A Good Night’s Rest: The ABC’s of Healthy Sleep

 A Good Nights Rest: The ABC's of Healthy Sleep

Jeffrey Besecker: This is The Light Inside. I'm Jeffrey Beesecker.

Sleep.

Every now and then, we've all experienced nights that it's eluded us. Thoughts racing, tossing and turning, we struggle to enter the Land of Nod. You've heard the buzz. About one-third of folks worldwide are tossing and turning throughout the night, or maybe even more.

Let's face it, snooze time isn't just downtime. It's prime time for our bodies and minds to recharge. Skip it, and we're flirting with trouble.

Wonky hormones, fuzzy memory, and a red carpet of health issues. The verdict? Sleep's a non-negotiable for our species. When it comes to sleep, it's no secret.

Sleeping well is a habit, just like everything that contributes to our health and wellness. Today we're diving into this two-part episode exploring the ABCs of a solid sleep routine. Because who doesn't wish to wake up feeling like a million bucks?

Tune in to discover the foundational elements of healthy sleep from neuroscientist and sleep expert Chelsea Rorscheib when we return to The Light Inside.

In a world inundated with distractions, constant connectivity, and a plethora of information, our cognitive well-being has never been more crucial. Amidst this clamor, how do we nurture our minds, keep our focus sharp, and cultivate habits that promote mental clarity? One possible answer? Healthy sleep.

Based on various studies, it's estimated that a significant portion of the global population, possibly as much as half, experiences some form of sleep disorder, with a majority of adults reporting dissatisfaction with their sleep quality and frequent disturbances.

Recognizing the pivotal role of sleep in physical and mental health, maintaining healthy sleep habits becomes paramount for optimum well-being. It facilitates vital functions such as immune response, hormone regulation, and memory consolidation, while insignificant sleep can heighten the risk of health issues and impair cognitive abilities. Therefore, prioritizing consistent and quality sleep emerges as a foundational element in our overall pursuit of health and vitality. Today we're joined by neuroscientist and sleep study researcher, Chelsea Rorscheib.

Chelsea, sleep is a foundational aspect of health, longevity, and our optimal state of functionality.

I'm eager to discuss how we can develop strategies and tools to create our optimum patterns of healthy sleep. But first I'd like to thank you. Our community is so grateful for your contribution to the cause of better sleep. So thank you for joining us today.

Chelsie RohrScheib: Absolutely. Thank you so much for having me. Sleep is my absolute passion. So anytime I can have a really interesting discussion, help people learn more is fantastic.

Jeffrey Besecker: Chelsea, let's begin today by looking at the core habits of sleep hygiene that lead to better rest and restorative sleep. For instance, developing consistency, quality, and regularity. If we consider the healthy patterns of sleep, what would be the core factors we could assess to determine the quality of our sleep?

Chelsie RohrScheib: That's a really good question. So let's just quickly define what sleep hygiene actually is, because I think some people can have a lot of misconceptions about it. So sleep hygiene is literally any behavior habits, medication use. or environmental factor that can affect the quality of your sleep. So if you think about sleep hygiene that way, there are literally hundreds of things that can affect your sleep. However, sleep experts such as myself usually have a standard protocol, standard list of things that we typically recommend most people follow. So a lot of these things are really obvious, like don't drink coffee before you go to bed, don't stare into your screens, but some things are not so obvious. And when we ask people to practice good sleep hygiene, we're doing so because we really want them to be able to meet the three pillars of good sleep quality, which is the amount of sleep you're getting, so total sleep time, The timing of your sleep, so when you're actually asleep versus when you're actually awake and the frequency of your awakening. So if you're waking up a lot, that's poor quality sleep versus when you're asleep throughout the night. And you've got a lot of REM sleep and a lot of deep sleep that's much better quality sleep. So when you improve your lifestyle and your sleep hygiene, you should see an improvement in these three features of sleep. And I'm happy to discuss, you know, go into all of the sleep hygiene habits. There's numerous, but yeah, that's, that's the overview.

Jeffrey Besecker: So as we know, sleep is more than the time we spend in bed. In our research of sleep study circles, the sleep metric of QQRT or the QQRT variable is regularly surfaced as a core indicator of our quality sleep, with that acronym translating to these four factors. quality, quantity, regularity, and timing. In this regard, Chelsea, what are some of the core concerns that affect these variables and what can we keep in mind when we establish healthy sleep patterns?

Chelsie RohrScheib: So the biggest concerns are, again, it comes back to your sleep hygiene. So what you're doing throughout the day and night that are affecting your sleep. So first and foremost, you need to live a healthy lifestyle. So focusing on getting good nutrition, plenty of exercise, making sure you live mostly a stress-free lifestyle. Now, a little bit of stress is healthy and normal. We all need to experience some stress, but we don't want to be chronically stressed. Before bed, we want to make sure that we're staying in a very relaxed state, especially that 60 minutes leading up towards your bedtime. So you want to make sure that you discontinue any overstimulating activities. So put away your work, your chores, you know, don't watch stimulating TV, don't play video games, don't look at your phone and scroll social media. You really want to focus on bringing your stress levels down and bringing the mind into a quieter state. In that regard, we usually recommend having a sleep routine that you conduct every night for about 60 minutes or 30 minutes if you can't commit to the full 60, and you just follow the same routine every single night. We also want to make sure that you're establishing a very restful sleep environment, so keeping a bedroom that is cool, dark, calm, quiet, and comfortable is really important. And also making sure that you're really only using your bed for sleep and intimacy. So we don't want you using your bed for work or entertainment or anything like that. And very importantly is keeping a strict sleep schedule. So making sure that you're going to bed and you're waking up at approximately the same time every single day. We say you can have about 15-minute deviations, but generally we don't want you going to bed at 10 p.m. one night and 12 the next night. The reason for this is that it helps you establish your circadian rhythm, which is your 24-hour biological clock that helps your brain keep time and helps your brain decide when to initiate sleep and when to initiate wake. getting that consistency really helps keep that rhythm nice and strong and consistent. And then there's other things like we don't want you to look at screens before bed. We want to make sure that you got plenty of sunlight during the day and plenty of socialization and mental activity during the day as well because a sluggish brain that isn't stimulated during the day is actually more prone to sleep issues as well. So if you combine all of these things, you should be able to get the quantity and quality of sleep, the consistency of sleep and also the timing of sleep as well.

Jeffrey Besecker: For me, that notion of maintaining that healthy routine becomes essential. Our circadian rhythms are our natural way of making sure we follow our inner drummer and stay on beat, so to speak. Chelsea, what role do our circadian rhythms play in regulating healthy sleep habits and patterns?

Chelsie RohrScheib: Right, so your circadian rhythm is your biological clock in your brain, and it's controlled by a very tiny amount of genes. So it's actually a very small area of your brain, but the circadian rhythm exists in pretty much every organism on the planet. So it's a very, very old mechanism in the brain, and then we have slight differences from other animals depending on, you know, how much brain energy we use, how much mental energy, cognition, things like that, how much physical energy. So when you add all of those things together, humans typically require on average about eight hours of sleep. And we also tend to sleep at night as opposed to some animals that sleep during the day because they're nocturnal. So what this means is your brain is essentially keeping your circadian rhythm regulated by having a cycle of chemicals and neurotransmitters and hormones that ebb and flow throughout the day. One of these hormones is called melatonin, and this is really our main circadian rhythm hormone. During the day when we have sunlight entering our eyes, that sunlight stimulates a nerve at the back of the eye, and that tells the brain to keep melatonin nice and low so melatonin is suppressed. And when melatonin is at its low levels, that tells the brain to be awake and stimulated and energized. Now, as the day gets longer and the light starts to dim, we have less light information coming into our eyes, so less stimulation of that nerve, and that tells the brain to increase its production of melatonin. So kind of, you know, around 5 p.m. to 6 p.m., that's when the brain really starts ramping up its melatonin production. And then usually the hour to 30 minutes before we go to bed, that's when melatonin levels are at their absolute highest. and when they reach their highest level, that initiates sleep. That tells the brain that it's time to start to prepare for sleep and also prepare to maintain sleep throughout the night. Melatonin will stay relatively high until about the middle of the night, and then it will start to fall off towards wake time. And when melatonin gets lower, that helps the brain initiate wake and we start that cycle all over again. So keeping that really strict sleep schedule helps the brain stay consistent because the brain is really routine dependent. And when your sleep schedule is all over the place, it makes it a lot harder for your brain to regulate that controlled release of melatonin. And so it can make it harder to initiate sleep when it does come time to sleep and also maintain sleep through the night.

Jeffrey Besecker: So as we're considering those healthy habits of consistency and regularity, what are the most effective ways to detect and monitor these patterns in our circadian rhythms? And are there things that consistently disrupt that like time change or that old spring forward and fall back pattern?

Chelsie RohrScheib: Yeah, that's a great question. So everybody has a slightly different circadian rhythm and it's highly dependent on your genetics. So some people are morning people. They tend to be up super early and they tend to go to sleep super early. Some people are more of the regular people. They're Sleep time is pretty typical. Maybe they go to bed at 11 p.m. every single night. Maybe they wake up at 7 or 8. And then some people are genetic night owls, so they have a tendency to go to bed later and stay awake later. Now, ideally, you would exist within your own genetic circadian rhythm. We also call that a chronotype. So trying to find exactly when your brain is most likely to initiate sleep and offer you the highest quality sleep is really the ideal scenario. That can be hard for a lot of people because we exist in a society where we have to get up and go to work at certain times and we have obligations. But trying to find a time that's as close as possible to your chronotype is ideal. Now, sticking to your sleep schedule that is close to your chronotype is going to help guarantee that more often or not, when your head hits the pillow, you're going to be able to fall asleep fast because your brain is very prepared to sleep, and that you're going to have a very restful, uninterrupted sleep. Things that can make keeping your circadian rhythm consistent very difficult are going to be sleeping way outside of your normal chronotype. So if you're a natural night owl, but you're trying to go to bed at 9 p.m. every night, it's very, very likely that you're going to have a big fight on your hands because your brain is going to be pushing you hard to stay awake. Other things would be too much light stimulation at night. So like I was saying earlier, melatonin is regulated by light stimulation coming into your eyes. If you have really bright lights in your house, especially fluorescent lights, or if you're looking at screens right before bed, that's very similar to sunlight and that's going to trick your brain into thinking it's still daytime and you still need to be awake. So making sure that you dim those lights in your house a good hour before your bedtime and putting away your electronics can be really, really helpful for keeping your circadian rhythm well regulated. Other things like daylight savings time, which is a big controversy in sleep medicine. Most sleep experts hate daylight savings time. We've been pushing to get rid of it for years because it's so detrimental, but the changes in the timing can really throw you off for a good week or two. Frequent traveling outside of your time zone, so pilots frequently suffer, pilots and airline staff really frequently suffer sleep issues because they're constantly traveling in and out of different time zones, and also shift work as well. So people who work abnormal hours that don't align with their circadian rhythm, so people who work nights or people who have rotating shifts, which means their shift changes frequently, also have a lot of issues maintaining their circadian rhythm. And shift work is so bad that it's actually classified as its own sleep disorder now. It's called shift work sleep disorder. So those are examples of things that can really throw your circadian rhythm off. So really working hard to maintain your circadian rhythm, going to bed at the same time, making sure you're not looking at lights, making sure you've got that really good bedtime routine is going to be really helpful. But on the opposite side, we also want you to get a lot of light stimulation during the day because that also helps you regulate your circadian rhythm. So making sure that you're not indoors all the time with no access to sunlight is also super important. So, you know, go outside, sit by a window while you're working, use a sun lamp, things like that can also be incredibly helpful.

Jeffrey Besecker: That answered my next question so succinctly. As we jump ahead, returning back to that idea of our chronotypes and looking at our sleep styles, our sleep styles can easily be defined by our usual patterns of sleep. Therefore, we have a unique sleep profile for each of us when it comes to our daily sleep habits. What role do these sleep styles in body positions have in determining whether or not we get consistent, healthy rest and rejuvenation?

Chelsie RohrScheib: So sleep styles can mean a lot of different things. So it can mean, you know, what your normal tendency is while you're in bed. Do you toss and turn? Do you sleep like a mummy? Do you tend to change positions a lot? Do you sleep hot? Do you sleep cold? Do you tend to follow the same sleep routine or do you tend to deviate? But generally speaking, so when we're talking about sleep styles, we really want you to pay attention to what works for you to get the best quality sleep. So just because somebody tells you that something is the ideal way to sleep doesn't necessarily mean that it's going to actually work for you. So Just because somebody tells you that sleeping on your side is the healthiest way to sleep doesn't mean it's going to translate to more restful sleep or less sleep fragmentation. So you have to find a balance. There's definitely recommendations on what the ideal way to sleep is. So the ideal way to sleep is on your left side, for instance, and we can get into that a little bit more. On your left side with a bed that has a medium firmness, you know, that's not too lumpy and that doesn't put pressure on your joints, in a quiet, very, very dark room that's at a very specific temperature. And you can certainly try to follow all of those things, but if it aggravates you to sleep on your side or your mattress is not comfortable to you, then it's okay to make adjustments. So what we always recommend is if you do change anything in your sleep routine or your sleep style, Take note of what's working and what's not working, and we always say give yourself a little bit of time to adjust to any changes you actually make. But you don't have to force yourself into a long-term situation that's not working for you. Specifically, look for how well-rested you are, whether you're waking up frequently, whether you feel like you're getting light or deep sleep, and how well you feel the next day.

Jeffrey Besecker: So in that regard, how do factors like temperature, light and dark exposure, our caffeine intake, alcohol, cannabis use, diet, things of that nature affect our quality of sleep overall?

Chelsie RohrScheib: So because sleep is regulated by the brain, everything that happens can affect the brain and make the brain do really funny things. Literally any behavior you have can therefore affect your sleep. So it's good to kind of tease out the things that you do, and this goes back to sleep hygiene, tease out the things that you do during the day and during sleep that may be negatively impacting your sleep. So for instance, room temperature. So scientific studies have shown that the ideal temperature for your room when you're sleeping is 60 to 70 degrees Fahrenheit. And the reason for this is because in order for the brain to initiate sleep, your core body temperature has to drop by about one degrees Fahrenheit. which doesn't seem like much, but it's a lot of metabolic work for your body to actually drop your core temperature, because for the most part, it's trying to keep your temperature very stable. So it's a lot of work. So you don't want to make it harder for your body to drop that core temperature by sleeping in a hot room or sleeping under a bunch of comforters and a really warm bedding. So ideally keep your room in that range that I spoke of. Use breathable bedding that's made of natural fibers that doesn't trap too much heat. I also recommend instead of using one thick blanket, using a couple thin blankets so that you can remove a blanket if needed. And if you're a hot sleeper, you can always use things like cooling technology, like cooling mattresses and gel pads and things like that. As far as substances, so substances like marijuana, alcohol, really any drugs or alcohol that can affect the brain can go on to affect sleep. Generally, we recommend avoiding those substances, especially within three to four hours of bedtime. They both do slightly different things in the brain. So alcohol for one, is a depressant in the brain, which means it acts on the areas of the brain that control mood, mental activity, things like that. So alcohol, initially, because it's a depressant, can make you feel very, very sleepy, which a lot of people appreciate, especially if they have difficulty falling asleep. So sure, it can definitely help you fall asleep really quickly, and then it can put you into deep sleep really quickly. But the problem is, as that alcohol metabolizes in the body and it gets broken down into different chemicals, those new chemicals then act on the brain. And then the second half of the night can be very wake-promoting, so it actually causes a lot of sleep fragmentation. and it actually prevents you from getting REM sleep. So alcohol before bed, definitely a no-no. Marijuana, in a similar vein, marijuana is somewhat sleep-promoting because it can make you feel really relaxed and sleepy. A lot of people use it right before they go to bed. And if you're somebody with really, really bad anxiety, yes, the appeal for using marijuana and cannabis is definitely there because it takes that anxiety away. The problem is that marijuana suppresses REM sleep. So over time, you can build up a REM sleep deficit where you are not getting enough REM sleep. And REM sleep is very important for many biological functions. And you can start seeing deficits in your cognition, your memory, and really you're just not getting the quality sleep you need as well. So again, even though these substances make you feel like you're getting better sleep, they're actually restricting your sleep in a lot of ways and not ideal. Other things, there's a lot of other drugs that kind of do similar things. There's also drugs that are stimulants that we never recommend. Stimulants is basically worse than drinking caffeine before bed, so avoid that. Caffeine, coffee, tea, most carbonated beverages also contain caffeine. Caffeine suppresses sleep by essentially tricking the brain into not using a chemical called adenosine. And adenosine is another sleep chemical, another sleep molecule that binds to a receptor in the brain. And when adenosine is at its highest levels, it makes you feel really tired. So it makes you feel really relaxed and sleepy, and it helps prepare you for sleep and initiate sleep and keep you asleep. Well, caffeine comes along, and it has a very similar structure to adenosine. It binds to that receptor in the brain, blocking adenosine from binding to that receptor and essentially preventing you from having that tired and sleepy response. So caffeine's great during the day when you're exhausted and you need to stay awake, but it's absolutely horrible at night because you just can't get that chemical upregulation and that reaction that you need from that adenosine binding.

Jeffrey Besecker: Looking at that long-term use of energy drinks as a stimulant or as an energy booster, can we zero in on that and any long-term impact or effects that might have itself?

Chelsie RohrScheib: Yeah, so I mean, besides the fact that it contains a massive amount of caffeine, usually way more than we recommend, so caffeine gets into your system and it takes a really long time to get out of your system. The way we calculate this is by something called a half-life, which means how long does it take for half of the caffeine in your system to leave the system? And caffeine's half-life is approximately six hours, and it can be longer for a lot of people, so it really depends on your sensitivity. So we really do not want you drinking any caffeine in the second half of the day. You can certainly consume it in the first half of the day, that's fine, but try to avoid it in the afternoon especially. The other thing about energy drinks is that they contain a lot of sugar. So sugar is also very stimulating in a different way. So when we consume sugar, our blood glucose levels spike and our cells have to release insulin and then the cells around our body uptake that glucose to use as energy. When you have a massive amount of easy access glucose, It's very easy for the insulin to spike in the cells to uptake that glucose quickly, but then you can have a massive sugar crash afterwards. So suddenly, that massive amount of sugar that was available is suddenly not available anymore, and it can make you hypoglycemic, and that can make you very tired and sluggish. and feeling absolutely horrible. Well, the issue is if you consume easy access sugar, like from an energy drink before bedtime, you're spiking your sugar, which is going to energize you when you're trying to fall asleep. And then if you do eventually fall asleep, you're going to have that sugar crash, go into hypoglycemia, and your brain will essentially have to wake you up to renormalize your sugar again. So it's going to make you feel starving and make you get out of bed to go find food. So that's another aspect of it as well. In the long term, we find that people who are consuming energy drinks just have consistently poor sleep in general. And so that compounds over time, you build up a lot of sleep debt, and that can lead to long term effects on your health and well-being. And we also know that energy drinks can change cortisol levels. It can spike your cortisol, make you a more stressed person in general, and stress also negatively impacts your sleep for various reasons. And cortisol also negatively impacts your sleep because cortisol is very weight promoting and stimulating. So when you take all of these factors together, energy drinks are not recommended for people who suffer from sleep issues.

Jeffrey Besecker: Does that excess sugar intake also have influence on our inflammatory response? And does that also kind of have a cascading effect?

Chelsie RohrScheib: Yeah, that's a really good question and good insight. So yes, we know that people with really high sugar diets tend to have more inflammation in the body. Sugar at high levels is practically a poison, according to most medical scientists and dieticians. Too much sugar is an assault on the body. It's really damaging to your cells and tissues, and When you have a lot of damage to your cells and tissues, that stimulates your immune response. Inflammation is not very specific. It's kind of an unevolved process in the body. It works to an extent, but when it's systemic, which means body-wide, it's actually very damaging to us, including our brain. And when we have high levels of inflammation in the body, we know from many years of science that that can actually change our sleep. It can change the quality of the sleep. It can change our sleep architecture. It can cause more sleep fragmentation. And it also causes more daytime fatigue and low energy levels, regardless of how much sleep we've actually received.

Jeffrey Besecker: What it sounds like is we're discovering that to a large degree, our dietary needs and habits dictate the overall quality of our sleep. With everything from our level of hydration and timing perhaps coming into play. As we consider those nutritional factors, what are some of the key aspects to keep in mind as we monitor and measure both our dietary intake and healthy sleep quality?

Chelsie RohrScheib: So sleep, like I said before, the brain is sensitive to everything. So any change you make can potentially affect the brain and therefore potentially affect sleep. So one really important thing to understand about sleep is we know from people who have researched diet and sleep together and also food intake and food timing as well have found that there's a lot of correlation between not only the types of foods you eat, but also the timing of when you eat those foods to the quality of sleep that you're getting. So we know that food restriction and being too hungry can negatively impact sleep because your brain has a drive that's specifically regulated by two hormones called gerulin and leptin, where these hormones interplay. One hormone is responsible for the hunger response, and one hormone is responsible for the feeling of being satisfied after you eat a meal. Now these two hormones can get really easily thrown off where one can become too active and the other one can become too inactive. So what we find is when we are too hungry before we go to bed or when we don't eat a good enough meal before we go to sleep, when our blood sugar gets low, that hormone that drives hunger gets massively upregulated. and it interacts with a bunch of other neurotransmitters and it essentially becomes very wake-promoting because your brain sees that this lack of food and lack of nutrition is a survival issue. And finding food becomes more important for survival than sleep. So your brain will essentially wake you up or make your sleep very fragmented or very poor so that you can get up and go find food. And so making sure that you get a good quality meal about three hours before you go to sleep is really, really important. Conversely, we also don't want you to be too full. So eating a very heavy meal, a meal that's high in sugar for the reasons we spoke about before, a meal that's highly acidic, highly fatty, too spicy is also very important. because things that tend to happen are we become bloated and this is very uncomfortable. A lot of people get gastric reflux, which can cause things like heartburn, and that is also very disruptive to sleep as well. So not eating an hour before sleep or two hours is really ideal, but also making sure that your meal is not too heavy, too sugary, too fatty. As far as nutrition, we want you to focus on a high-protein diet. Any carbohydrates that you do intake are going to have a low glycemic index, which means that they don't release that glucose, that sugar quickly, so they don't spike your blood sugar and cause that blood sugar crash. So, things like complex carbohydrates, whole grains, oats, vegetables, beans, things like that, as opposed to white bread, starches, those sorts of things, and avoiding foods that are overly fatty as well. making sure that you have a really well-balanced diet, so you're getting all of your nutrients, because all of those nutrients help to create the actual chemicals and hormones that your body needs to regulate sleep. So if you're missing out on any of those nutrients, then it can be really hard for your body and brain to synthesize those chemicals and neurotransmitters and hormones.

Jeffrey Besecker: So in that regard, it reminds me that notion that monitoring when we cut off that sleep and then being mindful of things like how acid reflux and GERD often disrupt our sleep and wake us at night.

Chelsie RohrScheib: Yeah, gastric reflux is a big problem in the U.S. because of the American diet. We tend to eat foods that really cause more acid in the stomach. And this includes fatty foods, sugary foods, proteins that are hard to break down, foods that are a little bit too easy to digest as well. So our American diet makes us a lot more prone to gastric reflux. Another issue that is a little bit more sensitive, but unfortunately it's just a fact, is that Americans have a tendency to be overweight on average and that can also increase your risk of things like gastric reflux as well. What we find is when you are prone to gastric reflux, if your stomach is too full and you're sleeping in certain positions, that makes it more likely. Sleep exacerbates it because when you're lying flat, It makes it a lot easier for the contents of your stomach to regurgitate into your esophagus and cause that burning and heartburn and discomfort at night. And it's very wake-promoting. It's not good for your sleep at all. Some people find that sleeping with elevation, so elevating their head, sleeping with a wedge pillow, or also sleeping on their left side can help because when you sleep on your left side, it positions your stomach in a way that makes it less likely for your food and acid contents to come back into your esophagus. And there's certain sleep disorders that make GERD more likely, such as sleep apnea. So people with sleep apnea have really, really high rates of GERD. Sometimes they think they only have GERD and have no idea that their sleep apnea is the actual cause of their acid reflux. So if you're somebody who happens to have really bad chronic GERD, then it's probably worth talking to your doctor about whether or not you have a sleep disorder like sleep apnea.

Jeffrey Besecker: So in that regard, do you feel from that perspective, over-the-counter remedies might actually inflame those conditions rather than addressing some of the core patterns and habits and more natural things like balancing our probiotic?

Chelsie RohrScheib: Right, so the over-the-counter remedies can range from really gentle, like Tums. You know, it's really hard to get sick off Tums. You can pop a lot of Tums. Pregnant women take tons of them. They're not too dangerous. Where you start getting into more long-term issues is with those acid inhibitors. So, um, omazapril, um, really any of like the, um, ones that you take that bind to receptors in your stomach and inhibit the production of acid. So those are good for short-term use, but we don't recommend them for long-term use because first they can cause digestion issues. They can cause gut motility issues and they can also cause absorption issues. So you can stop efficiently absorbing nutrients and things like that. People who are on them for a really long time can have bone mineral density issues. So it's not a cure-all. We'd prefer that you address the actual reason that you're having these issues in the first place. You know, is it your diet? Do you have a gastric sphincter that's not strong enough that maybe you need medication for or surgery for? Or do you have something like sleep apnea that is causing the GERD in the first place?

Jeffrey Besecker: It was something I battled myself for years in my late thirties and early forties, you know, and the over the counter remedies I found actually over the long haul made that reflux worse, especially at night. And then shifting that healthy diet, those healthy patterns again, keeping that healthy balance of probiotics in your system ultimately brought me back into that harmony and balance.

Chelsie RohrScheib: Yeah, so those drugs have something called an acid rebound effect, which is if you've been on them for a long enough time and you've been inhibiting the acid in your stomach, when you suddenly remove those drugs, your stomach overreacts and starts creating way more acid than it did in the past. So that's a pretty well-known side effect. So, you know, and I'm not a gastroenterologist, but I know a bit about it. Usually doctors will recommend that you taper off that drug instead of going cold turkey, but some people never really fully recover from it. So really working on your gut health and like you said, definitely focusing on your microbiome and making sure you're eating a lot of probiotics and prebiotics as well is going to be extremely important. And also, you know, making sure you get checked out by your doctor to make sure that there isn't a secondary medical condition that's actually causing the acid reflux in the first place.

Jeffrey Besecker: To change course a little bit, looking at that idea of healthy supplementation, of course, we always would ideally like to strive for a healthy balanced diet, several factors, sometimes causing fluctuation in things like our vitamin and mineral intake. I read a recent study that suggested magnesium was an essential element for healthy sleep and how it became a core dietary consideration for things like irregular breathing, sleep apnea, and restless leg syndrome.

Chelsie RohrScheib: Yeah, so magnesium is essential for sleep. Magnesium promotes and is an essential nutrient for the activity and the creation of a neurotransmitter called GABA. And GABA is primarily what we call our inhibitory restful relaxation neurotransmitters. So GABA needs to be free and available when we are sleeping because it really keeps our nervous system in an inhibited, restful state. So when you take magnesium away, your body is not able to synthesize GABA and it's not able to use GABA appropriately. Now, most people get enough magnesium for their diet, but some people with a lot of sleep issues supplement with additional magnesium pills or capsules, or some people take it in liquid form as well, or they just increase magnesium-rich foods. The type of magnesium we recommend specifically for sleep is magnesium glycinate because that's the one that seems to have the biggest effect on sleep. And we recommend taking it within the hours before bedtime, usually at dinner, take it with food, that's fine. And so it helps in that sense. And the other way magnesium is really helpful is magnesium is responsible for the activities of your muscles as well. So muscle relaxation, muscle stimulation, And what we find is people who are really prone to leg cramping, muscle pain, restless leg syndrome, typically have lower levels of available magnesium in their body. So increasing magnesium at night can help with that muscle discomfort. As far as sleep apnea, there's not a ton of evidence and it's unlikely to have a major effect on sleep apnea because sleep apnea is primarily an anatomical issue of the upper airway. Magnesium can certainly help somebody with sleep apnea get more restful sleep, but it's not really going to affect the reason for poor breathing at night, especially for the most common type of sleep apnea, which is the obstructive type of sleep apnea.

Jeffrey Besecker: Awesome. Looking at our core audience, a lot of our listeners are in that age range between their mid forties and their golden years. And so I know myself as I'm reaching my fifties. That need for magnesium can sometimes become a struggle to get within our healthy diet sometimes.

Chelsie RohrScheib: It's harder for the body to absorb nutrients as we age, and that's unfortunately just a part of the normal aging process. And also the amount we need changes as we age, you know, as we get older, we need more calcium, we need more magnesium. We need more minerals, especially for our bone density, because bone density starts to fall off a little bit as we age and we get more prone to things like breaks and injuries. So you need to increase certain nutrients and minerals as you get older. So it's important to talk to your doctor about how you should be supplementing.

Jeffrey Besecker: So looking at those dietary needs, regardless of our age, when it comes to supplementing a healthy diet, are there any particular dietary aids or supplements that fortify the quality of our sleep, rest, and recovery that you might suggest?

Chelsie RohrScheib: Yeah, so we already talked about magnesium, so we'll add that at the top of the list. We also need iron. So iron is really essential for a bunch of functions in the brain, and that includes regulating a lot of our neurotransmitters. So we find that people who have really low iron are more prone to insomnia, and they're also more prone to restless leg syndrome. So iron, super, super essential.

Jeffrey Besecker: Healthy greens.

null: Yeah, yeah.

Chelsie RohrScheib: If you're vegetarian, you can always eat seaweed, things like that. Lots and lots of different foods have iron, but making sure your iron levels are nice and high. I would have to say, especially if you're a woman, and especially if you're a woman who is pre-menopausal or post-menopausal, because that's when your iron levels just start falling off a cliff. But we also see it in younger women as well. So really just making sure you're getting all of your nutrients.

Jeffrey Besecker: Healthy shout out to athletic greens. No solicited pitch there, but it became a steady routine of my own where, you know, those healthy greens literally help supplement that balanced diet.

Chelsie RohrScheib: Yeah, so really pay attention to your diet. The other thing is you really, really want to make sure you're getting enough protein and amino acids. So when you break protein down at its very tiniest molecule, protein is made of amino acids, long chains of amino acids. And when you eat that protein, those amino acids get broken down. And many of those amino acids are needed to create the neurotransmitters in your brain, like dopamine, serotonin, you name it, pretty much every single one. So if you're not getting enough protein in your diet, that's going to have not only a massive effect on your brain and sleep quality, but your whole body, because basically your entire body is made up of protein. Other things that we recommend are going to be supplements that help you reduce stress and reduce cortisol. So supplements like ashwagandha, for instance, are very helpful for sleep. Valerian root are very helpful for sleep. There's certain teas and things you can drink that contain those supplements.

Jeffrey Besecker: tea out there called Ron Tea Gardens Spring Dragon Longevity. It contains the herb schisandra and their marketing suggests how the tea improves sleep quality by increasing sleep times and shortening sleep latency. So I guess we're spilling the tea on Ron's tea today so to speak.

Chelsie RohrScheib: Yeah, so really making sure that you get those nutrients and supplements before you actually go to bed is also really helpful because that helps your brain utilize them at the time that you need to actually be asleep. And then this one's a little bit controversial. It really depends on your situation. So we already make melatonin in our brain and you need a lot of nutrients and minerals to create that melatonin. So just making sure you have a well-balanced diet for that. But some people, especially older individuals, their brain gets a little less efficient at making the melatonin. So eating a diet that really promotes more melatonin. So this is things like a lot of dairy, milk, helps your body make melatonin, tart cherry, things like that. Making sure your diet has plenty of those things is important. And if you're really, really struggling, after consulting with your doctor, you can supplement with a low-dose melatonin supplement.

Jeffrey Besecker: So you sound like you're checking off my regular grocery list here. I'm looking at something that comes to mind with the tart cherry. I sometimes now battle with gout at night. Gout, if you've never experienced it will inherently not only keep you up at night, but irritate you throughout the day. Heart cherry being one of the key things that helps your body cycle through those pure rings that trigger gout.

Chelsie RohrScheib: Yeah, so there is research that tart cherry reduces uric acid, which are the crystals that get in your joints and cause the gout in the first place. So the study that I'm thinking of showed that it significantly reduced the severity and reduced the amount of flare-ups. that people with gout have. So it's like a double punch. Not only do you get that gout reduction and reduce risk, but it also promotes melatonin in your brain. So it can actually help you sleep better at night as well.

Jeffrey Besecker: So in that regard, we talked about Ashwagandhi also being one of those healthy sleep aids or healthy nutritional aids. I recently discovered another supplement that contains ashwagandhi that also helps manage that gout and keep that cycle going. So some of the seeds of the common interactions we have just in a healthy diet.

Chelsie RohrScheib: Yeah, so people often assign each chemical to doing one function in the body. One of the ones that I hear the most is like dopamine is your pleasure neurotransmitter, it's your reward neurotransmitter and that's all it does. But that's not true. The body is very, very good at using chemicals and neurotransmitters and molecules and hormones for many, many different processes. Dopamine is also important in your movement and muscle and coordination. and cognition and focus and all those sorts of things. So it's important to keep that in mind that these chemicals that circulate have many, many different functions. So that's why it's so important to eat a good diet and take supplements that are supportive of creating these chemicals and molecules.

Jeffrey Besecker: We've looked at the role that diet plays in healthy sleep. Yet, we often encounter tech difficulties with gaining sleep in our tech usage or interactions. Everything from stress to just simply changing circadian rhythms. What role do you feel technology or tech usage plays in regulating and monitoring our healthy patterns of sleep Chelsea?

Chelsie RohrScheib: Yeah, so sleep experts like to joke that the Industrial Revolution kind of ruined everybody's sleep, especially when electricity was introduced. Because you have to imagine, before we kind of lived by the sun, you know, we were awake during the day and we only used candles at night. And candles are not really that bad for you. The type of light they emit doesn't really spike our melatonin. It was actually a really good way to promote sleep. So people actually had much better regulation of their sleep schedules and their circadian rhythm, and they also tended to sleep better. And we saw much lower rates of things like insomnia back then. Now we have access to light 24-7 whenever we want it. We have access to very bright light, which is a problem, and we also have access to electronics that emit light on the blue wave spectrum, which is very, very similar to sunlight. And so that light gets into our eyes and suppresses our melatonin and makes it very, very hard for us to initiate sleep. On the other side, we're also addicted to our technologies. We have this tendency to sit in our bed and scroll and be on social media and watching videos and things. And we procrastinate our sleep now. So sleep procrastination, we call it revenge bedtime procrastination, is a legitimate problem in our society where we know we should be turning off our electronics and going to bed, but we just want to watch that one more video or play that one more game. So it's a huge problem, and I think it's going to continue being a huge problem until we get a lot more education out to people about the ramifications of chronic screen use, especially before bedtime. And certainly watching these things and playing video games is also very stimulating, especially if we're triggering our cortisol levels, so when we spike cortisol It circulates and it's very wake-promoting and energizing because cortisol is supposed to initiate fight-or-flight, which is getting us ready to either run away or fight in a dangerous situation. So obviously we don't want cortisol to be initiating fight-or-flight before bed, and this is especially important for people who are prone to stress and anxiety before bed as well.

Jeffrey Besecker: In that regard, we're looking at that interaction of reading things on the Internet that might instigate an emotional response or trigger that stress and anxiety, sometimes engaging in conversations that elevate those levels of cortisol and stress and just simply managing those and forming some of those healthy boundaries.

Chelsie RohrScheib: And also, it's an addiction, right? So a lot of people are addicted to their devices. That spikes your reward pathway, and it makes it really hard to put something away when your brain is constantly telling you, this is great. I'm going to release more dopamine. Keep doing this. This is giving you a sense of pleasure and joy. So with that in mind, I think we really need to help people better understand how this is affecting your sleep, but also everything in their life. So how it affects their mental health, how it affects their social interactions, how it affects their physical activity. We see a large decline in physical activity in people who tend to use their electronics. more than others. So, and that has ramifications for your sleep. If you're not working out, if you're not getting your daily exercise, that's also going to make your sleep quality worse.

Jeffrey Besecker: You mentioned in our early conversations that habit or propensity to sometimes linger in bed in the mornings, and even sometimes when we linger and we scroll before we rise and start our day. Let's look at the impact and the positive benefit that has of early rise and jumping up and launching into our day.

Chelsie RohrScheib: So I think the major issue and there's a few major issues, to be honest, but the big issue is that we never want you to do anything in your bed except sleep and intimacy. This is because the brain is very, very good at pattern recognition and making connections and associations. We only want your brain to associate sleep with rest, relaxation. If your brain is associating the bed with fun activities like scrolling or watching TV, it's going to make you less inclined to sleep when you're in bed and more inclined to do those activities. So that's the first major problem. People who have chronic insomnia, that's one of the very first things we tell them is if you do anything else in your bed besides sleep and intimacy, stop those things immediately. The second problem is if we sit in bed in the morning, We're not getting up. We're not having access to natural sunlight. So we don't promote that suppression of melatonin. We're not moving around, which promotes grogginess. It promotes low energy. It's promoting low cortisol. So conversely, from what I was talking to about earlier, we want cortisol to be nice and low when you're sleeping, but we need it to be nice and high in the morning because that helps us get out of bed. But when you're just sitting in bed doing nothing, it really doesn't promote the elevation of cortisol you need, and it definitely does not promote that suppression of melatonin. So get out of bed, you know, it's okay to sit in bed for like 10 minutes, but nothing longer than that.

Jeffrey Besecker: I like to geek out reading research studies and it was interesting to see how that balance between when we rise in our serotonin and cortisol debt start to automatically form when we linger in bed. And then how we can also have a debt in dopamine that we start to make up for throughout the day by doing other things like subconsciously triggering emotional responses with others, because we're looking subconsciously for that dopamine demand.

Chelsie RohrScheib: Exactly. So if you're not doing anything to promote dopamine, and dopamine is very energizing, and again, dopamine does a lot, but it is very important for cognition and being awake and energized and that reward pathway. And sitting in your bed is not helping you release the dopamine that you actually need to accomplish any of those functions. Also, if you're sitting in bed, your brain still thinks, oh, I'm still in bed. I should probably still be sleeping. Because again, your brain is very good at making that connection to your environment with your behavior. So it's really best to get out of bed as soon as possible and find a natural light source as you can. I personally get out of bed right away. And if it's the summertime, if it's really nice, I'll go outside. Or if it's the winter, I'll go sit by a window and have my coffee.

Jeffrey Besecker: You brought to mind our coffee and caffeine intake again. What is the optimum level of caffeine intake in the morning, regardless of whether it's coffee or anything else? And is there a particular timeframe with how quick we consume caffeine in the morning? I know that there's a lot of suggestive data out there that says we might want to wait an hour before we even start to consume coffee and then start with water and then alternate to our coffee. As painful as that might sound.

Chelsie RohrScheib: Yeah, so coffee is not, I want to put this out there, coffee is not bad. It's not a bad thing. It's actually a very good thing because coffee contains tons of antioxidants. It's one of the most antioxidant rich things we can consume. and clinical studies have shown that it's very neuroprotective against things like neurodegeneration, and it's also really good for cognition and energy levels. However, you have to be smart about how you take your coffee, so you don't want to drink too much because too much is not always a good thing. You want to time your coffee intake correctly and you want to make sure that your coffee is not affecting other aspects of your life. One camp, and I'm not a nutritionist, but one camp very strongly suggests that you wait an hour to consume your coffee and also that you take your coffee after you eat because there's some evidence that coffee can affect your blood sugar levels and also how you absorb your nutrients. So there's that. We also don't want the coffee to affect the natural chemicals and hormones in your brain that wake you up. So we don't want the coffee to affect your melatonin levels. We don't really want your coffee to affect your cortisol levels too much. So waiting an hour and letting things happen naturally in your brain is probably a good bet and focusing on rehydrating with water is the safest option. We also don't want you to drink coffee too late in the day. I usually say a good cutoff time is after that mid-afternoon slump that most of us get. So that, you know, kind of like 2 to 3 p.m. period where we start feeling really tired and we really want a nap, it's okay to have a coffee then. if it helps keep you out of that slump, but I would not have a coffee after 3pm. That's just my personal recommendation based off of how long it usually takes caffeine to get out of your system and also taking into account that some people are a lot more sensitive to caffeine than others.

Jeffrey Besecker: So looking both at monitoring excessive caffeine intake and sometimes experiencing that slump midday, and then sometimes when we were just very active in having that natural slump midday, what role do you feel non sleep deep rest might play in that regard? Or sometimes just taking that time to take a little aside or a little break or meditation break. to just simply restore and rejuvenate. When we get outside of our American hyper-focused, hyper-achievement culture, there's very many cultures that nurture and engage in that habit regularly of taking that afternoon siesta or that afternoon reprise to just stop the world for a minute.

Chelsie RohrScheib: So if we are constantly on the go and focused and energized and we're constantly stressed, our body and our nervous system is always going to be activating the sympathetic side of our nervous system, which is fight or flight mode. Now, it doesn't mean that your body's activating it because you're actually in a fight or you actually need to run away. It just means that your nervous system is aware that you need prolonged energy and focus, so it has to upregulate those things and usually that is a lot of neurotransmitters that circulate and also cortisol will be constantly spiked. We know that that constant spike in cortisol is not good for you. People who have constantly spiked cortisol have issues with chronic health problems, obviously sleep like we spoke before. They tend to have issues with early mortality and longevity. So it's not healthy for your cortisol to constantly be spiked. So taking that break to do activities that move your nervous system into the parasympathetic side, which is more of your rest, relaxation, and digestion side, kind of cleanse your body of that cortisol, give your body a break, and also lower your risk of things like chronic stress, which also can heighten your risk of mental health disorders if you don't get your stress under control. So I think, you know, taking a walk, meditating, deep breathing exercises are super, super important just to maintain our health and our mental health. But also exercising. So exercise essentially does the same thing by utilizing all of your stored cortisol, because you need a lot of cortisol to maintain your exercise routine. So by working out every day, getting that 30 minutes of activity, you massively spike your cortisol, but then it's gone by the time you're finished. So those stores are not then kicking around to affect your sleep and your mood and your health later.

Jeffrey Besecker: Looking at that aspect of timing and consistency again, are there ideal times of the day to exercise or maybe a cutoff time where we might limit our exercise so we hit that optimal target point?

Chelsie RohrScheib: So the research shows that the optimal time to exercise is usually in the first half of the day because that's when our cortisol is at its highest. So your physical output may be better if you work out in the first half of the day as opposed to the second half of the day when cortisol is lower. The other aspect of that is that your circadian rhythm is also helping you a lot by suppressing that melatonin and just making you feel more awake, which is going to help you feel more inclined to exercise in the first place. And then finally, we definitely don't want you working out right before you go to bed, because again, exercise does spike your cortisol temporarily, but it does massively spike your cortisol So we don't want you to do a massive workout and then try to sleep immediately after because it takes a little bit of time for that cortisol to get out of your system. And if your cortisol is still spiked, you're never going to be able to fall asleep. Or if you do, your sleep is going to be pretty light and fragmented.