A Sleep Specialist’s Secrets for Better Mood, Skin & Energy

Monique Ramsey (00:03):
Welcome everyone to The La Jolla Cosmetic Podcast. Today I have a very special guest and it's a Dr. Swistun, but maybe not the Dr. Swistun that you're used to hearing from. It's Dr. Swistun's wife, Dominika Swistun. She's a clinical psychologist and a sleep specialist with a deep background in sleep research and she's here today to talk about how sleep plays a surprisingly powerful role in how we age inside and out. So welcome Dr. Swistun.

Dr. Swistun (00:33):
Thank you so much for having me. Good morning. I am glad to be here and thank you for bringing attention to this very important topic. As you know, and we all know we sleep every day, every night and it's like a cornerstone of our functioning, so I'm really happy to talk about it and hopefully listeners will find it interesting.

Monique Ramsey (00:56):
I think they will. We've got some really great questions and I think everybody's going to want to hear all of your answers to them. So just tell me a little bit about your career and what you do.

Dr. Swistun (01:07):
So I'm licensed clinical psychologist practicing for about 10 years in various settings from hospitals, clinics, rehab centers. I also have a small caseload of private clients and I focus on adult psychology and psychiatry, addressing different behavioral, emotional, cognitive struggles that people might have, but also functional and their health. As you can imagine, our physical and mental health are very much intertwined and I wouldn't be really efficacious and didn't have that much agency with treating patient's mental states if I didn't address physiological wellbeing. So obviously we talk about things like sleep and diet and their everyday habits. In addition to my clinical work, I also do research within sleep medicine. I am on various clinical trials. I'm interventionalist treating sleep apnea, insomnia and various other sleep disorders.

Monique Ramsey (02:16):
So tell me a little bit about what happens when we sleep.

Dr. Swistun (02:22):
That is very interesting and important question. I think for most of us. If you ask anybody on the street what happens when you sleep, people kind of envision that they just go off. You turn a switch like a light and you go to sleep and your mind is sleeping, your brain is sleeping, your body is resting, and that's only partially true. Our body is resting, our body is not moving and for most part is fairly still, although there are some changes internally, physiological processes and peptides and hormones acting. However, our brain is very active during the sleep going through many different stages and cycles, and that's the most important part in our healthy mental and physical wellbeing. Some listeners might already know that when we sleep, we go through these sleep stages that start at the top, this twilight falling asleep, feeling a little bit drowsy, kind of being in and out of it, and we go from stage one through two and three being the deepest sleep and then moving towards the REM, rapid eye movement stage.

(03:33):
When we dream, that's the most active stage in our sleep and that constitutes one cycle and it takes about 90 minutes. So going from light sleep, twilight one to deep sleep, REM and we repeat it again and again and again throughout the night. Healthy sleep requires about four to five sleep cycles. So we can right away think if we don't get seven, eight hours of sleep, we're probably missing some of these cycles. If we wake up frequently, there's a disruption in the sequencing of a sleep cycling and stages. Each stage is responsible for different physiological processes, and I'll talk about it a little bit later, especially when we talk about our body regeneration and physical health. REM stage is typically at the end and it becomes longer and longer as we progress into our sleep. And this structure is referred often to as sleep architecture.

(04:36):
So anytime someone doesn't sleep enough, their sleep is disturbed, it's not comfortable, there are interruptions or for example has some condition, chronic condition like sleep apnea, chronic pain, autoimmune disease, these cycles are interrupted and they might not be spending enough time in a deep sleep and REM is very important for our mental and physical health. So this is a part of our sleep. When we consolidate our memories, we figured out our emotions, we file, we reinforce things that we've learned. When you compare functional MRIs of brain in an active awake state, like right now when I'm talking to you, when I'm interacting, and when you compare that to a brain of a person who's going through REM, you can see a lot of glucose metabolism, meaning that the brain is super active. So during the sleep, our brain is acting in those periods of time as if you are awake. So now imagine if you're lacking REM or it's cut short or you don't get enough of the REM that needs to be repeated, then it creates a lot of problems in daily functioning and any emotional struggles with depression, malaise, lack of ability to enjoy things, difficulties with memory, all that comes from not getting enough of most likely time in that REM stage.

Monique Ramsey (06:05):
So tell me about the benefits of quality sleep on aging.

Dr. Swistun (06:11):
Absolutely. As we might know from our daily experience that not sleeping enough, not sleeping well, not being able to get this restorative sleep is associated with symptoms that we feel in a daily functioning. We don't feel as energized as we would like to. We feel groggy. Our mood is different. At the very least we're just having a hard time enjoying things. We're less patient, more irritable. So benefits of this sort of quality beauty sleep is not only on our mood and daily functioning, but also on health in general. So for example, our tissue doesn't repair as well, we don't heal. I mentioned stage two as a deep sleep. That's the stage in which our skin regenerates cell division happens. So if you don't spend enough time in that stage, if you don't go through it in appropriate fashion, you don't get the same benefit from your immune system and it can actually go both ways.

(07:18):
Your immune system is not as efficient, so it makes you prone to getting infection, bacterial, viral infection, but also can be activated so it can act like an inflammatory state. So it can go both ways. Your immune system might not be efficient or it might be overactive because poor sleep, lack of sleep can act as this pathogen stress has the same role, lack of sleep, they just aggravate your immune system as if there is pathogen. So it starts attacking something itself in the absence of virus. But also if you're not enough rested, if you don't have that chance for the repair, the immune compromise state might occur. When we sleep, especially in a deep sleep, we restore muscle function. So anytime you had a very busy day you were walking or running, there's any tissue damage, muscle damage, it repairs during the sleep. Some listeners might even recall that if you get a cut on your hand or you pick your skins or you have something on your face, it tends to recover much faster through the night and you can see in the morning, oh, it's almost gone. So eight hours of sleep, seven hours of sleep will give you a better result at 12 hours in a daytime because that's much more intense cell restoration and cell division period.

Monique Ramsey (08:48):
So what changes do you see in people when they start to sleep better?

Dr. Swistun (08:53):
Well, first and foremost, they feel more like themselves, what they expect to be what they may be were once back in the day before sleep difficulties. They report very simple things. They will say, I'm just able to listen. I enjoy myself more. The things that were irritating to me before, now I have better understanding, I'm patient. I'm just happier with myself with my daily life. So that would be like a mood improvement, quality of life, ability to enjoy things health-wise, most patients and research subject report increase in energy, increase in cognitive functioning. These individuals actually say now that I sleep longer better, I actually do these things much more efficiently and I enjoy them. They have more meaning. I'm more present, I'm more thoughtful, my relationships are different. And this constant feel of drag, of feel like life should be better. I should feel, I should be more efficient, I should be feeling more accomplished or grateful, but I don't. It makes people feel very depressed because it's like I don't know what my problem is, but why am I not happier or why am I not more fulfilled? And that's what it is. If you are just always running on the low fumes related to poor sleep, it's hard to get the essence of all the things that you're doing and it's hard to really enjoy day-to-day life.

Monique Ramsey (10:44):
Wow, that's powerful. It sounds like the sleep is such a foundational thing and obviously it should be, but that it would have all these benefits even for the next day. But are there long-term protective benefits for good sleep as well?

Dr. Swistun (11:04):
Oh, absolutely. And that's absolutely true what you've just said, Monique, that it's a cornerstone, right? We do it every day. When we have a poor sleep. For most individuals who struggle with chronic poor sleep, it's not a night, it's not two nights, it's not a week, it's not a month. At some point when I see my participants or patients, it's been decades since they were not sleeping well. So now they go through their thirties and forties and fifties of not sleeping well. So they're not aging the same way as they would have otherwise. All of their systems are getting the hits, right. So cardiovascular disease, metabolic systems that I've mentioned, all of it is aging and wear and tear is happening very differently on those systems. Years of living with an anxiety state or depression also will take its role toll on health on your internal organs and on outside as well.

Monique Ramsey (12:08):
Wow. So on the outside, if we talk about how sleep relates to beauty, I mean they talk about beauty sleep, but does it really help us look better longer?

Dr. Swistun (12:19):
Yes. Throughout the years it's a cumulative effect of all these events will have an impact on how you age. And at that point it's very difficult to reverse it. You can try putting creams or maybe at some point you will need to have other interventions, but it's hard to restore that lost time because it's really an investment into day-to-day habits. The days that have not happened, though I tell my patients they're still ahead of you. So there is always a good reason and it's always recommended to change your habits because those days are about to come and you can have better quality of life. But sometimes when we live decades certain way, it's very difficult to restore it.

Monique Ramsey (13:07):
That's true. Now for your patients and people out there. Okay, I'm going to admit something that is not the sexiest thing, but I have sleep apnea and I've used a C-P-A-P machine for over five years. It'll be six years in the fall. Now they're not the most beautiful things, but sleep for all the things you mentioned, it's like what's the trade off?

Dr. Swistun (13:36):
Exactly?

Monique Ramsey (13:36):
I've got to use this machine, but I'm getting into the REM sleep and I was waking up and mine was called moderate, so it was like 18 times an hour, which is like every two and a half minutes. Some people are way worse than that. And I'm thinking, how the heck? And you have no idea. Sometimes I would catch myself looking for air, but the oxygen saturation was down to 77%. I'm like, oh, I wonder why I wake up with a headache. So all those things.

Dr. Swistun (14:10):
Exactly.

Monique Ramsey (14:10):
So it's like there's answers out there and to think about, to take sleep seriously enough to say, not just for my looking pretty, but you were talking about the organs and just your overall mood the next day. So I feel like people need to think about what are the interventions, whether it's something like a machine and you have a sleep study or what are some of the other things that you recommend to people to help them lay down that good foundation for sleep?

Dr. Swistun (14:48):
Yes. You've mentioned very sleep apnea is very common. About one third of our population has a sleep apnea,

Monique Ramsey (14:54):
And I bet a third don't have a machine.

Dr. Swistun (14:57):
More than that, that's why most of my clinical trials and research projects involve sleep apnea because that's, unfortunately we don't have anything better. There are no other treatments other than the pressured air that you need to take. And as you mentioned correctly, this is a kind of pesky treatment. You have to learn to sleep differently. You have now this machine on your face. It's like you've said, I hear this again and again. It's not the sexiest thing, but the thing that I tell my participants, do you know what's not sexy? Being grumpy, not having desire or joy to be intimate even because people say, well, I'm going to have to be in bed with this thing. And I'm like, well, but that's sleeping, right? It's sleeping. And that's investing in your health so you actually can be your best self and able to convey your character, your personality, your joy.

(16:01):
Those things are sexy. Those things are the ones that connect you with your partner. Those things are the ones that actually pump the oomph into your life. So you have a choice. You might sleep without the mask and then just kind of be another version of yourself that it's introducing suffering. It's not letting you be who you are. So sleep apnea is very much serious condition that like you've mentioned, can make a lot of difference. And people don't know, but like you said, your sleep apnea was your AHI was at the level of 18. Right? So 18 times you stopped breathing and they call it mild. Yes.

Monique Ramsey (16:45):
Yeah. It was like, how the heck is that mild to moderate? I don't how much worse could it get? I felt like.

Dr. Swistun (16:51):
But when they go to the doctor and the doctor says, you have mild, and you're like, well, maybe I can still deal without it. I don't have to. I don't like the mask. It makes me anxious and they don't use. So adherence is really, really poor. And that's why we have all these studies helping patients train, understand desensitize and be able to use the mask because it's so crucial to actually stay on it and it's so difficult and it's so not appealing. And it takes a while for many people. Drowsy driving, driving when you have untreated sleep apnea has been studied extensively and it's fascinating to see that untreated sleep apnea like the one you've mentioned with AHI of 18. So 18 episode an hour, it's equivalent to legal, illegal limits of alcohol in blood. They did studies when they compared individuals who play the video games when driving, how many mistakes you make, how your response time, how many crashes you made in the video games. And people with untreated sleep apnea were very much comparable to people who were drunk and they were getting them progressively drunk so they could even compare the higher sleep apnea was correlated to a higher alcohol level intoxication. But when you pulled over, nobody says, ma'am, have you slept well last night? That's true,

Monique Ramsey (18:11):
Right? They say, have you been drinking or do you have any?

Dr. Swistun (18:14):
Yes. And you can get in trouble for that. And so also you regulate that, right? You want drink, you have rules, but you never think I better sleep because I'm driving my kids tomorrow because I'm driving myself and I'm on the road and I should. We never think that way. So like I said, it's really deeply rooted habit conviction or just lack of commitment or recognition, how important, how just central to everything good sleep is. Other things that we can use, just going back to basics, there's something like sleep hygiene that really promotes good sleep. Our bodies like routine, going to bed actually at the same time getting up at the same time. Very important. We do need seven to eight hours. No matter what people say, oh, I can live on four or five. No, you can't. And you probably are sleeping a little bit more, but six hours is not enough either.

(19:13):
So getting enough sleep, having your environment appropriately set. Typically we need dark and quiet. We need our bed to be just for sleeping and sleeping nowhere but in bed. So not having good habits of getting back to your sanctuary, your bedroom, your bed, your sheets that you enjoy that are comfortable, that are welcoming to you. So pillow, mattress, all these things are actually quite important. It's maybe a small effect from each, but those add up and they become a big thing. So making sure that your environment is comfortable, that you have a routine. For people struggling with insomnia. Interestingly, most of the time I actually tell them to go to bed later, not earlier. You have to be able to recognize when you're sleepy, not tired, sleepy. Those are two different things. I often hear from individuals who say, well, I was trying to be so good I was in bed at nine.

(20:14):
Well, you might have been tired, but you didn't have enough sleep hunger yet. Sleep hunger is something based on circadian rhythm, on the clock really, and it starts going off from the time you woke up. So it's just like with food, what makes you hungry is how much time has by from your very last meal. And sleep is the same way. So often people will get to bed because they're tired, they're aching, and they want to be good, so they get in bed and then they can't fall asleep. Then toss and turn and try to stay maybe on the phone or try to put themselves to sleep with the TV or some other things. And that is making it worse. They really are reinforcing inappropriate way of falling asleep. They reinforcing insomnia and it becomes just really messy. So one thing, very simple, I would say try to recognize when are you tired and when you tired, sit, relax, feed up, watch tv, all those things. It's a good idea. Don't go to sleep yet. Go to sleep at the very last moment when you really feel like your eyes are closing and you're sleepy.

Monique Ramsey (21:26):
Yeah, I think that's one of those biggest issues of getting your phone out and thinking, okay, I'm going to go to bed now. But then you open up and you start doom scrolling through social media and it's like, what do you do? It shouldn't even be, I know some people who put their phone in another room so that they don't even have the temptation to start with their phone. And I mean, what do you recommend for breaking maybe some of the habits that people might have when they get into bed?

Dr. Swistun (22:06):
I would start with one thing at a time. Negotiate with yourself. Changing habits is very difficult and if you want to be successful, do one thing at a time. You can start even with the smallest thing. It has to make sense to you why you're doing it. Giving up for what? So for example, yes, putting phone away and telling yourself if you do a lot of things in bed, like watching tv, being on the phone, maybe eating even, or just sitting in bed, start cutting these things slowly out. One other thing that it's actually quite tricky, clock watching. If you're really trying hard to fall asleep, you cannot be doing clock watching because that's the part that keeps you awake, obsessing about your sleep. That's the tricky part that when you want to fall asleep, you just have to let go. Your mind has to be in this very calm, peaceful state.

(23:03):
So worrying about not falling asleep, focusing on it overly, it's the opposite thing. It's hard to do if you worry if you have to get up the next day. If sleep has been your struggle for years, it's hard not to. But people are even avoidant of going to bed. They're like, oh no, it's not again, I'm probably going to be up. And it's already this attitude instead of being have an active day. And that's another part, good sleep results from a good day. And good day is when we active, active physically and active mentally. So when you spend yourself, when you're very active throughout the day, you will be hungry. You will yearn that good sleep. So wait until last moment and start winding down maybe closer to bedtime, about 30 minutes before bedtime, having your rituals, like going to bathroom and using some products or taking shower or must face massage even.

(24:11):
All those things, meditation, reading, all the things, whatever is your thing that you find. It's like your bedtime routine. Getting into PJ's, listening to music, lowering the lights already, all of that signals to your brain. Uh-oh. Sleep is coming. If we just get to bed and we're used to doing a lot of different things in bed, your brain is like, okay, party time. Like, oh, we're getting into business. Or if you used to worrying in bed, if you pay your bills in bed and you think about your finances or problems or answer emails or deal with personalities and people and work, you get into bed and your mind and body are thinking not about sleep, but about, okay, here it comes. Right? And it's all the association. It's all the tone we set for our mind and our body. So it should be literally quieting down and lowering and just saying to yourself, this is a problem, this is tomorrow problem. Right? I'll think about it tomorrow, Scarlet O'Hare. I'll think about it tomorrow.

Monique Ramsey (25:13):
Now, do you recommend people like to be able to think, oh, tomorrow, write it down and then put it away.

Dr. Swistun (25:21):
Yes, absolutely.

Monique Ramsey (25:22):
Or something like that so you don't forget. So you're not obsessing about it.

Dr. Swistun (25:25):
Don't forget, but it's also emotional and mental. Someone, one of my participants said, it's like a mind dump, right? You feel more secure, you feel more grounded, like, okay, I committed it to a paper, right? Write a list even down to talk to this person or think about that or pull out the clothes for the trip or just the most minute, and then you feel relieved because you're like, I committed it to paper. It's there. I'll take care of it. I'm not going to forget. So definitely before bedtime, using these strategies of either journaling, making notes, making lists, and getting who you want to have your mind is in more of a dreamy visualization place. When you fall asleep, your narrative in the head shouldn't be like, okay, tomorrow when I get to work, I got to talk to this person. This is what I'm going to say.

(26:12):
Well, you're already working. You're already there. It should be more visual, a beach, a mountains, whatever is your thing. Maybe something from the past from your childhood spaces, places, smell, sound, sunlight. And when you see that, you take yourself there. That's the power of our mind. We can go any place. We can be with anybody we want. We can become anyone. You can be strolling. And once you do that, that's almost like alert dreaming. You're not asleep yet, but you're to introduce these images and they slowly pull, you remember you already have a sleep drive on board, right? The sleep hunger because it's happening at 10, 11, 12, wherever you're going to bed, that will quickly pull you to sleep. So what we think, what we do, our environment definitely play important role in our ability to fall asleep and stay asleep. Interestingly, also, sleep as a psychologist is one of those things, and I've heard that initially from my advisor 20 years ago, and I just looked at her.

(27:15):
She's like, sleep is one of the easiest things I can fix. Give me any person. 98% of them, I will fix it. It's very powerful. And when you fix sleep, you fix 50% of psychological problems. And that's why she decided to be a sleep therapist. And I was like, that just sounded so like, I'm doing this doctorate program for 10 years and you're telling me that sleep is something that, and it was so true. That's why being a sleep researcher and therapist, I love it because I have so much agency, I can see change again and again and again. So I start my sessions, I know I sound too confident and cocky, but I can fix it. I can fix it. Give me six successions, I'll fix it.

Monique Ramsey (27:59):
Wow.

Dr. Swistun (27:59):
I can't say that with other disorders. I can't say that with depression and anxiety and personality issues and couples issues, sleep is actually quite straightforward. If you follow the recommendations, if you get on it, obviously it gets nuanced. I simplified it. But out of all the things when you fix sleep, you can improve so many other aspects of your life.

Monique Ramsey (28:29):
And it sounds like bringing it back to a very superficial thing, it sounds to me like if you consistently take your sleep seriously, you might be able to delay the need for a facelift. I mean, right? Could you?

Dr. Swistun (28:43):
Absolutely. Well, that goes back to the restoration of your tissue of and systems that work in your body. If your cardiovascular health, if your immune health are working better, you're aging very differently. You're definitely aging slower, more appropriate, you have more energy. So you work out, you work out. You're healthier, you have propensity to eat better foods. So everything, it's like a puzzle. One thing pulls another. When you sleep better, so many other things that are associated with usefulness and energy and life satisfaction, you see yourself different. You actually care, right, more. You feel more beautiful even you want to be energized and creative and because there's enough of fuel that because the bases are there, right? If you're not getting enough sleep, I would put it the other way as well, that as an organism, you'll only go through the basics needed. You'll get up because you have to.

(29:57):
You'll go to work because you need to provide for yourself and your family. You'll try not to fall on your face. But everything is a drag. Everything is just at the bare minimum. Let's get through the day. Let's finish that. Many people refer to this as not a way to live. Many people try to express their suffering through exactly that, that they're just going through emotions. They don't have enough energy and presence and willingness to actually see some joy, some light, because exactly there are running on the material that they restore through the night and it's not enough to have the higher experiences. So you'll go through basics. You'll feed yourself, you'll survive, you'll seek shelter, you'll carry on. But that's about it. And in terms of also general physical health, there's a wonderful study with graphs that are just shocking. The study referred to longevity and a hundred percent of individuals were diagnosed in the study came in with diagnosis of sleep apnea conditions you've mentioned when you stopped breathing during the sleep, they all were given mask to sleep with during the night, and then they were followed throughout the, they had no treatments, no recommendations. Some folks were able to stay on it, some were not. Those that did not, after three years, 60% of them were gone. They died.

Monique Ramsey (31:32):
Are you kidding?

Dr. Swistun (31:34):
And it's not the sleep apnea. I have the study. Yeah, I have the reference for, and it's not the sleep apnea killed them, but it was stroke, it was a heart disease, automotive vehicle accidents. It was all the issues that are associated with poor sleep. So absolutely, sleep is related to longevity. You'll live longer and you'll live healthier.

Monique Ramsey (31:59):
Now, how do things like stress or screen time affect our sleep quality?

Dr. Swistun (32:08):
Well, stress would be that the obstacle, the hurdle that stands in the way of falling asleep, right? Because where do we feel stress in our head? We think about it, we ruminate, we feel it in our body. It's more restless. There's a tension in the stomach and the muscles. So that's definitely interferes with falling asleep. But it might also interfere with staying asleep because if you wake up in the middle of the night and right away thoughts come in, your body feels tense, you're ready to jump out and go to work or you worry, whatever it is that you worry about, it could be about health, could be about sleeping. People worry about sleeping. That again, I woke up, why is this happening? So your thoughts, your stress level, whether experience in your mind or in your body definitely will continue to affect your sleep. And it's like a cycle. Something has to just come in and break that cycle that is being promoted. Poor sleep introduces more stress. More stress is again feeding into poor sleep.

Monique Ramsey (33:13):
Now, what about hormonal changes? Does that menopause, for example, does that impact sleep? And if so, what kinds of things can women do to help with that?

Dr. Swistun (33:25):
Yes, absolutely. There's data, there's research suggesting that there is association with sleep apnea, hormonal changes contributing to increased risk for sleep apnea among women. Obviously physiological changes associated with menopause and every woman will go differently through this period. But hot flashes, discomfort, added pain, increase in irritability. So the way you help yourself in that state with respect to sleep, you try to treat those symptoms. So you try to be as comfortable as possible for some women, could be hormonal replacement for some women can be other strategies that are more from homeopathic realm or exercise or things that they know helps them to be more relaxed, to decrease the mental and physical states that if they persist, they will impede your sleep. So you're treating that for another reason is that these things stand in a way for me to feel relaxed enough to continue to fall asleep.

Monique Ramsey (34:39):
Now there's a lot of things, if you go to the pharmacy and you look at, there's an aisle practically devoted to remedies and there's a whole section with melatonin or glycine or NyQuil, PM or some sort of allergy pills. And what do you think about those over the counter type of solutions and maybe what to watch out for?

Dr. Swistun (35:06):
Yeah, so definitely on one level I think to myself, and I recognize that whatever works, if it's working great, but also everything comes with side effects. So you have to weigh your benefits. As I mentioned before, sleep is one of those things that it's naturally designed in our body. We're meant to sleep and we're meant to sleep well. So it's possible. First line of treatment, I would say use behavioral strategies. If you struggle with sleep, you can read books on sleep, on sleep, on sleep hygiene, you can see psychologists because the discipline that actually treats sleep difficulties is psychology or sleep medicine or pulmonology if it's related to things like sleep apnea, restless leg syndrome or chronic pain. I would try to use some behavioral strategies and really educate, really understand where your issues are coming from. In some cases it is needed to help yourself with medicine over the counter, melatonin is the most commonly used.

(36:11):
Sleep aids are tricky. They have a lot of side effects, and I'm not a prescriber, so I usually don't manage them. I would say from my experience though, there are some cases when sleep disturbance is so severe and the consequences are so severe that we have to start with that. But the idea would be that we taper off, I would say learn to recognize what is actually standing in the way of your sleep. And if you can't do it on your own, if you can't make that inventory on your own, maybe seek out a help from someone like psychologists use behavioral strategies. But there also are things from this mindfulness, meditation, relaxation area like Chamomile tea that promotes good sleep. Foods that include tryptophan, right? So like a Turkey sandwich if you have to snack at evening, avoiding things, avoiding caffeine, avoiding heavy meals, avoiding stressors or getting emotionally and or physically charged right before bedtime. So a lot of behavioral strategies that I would use first.

Monique Ramsey (37:17):
Now is there such a thing as too much sleep?

Dr. Swistun (37:22):
Yes, there is. Where our bodies were designed more or less, I know some people will say, I need less sleep now to sleep about seven to eight hours, eight and a half. When you sleep more, you really disturbing that cycle again, and probably most of us, I'm sure you had an experience when you slept too much, you almost were too tired, really groggy, waking up, off cycle and sometimes just on the clock. So when I try to regulate patient sleep, I say, I know it's not going to feel good, but you are getting up at the same set o'clock at seven o'clock. You are building towards your future nights, but you have to get up on the clock. And then they get in this rhythm and it's so much easier. But staying in bed longer or dozing off again or taking naps, generally not a good idea.

(38:17):
It really steals from that sleep hunger at night. So there is typically we sleep, we see oversleeping sleeping too much as a symptom of depression or some other physical illness. People use it as a coping mechanism to just escape, right. So things are hard. I don't like how I feel physically or emotionally. Let me go to bed. You have 24 hours, your body is the healthiest when you use certain amount of it, about 16 hours on active life. We were designed to be active to the degree with reflecting our age and abilities, but to function to live. And if that's not happening, everything else is disturbed. So eventually when you are oversleeping, you're taking away from the quality of life, you're dysregulating your systems, and most likely you will feel a little bit groggy. And the other myth I guess is that you can catch up with sleep. There's no such thing.

Monique Ramsey (39:23):
Right, on the weekend. when you sleep in on Saturday.

Dr. Swistun (39:24):
Yeah, no, if you do, you're probably crashing. Your body was so overwhelmed that it is giving you 10 hours and you're writing through it because you're so exhausted. But the hits that you took on Monday, Tuesday, Wednesday that already happened, that already damage your body took a hit. You can't restore that. That's already gone. You can only move forward. And I wouldn't recommend catching up. I would just sleep eight hours, wake yourself and start getting into the good cycle.

Monique Ramsey (39:55):
Yeah, I feel like routines once you start, and especially with sleep, if I say I'm not a morning person, but if I had to get up five days in a row at 7:00 AM I'd probably become more of a morning person. You know what I mean? Just even if it's Saturday and I've got kittens, and so they wake me up, they wake me up so early and it's like I want to be sleeping, but every day it's the same thing. It's like, okay, I'm up. And Saturday's no different than a Wednesday. So your body does start to adjust. And so the last question I have is about, okay, we all have these little devices, so wearable, whether it's a watch or these different rings and they have sleep reports in there. Tell me what you think about some of these devices and can they lend any insights into your sleep?

Dr. Swistun (40:49):
It's tricky. Research wise in the project, we don't recommend using them. And I'll say why they're not always accurate. They give patients wrong ideas. They're obsessed more about sleep. That's the one thing that I'm trying to do. Don't be so hypervigilant. We got to partially it's because it's a study and we need to control everything very neatly. So we have our own ways. I would actually say good old pen and pencil journal, the one I mentioned in the morning. It's probably better, however, if you will find it, that it just giving you some insight and it's really motivating you and it helps you make changes. Well then like I said, whatever works, generally it's kind of half, half. They can maybe provide with some people some information, but they also can pose a risk for just really being hypervigilant and just tracking only that or making changes that are not really jiving with your needs, your lifestyle, just because the watch is telling you.

(42:02):
Right? And sometimes they don't pick up enough of movement. It's a quite crude measurement. However, sleep studies where we're used to them only in the clinic and now we do have a fairly sensitive apparatus that you can take home and they measure your heart rate oxygenation and the movement and we rely on those as well. So with the grain of caution, I would say using those, is your life getting better? Is your sleep getting better with it? Then I guess it did work right? If you made some changes. But be cautious and you can do it some other ways too.

Monique Ramsey (42:39):
Yeah, sometimes low tech is better, but okay, so this has been so interesting. I think our listeners are going to be so surprised to learn how much sleep really impacts everything from, like you said, healing to beauty to your mood and how you function during the day. And any last things that we need to cover that we missed?

Dr. Swistun (43:07):
No, I do hope that our listeners can take that moment to reflect. It's one of the simplest things. It's one of the things that it's right there and you really don't want to miss on that. Time is passing by no matter what, and sleep has a cumulative effect. So you want to put your eggs in the right basket, you want to invest appropriately. We spend so much time investing in our future, whether it's financially, intellectually, protecting ourself, and there's so many about our life to sort of investing literally and figuratively into life and health and we missing the basic invest in your sleep.

Monique Ramsey (43:49):
Yeah. All right. Well thanks everybody for listening and we will hope that you take some of the things that Dr. Swistun has recommended and maybe implement them starting tonight. So thanks everybody again for listening, and thank you Dr. Swistun for joining us.

Dr. Swistun (44:07):
Thank you so much for having me again.

Monique Ramsey (44:08):
Appreciate your time. Thank you.

Dr. Swistun (44:10):
Thank you.

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