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Sleeping During Stressful Times

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Season 9, Episode 9  | April 5, 2020

Many of us — even those who normally sleep well — may be having trouble falling and staying asleep given the fear and anxiety we’re facing as part of the COVID-19 pandemic. Yet sleep is critical for our immune function, our ability to fight off infection, and our mental health. Integrative psychiatrist and author Henry Emmons, MD, is back to talk about these connections and offer tips for getting more sleep during this stressful time.

Bedroom With A Bed, Nightstand And Alarm Clock.

02:01

In this episode, we’re joined again by integrative psychiatrist Henry Emmons, MD. Dr. Emmons was our guest on our “Why Sleep and Stress Management Are Non-Negotiables” episode. He’s also the author of The Chemistry of Joy, The Chemistry of Calm, and Staying Sharp, and is a columnist for Experience Life. He’s here to revisit the topic of sleep and speak to why it’s so important during these stressful times.

02:53

Why is sleep especially important right now?

03:10

Sleep is a critical factor in our bodies and immune systems working at an optimal level. In addition to the viral pandemic, we’re also experiencing a fear pandemic, and fear and stress are both very tightly linked to sleep.

05:12

Dr. Emmons discusses the connection between sleep and the immune system, as well as the ways we’re at risk if we aren’t sleeping well enough to calm inflammation.

07:18

Right now, we’re more connected to our devices and more exposed to an influx of troubling news. Dr. Emmons offers some strategies for getting good sleep despite that.

09:47

Dr. Emmons dives into exactly what your body is doing when you’re asleep. He talks about the importance of different parts of your sleep cycle, the role of your hormones and circadian rhythm, and how deep, restorative sleep can benefit immunity and tame inflammation.

14:19

Many of us are having trouble falling and staying asleep due to the fear and worries we’re facing. Dr. Emmons discusses his thoughts on using prescription and natural sleep aids to help.

17:27

Dr. Emmons offers advice for staying calm so you can fall back asleep more easily if you wake in the middle of the night.

19:01

Do sleep aids compromise the quality of our sleep?

20:22

If you consume alcohol, the key to it not disrupting your sleep is the timing and amount.

21:55

Dr. Emmons has seen CBD have a calming effect on some of his patients, and in some cases, it may help you get better rest.

23:04

It’s normal to be stressed right now — there’s a real threat. But it does not have to turn into fear. Dr. Emmons discusses the distinction.

24:39

Dr. Emmons’s shares his suggestions for ways to make this out-of-norm feel more normal, including ways to use technology to feel less isolated.

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Transcript: Sleeping During Stressful Times

Season 9, Episode 9  | April 5, 2020

Jamie Martin

Welcome to Life Time Talks, the healthy living podcast that’s aimed at helping you achieve your health, fitness, and life goals. I’m Jamie Martin, editor in chief of Experience Life, Life Time’s whole life health and fitness magazine.

David Freeman

And I’m David Freeman, the signature program lead for Life Time’s Alpha program. We’re all in different places along our health and fitness journey, but no matter what we are working toward, there are some essential things we can do to keep moving in the direction of a healthy, purpose-driven life.

Jamie Martin

In each episode we’ll cover the foundational elements of healthy living, including fitness and nutrition, health issues like sleep and stress management, and mindfulness and community.

David Freeman

And we’ll be talking to experts from Life Time and beyond who’ll share their insights and knowledge, so you’ll have the tools and information you need to take charge of your next steps. Here we go.

[Music]

Jamie Martin

Hey everyone, David and I are so glad to be back with you, even though it’s a little sooner than we were planning. In early March, we were just starting to finalize details of Season 2 for Life Time Talks, and then all of our lives were turned upside down by coronavirus.

David Freeman

So, we decided to extend Season 1 and bring you some additional episodes on coping with this new normal. With all the worries, the changes, the challenges, and the opportunities.

Jamie Martin

Like many of you, we’re in our respective homes. I’m in Minnesota . . .

David Freeman

And I’m in Texas . . .

Jamie Martin

And we’re recording in the quietest rooms we could find. I’m in my home office and there’s a good chance my daughters will come knocking sooner than later.

David Freeman

And I’m in my man cave. My kids are probably thinking I’m playing hide and seek, and they’re “it.”

Jamie Martin

We know that a lot of people are concerned and worried about coronavirus and its effects on our family and friends, our communities, our world. We are too. It’s impacting every aspect of our lives.

David Freeman

And while we’ll be leaving it to the local and state officials, along with public health experts and the CDC, to revive the latest information about the illness, we’re here with the intent of offering some ideas, information, and inspiration that we hope helps you navigate the days ahead.

[Music]

Jamie Martin

Welcome back to Life Time Talks, everybody. We have brought back Dr. Henry Emmons for today’s episode to talk about sleep, this time in the context of sleep during really stressful times like we’re all experiencing. And I want to kick it off by reading the intro of Dr. Emmons’s column in the April 2020 issue of Experience Life.

The title of the article is “Sleep Yourself Well” and Dr. Emmons writes: “Why would humans evolve to spend one-third of our lives unconscious and therefore vulnerable? What could be so important about sleep that every mammal is tethered to sleep more tightly than any other rhythm in nature? It’s because there is no other form of self-care that affects our mental health, indeed our overall health, as much as sleep. And it’s not even close.”

So, with that in mind, Dr. Emmons, welcome back to Life Time Talks.

Dr. Henry Emmons

Yeah, thank you. I’m happy to be here.

Jamie Martin

I want to remind everybody, Dr. Emmons is an integrative psychiatrist and also the author of several books including The Chemistry of Joy, The Chemistry of Calm, and Staying Sharp. We’re really excited to talk to you about sleep. Let’s just talk about it, especially right now, what are your thoughts on why sleep is especially important at this moment?

Dr. Henry Emmons

Well, I think it’s really important for two essential reasons. And one is because there is this virus that is out there that is the course causing this pandemic, and we all need to have our bodies and our immune systems working at optimal capacity right now. Because, you know, we can do everything possible to prevent exposure but it’s really our body and how it reacts to potential exposure that determines the outcome. So that’s just really a crucial piece to it.

But the other really important piece — and these two are very closely linked — is that there’s not only the viral pandemic, but there’s the fear pandemic. And it is affecting everybody, of course. And there’s almost no way that it wouldn’t cause fear or make people feel scared, but again, how we respond to that makes all the difference. And so sleep and fear and stress are so closely linked that it does just a great deal to keep us in a more balanced state and keep our bodies working optimally, which is just so important right now.

David Freeman

And I want to talk on the connection between sleep and our immune system. Me personally, I shared with Jamie and Molly and the team earlier this week that it’s almost like a placebo effect that’s going on right now. Any little thing — whether it’s a sneeze, whether it’s a little itch in the throat — now has me thinking something is going on with my body and I’m anxious at night and I’m never really getting into a deep sleep pattern that I once had before seeing all these different things that we’re now consuming through TV or social. So, can you tell us the connection between sleep and the immune system and all the different ways to probably put the anxiety and everything else to the side?

Dr. Henry Emmons

Absolutely, you know there’s two aspects to the immune system and we often don’t think about the importance of both of these. So, on the one hand, we want our immune system to be able to react to any invader like a virus or bacteria. It needs to be able to react and neutralize that, and so it has to kind of mount this big response. And that’s really how most of us are thinking about the immune system right now.

But the other side of it is that we want our immune system to react but not to overreact. And it’s the overreaction that may in fact turn a mild case of coronavirus into a really severe one, where your body is now responding to this invader, but it’s responding so much that it’s actually hurting your own body. So, if that makes sense, what we want to do then, is we want to think about keeping this kind of middle way, this even balance between the appropriate amount of reaction but not overreaction. And that is all tied very closely to the stress hormones, the stress system.

And so the immune system and the stress system, you can hardly separate those. They’re just so tightly linked. And the way that we respond to things is just intimately connected to our sleep. So it’s both important for sleep to be as normal as possible so that the stress hormones aren’t taking over, kind of oversecreting, but it’s also important because it keeps the inflammation down. So if we do have an infection, and our body is reacting, sleep is really key for reducing the inflammatory reaction. Again, that’s what can cause a lot of the actual damage.

Jamie Martin

I think that is so critical, like sleep as a mitigating tool in some ways. But I’ve heard more people recently talking about, “My sleep has been disrupted.” So, you know, we talked about this in our previous episode, things we can do to help, but are there any specific exercises or things that you would recommend, any practices for people as they’re winding down at night as they’re disconnecting from their tools? Many people are more virtually connected than ever before because of the way we’re working from home. To help people, you know, really try and find calm in the evening so that when it’s time to go to bed, we really can let some things go and go to sleep. Does that make sense?

Dr. Henry Emmons

That makes total sense. And you know, like so many people right now, I’m working from home. So, my daily routine is completely different. And so that has really changed, for example, how connected or how much of my time I’m spending online. And I’m struggling with this probably like everyone. What I’m finding is that it’s important for me to stay tuned in to what’s happening. So, I do check in with the news feeds and so forth, but I really have to watch that I don’t overdue that. Especially in the evenings, you know, if you’re going to get your fix of all the crisis and big challenges that are happening, do it during the daytime hours.

Try and preserve your evening now even more than usual for relaxing with your family or whoever is in your household, maybe connecting with friends on a virtual meeting or get together of some sort or just a phone call, but also, really, really take seriously the need to unplug from troubling news but maybe even unplugging from the electronics a little earlier than normal.

Normally I tell people, try and save the last hour if you can where you’re more or less unplugged. But I think now, maybe you need to extend that to 90 minutes, two hours where you’re just doing something like reading a good old-fashioned book or you know, something on the Kindle, or maybe listening to music or a podcast, but not really engaging too much with the visual electronics.

David Freeman

So, let me ask you another question as it relates to winding down. So, what exactly is the body doing? I know we have this, I want to call it, optimal window. We always talk about after you get done working out how you work hard but recover harder. So, what’s the body actually doing during certain hours of sleep? Is there an optimal time we know of, obviously seven or eight hours, but when we look at from 12 a.m. to 2 a.m., or 12 a.m. to 3 a.m., are there certain times that are optimal for the body to actually be recovering? I know you spoke on inflammation, but can you dive a little into what the body is doing during the sleep?

Dr. Henry Emmons

Absolutely, great question. So, this is really important, I think, because what I’m going to say here is so tied in with what we’re talking about before, with your stress system and with your immune system. So, the body is really geared toward this circadian rhythm, this 24-hour circadian rhythm. Everything is really controlled by that, so the release of all your hormones, including the stress hormones, and so everything changes over the course of the day, this is just normal. You know, everyday patterns that we’re supposed to be living with.

And so, if you think about sort of the ideal, let’s just say the ideal time in bed is from approximately 10 p.m. to 6 a.m. or 11 p.m. to 7 a.m., roughly eight hours, in the evening hours, so those three to fours hours before you go to bed, you’re your adrenal system should really be shutting down. You know, all the stress hormones which you do need to be able to function and stay focused and productive during the day, they really start to recede and they really go down in the evening, so that by approximately 10 or 11 o’clock your body is really ready for bed and melatonin can really put you to sleep.

Those first three to four hours of sleep, David, are probably the most important. That’s when most people get the bulk of their deep sleep. So, you know you go through cycles of sleep over the course of the night and it’s really important that that first cycle or two stays intact so that you really get a chance to go into the deep, restful, restorative sleep. And typically, that’s going to be between, let’s just say, 11 p.m. and 2 a.m., or so. So, the first hour you might be sleeping kind of lightly or taking a little while to fall asleep, but then pretty quickly, in those first one or two cycles of the night you go down into that really deep sleep, which is so important at kind of toning down this immunity and the inflammation response.

Then, you know, for a lot of people, for about let’s say 2 a.m. until 6 a.m., their sleep cycles are lighter, it’s much more common for people to wake up during those times. Maybe that’s what you’re even describing here, David, kind of in the middle of the night until the morning hours you’re just not sleeping as deeply. If there’s something on your mind or if your stress levels are just a little higher than normal, you might find yourself laying there awake for a while and then of course you know as soon as the mind kicks into gear, you know, all bets are off as to whether you can get back to sleep.

But I really encourage people not to be overly concerned about that, you know again, hopefully you’re getting really good chunks of deep sleep in the first half of the night and as long as you don’t feel too miserable laying there and ruminating or whatever, if you can let that go and just know that even just laying down and resting is still good for you, I think it’s just really important to remember that. And I think, a lot of times people find if they can just relax about the fact that they’re lying there awake, they’re much more likely to fall back to sleep. A lot of what keeps people awake in the middle of the night is the fear that they’re not going to be able to return to sleep.

Jamie Martin

And worrying about how they’re going to the next day and function and all those things.

Dr. Henry Emmons

Exactly. Yeah, and so my message would be, you know, for the sake of your immune system and inflammation, I think the most important time is those first few hours of the night.

Jamie Martin

So for people who, you know, maybe normally sleep really, really well­ I don’t wake up in the middle of the night typically, that kind of thing — you know they might be starting to do this just because of again the fear, the worry, just the unknown and uncertainty right now. What are your thoughts on, you know, maybe they’re turning to sleep aids right now to try and help them through this, but what is your take on that and what would your recommendations be around sleep aids in this kind of transitional period that we’re in.

Dr. Henry Emmons

Yeah, that’s a really important question. I usually tell, you know, because I usually work with people who have anxiety or depression, and if they start going without sleep, it’s much more likely to cause a recurrence of illness. And so, what I usually tell people is that it is better for you, most of the time, it is better to take something to sleep rather than to not be able to sleep. But, at the same time, it’s good to remember that if you’re using, most sleep aids, especially the prescription drugs, but even an over the counter thing like Benadryl, you might sleep, but the chances are you’re not getting the really deep sleep that’s so important.

So I usually encourage people to begin with some natural remedies if the sleep problem isn’t too bad. You know, just some really gentle things. There’s some good teas, you know, that that have herbs that are useful for sleep, valerian root, of course, hops, chamomile, there’s some, people can get some herbal elixirs with those things that are a little more potent than the tea might be, you know it’s just like a dropper bottle and they can put that in water before bed, and then using something even like magnesium at bed time, and maybe if you want something a little more potent than that you could try some kava or tryptophan and those things are, for most people, they are gentle but maybe just enough to get over that hump of not waking up so much in the middle of the night.

A lot of people wonder about taking melatonin and that’s a little more tricky because if you take melatonin you know, a pill, or a liquid form of melatonin, if you take it at bedtime, it wears off in about three hours for most people, and when it wears off, most people will have a rebound and they’ll wake up. So it’s not idea for the problem where you’re waking up in the middle of the night. Melatonin can be super helpful if you can’t fall asleep when you first go to bed, so you know if you’re getting ready for bed and you’re doing all the good calming activities and you’re still just super alert and wide awake, that might be a good time to have some melatonin. I think it’s better in that instance to use the sublingual melatonin where it dissolves under your tongue, because it works faster and gets absorbed better, but it’s not a good thing if your problem is that you’re waking up in the middle of the night.

Jamie Martin

Are there any things we could do if we do wake up in the middle of the night, like if I just am sitting there like is it getting up and stretching for a little bit or is it getting up to do anything? I mean I’ve heard some people say, like sometimes I just need to move around or I need to change my location and that helps me fall back to sleep. Any thoughts on that?

Dr. Henry Emmons
Yeah, you know most people who work with people with insomnia advise them to get out of bed and just use the bed for sleep. I actually am a little more mixed on that, I think it’s helpful for some people but a lot of times when people get out of bed, they’ll turn on lights, they’ll go to the kitchen, or they’ll, worst case scenario, they turn on their iPhone or get on their computer and start working you know. I feel like you guys be careful with what you do when you’re, if you’re up and about. I feel like it’s important to keep lights off because lights will quickly tell your body to wake up. I think a lot of people if they just give it a little time they could stay in bed, pay attention to their breathing for a little while, you know do a quick body scan, you know it doesn’t take long but if you just put your attention on your body, maybe even just feeling yourself laying on the bed and how you’re supported from below by the mattress, turning your attention there takes away the thinking that your brain wants to do and it just makes it easier for you to calm your thoughts and go back to sleep.

David Freeman

When it comes to some of the sleeping aids that we were talking about, I know we said sleep, some sleep is better than no sleep. But I want to go back to what we said earlier as well, if we are taking these sleeping aids, are we compromising the optimal response of the body to reduce the inflammation or allowing you to actually recover and boost the immune system? Or, is that still not going to be compromised if we’re taking the sleeping aids?

Dr. Henry Emmons

You know, I don’t know the answer to that for sure, but my sense is, this is just my speculation, I think that if people rely too long on prescription sleep aids, I don’t think that there’s likely to get the deep sleep and that’s really what’s key for the inflammation. So, my thought is that you’re better off trying to avoid the reliance on sleep aids long-term. I think if it’s just a night or two, here and there, or maybe one or two nights a week, I think that’s probably fine. Even if it’s a prescription sleep aid. Again, I think the natural sleep aids, they’re gentler, they don’t disrupt the normal sleep pattern as much. So, if you can get by with that, I think you might be better off trying to start there.

Jamie Martin

One thing I just, it just occurred to me is, you know, alcohol and sleep. You know, there’s some people who are like, “I wind down at the end of the day and have one glass of wine or something,” and you know, some people might be relying more heavily on alcohol right now. I hope that’s not the case for a lot of people, but, I have, you know, there’s lots of research about your body when you’re sleeping after having a drink you’re not really getting into that same sleep pattern. Can you speak to that a little bit?

Dr. Henry Emmons

I think here the key is timing and amount. And so I think most people, frankly, are better off having their glass of wine or a drink around suppertime. Or at least a couple or three hours before bedtime. Anybody who has any trouble sleeping should probably avoid having a drink right at bedtime. It’s for two reasons: One is it works kind of like melatonin where it might relax you and help you fall asleep but as soon as if wears off in a couple of hours, you’re going to have a rebound and you’re probably going to have a really bad night sleep in the middle of the night.

The second problem with alcohol though is that it, if you drink very much, it’s really going to keep you from going into deep sleep. If you have, and I would say more than a drink or two, probably better of limiting it to one if it’s at bedtime. Certainly two or more drinks at bedtime, I think it’s going to affect that normal architecture of sleep where you go through the normal cycles and have the deep stages.

David Freeman

Doctor, let me ask you this, so, being that we were talking about alcohol just now another form of a drug that you probably have heard of, hemp or CBDs and things of that nature: What’s your thoughts on that because I’ve heard of positive things coming from that side of it, whether it helps aid to sleep, what’s your thoughts on the hemp, the CBD, and things of that nature?

Dr. Henry Emmons

I have a lot of my patients who are using CBD oil and I would say, by and large, it has been quite helpful. I have not seen people develop a lot of problems, and I think it’s helpful enough for anxiety, but that may be why it’s helping with sleep. Because I don’t think of it as being particularly sedating, but I just think it can help people feel calmer, mindless racing, and so forth, and so I would say people would have to try it out for themselves if they’re wondering, because everybody does react a little differently. But overall my experience with it has been largely positive, especially for sleep and anxiety.

Jamie Martin

Well, Dr. Emmons, is there anything else you would want to add, and I’m thinking about our current circumstances, anything else with sleep, stress, fear, that you want to make sure we touch on before we go onto David’s got his power minute that we do here shortly? So we’ll get to that in a minute but anything else you’d want to add that you think is really essential in this moment that we’re experiencing as a society as a whole, globally?

Dr. Henry Emmons

Well you know, since fear is such a big part of this, I think it helps to make the distinction between stress and fear. So, you know, of course it’s normal to be stressed right now. There is in fact a real threat, and there’s a lot going on out there, and so that’s just a completely normal reaction but it does not have to devolve into fear where which takes over and then you start, you know, the mind gets a hold of it, and you start ruminating, and not being able to let go of it, or wishing things were like they used to be or what have you. It’s important to keep that distinction and try and keep it in perspective. And if it’s stress that, the stress response that we’re dealing with, there’s a lot of things we know that mitigate that. You know, exercise, incredibly helpful for mitigating the effect of stress. Um, you know, eating well. Taking care of your sleep in the ways we’ve been talking about. Doing some meditation practice. Learning to observe your thoughts and your mind just enough so it doesn’t completely take over and overwhelm you, it’s a great time to practice some of those things that can be lifelong allies.

David Freeman

Alright, awesome, so here we go. Drumroll please, we have our power minute coming. So we do this at the end of our episodes and what we usually ask is a question for our listeners to kind of just empower them with the way forward. And so, as we all know what’s going on right now and how everything is affecting our everyday life, what we want to ask you is, what would you suggest in these days to come as to get people to make what might not seem normal right now, to bring them back to making things normal. We can call it pressing the reset button, being present around family and friends, reconnecting across the world, whatever it may be: What would be Dr. Emmons’s suggestion to getting people back to making what is not normal, their new norm?

Dr. Henry Emmons

Well, I think you pointed out some great things. You know, I’ve found that connecting with people virtually is really satisfying. I’ve been pleasantly surprised by that. So I think that right now because people are so, feeling so much more isolated and kind of separated from one another, it’s all the more important to keep those connections alive and vital. And you really can do that by reaching out virtually. I’ve had a couple of virtual happy hours, we had a date night with another couple that was super fun where we had dinner together, you know, virtually through FaceTime, and then we watched a movie, watched the same movie, then we got together again and talked about it, just doing things like that people can be really creative that way.

Jamie Martin

I think that’s what’s been very eye-opening during this is people finding unique ways to connect, which we know is so essential to the human experience. Dr. Emmons, thank you so much for joining us again, we really appreciate your insights and hope to have you back again soon.

Dr. Henry Emmons

You are so welcome. And thanks so much both of you.

[Music]

David Freeman

Thanks for joining us for this episode. As always, we’d love to hear your thoughts on our conversation today and how you approach this aspect of healthy living in your own life, what works for you, where do you run into challenges, where do you need help.

Jamie Martin

And if you have topics for future episodes, you can share those with us too. Email us at lttalks@lt.life or reach out to us on Instagram @lifetime.life, @jamiemartinel, or @freezy30 and use the hashtag #LifeTimeTalks. You can also learn more about the podcast at experiencelife.com/podcast.

David Freeman

And if you’re enjoying Life Time Talks, please subscribe on iTunes or wherever you get your podcast. Feel free to write a review and also let others know about it, too. Take a screenshot of this episode and share it on social or share it with your friends, family, work buddies, life coach, you get the gist. 

Jamie Martin

Thanks for listening. We’ll talk to you next time on Life Time Talks.

[Music]

Jamie Martin

Life Time Talks is a production of Life Time — Healthy Way of Life. It is produced by Molly Schelper with audio engineering by Peter Perkins and sound consulting by Coy Larson. A big thank you to the team who pulls together each episode and everyone who provided feedback.

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Have thoughts you’d like to share or topic ideas for future episodes? Email us at lttalks@lt.life.

The information in this podcast is intended to provide broad understanding and knowledge of healthcare topics. This information is for educational purposes only and should not be considered complete and should not be used in place of advice from your physician or healthcare provider. We recommend you consult your physician or healthcare professional before beginning or altering your personal exercise, diet or supplementation program.

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