David is here, but she also has a background in sleep research. So I want to get into this conversation with her with you today. Hello, Dr. Beverly. Hi. Hello, Gina. Good morning.

This is one of your favorite subjects. This is one of my favorite subjects. I get very excited and extra nervous. I don't know why. Maybe it's because it matters to me. So like matters a lot. I suppose I'm always nervous when we talk, but this is, I love it. It's very important. I'm so, so pleased you've included it in the program and letting everybody know how important it is and how to prioritize our sleep is so important. So three cheers, three cheers for the with you and Alana and Dr. Alinka, even my mind has been blown to how important sleep is in someone's journey. And again, it's not necessarily quantity or how much sleep that you're getting, but the quality of sleep. But I really want people to understand today, we're going to talk sleep tips with Alana, how to get a better night's sleep. We're going to talk about how physically sleep is impacting the body and your weight journey with Dr. Alinko hormones and whatnot. But one of the things I've learned for you is how much sleep affects our brain and the choices that we're making, how we are feeling and all of that. So I want to get into

that conversation today. I also want to talk about that cognitive behavioral therapy piece along with sleep. So I know that this conversation is going to be the conversation people didn't know they needed to have. So you know our members. You know the Libby Method. You know all the things that they're doing to try to lose weight in all the healthiest of ways. How do you think this sleep conversation factors in? I think when we talk about sleep, we've got to first remember that sleep is an indispensable pillar. And when I say pillar, I would say the pillar, the pillar of all well-being. And it's not just luxury.

It's actually a fundamental building block to achieving and what you always talk about, achieving and maintaining health. So it's part of the whole thing. If we don't sleep, we don't survive. Mother Nature knows best. We are supposed to be spending at least a third of our lives asleep. And it's where very important things happen so that we can be busy humaning in the day. And it's gone very wonky. And we know why it's gone wonky. We can look back in history and pinpoint times where we've thought, oh, whoops-a-daisy, the invention of the light bulb has made us work longer and stay up longer. And so slowly, slowly, slowly, we've started to borrow from our sleep and push our sleep and displace our sleep,

thinking that it's just a thing and if we could be more productive during the day, that would be better. And actually now we're seeing the huge fallout with mental health, anxiety, depression, obesity. Everything could be improved if we went back to trying to prioritize good sleep. And you're right. Good sleep isn't just quantity. It's a mixture. it's quantity and quality um so so hopefully we'll be able to talk about that as well because some people um will worry a lot about their sleep and of course worry is is the enemy of sleep because as soon as we worry about it or we chase it or we become preoccupied with it if we're relying on the devices because we think it's telling us about our sleep,

we can create more of a problem. So yes, this hour is going to be fast and furious. It's going to be, yeah, sleep in a nugget. Okay. I was reading over some of the questions that some of our members asked and someone asked, what are the characteristics of a good sleep? And I'm going to combine this with what you're talking about historically. So let's say we go back in a day before we were all stressed out at work and working late and the invention of the light bulb. What, what, like, what is the, like the best possible human sleep pattern you could have? Like what, what, what, what are, what are we designed for sleep wise? If you take all of that other noise away, what would that look like? What a beautiful question. Very lovely question. I would say what, what actually preserves and

protects sleep and what we're forgetting to do now is just consistency regularity is the guardian of sleep and we do this a lot now we we push it a little bit later at the weekend we know that we have the that jet lag effect on a monday our children do it so if we were trying to prioritize one thing it would be that it would be consistency um planning our bedtime because often we haven't got a bedtime when we're adults so we might think oh I'll just put another episode on or I'll just you know press continue on Netflix and the thing is we're missing our sleepy cues we push past them and actually if we thought to ourselves okay my it's 10 o'clock 10 o'clock is going to be my bedtime then we then we are more likely to follow that and think okay got a half an episode left save it for tomorrow go upstairs do our bedtime routine and get to bed and that

regularity supports everything we've got a circadian rhythm in our clock and circadian means a little more than 24 hours, about 24 hours. And so that means we're not on a 24 hour clock, which means we need to try and help our body through daylight, our food intake, the timing of things, our timing of exercise to help and train us to keep us on that 24 hours, because otherwise we move a little bit. So regular bed, like a set bedtime and a set wake up time, because that's where the havoc starts to happen. Our body loves predictability. It wants to know what's what, it wants to know when when it's coming and then our body can come and support us um so that we we know when to start winding down we know when to um release our melatonin so that it's telling our body sleep is approaching um so regularity is the key and we'll all we all

know if we think of our children if we ever let them go a little bit later, we become aggravated. They become aggravated or irritated or grumpy or they lose their emotional regulation. And as adults, we're just the same. So we want to be queuing in. And again, that's another thing that we could do to be protecting our sleep, being mindful of ourselves, because when we're on our screens, when we're not mindful, we are missing that we're yawning or we're on our screens when we're not mindful we are missing that we're yawning or we're rubbing our eyes and these are really fundamental sleepy cues hypnagogic cues that are like oh I could sleep you know I think I could sleep and if you if you're sleepy which you're supposed to be by the end of the day that's how it works

we want to be going to bed, not thinking actually one more Downton Abbey, you know, one more episode of whatever it is. Because we're then we're really sacrificing it and we wake up and we have not allowed ourselves the opportunity to have the sleep we need. That's so important. I'm thinking about my own sleep. I don't think I've gone to bed at the same time, two days in a row ever. It's always like I'm staying up really late one night. And then it's only when I'm like really, really tired, I will make an attempt to actually go to bed early. So there's like absolutely of things you said on the top of this conversation. One is like looking at sleep as a luxury is one. The other is I want to, I want to dive into this concept that we'll, we'll sleep when we are dead.

Like a lot of us were raised. I'll just, I'll sleep when I'm dead. I'd like this. I'll sleep later. I'm just gonna. So. We'll die sooner if we don't sleep.

So we know that we know, and it's, and it's scary. And that's part of my part of my job is educating so that people take this very seriously, because it is serious. And we know that mortality rates that it relates, it relates to whether you're a very short sleeper or a very long sleeper. It has an inverted U-shaped curve. If you're sleeping far too long, often that might be indicative of that you're not well. So that indicates mortality or leads to greater mortality. And so does very short sleep. So we know that sleep is really important and how linked it is to all of those conditions that we are scared of. If we don't sleep well, they are more likely to come, the cancers, everything.

So it's important. This is your lifeline that we're supposed to plug in every night. Why do we have this concept that we don't need it or that it's supposed to be some luxury to have it it's it's probably where we are in society now I think I hope the pendulum is swinging back but doing more being busy the the idea that you know if you're sitting down or resting, you're lazy or you're not going after that thing you wanted. It's probably accidental messaging that we think that we should be always on the move. And then, of course, we wonder, well, why can't I sleep? You know, we've given ourselves no time in the day.

We've been busy, busy, busy, busy. And then, of course, we start to see self-medicating we think okay why why are people drinking more alcohol why are people looking for more cannabis intake why are people smoking more like why are people going to you know what why why why is pharmacology up and it's often because they're trying to to manage this and well it's eating it's having your cake and eating it it's gonna it's gonna cost us somewhere um and we we want to be thinking actually we want to start with sleep you know if we if we give sleep back to people well first of all as a psychologist when i did my first PhD in sleep actually prior to that

one of my first roles in the sleep lab was to sleep deprive people to see why do we sleep and often when we want to know why we do something we take it away okay so we would sleep deprive people and the very next night after sleep deprived night or even a very shrunken night, we immediately see changes. And it's very related to the prefrontal cortex initially. So impulse control goes out the window. And we tested this with the saltier foods or the higher fat content or the heavy carbohydrates, because we just, we want that. We are also very risky. So if we put them in a car simulator, they will drive faster and more reckless. We will bet more money if we,

you know, build up a sort of a simulator of a casino. And that's why Vegas works, you know, no natural light, no clocks, keep everybody up all night. And then we become just a little bit gung ho. So we want to be really careful. We also see immediate changes in hormones that manage our hunger as well as our fullness. So we miss them. We're hungry all of the time and our body doesn't tell us, OK, I've had enough. So that is a very powerful bit of sleep as as with the insulin sensitivity. So our ability to manage blood sugar levels further contributes to our body going wonky. And that's not even talking about our memory. So when we talk about what our brain is

doing, and this is our power, you know, this is a computer on top of our head. During sleep, we are washing our brain. It's like a sponge that through the day, we have accumulated all of this information and all of these toxins that through the night, we're clearing it. We're allowing all of these toxins and we'd wash it with flushing out. And it's really, really important. And we know that if we have shorter sleep, we wake up and it's not totally flushed. And that means it's harder to lay down new memories. It's also harder to retrieve memories. Our emotional regulation starts to play havoc. Okay, if we do have, we all know that if we've had a poor night's sleep, we're more edgy, we're more impatient. And that internal critic that I talk to you about often I'm so stupid I'm

so this I'm so that I'll never do this that internal critic volume is up and it's all about that we didn't get that essential amount of sleep during the night and I know what you're going to ask me now what is the perfect amount of sleep in a night? Well, everybody is different. Everybody. We are all so individual. But we want to be giving ourselves the opportunity for seven to nine hours. We want to hope to have that opportunity. If you're getting into bed at one o'clock in the morning and your alarm is going off at five, you haven't even got the chance.

And then through our sleep, there's going to be the stages. So it's not a state of just flatness. If we had you plugged in for an overnight study with our electrodes on very specific parts of your brain, we would be watching you go through stages. So through the night, we have stage one, we spend about 5% there. Then we have stage two, we spend about 50% there. That would be where your leg might be starting to flick.

You'll see spindles in your brain, you'll jolt. Then we go into the delta, the beautiful deep waves, which we now call stage three. And we spend about 15 to 20% there. And then REM sleep, rapid eye movement. So we spend 20 to 25% there. And this cycle goes stage one, stage two, stage three, stage two, stage one, REM. And it moves in and out around about 90 minutes for a cycle. And we often will take, when we look at a night, we take our deeper quantity first. So we see deeper levels in the first part of the night.

And then we finish off with more lighter stages and often a little more REM comes later, that rapid eye movement. And rapid eye movement is often known as the dreaming state. But we do dream in deep sleep. We just don't remember that. That's where our children, if they do suffer with night terrors, that's where they're having their night terror. So we don't want to wake them up. We want to be very gentle, very caring, make sure nothing's in their way, get them back to bed and they won't be distressed. They don't know it's happening. But in REM sleep, if I wake you up, if I see your eyes doing the REM, if I wake you up, you're more likely to say, oh, I was dreaming about swimming across Bob Lake. Okay, so you'll likely remember it.

Men will have an erection. We will tense. We will physically be paralyzed so that we don't act out our dreams. However, my dad does. He's broken his collarbone many a time. But so that would be something going a bit wonky with our REM where we're not supposed to act out our actual nighttime dreams. So those stages happen and they all have something different to do. When I used to sleep, when we sleep deprived in my undergrad we were really focused on the slow

wave sleep the delta because that seemed like it was the most important sleeper and Jim Horne Professor Jim Horne who passed last year one of the B sleep there's B sleep professor of forever um he used to call that core sleep optional optional sleep and core sleep. Now we know that actually all of it is core. But what we would notice is when we'd sleep deprive people, the next night, the recovery night would be saturated with deep sleep. Our sleep shuffles around and it takes the deep sleep really quickly. Okay, really quickly. So we thought, right, that's the most important bit. Now, what we didn't have was resources back then to keep following people for the, you know, for a rest of the week. But now, you know, there's more funding, there's more money spent on sleep. Now we know if we follow you longer, Other bits of sleep also come back. We also see REM rebound. We also see the stages to come back a little bit.

So it's all important. But it's and it's wonderful because our brain will do it. It'll know what to do. So trust your sleep when you've had a poor night's sleep. I want you to start trusting it the following night. We can't get our sleep back. It can't be banked. It's not like a bank. Okay. But our hypnogram, that's the graph of the sleep stages will start to shift and it will help you out. Okay. I love that you said that. Cause I, I wrote down my next question was going, first of all, I want to backtrack to all that you just talked about. There's so much to unpack there. It's so exciting. But this concept of, I was going first of all i want to backtrack to all that you just talked about because there's so much to unpack there it's so exciting but this concept of i was going to ask can you get caught up on sleep that you miss so you you can't get your sleep back you can't get caught up on it but you can get back into that rhythm and cycle okay i y'all gotta rewind rewind and listen to this. Slow my Welshness down.

I love your passion for this topic. I love your passion for this topic. It's so important. Honestly, I would beg to differ that sleep is the foundation of weight loss. Honestly, it's a pillar of health and probably the most important. Everyone out there worried about what they're eating and when and then not getting any sleep. I mean, this is one of the reasons that we suggest not eating after dinner, because you really, you got to treat that sleep like it's sacred because that's when your body makes change. I'm going to get into it. I'm

going to ask you what our body does when we sleep, but I want to take it back. Impulse control when you're not getting sleep. This is so important because people think, oh, willpower, I'm having such a hard time. Why is it so hard for me to make the choices I need to make? Impulse. You're not sleeping. It's affecting your impulse control, right? It's not that you just don't have willpower. Hormonal, affecting your hormones, your leptin, your ghrelin, your hunger hormones, your hormones

that let you know when you're hungry and when you've had enough, all fucked up if you're not getting the sleep. Insulin resistance. Insulin resistance. I'm going going to get it i got a post on insulin resistance breaking that down what that means to you guys in terms of your weight and then the the whole the emotional part of the brain so if you can just imagine how if you're not getting sleep how this is affecting the choices that you are making how how your body is, the hunger cues you're trying to get in tune with, how your body's actually processing and digesting the foods that you're eating and how you are feeling going through this whole process.

Did I drop the fucking mic? Did I not tell you that this would be the conversation that you didn't know you needed to have? Oh, that was brilliant. What a brilliant summation. Holy moly macaroni. That was well done, Gina. I adore you. Okay. So the question is, so I want to get into those sleep patterns too, because this was a game changer for me, understanding that a good night's sleep isn't like you sleep through the whole night, never wake up. Once I really understood my sleep pattern, my mind's about 90 minutes. This is like really understanding, like this makes all the difference

between if you wake up naturally at six o'clock and you know that you have to wake up again at seven o'clock, get your ass up. Because if you go back into that sleep cycle again, and you don't get that full 90 minutes, I'm my ass is waking up so tired. I'm like groggy the rest of the day. So I do want to talk about that sleep cycles and like kind of like what a good night's sleep should look like. But why do we need sleep? What what is our body doing when we are sleeping? It's doing it's doing all of that flushing out. It's doing, it's, we used to also think it did a lot of repairing and it does, but mitosis does happen anyway. When, if we, if we can't sleep and we're lying there, mitosis is happening on a circadian rhythm anyway, cell, cell regeneration. But we know it really, really supports us. Now, this is really key for people

also that suffer with pain, because pain and sleep are so entwined. And unfortunately, when we get poor sleep, or sleep at the wrong time of the day, if we're just snacking on sleep and dozing, we then don't get this sort of consolidated sleep at bedtime or at nighttime when we then produce growth hormone. And growth hormone then helps to manage pain. And so we really want to help tease apart and support people with pain and sleep so that the two things can improve. We know that if we improve sleep, we can improve anything. If I've got somebody with anxiety, if I can help their sleep, we see change. If I have someone with depression and I help their sleep, we see change.

Bipolar, ADHD, anything. If we can make our sleep more powerful, we can see very powerful differences in our daytime. But what does it do? It washes us. It's highly related to our immunity. It allows our brain to think and remember. It gets rid of the toxins which are related. If we don't do that, we're going to be more likely to have plaques.

But then the science is now showing how related it is to dementia alzheimer's our brain needs to sleep it needs it doesn't we don't it just needs it okay so so what else to tell you well i want to i'll interrupt you you can think on that okay um. Um, I want to talk about the sense of routine. Cause I know there are people who are like, ah, I'm going to be, I never going to lose my weight. You're telling me that sleep is the most important thing. I have a crappy sleep. Maybe I have small kids. Maybe I'm nursing. Maybe I work shift work. Maybe I'm menopausal and I just, it's so hard for me to get sleep. I haven't slept great in years.

So I want to, I always like to point out to our members that you are already doing so much in following the food plan. When I talk about being consistent and how the body loves routine, it loves routine across the board. And when you are routine, you're creating a routine, especially with your foods, this is going to make a big difference and impact your sleep. You are going to walk away after following the Libby Method sleeping a lot better. We're talking to Dr. Beverly today.

I want you to really understand the impact and the importance of getting good sleep. Alana McGinnis is going to join us tomorrow. She's a sleep expert. She's going to talk about tips for sleep, strategies for sleep, like sleep hygiene. And then we're going to get into the physical stuff with Dr. Alinka. So I know always I like to preface, try not to be overwhelmed by this conversation. We're going to give you the tips to help get that better night's sleep. But talk about the importance.

We talked about the importance of the routine of the bedtime. But can we talk about specifically the living method and how that helps with people get sleep? I think it's great because just like you said, our body loves regularity, routine, it likes predictability and that circadian rhythm that helps us through the day. We also have that same clock in the liver, in the gut, in our digestive system. So as soon as we put our first calorie into our mouth in the morning, and a calorie does include if you have a cup of coffee, because it has a little bit of calories in there. So it's going to go, oh, it's morning.

It's a signal. It's a switch. And as soon as you do that, it's going to tell the mouth and the stomach to start secreting the gastric juices in anticipation for food. Okay. And then that then leads to a cascade of hormones and enzymes and genes that start what we would call the irregular daytime chores. I am ready. Okay. So you want to think when is the first thing, what's the first thing you put in your mouth? And when's the last thing you put in your mouth? And if you could, if you could think, think of a 12 hour. It's called time restricted eating, but it's 12 hours. You could think, OK, if you put your first calorie in at 8 a.m.,

try and aim for the last calorie in before 8 p.m. And that's going to give your body enough time through the night to do what it needs to do. If we accidentally snap, say at 10 o'clock at night, our body's going to start again, it's going to go, Oh, okay, she's up again. And so it gets a little bit confused. So if you can keep in mind, let me try and give my body the best chance by letting it know what's what. And then in the morning, you could always think, okay, well, I probably have at least two of these hot water before I have anything. So think water is not, is not calories. So you can have a beautiful flush. You can, you can just cleanse your body before you think, okay,

what will I have for breakfast today and often once we've had our water because we've been dehydrated through the night we will make a good choice to think what will I what will I choose for breakfast what protein will I have what will I how am I going to start this day um and so we want to start there but I like to think of the 12 hours because it makes it a little bit more simple um yes this this you know different techniques out there with fasting but keep it keep it simple keep it simple and start watching to see what happens if you give your body predictability and the gina gina method of of feeding and nourishing your body through the day, not only gives it messaging, but it also tells our body we're safe and sound and all is well. Because when we're anxious, when we're

rushing, when we're not eating, when we're scrambling, we're going to take that to bed with us. If we have not had some time or some just calmness or mindfulness during the day then it's going to wait for us you know how many of us go to bed and that's where we do our thinking or that's where we do our worrying or that's where we do our regretting and our should have could have would have so we want to have time for that during the day and that and that is part of a cognitive behavioral therapy for insomnia packages is find different times during the day to think through your thoughts, to plan your tomorrow so that if you wake up with worries, you can think, actually, I've written them down in my worry journal. Or if you have a little journal by the side of your bed, it can be a little one just like this or yours, your lovely journal, write it down.

Say, oh, I've forgotten to pay, you know, my son's hockey subscription. And then close the book on it and allow yourself then just to rest. Don't chase sleep. Just allow yourself to rest, rest your mind and then sleep will, we hope, with all of this in place,

our predictability come and find you. I want to get into that because you said something to me once. I thought you were just so full of shit, but it turned out to be a real game changer for me. I want to go back to the starting your day, that breaking the fast, right? That's what breakfast is, which you mentioned coffee. Y'all, this is what lemon water, apple cider vinegar is really good at doing. And that's that creating that routine. You use two words, safe and calm. And when I say we want you to get to a place where you're calm physically and mentally, like this is what I'm talking about. And that routine is allowing right now the focus is giving the body what it needs. So it no longer feels the need to store fat. Also feel like it's in a safe place. It's routine. It's calm. You're giving it nutrient rich foods. You're not stressing about

what you're eating or not eating because you're just eating good nutrient healthy foods for yourself. Right. So that's, that's that piece. And that's that routine. Okay. Um, one time you said to me, just don't think about sleep. I was like off dr beverly you're full of shit um but let me tell you it was like a game it's such a simple concept don't just don't think about just don't try to go to sleep and i'm like what i honestly when i i got off and i was like she's you wouldn't believe what she said she's a twat um game changer what do you mean just don't think about don't try to sleep because that was a game people think it's such yeah never try to sleep um listen i'm telling you who's listening i thought she was full of shit too you probably will too but hear her out because this was a game changer for

me what does that mean basically that so yeah, what we know, what we know is we have sleep disorders. We have insomnia. We have restless leg syndrome. We have sleep apnea. We can talk about all of that and what makes them different. But if we are edging on or we have insomnia, what we have done is we've accident,

well, over time, and we can talk about how it develops we have a maybe a predisposition we might have had fragile sleep even when we were little okay we might also have a a temperament that might be more anxious or more worrisome or thoughtful that can be you know a predisposition to poor sleep Then we can have something that comes along and disturbs it, a precipitating factor. We might move, we might get, we might go through puberty, we might have a baby, we might divorce, we might have menopause. They might build an airport next door. So that's going to be the trigger for our sleep going wonky. And then we've got the things that keep it wonky, the perpetuating factors, what makes sleep not come back.

And often it's this hyper vigilance on sleep. So actually, when it comes down to it, even sleep, like I'm on the committee for the Ontario Health Committee at the moment. So we're advising on the quality standard for insomnia care, not only in adults, but also in an older adult insomnia collaborative and sleep hygiene is not it. Okay, sleep hygiene. So when people think, okay, I need the eye mask, I need the noisemaker, I need the blackout blind, that is not going to fix your insomnia. To fix your insomnia, you need the evidence-based practice of cognitive behavioral therapy for insomnia. That's it. Not medication. You shouldn't be offered sleeping medications for insomnia. But one of the tools in it also involves never trying to sleep. It's called paradoxical intention. If you try to sleep, you're going to perpetuate the problem because you're trying, come on, I need to sleep.

I've got that meeting tomorrow. If I don't do it, I'm going to be a mess. Now that releases cortisol, that releases stress. And it's it's just you're not going to find sleep that way because now you are in fight, flight or faint. You're worrying about it. So part of the protocol, we work on the sleep clock and the circadian rhythm and the sleep need. A lot of people will start doing the wrong thing. They'll try and get sleep. They'll stay in bed too long and attempt to get sleep. And they'll avoid things during the day or they'll nap during the day because they think that that's going to help them now if we do that and we have insomnia remember this is specifically insomnia if we're sleep deprived it's very different if we actually cannot get sleep if we're a new mum and we're getting three hours we need the nap we if we're a shift worker and we're getting three hours, we need the nap. If we're a shift worker and we're not able to get

the length of time, we need the nap. We need to plan it. But insomnia is not that. Insomnia is the relationship between the bed and sleep has now become dismantled. We now don't trust the bed. We don't trust sleep. We're more likely to probably sleep on the sofa and then we've conditioned our bed to wake up we get there and we start thinking we start worrying so we try we remove the effort the effort is the cognitive effort of trying so it's called paradoxical intention it's never try you you if if once we've once we've done the formulation of what time you should be going to bed and what time you should be going to bed and what time you should be getting up and often we shrink it because a lot of people will be spending say

10 hours in bed and only sleeping five now you've got you are accidentally diluting it now you've got a relationship with wakefulness in bed so we want to replace that if you're not sleeping you've got to get up and somewhere else or you have to give up the effort you can read you can move to a chair whatever that is we're starting to extinguish that relationship and not trying to sleep is part of it to and I with little Leo my son if he says I'm not tired then that's that's okay. You should never tell a child go to sleep. Okay. Just say, rest your body, rest your mind, rest your eyes. And I'll say goodnight to every little bit of his body. And I'll say, just rest. And then sometimes I will do that. I'll say,

I'm just going to go brush my teeth. You stay awake until I come back so that I can give you a last snuggle. He is always asleep when I get back, because I've given him permission to not try. Just lie there, just lie there, and often sleep will come. And the analogy that's been in books, the metaphor rather, in sleep books since before I probably was a twinkle in my dad's eye, was sleep is like a dove. If you ignore it, it will stay. If you look at it or attend to it, it will fly away. You will lose it.

So we don't want to focus on it. Good sleepers, when we look at good and poor sleepers, that was my PhD. How do good sleepers remain good what's the difference between people with insomnia good sleepers so I followed them for a whole year every single night 86 participants the longest largest ever study of its kind and and the difference was not good sleepers don't worry when they have a poor night's sleep they don't they don't overthink they don't think that's it and I'm doomed for the rest of the week. It just happens. And they trust the sleep will happen again tomorrow night,

or even the following night. When we have insomnia, when it starts getting under the skin, we start worrying, we start doing too much, we start maneuvering too much, and we start paying too much attention to it. And then we don't do things in the day. We rest during the day thinking that we've got to savor our energy. But if we don't use energy, we don't sleep. So we've got to be rethinking. And that's when I talk about the inside out versus the outside in. If we're waiting to feel energy inside, like I'm waiting for motivation to go for that swim, it might never happen.

You've got to go for the swim. So it's the outside in. You go for the swim and then you feel the energy. And that energy, when we've used it and we've built it, we then sleep better. We've got to spend it. We've got to spend it. We got to spend it we're supposed to be on the move we're supposed to be socializing we're supposed to you know how I say base the day

something for your body something for achievement something for connection something for enjoyment but that goes wrong when we're worrying about sleep we think I can't go to Thanksgiving and I can't go to that event and I have to get to bed early and now the perpetuating cycle continues that was soliloquy sorry sorry I'm here for it I know Atlanta's going to talk a lot about that tomorrow too like making sure you get up and it really your your your ticket to good night's sleep can be what you're doing in the morning I want to take it back so there's a couple things I want to talk about I want to talk about um I just want to break down the insomnia versus sleep deprived, because I know people are like freaking out about their nap time. So what's the difference between somebody who has insomnia?

What defines that versus someone who is sleep deprived? Because you're saying naps are a no-go for insomnia, but naps can be beneficial for sleep deprived, like new moms, shift workers, that type of thing. So can we just quickly define that? So insomnia, if you want to think about the threes, insomnia, you should have difficulty either falling asleep, staying asleep, or waking up too early and feeling refreshed refreshed or a combination of that. It should happen at least three nights a week and it should be should have been happening for at least three months. And the big bit is that this happens even with the opportunity to sleep. So you've got the opportunity. You've got eight hours available to you but it's not happening okay um it's not related to substance

use it's not related to you know it it that's what insomnia is now we know that what we used to say was pure insomnia it's very difficult because often people with insomnia do also have anxiety or depression or pain so it's really hard to say and nothing else you know a lot of the early literature was just too clean it was too artificial most people don't just have insomnia they have other things now a person with insomnia when we when the literature and when the science would bring a person into the lab and ask them just, you know, fall asleep, they don't fall asleep quickly. So that would lead us to believe they're not sleep deprived. Somebody that is sleep deprived will fall asleep. It's you have to fall asleep, you cannot keep going, even if you don't

know it, you will be taking micro sleeps during the day which is very very dangerous if you're driving or using heavy equipment or surgery or anything like that your brain has to and that's why often if we've had poor night poor night poor night poor night often we'll have a recovery night where our brain just says i need i need some sleep yeah okay so when we so this specific set of questionnaires and diagnosis criteria for insomnia, then we look at different things. We want to rule things out. Could it be that there's something else? Now, if we're thinking about something like sleep apnea, sleep apnea, you are chronically, dangerously, devastatingly sleepy. This kills. This kills more than drunk driving because people don't know they

have it. So sleep apnea, if you've got obstructive sleep apnea, that's where our throat is relaxing or our tonsils might be impeding or our adenos, something. As we are falling into those stages, remember stage one, stage two, now we start to relax. Our throat relaxes and it stops the oxygen getting to our brain. Our airway is closed. Our brain will preserve life, okay? It knows something's up and it will make you do something. Splutter, snore, cough. Okay, we do that. We open our airway. Now, a person that doesn't know that's happening to them many, many, many times every hour, every minute is not getting the deep sleep. They're not getting to stage three, but they think they slept well. This is the interesting thing about, oh, but I slept well,

because they think that they didn't, you know, wake up many times in that, that they didn't you know wake up many times in that but they didn't know that they weren't getting it and so what we would see in the day with a sleep deprived person we will often use something called the Epworth sleepiness scale we'd ask them do you fall asleep in meetings do you fall asleep in the car do you fall asleep you know when someone's actually trying to talk to you do you drift off do you have pockets of vacant time where you're like, wow, I don't normal healthy person we're looking at 10 minutes we're looking at 10 minutes over 30 minutes that's gonna tip into could it be insomnia if you know three times a night they're taking longer than 30 minutes but 10-15 minutes is totally normal because we're winding down we're winding down and what we what we say is you know if you haven't given yourself a wind down period it's very hard to stop at the stoplight you want to

come in slow okay you want to come in so you can land so that's the difference and if we are sleep deprived we want to build in some more sleep opportunity and that's where you want to think of the 24 hour clock as a whole and if you can try and get eight hours even if it's chunked up if a shift worker is getting five could they get three more just before their shift okay if you're a new mum is there anybody that could perhaps help or somebody bring the baby in for a dream feed so that you can just get a little bit longer stretch like four hours in a row five would be amazing but I know it's difficult but have help and and really really if you can I know it's difficult sleep when the baby sleeps don't think I've got to hoover I've got to prep sleep because sleep is really important for

you also um especially when we see you know postnatal depression often is that is it involves sleep we just start unraveling it's so devastating um so if you've got family or friends or neighbors um or me because I always want to come and hold babies. Just recruit, recruit during that, that tricky time. Yeah. You don't know what you don't know. Right. And I think this is the thing that I just, I'm like, how do I just let people know? Like, I didn't listen. People told me sleep in the baby sleeps. I'm like, yeah, I'm good. I'm going to do this. You know, listen, I also want to get into this menopause thing because, you know, it's one thing when you're in it, you're like, oh, okay. I wish someone would have told me this. I remember my mom though, like I used to have like night sweats

and I just thought it was from drinking wine. But my mom's like, oh, you're probably in perimenopause. I'm like, no, I'm not mom. I'm like way too young. Now I'm realizing, oh, she's probably right. I want to talk about, I know we don't have a lot of time left. So, and you're going to come on in my menopause add on and talk about what the fuck is going on with our brain. Um, and what is happening with our sleep. So I know we could probably book a whole hour to talk about this. Um, so I want to talk about getting up to pee in the night because well, obviously with the living method, people are drinking drinking more water the body is detoxing at night it is normal so if you have that 90 minute sleep cycle right you might wake up a couple times at night and you might also while you were awake

decide you have to get up and pee now there there could be some pelvic health issues happening with people throughout the night that's a that's another conversation we'll have with our pelvic health specialist it's not the end of the world if you're waking up in the middle of the night to go pee. But is that like that's normal? So you're right to remind people that sleep is not static. Through those stages, we are more likely to be disturbed. So stage one, you're absolutely going to hear your name, or you're going to hear the dog bark, or you're going to hear the neighbors get home.

So you'll hear it and you'll say, I wasn't asleep. I was resting my eyes. As we get to stage three, the deeper sleep, it's going to be quite alerting if you're awoken from that stage, like, but we will, and we're supposed to, we're supposed to wake up if it's an emergency okay that's really important because we otherwise we're dead you know we've got to wake up and so as we're going through the lovely hypnogram there's going to be times like when we go back up to the later stages of sleep that we might notice you know we might get warm because warmth wakes us up we want to be nice and cold when we're sleeping 18 and a half degrees. We might then notice our bladder, hopefully for most, but it does definitely change across our lifespan.

Our bladder is also on a circadian rhythm, so it should go to sleep. It should help us and be asleep through through the night. However, if we are increasing our water, it might be being challenged. So see if you can just monitor. Can you just have a little bit less before before right before bed? And also don't automatically go for a wee. OK, so if you do wake up,'t think okay i'll have a wee because a lot of people think well i better have a wee because i'll be up you know in another hour but try not to because then you're not training your bladder to have a nocturnal bathroom break um men the prostate can prostate gland can cause havoc for sleep as well because of the pressure um and but if you are i want you to not just like we talked about not worry if you can not link it to well there we are that's the

end of my sleep for the night i want you to see if you can have a dream we just go to the bathroom keep the lights low but don't fall triples you know be careful um have a little low light have a wee try try not to think much about it don't even bother flushing the toilet we'll forgive you back to bed and then just know it was because you were in later sleep and try not to jump ahead to that's it i'm up now um but yes our bladder we we hope that it's falling asleep with us it takes time when we're little to learn that and then as we get older it can be challenging um and yes that the heat the heat that comes off us when it's not it's not always there but it's often there it's a very common thing um but uh 30 to 40 um percent, uh, are going through the perimenopause

menopause will have sleep disturbance during this because the estrogen drops, it disrupts serotonin. That is really important in the regulation of sleep. Um, so the hot flushes, when we look at data suggest it's like up to 85%, um will report that this is this is causing them to wake up so we want a cool bedroom maybe wear less have a cool wash um but again the evidence-based treatment first-line treatment is still cognitive behavioral therapy for insomnia it it's that is it that is where the evidence is it works it lasts it's it it's not sleeping drugs it's not sleep medication because we know that that changes our hypnogram we might think

we've slept because we didn't move much or we didn't get up but actually all of those stages start to change and before I forget I must say please don't rely on your devices because that is another huge perpetuating factor for worry people look and they think oh I didn't get any REM or I didn't get very much stage three or two it does not know it doesn't know. It is not science graded. It's going to be based on heart rate. It's going to be based. It's good. It's it cannot accurately tell you what stages you have been in. If you saw when I plug people in, how much goes into actually knowing if somebody is in a particular stage, it is vast. It's fast, it's uncomfortable, and you don't generally have a good night's sleep when you've got all the wires on you. So try to ignore that. Try and just use them for something else. I'm glad you mentioned that. So many of our members are asking. Yeah, I pitched my Fitbit at night. I remember you saying that you would

tell people who had a good night's sleep that they had a crappy sleep, and you would tell people that they had like you would tell people who had a good night's sleep that they had a crappy sleep and you tell people who had a crappy sleep you had they had a good night's sleep and it totally changed the way they move through the day isn't it but it works the power of you know when we decide to kind of reflect and review and think i i have had a terrible night's sleep you You're absolutely right. The data show that the whole day is affected. And if on the reverse, we're told that we had a cracking sleep, you know, cracking, you're going to, you're in bed. Then we do. We, and it's, it's placebo really, it really, really works. It's very effective.

The power of the mind and how we enter the day and how we choose to step into the day. A lot of it is what we're thinking about. Well, it is just everything is what we're thinking about. Yeah. I do not want this conversation to end because I think cognitive behavioral therapy, and I know I've talked about this before when I was at the Canadian Obesity Summit, this is the missing piece of weight loss that they were all trying to figure out. How do you implement this en masse for people, right? They were like, yeah, we know it's a huge piece. It's great if you can see my client,

see their clients one-on-one. And I'm like, can't you just teach this? So you can't teach this en masse. And I beg to differ. And this is why you're here, sharing your knowledge and tips with us. People are capable of working through their own shed and making the changes they need to make. Great if they can seek help from someone like you.

So I do want to get into that cognitive behavioral therapy piece. I think we're going to have to book another time for you to come on. I want to talk about menopause lastly, because I am working on that menopause add-on that we're going to roll out in the next couple weeks. You're coming on to talk. I'm just letting you know now. What is, I know because sleep is such a big part of that. So before we go, if I was to have you on and talk menopause and sleep, what are some of the things you would talk about just to give people a heads up on that conversation?

If you wanted me to talk about what would improve the sleep i would have to because i have to follow the evidence i'd have to talk about cbti and that is how to how to get back in touch with our sleep clock our sleep need what we do during the day so it's really important to to work on that uh rebuilding the relationship and extinguishing with awakefulness and that's the that's a hard bit but it's the bit that's effective um because again assume if we go to bed and we wake up and we're hot and we then immediately think there we are not going to get sleep that then leads to the lack of lack of sleep or if we wake up and we think that's it um my sleep is terminated I'm not going to manage tomorrow then

tomorrow is a very different day and you know we'll we'll blame a lot of it on our sleepiness we'll be like well I didn't I didn't get sleep now I'm'm a bit foggy. Now I'm, you know, around and we want to not do that. We want to think let's let's support sleep. So because if we're all able and get to the right age, we're all going to be going through menopause. So we want to support that while it's happening. And then because we're hopefully preserving good quality sleep or understanding the mechanisms that make it worse or perpetuate it then we can we can get get in there early so that then we've got the power of sleep to help us then get to the doctor and talk to them about our symptoms get to the you know

make decisions advocate for ourselves because we know we're still really behind with this you know it's just oh too bad that just happens to everybody and it's you know we're still really behind with this. You know, it's just, oh, too bad. That just happens to everybody. And it's, you know, we just need to move. We need to move with the times. We're lasting longer. We're aging together. More of us, you know, going through the menopause.

And so we've got to catch up. You know, the patriarchal health system, it's time. And you're here at the right time you know you said something i had a bit of an aha moment there because what just quickly in like one sentence what is cognitive behavioral therapy it just occurred to me that some people might not know what we're talking about there okay so the cognitive means our thoughts it's a fancy word for thoughts yeah whenever you've seen me draw that clock like looking thing like a 12 o'clock a three o'clock a six o'clock and a nine o'clock

that's that's like that's like the vicious circle or the hot cross burn or the windmill of cognitive behavioral therapy our thoughts affect our feelings and it's a two-way arrow thoughts feelings our feelings affect our thoughts our thoughts affect our feelings. And it's a two way arrow. Thoughts, feelings, our feelings affect our thoughts. Our thoughts affect our feelings. If we're disappointed, our thoughts are probably going to be quite disappointed in tone. If we're thinking negatively, we're probably going to be feeling like an emotion. This is an emotional feeling, something like, oh, OK, six o'clock is our behavior how we think and feel about things often ends up with us behaving in a particular way if I think I've got to preserve my energy I think I've got to get to bed early I'm going to not go to that party okay the behavior is I'm not going to do it if I think oh I have to have cannabis to fall asleep we're going to do it. If I think, oh, I have to have cannabis to fall asleep, we're going to do it.

Even though if we looked at the data, it's going to mess up your sleep. Nine o'clock is our physiological self, our body. So now we've got the clock. We've got our thoughts, our feelings or emotions, our behavior and our body. That's the fight, flight and faint. That's the activation flight and faint that's the activation that's the adrenaline the swirly tummy that when we think oh my goodness I'm next or when I'm on Gina I'm sitting here thinking I can just feel my heart beating that your team knows I have to go for an emergency bathroom break beforehand that the physiological arousal telling me you've got something that matters and I'm

thinking I hope I say the right thing I hope I don't mess up I'm feeling a bit anxious but also excited and my behavior is try and be prepared Beverly try and listen try and calm yourself try and stay grounded put your sheep earrings on because it's a sleep session like those are those behaviors you know have my water ready you know anxiety loves a plan so that's the loop okay now if we went into a little bit deeper cbt we want we want to know where did those thoughts come from in the first place yeah you know why our body does that the things it does to protect us. So that's like as we go out and out and out. But that's what cognitive behavioral therapy tries to interrupt that loop. We can start anywhere. I'm glad I asked because I want people to walk away from this conversation

understanding how it all works together. And I had this aha moment a few minutes ago where you talk about sleep. There's like sleep hygiene, right? The things that you're doing to try to get that better sleep. And then there's that cognitive behavioral therapy piece, which is really, that's the difference. I think the living method is the same. There's the food plan, right? There's the, what you're eating and when, and all of those things that you're doing, but it's that, it's that cognitive behavioral piece. That's that piece. We need to book a whole other session to talk about that because we're out of time. Again, these conversations are not meant to overwhelm, even though we talked for a whole full hour, 59 minutes and 55 seconds. Every single one of them, it's not to overwhelm you. It's to bring awareness that it's not just so black and white when it comes to weight loss. If you're having a hard time

with the choices that you're making, if you're having a hard time with the cravings that you're having, if you're having a hard time moving the dial on the scale, there's so much more to it. There's just so much more to it. And we're going to walk you through all of it. Dr. Beverly is going to be back and back again. And I'm already looking forward to our conversations in the menopause add-on because we got to go there. We got to have them. Thanks to everyone who joined me today. So Dr. Beverly David, you can reach her at your psychology sleep center. She has a new course coming up on cognitive behavioral therapy and sleep, right? Yes. So CBT-I. So it starts next Tuesday. Okay. There's still a few spots left. I try and keep it small because I want to be able to talk to people to like, so a nice small group online.

And so you don't, if you're traveling, you don't, it, you can, um, you can submit your receipts for your insurance it will go under psychological services um and it's it have a look have a look at the website and think does this fit me because it's going to help people with insomnia it's going to help those people that can't fall asleep can't stay asleep and wake up it's it you we would be doing something different to help you if you were sleep deprived or if you had restless leg syndrome. So have a look, see if you feel like you fit the criteria. Sign me up. I don't get some sleep. That was me all like last couple of nights. I don't know. I said, Tony, I think something's on my mind. I'm just wide awake. I'm wired. I'm drinking decaf.

I don't know what the fuck's going on. I think I'm thinking about sleeping. I'm just wide awake. I'm wired. I'm drinking decaf. I don't know what the fuck's going on. I think I'm thinking about sleeping. I'm going to try not to sleep tonight and see how that goes. Dr. Beverly David, I adore you. I'm so grateful for you. I'm so appreciative of you taking the time to share your endless knowledge with us. Thanks for everyone joining us live and a special thanks to Dr. Beverly David. I'm already looking forward to our next conversation. Have a great day, everyone. Thank you.