Episode 93 - How To Get To Sleep And Stay Asleep With Board Certified Physician Dr. Holliday-Bell, The Sleep MD (Full Transcript)

This is a full transcript of the Nirvana Sisters podcast Episode 93.

Editor’s Note: Please know that this podcast transcript is automatically generated and may contain minor errors such as typos and word switches. For more information, be sure to listen to the podcast here or view our podcast episode guide.

[00:07] Amy Sherman: Welcome to Nirvana Sisters podcast, where we take the intimidation out of wellbeing and beauty to help you achieve your highest state, your nirvana. We are sisters in law and your hosts. I'm Amy Sherman.

[00:18] Katie Chandler: And I'm Katie Chandler. So let's get into some real conversation. Welcome back to the show nirvana Sisters Family. It is Amy and Katie. And today we are sitting down with Dr. Angela Holiday Bell. Dr. Holiday Bell is a board certified physician certified sleep specialist, speaker, and founder of the Solution Is Sleep, LLC. As someone who formally suffered from insomnia herself, she understands the transformative power of good quality sleep and how obtaining this regularly can lead to happier, healthier, and more productive life. She's been featured on local and international television shows and networks such as The Dr. Phil Show, ABC News, and WGN Television, spreading her message about the power of good sleep. She also sits on the advisory board of Health Magazine and regularly contributes to a number of print and online publications such as the Sleep Foundation, women's Health Magazine, well and Good, and Today Show. She also helps overwhelmed workers beat, burnout, and build resilience while increasing productivity and engagement through better sleep. So we are so incredibly excited to have you here because sleep is everything, if you ask me. So welcome to the show, dr. Holiday Bell.

[01:32] Dr. Holliday Bell : Thank you. I'm excited to be here. Thank you guys so much for having me.

[01:36] Katie Chandler: Yeah, we're excited.

[01:37] Amy Sherman: Yes, welcome.

[01:37] Katie Chandler: Well, let's kick it off.

[01:38] Amy Sherman: I always tell my kids, sleep is medicine.

[01:41] Dr. Holliday Bell : 100%. Good night.

[01:43] Katie Chandler: That's the truth. We like to get started with a Nirvana of the Week. Just a moment that brought you a little bit of joy this week. So, Amy, let's start with you. What was your nirvana this week?

[01:55] Amy Sherman: Well, let's see. This week was a super busy week, and I think my nirvana this week was kind of a series of things. I just got a lot done and I was very productive this week. And I feel like every time I'm productive, it makes me feel better and I just feel accomplished and really good. And so I just got a lot of things off my list and a lot of projects done work wise and otherwise. So I was just feeling really motivated this week. What about you, Katie?

[02:20] Katie Chandler: Thanks. Mine, I think, is today, this weather. I am in New England, and it is typically very cold in February, and we have a 50 degree day. The sun is high in the sky and shining, and I can feel the vitamin D coming into my system. I've got the happiness joy of the vitamin D hitting me today, so I think that would be mine. What about you, Dr. Holiday Bell.

[02:46] Dr. Holliday Bell : I got to spend some time with my family, my parents this week, and I'm always so busy and on the go that I don't often get that time. So it was really nice to just take a second to sit back and enjoy some time with them.

[02:58] Katie Chandler: Yeah, that sounds great. That's always the absolute best. Great. All right, well, let's start out I don't know. I have a million questions, but I'll try to keep it reeled in. So to start out, let's hit some basics, right? How much sleep should we all be getting every night? Is there like a certain time? Should we all go to sleep at a certain time and wake up at a certain time? What's the 101 there?

[03:24] Dr. Holliday Bell : Yeah, that's a great question and one I get opt in. And I always like to say sleep need is variable for every individual. So sleep need is like shoe size. There's no one size fits all. So most of us have heard that you need seven to 8 hours. That's very much an average. Some people need six. Very few people need six, but some people need six up to 10 hours. And so it's important to determine what that sleep need is for you and then aim to get that. So mine is 9 hours. I know that I need a solid 9 hours to feel rested. 7 hours, I'm exhausted. So it's important to know what that number is for you and aim for that every night.

[03:59] Katie Chandler: And do you suggest I've read before that it's good to go to sleep around the same time, have a similar sleep pattern, start falling asleep same time, waking up the same time as much as you can. And why is that beneficial? If it is?

[04:14] Dr. Holliday Bell : Yes, it's 100% beneficial. And that's because your circadian rhythm, which is the roughly 24 hours cycle that dictates many functions of your day to day life. But sleep is a big one, thrives on regularity and schedule. So the more that you keep your schedule consistent and honestly, waking at the same time is even more important than going to sleep at the same time. The more you keep that consistent, the more you entrain your circadian rhythm. Or teach your circadian rhythm to start giving you alerting signals at the time that you want it to be so at the same time each morning and then giving you signals to fall asleep at the same time each night. So it really makes it easier to fall asleep and wake up when you are keeping your schedule consistent.

[04:56] Katie Chandler: Is that same time 06:00 A.m. On the dot, or do I have a window? Let's say an hour or two wiggle room?

[05:04] Dr. Holliday Bell : Yeah, it's best to keep it literally as consistent as possible. So we in the sleep world will say, just set an alarm Monday through Sunday and have it be that same time. But to be fair and to be honest, there is a little bit of wiggle room. 30 minutes is probably the longest. I will push it sometimes up to an hour, just depending on how it interferes with their sleep. Everyone is a little bit different with how much that may throw off their schedule, but keeping it as consistent as possible, even my down to the minute will be the best course of action.

[05:35] Amy Sherman: Yeah, I was going to just make a comment that that totally makes sense because on the weekends, because I'm not a morning person, I've become a morning person, obviously with kids and my husband's an early riser, so I've become a morning person. But on the weekends, I try to sometimes sleep late. And everyday time I do, I feel terrible that day I'm like more tired, lethargic. And I always said my husband, I'm like, it's so weird, it's because I got up late, but if I get up the same time every day, like I usually get up at seven during the week, I feel a million times better.

[06:02] Dr. Holliday Bell : Exactly. And that is your body telling you like, no, we need to keep this consistency. It screaming for that. Even down to meal times at the time you exercise. Like your circadian rhythm actually controls many different functions in your body and really likes to keep it as routine, consistent as possible.

[06:15] Katie Chandler: Sounds interesting. Okay. All right, so we've all heard melatonin, melatonin, melatonin. For a long time I just thought melatonin was a pill that I took. But melatonin is something we make, is that correct? What is melatonin? What is the science behind it, what triggers it, what inhibits it, et cetera.

[06:36] Dr. Holliday Bell : Definitely. So melatonin is a natural hormone that we produce in our bodies from the pineal gland in your brain. There's also some research findings to come out showing that a lot of meatonin is producing your gut. But the melatonin we think of that signals sleep is producing your brain, so we produce that naturally. It does also come in supplement form, and I like to think of melatonin as the hormone of darkness. So as let's say before, we had all the artificial lights that were keeping us up and awake at night, your circadian rhythm and the hormones that were released were regulated in large part by the light and dark cycles that naturally occur in the natural environment. So as the sun went down and you didn't have any more light to alert yourself, that's when that signified melatonin to be released. And melatonin helps to set the stage for sleep, so it signals to your body, okay, it's time to wind down, it's time to transition into sleep and then allows you to make that transition easier. Light is going to be the strongest thing that inhibits that. So as we're spending a lot more time in artificial light, and even if you're spending time outside, let's say on a late summer day when the sun is still out, that's going to be signaling to your body that it's time to be awake and be alert. Because there is light outside, so it inhibits the release of melatonin. So the way that I tell people to utilize their own natural melatonin release is by decreasing the light emissions about 2 hours before bedtime as much as possible. So for some people, if you have to use if you have to be on your computer during that time, using light blue, light blocking glasses, simply, if you have dimmers in your house, dimming the lights, turning off overhead lights and using instead table lamps or candles. All of those things help to decrease the alerting signals from the light and signal to your brain that it's time to start releasing that melatonin.

[08:27] Amy Sherman: So I guess that means you shouldn't have a TV on in your bedroom.

[08:31] Dr. Holliday Bell : Exactly. That is why we say limited electronics, because light is made up of a lot of different wavelengths. But the blue wavelength in particular is the strongest inhibitor of melatonin and that is the more prominent wavelength that's in electronics like your television, your tablet, your phone, et cetera. So it's best not to look at those things close to bedtime because you're going to be inhibiting that melatonin release or at least use something to block out the blue wavelength so it's not so strongly inhibiting melatonin.

[09:03] Amy Sherman: It's funny, we sometimes watch TV at night, but I fall asleep. So then I'm like, well, does it matter because I'm still falling asleep.

[09:12] Dr. Holliday Bell : That's actually a good point. So I like to say, generally speaking, some people can literally sleep anywhere, anytime, no matter what their schedules are, what they're doing. Yeah, that's an accident outside and they're fast asleep. Praise. I'm so happy for you guys. I wish I had that ability. If you do, then you don't really need to change things up that much, right? Because it's working for you. There are differences in sleep reactivity, we call it. So I have a very high sleep reactivity. My environment really interferes with my sleep. Stress, anxiety, all those things interfere significantly. My husband has a very low sleep reactivity. We could literally be getting robbed and he'll be passed out. And I'm like, how are you sleeping through this? So every person is different. But I would say for many people, and especially now, that a lot of these things like electronics are more pervasive in our society. They are starting to see those effects. And so if you're one of those people that have problems sleeping, then try to look at those things close to the time.

[10:10] Amy Sherman: My husband is like you in that he is literally the worst, worst, worst sleeper. And so this episode can be very helpful for him to listen to as well because he just really is rough and so is his mom. So it's the runs of the family, I guess.

[10:25] Dr. Holliday Bell : For sure.

[10:26] Katie Chandler: Absolutely. Yeah. I am more like you are Dr. Holiday Bill in that I have to have kind of like a bedtime ritual. I have to shut the lights, need to go down, I have to do the whole thing one to 2 hours before I want to be asleep. And if I can't, I am inevitably up later and my sleep is disrupted. So last Wednesday we went on a random couple's night, which we never do during the week. And I didn't get home in my bed until 10:00, I didn't full sleep until midnight. So it's like part of the routine and I guess it's all triggering that melatonin. So when we take melatonin as a supplement, we're really just trying to replace the lack of what we're making or not making, essentially.

[11:13] Dr. Holliday Bell : Yeah, essentially or augmented. Like the amount of melatonin we take in supplements is significantly more than what's produced by our pioneer gland, by our brains. And so there are thoughts about whether or not we need that much. We actually often take away more than we need to trigger sleep, but it helps to just augment that process to help us accrete more so that it's moving our body towards preparation for sleep sooner than our natural release.

[11:38] Katie Chandler: Okay.

[11:39] Amy Sherman: Yeah, it's funny, even though I am a good sleeper, I do find that when we do do more of a wind routine and dinner lights and all that stuff, I do sleep more soundly and better and I don't get up in the middle of the night.

[11:51] Katie Chandler: Yeah, I'm sure. And Adam, Amy's my sister in law, so my husband is her brother. He sleeps like Amy sleeps. He sleeps like a rock. He could sleep through anything too. You guys have the good genes. So, some tips for falling asleep quickly. Do you have anything particularly that our listeners would like for that?

[12:13] Dr. Holliday Bell : Yeah, so I think establishing a bedtime routine just like you guys both mentioned and alluded to is so important because right now we live in such busy time. We all just talk about how busy we are. We are talking about our nirvana moments and we're working and we may be parents or taking care of spouses and doing all these things and our brains are going constantly. And then many of us treat sleep like it's a light switch, so we just turn off. I'm like, okay, you can go to sleep. And again, there are those amazing, incredible superhumans that can do that, but for the most part we can't. And so your brain needs that time to wind down and transition to sleep more than just even the melatonin release. Like one of my colleagues like to say, brain waves have to slow down in order for sleep to happen. And that's very, very true. And so you're giving yourself and your brain that time to slow down. So just implementing a consistent bedtime routine will help you to fall asleep faster than if you all of a sudden try to go to sleep in the year in bed, tossing and turning and not able to do so. And then having a relaxation technique that you can engage in either regularly or after a particularly stressful day is super important. And what I mean by that is not just like okay, I'm sitting down and I'm relaxing. There are actually techniques you can do that trigger your brain to slow your heart rate, slow your breathing rate, lower your blood pressure, and signal to your brain that okay. Or signal to your body, okay. We are actually relaxed, and now we can fall asleep because whether we know it or not, when we're stressed or we're anxious and brain waves are going quickly, we start to breathe quicker, we take more shallow breaths. We do all these things that trigger to us that, oh, there is a reason that we need to be alert. And so by triggering the opposite of that, you tell your brain, there's no reason that we need to be alert. Now we can relax and now it's safe to go to sleep.

[13:54] Amy Sherman: Okay, so what are some of those things? Like breathing exercises?

[13:59] Dr. Holliday Bell : Exactly. Breathing exercises. Diaphragmatic breathing is one of my favorites because you can do that anywhere. It's easy to practice, it's an easy technique for most people to grasp, and it literally is just practicing taking deep breaths. As I mentioned, we naturally breathe more shallowly and so it doesn't allow our lungs to feel completely and it doesn't trigger that parasympathetic nervous system or the one that slows everything down. So it's literally focusing and anchoring our breath so that we're breathing more deeply to trigger our bodies and our brains to say, oh, we must be relaxed because we're able to take these deep breaths. And that triggers a relaxation response, something like progressive muscle relaxation where you literally go through every part of your body and focus on tensing and relaxing each muscle in a specific way, in a specific fashion that allows you to sense when you are tense and then to manually relax yourself is also helpful. Guided meditation. Like, I always recommend trying different ones. See what works well for you. Practice during the day when the stakes are not so high and you're trying to fall asleep, and then incorporate that into a bedtime routine.

[15:05] Katie Chandler: Oh, that's smart. Yeah, I've never thought about trying it that way.

[15:10] Amy Sherman: Yeah, go ahead.

[15:13] Dr. Holliday Bell : I say some people try like, oh, I tried that last night and it didn't work and I couldn't fall asleep. And that's because you're anxious and frustrated and trying to fall asleep.

[15:21] Katie Chandler: Hey.

[15:23] Dr. Holliday Bell : That'S not going to work. But if you practice it during the day when there's nothing on the line, it's not high stakes. You're just teaching yourself how to trigger that, then you're going to be more effective at doing it at night. So I always say practice it just ten minutes during the day and you get better at it, and then you can incorporate it at night.

[15:39] Amy Sherman: Yeah, that's a great idea. Really smart. So what would you say for people and I have this a lot, and so does my husband, where you get up in the middle of the night to have a bathroom or whatever, and then you can't fall back asleep because your mind starts racing.

[15:52] Dr. Holliday Bell : So common, they'll call it the 03:00 A.m. Syndrome because for some reason it's like around 03:00 A.m. For you, so right, yeah. But you get up and so there are a couple of factors there. The first thing is your sleep drive. There's actually, like we call it processes. So your drive to sleep decreases the more you sleep. Makes sense, right? And so the closer you get to morning, the more you've slept off that sleep drive. So that drive to sleep is decreasing. And then we're getting closer to the morning hours where you're alerting factors from your circadian rhythm will start to pick up. So it makes sense that it's going to be harder to stay asleep at that time, especially if you have a reason you woke up, like going to the bathroom and so on. And then you start ruminating on thoughts and things like that that make it even more difficult to fall asleep. So I first like to start by telling people that waking up in the middle of the night is not a problem. That in and of itself is normal. You're human, you're going to wake up in the middle of the night. We actually wake up several times as we transition through sleep cycles because some people start to focus too much on that for oh, I'm waking up, that's fine. The problem is not being able to fall back asleep. So a normal sleep latency or time it takes to fall asleep, either at the beginning or the middle of the night, is actually up to 20 minutes. It takes you to all in a fall asleep. Fine. Try to do your deep breathing, try to do some relaxing activity until you fall asleep. But if you are not falling asleep after that 20 minutes, the the recommendation is actually to get up and out of your bed and do a relaxing activity like reading a book, meditation, something like that, until you fall back asleep. The reason for this is for individuals who say every night at 03:00 A.m., I wake up, I get in bed, I can't fall asleep, I'm tossing and turning for 2 hours and it's five and I finally fall back asleep. Then my alarm goes off. You're teaching your brain that that's what we do at 03:00 A.m. In the bed is that we wake up, we toss and turn, we're frustrated, we're anxious, and we can't fall asleep. And that entrance your brain, that that is what you do. You start to connect those thoughts, those feelings, those emotions with being in the bed rather than sleep. So you want to break that cycle by getting out of your bed, doing something else to induce sleepiness, and then getting back in bed only when you're sleepy again. That helps to reestablish that relationship and makes it less likely that you'll be up for the same amount of time and subsequent wow.

[17:59] Katie Chandler: Haste. Ever tried that? Amy, her husband is notorious for waking in the middle of the night, not being able to fall back asleep.

[18:06] Amy Sherman: I don't know, I have to ask him. I know sometimes he's like, gone downstairs, got something to eat or something like.

[18:14] Katie Chandler: That, and he's gone back to sleep.

[18:15] Amy Sherman: But yeah, he's done it all. Who knows? But that's a good idea to just get out of the bed and stop tossing and turning.

[18:23] Dr. Holliday Bell : The key is not to engage in other stimulating activities. So some people are like, okay, I'm going to be on my phone or I'm going to watch some Netflix shows. All that is doing it further waking you up, stimulating you, or even eating, because then that teaches your body again, this is when we eat. So then what happens is your digestive hormone starts to release at around 03:00 A.m. Because now it learns, oh, I'm preparing for a meal because at 03:00 A.m., we eat. So it's very important to choose specific activities that are going to be conducive to filling sleep again, rather than stimulating or signal that you should be doing something else interesting.

[18:55] Katie Chandler: All right, so I have a question related to sleep and our metabolism and our weight and everything. I notice that when I am able to get consistent more longer sleep, I just naturally shut down without even trying almost. And when my schedule is more especially, like, maybe during the school year, I have to be up by 06:00 A.m. To get the kids to school and whatnot. It's not as easy. It just seems to be a pattern. I feel like I'm not burning as much at night sometimes as maybe I once did. What's that all about?

[19:31] Dr. Holliday Bell : Yeah. So you are absolutely right in what you're feeling in that sleep is a huge regulator of your metabolism. And for anyone who's on any type of fitness journey, I say one of the best things you can do, it's exercise, nutrition, sleep. It's right at the same level. And the reason for that is that your hormonal regulation occurs via sleep. So the hormone that makes you feel hungry, grelin, is actually secreted in larger quantities when you are not sleeping well or you don't get sufficient sleep. And the hormone leptin that makes you feel full is secreted in lower quantities. Your metabolism actually slows down when you're not getting sufficient sleep, and you're less likely to move or burn calories when you're awake when you're not getting sufficient sleep. So it's actually the perfect setup for you to gain weight. And that is why insufficient sleep leads to obesity is independent risk factor for obesity is insufficient sleep. So it's super important from that standpoint to make sure whether you're going to finish your not that you're getting adequate sleep because your body actually almost works to gain weight when you're not getting enough sleep.

[20:37] Katie Chandler: Yeah, it's wild that it regulates all of that. I do notice that when I don't get a good night's sleep, I want to nosh all day long, I'm hungry.

[20:48] Amy Sherman: Totally.

[20:48] Katie Chandler: And I always thought, oh, I'm reaching for this, for the energy that my body is missing. But meanwhile, it's a hormonal thing that's really interesting.

[20:57] Dr. Holliday Bell : Exactly. And you're just more likely to make poorer food choices. So when you're asleep deprived, you're less likely to grab that valid you're more likely to grab that donut because it's about the immediate satisfaction of that. Your rational mind and your frontal lobe are less active when you're not getting enough sleep. So you're less likely to think through the benefits of the salad versus the donut. You just want the donut. And so all those things lead to poor weight gain and then poor metabolic.

[21:23] Katie Chandler: And does the quality of sleep matter? I know REM sleep, right? So let's touch on that really quickly. What is REM sleep and why is it so important? How do we achieve it?

[21:35] Dr. Holliday Bell : Yeah, it's so funny. There's been a lot of focus on REM sleep lately. And REM sleep is important, but so are all the other stages, I like to say so there are four main stages of sleep you have in one sleep, but you're super light. Like as you're kind of drifting off, you may not even know you're sleeping. That stage into sleep is a little bit deeper, but not the deep sleep. In three is deep sleep, which is actually that restorative sleep that we say in three. Deep sleep is restorative for their body, REM sleep is restorative for the brain. It's not that clear cut, but that's just kind of the way we think of it. And then REM sleep is a sleep that most of not all, but most of your dreaming occurs in. And your emotional regulation, your memories are laid down in that stage. So it's very resorted for the brain. But all of those stages are important and you cycle through them throughout the night. So I've had people ask, well, how do I get more REM sleep? And the answer is to get more sleep. You just need to get more sleep. And your body will give you the amount of those stages that you need with the caveat that if you're not getting enough sleep in general, your body will try to make up for a certain amount that it's missing. So you are likely to have more rim catch up, what we call a rim rebound sleep when you're catching up from not getting enough sleep. But if you're sleeping well, you spend about 20% of your time in the deep sleep, 25% of your time, and REM the other amount in the lighter stages. Now, there are medications and alcohol can interfere with REM sleep, so that can make you have less sleep. So for medications, you speak to your doctor about it sometimes benefits outweigh the risks of that. And then you don't want to drink alcohol too close to bedtime or it's just full of sleep in general. But other than that, there's not a big way to target, okay, I want more REM sleep tonight, more deep sleep, just get more sleep and then your body will regulate how much of each of those stages you get.

[23:24] Amy Sherman: Okay, yeah, exactly. It's not like when you're working out at the gym and you're like, today I want to focus on my arms. It's like your body is going to do it for you as long as you're sleeping. I had a question about jet lag and how, if you're traveling, can you regulate your sleep? Any tips on that?

[23:44] Dr. Holliday Bell : Yeah, definitely. So jet lag is a time when melatonin actually plays a big factor, supplemental melatonin, because your circadian rhythm is thrown off from when it would naturally produce melatonin, which is really what causes the jet lag. The first thing I recommend is trying to travel overnight in general. Like if you can travel overnight and get to the next place in the daytime and sleep on the plane, that's a good way to kind of slowly get your body into the next time zone. The other thing actually, even before that is adjusting to the time zone even before you leave. So if you are going somewhere in which your sleep time will be later than your current sleep time, actually adjusting by about 20 minutes each night prior to leaving will help to slowly get your body used to it because it takes about a day, we say, for each hour time zone difference for your body to adjust. So if you can slowly do that, it makes that happen faster. The other thing is light. Light is so important. Like I said, it's a strong factor in regulating the circadian rhythm and inhibiting melatonin release. So if you get somewhere in what would be your native nighttime, but it's daytime in that place, you need to be out in the sun, out in the day, get natural light because that sends alerting signals to your circadian rhythm. Say, oh, actually it's not night, it's daytime, you need to be awake. And then as it gets closer to nighttime, take melatonin. So that because it's unlikely for your natural melatonin release to occur because it's not used to being released at that time. But you take melatonin to signify to your body that it is night time. It's the darkness here and that helps to transition things.

[25:19] Amy Sherman: Those are great things.

[25:20] Katie Chandler: Absolutely. I know it can be such a crusher. So let's talk about some sleep disorders. I know of sleep apnea, but are there others? What are they? And how would someone know that they're suffering from them?

[25:37] Dr. Holliday Bell : Yeah, so as you mentioned, sleep apnea is probably the biggest one and can have some really significant consequences for health down the line. So that's always one that I recommend getting checked for if you're concerned. So if you're snoring every night, if you are taking. Processing your breathing, waking up, gasping for air, waking up with sporting headaches. Definitely recommend getting assessed for sleep apnea. Another fairly common one, and I think way more common than we even know is something called restless leg syndrome. And that is when you have this urge to move your legs. But really it can be any part of your body, mostly the legs, but it can actually be the arms as it gets later into the night. And it makes it difficult to fall asleep and to get good quality sleep because as you're going throughout the sleep stages, you have this urge to move and it kind of alerts you before you can get into the deeper stages and so it causes poor quality sleep. Well, one common cause of that is iron deficiency. So it's actually one that we oftentimes can manage and actually have a treatment for. So the problem is a lot of people don't know so they are not like oh, I have this urge to move my legs before I go to sleep and then they don't know that that is a thing. So education is key and it's also why I tell people if you're having problems sleeping, talk to your provider about it. People treat sleep issues as if they're just doomed to have them forever and there's nothing you can do about them. But sleep is so important, integral to health. Like if you broke your leg you were just like oh, guess my leg is broken, nothing I can do about that. You would go to the doctor, you would get it. Same thing for sleep because there's things that you may not know to be assessed for. So bring it up. Similar to restless sex syndrome, there's something called periodic limb movement disorder. It's similar in that it's movements that disrupt the quality of sleep but it doesn't interfere with the ability to fall asleep. Generally it happens like while you're sleeping you're not necessarily aware of it. You just know that no matter how much sleep I get, I'm not getting quality sleep, I'm exhausted all the time. And then you get a sleep study to diagnose any one of those things. So that's where you go to a sleep laboratory. They hook you up to these things, you sleep there. Now they actually have at home test that you can do for some as well and then they assess your movements, your breathing, your oxygen level while you're sleeping and then determine whether you have any of those things. I would say those three are the most common.

[27:51] Katie Chandler: Actually. This past summer I want to say I was diagnosed with sleep apnea but it was strange because it took me maybe six months to realize what was happening because it was like low lying. So I was shocked when I realized that that's what it was because I would wake up a lot but I wasn't waking up and bright eyed. It's that kind of thing where you wake up and you sometimes you open your eyes, sometimes you don't, you fall back asleep. But what I didn't realize that I was doing that like 100 times a night. So I was having really disruptive sleep and wasn't feeling good. But I never million years would have thought sleep apnea and since then, and using a mouthpiece and just good old snorestrips, I sleep a lot deeper. So it's fortunately, mine is an easy fix, but I think people can be surprised. When you think of sleep apnea, you think of someone that is typically pretty overweight, right. That's usually the standard that causes sleep apnea. But you can also have obstructive airway, which is what I have. And so I don't know, I think essentially why I'm saying this is if you feel draggy all day long, if you feel starving all the time, if you are gaining weight and you can't lose the weight or whatever it may be, maybe look into your sleep. Right.

[29:06] Dr. Holliday Bell : 100, you hit the nail on the head. And sleep apnea is much more it's often less diagnosed than women because of the reasons that you said it tends to be milder. It's not your typical overweight middle aged male, which is what we think of with sleep apnea. You may not even be snoring. Right. Like you said, you're just kind of like waking up multiple times, not really aware of it. And it's often misdiagnosed as like, anxiety or depression because insufficient sleep for a long period of time independently increases your risk of having those things. But instead of getting out of the underlying disorder, it's like, oh, you just have anxiety or you're just depressed. You're just these things. And we don't think to look into things that are interfering with sleep. So you're absolutely right. It can be so mild and it can be something that you're not aware of, which is why it's important to talk about it. As I'm a physician and a sleep specialist, but separately, in my role as a physician, every visit I'm asking, how are you sleeping? Because it's important and a lot of people don't think to even bring that up for themselves.

[30:03] Katie Chandler: Yeah, I'm sure that's such a good point.

[30:06] Amy Sherman: So talking about getting that good atmosphere for sleeping, I always hear, and you never know what's true or what's not, but is there a good temperature to sleep in? I heard the colder the better, but I want to get your official answer on that one.

[30:22] Dr. Holliday Bell : Yeah. When it comes to setting up your sleep environment, I like to say keep it cold, dark and quiet. And the reason for the cold statement is that your body temperature has to decrease by one to three degrees in order to facilitate the transition to sleep. It's actually one of the things that also triggers your peak mellows on the release is when your body temperature decreases. And so in the literature, you'll see temperature recommendations of 62 to 68 degrees. And some people look at me like I'm crazy when I say that. And I'm like, what? I keep my house at 80. That sounds so cold. And you know, it kind of goes back to shoe size and there is no one size fits all right? So I say if you're walking around comfortably in your home at 80 before you go to sleep, put it on a 77. It's not an absolute number. It's just it needs to be it should be decreased from your baseline when you're walking around in order to facilitate that transition and then blocking out light, blocking out sounds because that can interfere with sleep too.

[31:19] Katie Chandler: Yeah, I like it cold. What about you, Amy? I keep it cold.

[31:23] Amy Sherman: Well, it's funny, the older I get, the colder I like it. But I feel like I always get into bed and I'm freezing and my feet are always cold. So then I put socks on and then I warm up and then I take the socks off the night sometimes because I get like hot and cold. But I do find it easier to sleep when it's cold because you can get all wrapped up and everything and I was going to ask about that too. Do you have favorite? Katie and I are really into a weighted blanket, but do you have favorite kind of sleep items, sheets, PJs, like, all that kind of stuff that you would recommend?

[31:56] Katie Chandler: Yes.

[31:57] Dr. Holliday Bell : Anyone who knows me knows that I do not go anywhere. I don't spend a night in my own bed, in a hotel, anywhere without my blackout mask. It's like I have to have it. If I forget to pack it, I'm going crazy. And that's because like I said, my sleep reactivity is so high, so any light that's coming through my eyelids is not good. And I have the plush blackout mask. I'm not talking about like the little mask they give you on the plane, like the real deal 3D blackout mask with a plush cups. And the ones that I use actually have built in speakers. So if I want to do a sleep meditation before I fall asleep, it's like easy to do that. Number one, I have to have my blackout sleep mask. I also sleep with a fan every single night. So in addition to turning the temperature down, I need a fan. I mean, I'm in Chicago. It's wintertime. I sleep with my fan every single night. I have a little travel fan that I take with me again because it's hard to control the temperature in some areas. So I have a travel fan. I sit right there next to me on the night stand. So I would say bills are my two must have, cannot sleep without.

[32:59] Katie Chandler: What do you think?

[33:00] Amy Sherman: The noise of the fan too, is probably relaxing, I would think.

[33:03] Dr. Holliday Bell : Exactly. Yeah.

[33:04] Katie Chandler: What about Sunrise Timers? Those are new and we've reviewed a couple I know. Amy, you have one that you love, right? Is it the hatch?

[33:10] Amy Sherman: Yeah, I had one from Amazon and now I have the hatch, which I've had I need to set up, but my waking up game has significantly increased using those because it's not so harsh. It's like a gentle tap.

[33:23] Dr. Holliday Bell : Yes, I love hatch. I love hatch. It's a great, like I said, gentle way to wake up. Historically, that's how we were signal to wake up was from sunlight sending those alerting backers to our circadian rhythm and saying, okay, stop melatonin release, it's time to wake up. So it's such a gentler, more natural way to wake up. So I absolutely love hatch because I sleep with my blackout mask, it doesn't work as much for me, that makes sense. So unfortunately I personally don't utilize that as much. But for individuals like don't like blackout masks or whatever, don't sleep with them. I always recommend a good sunrise clock because it just makes it gentle. You just start your day so much better. It's more natural. I love a good sunrise clock and I also recommend blackout curtains. Like I have like two sets of blackout curtains on my window. So you're not getting that natural light from outside. So it is helpful to kind of recreate that through something like a sunrise alarm clock.

[34:14] Amy Sherman: Yeah, if it was up to me, I would sleep with the windows open because I love the natural light coming in the room in the morning. But again, like I said, my husband's like you, he's got the mask, the earplugs, the whole thing. And then what about beds? Do you have a certain bed that you like that is like game changing for you for sleep?

[34:32] Dr. Holliday Bell : You know? So I've gone through several, I went through several different beds. But what I will say in general, what I've found is that beds are very, it's different for different individuals. So I am someone, I'm a stomach sleeper, but I like a soft bed, which doesn't really make sense in the sleep space because if you are some sleeper, they typically recommend more firm mattresses because it's better for your back, whatever. For me, when I tried to like, okay, yes, I'm going to do this and because that's what I should do, I just sleep horribly. I like soft, like a cloud, like soft as possible. And so I think it's important to just find out what is most comfortable for you. Investing in that though, like a good solid mattress is going to work wonders for your sleep. So it is worth the investment, I will say. There's a brand new mattress called Kingstown that has a line that has separate comfort levels or firmness levels on each side. Like my husband prefers a firmer and I prefer as soft as possible. You can actually get the two different preferences built into the same mattress because that can really make a huge difference. So that's a one brand that I think does that well. But in general, finding what feels good and comfortable to you and making that.

[35:49] Amy Sherman: Investment, would you say that would be the same thing with pajamas and what you wear to sleep? Because like it's funny, I like to wear like pajamas, pants and a t shirt and some people wear like shorts and a tank top and I would be freezing all night.

[36:04] Katie Chandler: Yeah, I feel like an 80 year old woman in my nightgown.

[36:09] Amy Sherman: Feel like I couldn't wear a nightgown.

[36:10] Dr. Holliday Bell : That would make me whole. Exactly. Yeah. I think when it comes to what you sleep in, the fabric is more important than even like the type of clothing. So it helps us to wear light breezy like cotton, moisture, wicking fabrics because if you have some that hold too much heat, again, it causes you to warm up too much and integrate with sleep. But for some people they sleep in the nude, some people they like the full shebang pants, long sleeves. I think whatever makes you comfortable and not too hot is going to be the best thing to sleep in.

[36:38] Amy Sherman: Yeah, makes sense.

[36:40] Katie Chandler: This is all such great information. I feel like we could probably keep going and going and going.

[36:45] Amy Sherman: But I know there's so many more questions, but we know you have an amazing Instagram feed with so much good sleep content. So I know a lot of our listeners are always asking questions about sleep, so we definitely want to make sure that people are checking you out. Your instagram is the sleep underscore MD. That's correct, right?

[37:02] Dr. Holliday Bell : That's correct. Yes.

[37:04] Amy Sherman: Lots of great content on that.

[37:05] Katie Chandler: And where can our listeners find you if they want to work with you? Because as sleep specialist yeah.

[37:13] Dr. Holliday Bell : So you can find me at my website, www dot the Solution isleep.com. I offer a range of services for a range of sleep issues. If you're someone who just is like, I don't know what I'm doing, I just know I need to get my sleep on track. Or if you're someone you suffer from chronic long term insomnia and you've tried all the normal sleep hygiene things and it hasn't worked. I offer cognitive behavioral therapy for Insomnia, which is a longer term process to really dig deep into the root causes of insomnia and go into some therapeutic strategies to improve it. And then on a business corporate level, I work with different corporations to help their employees get better sleep because we know that sleep improves productivity, efficiency and the overall bottom line, companies basically lose less money per employee if the employees are sleeping well and they're investing in employees sleep. So I'll offer that. Just head over to my website, check that out. You can also find me on LinkedIn at Doctor Holiday bell. I try to give more longer form content than I can give on Instagram. So any of those avenues are great.

[38:17] Katie Chandler: That's great.

[38:18] Amy Sherman: It's amazing.

[38:19] Katie Chandler: It's so true. Like, sleep is absolutely everything. You know, all these people that are like, wake up at 05:00 A.m. And go to the gym and do all of this. I'm thinking now I need that extra one or 2 hours of sleep. I am prioritizing that and I'm a morning person.

[38:35] Dr. Holliday Bell : You will get more done in your day if you've dedicated the time to getting your sleep need and if you're like, oh, I'm just going to wake up thoroughly and go to sleep late. You're actually more likely to get less done in that time than if you just prioritize. So start with sleep in mind and adjust the rest of your day around. That is what I like to say.

[38:53] Katie Chandler: Nice. Well, there you go. You heard it here.

[38:54] Amy Sherman: So true. All right, so we're going to get into our wrap session. So what is your favorite wellness or beauty hack?

[39:02] Dr. Holliday Bell : Sleep chakra. But it's so true. Sleep is good for the skin. It's good to keep you young. It's sleep is always my answer.

[39:11] Katie Chandler: All right, this next one, we call it our five minute flow. You just got out of the shower. Uber's pinged you. They're five minutes away. What are you going to do to get out the door and get into that Uber on time? What are your Holy grails, your go to? What's the quick routine?

[39:24] Dr. Holliday Bell : Yeah, my skincare is super important to me, so I'm always going to have a good I like the seraph in the ordinary products. So good. Face wash sunscreen is so important. So if nothing else, face wash, moisturize, sunscreen, maybe a tinted moisturizer. Eyebrows are also important to me. So fill those in, lip gloss and out the door.

[39:45] Katie Chandler: Nice. Yeah.

[39:46] Amy Sherman: Your skin is gorgeous.

[39:47] Katie Chandler: Yeah, it is beautiful. We were just talking about our love for Saravay in the ordinary, like 2 hours ago. Amy and I had funny.

[39:56] Amy Sherman: And how do you maintain your daily nirvana?

[40:00] Dr. Holliday Bell : Self care prioritizing what makes me happy and what allows me to be the best that I can for everyone else and all the roles that I play. That's something fairly recent for me. I would say in the past couple of years, I started to invest in and it's really changed my entire outlook on life and who I am as a person. So prioritizing my sleep, exercise, taking care of my skin, just the little things that make me feel like me and allow me to be the best version of me for everyone else.

[40:29] Katie Chandler: So important. The magic recipe right there. We really appreciate your time and I know our listeners are going to get so much from this. I'm definitely going to be sleeping better now as well. So thank you for being with us. And before we go, we'd like to close with a little mantra. So, Amy, what do you have for us?

[40:45] Amy Sherman: So I took a mantra or a quote from Dr. Holiday Bell on her Instagram feed. And I just thought it was so relevant for our conversation. And that quote is sometimes the most productive thing you can do is rest.

[41:01] Dr. Holliday Bell : Absolutely. It's love it.

[41:03] Katie Chandler: I have to say, I had a quote, too, from Dr. Holiday Bell's feed because it was so good. So I think we need to drop this one as well.

[41:10] Dr. Holliday Bell : Let's hear it.

[41:11] Katie Chandler: Rest is not the absence of activity, but the presence of peace. And I love that. It's such a good reminder and like to give yourself permission to rest, right?

[41:22] Dr. Holliday Bell : Yes, absolutely. Because you're being productive by resting and refilling your own cup. So I love it. Thank you, guys.

[41:28] Amy Sherman: That's so great. Thank you for joining us, and we would love to have you back any time. This is such an important topic, and I think it's gotten a lot of visibility over the last few years, and it's like a continuing subject I feel like I see all the time in the media. So thank you again.

[41:42] Dr. Holliday Bell : Yeah, thank you so much. I'd be happy to come back.

[41:46] Amy Sherman: Thanks for listening to Nirvana Sisters. For more information on this episode, check out the show notes. Please subscribe and leave us a review. Also, find us on Instagram at Nirvana Sisters. If you loved what you just listened to or know someone that would, please share it and tag us. Tune in next week for a fresh new episode of Nirvana Sisters. We'll continue to watch out all things wellness so you don't have to. Bye.