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Ep 59 - How to get better sleep when you have IBS
Episode 5925th June 2024 • Inside Knowledge for people with IBS • Anna Mapson
00:00:00 00:23:19

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Ever noticed your IBS symptoms flare up when you're tired?

This week the intriguing link between sleep and gut health and I cover

  • how poor sleep can worsen digestive issues,
  • essential sleep hygiene tips,
  • diet changes that can help you sleep better.

Whether it's dealing with stress, adjusting your caffeine intake, or setting a sleep-friendly routine, I've got practical advice to help you break the cycle of sleepless nights and painful mornings.

Tune in for insights that could make a big difference in managing your IBS.

Work with me

Ready for your gut reset? 🌍 I work with clients worldwide, providing remote consultations and a wealth of educational resources.

Instagram - @goodnessme_nutrition

The information in this podcast is not medical advice and is not designed to treat, diagnose or provide personalised health advice. This podcast content is information only and any changes you make are at the user's own risk. Please consult with your doctor or healthcare provider before implementing any new treatment.

Transcripts

Speaker:

Have you ever

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noticed your digestive symptoms

are worse when you're really tired?

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Unfortunately, there are some links

between IBS and SIBO and how you sleep.

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We've all had those times when

you just don't sleep well and

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life feels so much harder.

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But what about if it goes on for months?

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In this episode of the Inside Knowledge

podcast for people with IBS, I'll

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cover how sleep and your gut health

interact, I'll talk about some sleep

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hygiene tips so you can try and get

the best night's rest possible, as

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well as covering diet and eating

patterns to help you get better sleep.

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Hello, welcome to episode

59 of the Inside Knowledge.

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I'm Anna Mapson.

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The reason for picking sleep as a

topic for a podcast is that a lot of

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my clients really struggle with sleep.

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It can be down to things like waking up

because your symptoms are waking you up.

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So you're waking up with gas and pain.

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That's the probably the most common,

but also it can be because IBS and

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sleep issues often go hand in hand.

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IBS is often linked with, anxiety and

mood disorders and we know that they

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also play into sleep problems a lot.

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So feeling well rested and

energetic really helps you make

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better choices for your food.

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It helps your ability to concentrate

at work and perform and your desire

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to want to move your body as well.

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Like it's very hard to Want to go

and exercise when you just haven't

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slept well for weeks and weeks.

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So sleep is really important for our

overall health and it also massively

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impacts on our immune system.

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So when people are very tired and sleep

deprived, they often feel run down and be

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more susceptible to getting infections.

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You already know all of this, I'm

sure, that sleep is important.

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However, what we want to try and

work on is how to make it easier or

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how you can improve your sleep to

sleep for longer and sleep better.

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Because sometimes when you are struggling

with sleep, knowing all these things

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about how important sleep is, and how

you're going to wake up feeling even more

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tired, can be a bit counterproductive

with people going on and on about how

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terrible it is to be sleep deprived.

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It is also very common that

people don't sleep enough.

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I found some data saying that men in

the UK get around six and a quarter hour

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sleep a night and females get around

six hours And the one of the most sleep

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deprived age groups is the age 35 to 44

getting less than six hours on average

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and this was in one study, But I think

it just goes to show that When you've

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got a lot of worries and obviously that

sort of midlife can be quite stressful.

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They sometimes call it

the sandwich generation.

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You've got children or other caring

responsibilities and then maybe parents

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who are aging and responsibilities

plus work and then on top of that

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you've got your health concerns.

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There's a lot of things that could be

disrupting your sleep and knowing that.

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Sleep is important isn't really enough.

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So I'm going to focus a bit

more on how we can get over it.

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I thought it might be helpful to talk

a little bit about how we fall asleep

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as well Just so that you understand

there's two Triggers for us falling

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asleep and getting a good night's sleep.

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The first is our cycle

of the sleep hormone.

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Melatonin is one of the hormones

that really drives our sleep and this

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does have a kind of rhythm to it.

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It tends to be really low in the middle

of the day Obviously, that's when we're

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wide awake and then as the night It

starts to fall, the light becomes darker

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and also throughout our day we change

our pattern, we start to slow down

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and then melatonin will increase and

it tends to peak just after midnight,

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like the early hours of the morning.

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And then it decreases again

as we start to wake up.

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The other way that we sleep is

something called sleep pressure.

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So throughout the day all

our cells are burning energy.

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We're moving around doing things.

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And there is a byproduct called adenosine.

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So there are adenosine receptors in the

brain and there is this kind of build

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up of pressure, this adenosine, that's

getting stronger and stronger and that

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is also triggering the need to sleep.

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Now adenosine is blocked by caffeine.

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When we have a cup of tea and coffee,

that will stop your brain receiving

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the messages about adenosine, which

will reduce your sleep pressure.

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Also if you have a nap, that also

reduces the pressure to sleep.

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You've probably already noticed

that when you're more stressed,

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you feel more anxious and therefore

sleep becomes even harder.

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We know when we're overtired, we

might feel more anxious and that

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can be really hard to switch off.

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It's basically your brain putting

your body into a kind of danger mode,

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thinking, okay, I haven't slept because

there must be something going on.

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I've got to be on high alert all the time.

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And always looking for danger and

something that could go wrong,.

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So you're always looking out to anticipate

the worst case scenarios, and then

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this can further drive anxiety levels.

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So, We also know when we're

in that fight or flight state,

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we don't digest food as well.

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And this can end up leading to

higher levels of bloating and gas

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and pain that then can wake you up.

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So it can become this really vicious cycle

that is actually quite hard to get out of.

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We also know that sleep can

change your gut microbiota,

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which is really interesting.

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I found this study where some young

and normal healthy men, and they

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sleep deprived them for two nights.

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And they tested their gut microbes before

and after the experiment and in just two

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nights of four hours sleep, so they had

half the recommended time rather than

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eight hours, they saw changes in their

gut microbes and these Microbes were more

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associated with metabolic disruption,

so think about things like blood sugar

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regulation, increased weight gain.

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Also, The men had worse insulin

responses, meaning they were less

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able to pack away glucose from their

food, they got a big insulin rise.

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If that was to go on over time, it can

potentially lead to metabolic conditions

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like diabetes and that sort of thing.

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They've also done experiments taking

sleep deprived mice, that, sort of mimics

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a jet lag experience, and they noticed

this sort of insulin changes in these

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mice., when they gave the bacteria from

the jet lagged mice to other mice, they

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also saw the insulin responses., we also

know that there might be a immune response

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as well, as some inflammatory markers

are increased by sleep deprivation.

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These are interleukin 6, TNF alpha,

sometimes nuclear factor kappa beta, B.

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These are increased when people are

really sleep deprived chronically and

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in the short term as well in studies.

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Then the other thing is when we're tired,

we tend to make different food choices.

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We choose foods that are energy dense . We

crave sweet things that are going to give

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us a hit and that is because When we're

really tired, your brain is just desperate

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for some energy and the quickest release

carbohydrates would be like simple sugars,

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simple carbohydrates, because you know

that those are going to give you that

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energy hit to get through the next stage

of the day until you can sleep again.

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Now, I'm going to move on to what you

can do to improve your sleep now, but I

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wanted to just labour that point a little

bit that it is important and it does

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affect your digestion, so lack of sleep

is not something to ignore when we're

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looking at how to improve your digestion.

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Some people are surprised about

that and don't give sleep the

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priority that it deserves.

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One of the key things that I

see with some clients as well is

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you're not giving yourself eight

hours opportunity for sleep.

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You're not going to bed

in enough time, basically.

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A lot of people will go to bed at

11, 12 o'clock and then be needing

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to get up quite early or they're

waking up quite early, and so they're

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just not getting enough sleep.

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even eight hours in bed, let

alone eight hours asleep.

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So one of the first things that you

can do to try and improve your sleep

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is to just give yourself an opportunity

to get that eight hours sleep.

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Now when we talk about eight hours that

is the magic number, but we know probably

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from studies that some people will do

better on a little bit less, some people

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will do better on a little bit more,

and there's no exact science to it.

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It's what We also know some

people are more of a early

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morning, like Lark chronotype.

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So somebody who prefers to get

up early and go to bed early.

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And then there's the night owls who prefer

to wake up late and go to bed early.

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late.

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Now the problem is for the night

owls that our society is very much

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geared to people who get up early.

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And school and work mostly all require

people to be up dressed out of the house

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early in the morning and not sleeping

in, and this is a real problem for

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teenagers who have a late chronotype

as they sort of get to 14, 15, 16.

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It's natural for them to want to

sleep in later and wake up later.

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However, school and everything normally,

Means that they have to get up early,

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which means that they then are sleep

deprived if they're staying up late.

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So although they hate it, going to

bed early for teenagers is some of the

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best things they can do to maintain all

those things I was just talking about.

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The blood glucose, the better insulin

response, the healthy immune system, and

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also ability, obviously to concentrate.

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So that is one of the first

things we've got to get.

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you having enough sleep

and enough time in bed.

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Now, if you are someone who has got

ability to change your schedule to meet

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your needs and you're someone who can

start work whenever you want, you'd

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prefer to start work at 11 in the morning

and you sleep through, that is okay.

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Although, there is some sort of

research that says people who are the

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earlier chronotype tend to be healthier

and tend to have healthier weight.

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But it might be more skewed

because of the way society treats

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people who like to sleep in.

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Often you can't juggle your

schedule around to meet that.

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But if you can and it works

for you, that's okay.

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If you're well rested, you're getting

your eight hours sleep a night, but

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you're just waking up at ten o'clock

in the morning and then going off to

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work, that is fine if it works for you.

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As I mentioned at the beginning, one

of the biggest disruptors for sleep

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is, our Intrusive thoughts, repetitive

thoughts, anxious worries, basically

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feeling stressed, feeling anxious.

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So, during the daytime, we've got to try

to find an outlet for these emotions.

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It can be things like journaling,

which is really helpful for writing

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down all the thoughts that are in your

head, getting stuff out of your brain.

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Maybe it's chatting to your

friends more frequently.

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But, another really good approach if

you are struggling with sleep is to have

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therapy and go for some counselling if

that is financially available to you.

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If not, you might be able to get something

through your doctor, although there are

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massively long waiting lists out there.

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But finding a way to be able to talk

about your emotions, talk about your

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thoughts, is really, really helpful

to getting better sleep, because

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those are the times when the worries

come cascading round your brain.

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The other thing you need to start doing is

practicing relaxation, and not only doing

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it when you're stressed, is practicing

some of those deep breathing techniques.

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Listen to episode 48 for a run through

of different breathing techniques

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and things that you can do for IBS.

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Practicing those regularly so that you

can call on them when you need them.

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If you only practice them when you're

feeling really stressed or you're

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having a period of insomnia, then

that is not going to be as effective

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because you have to be able to call

on these practices in tough times.

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And so you have to get the practice in

when you're feeling a little bit better.

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The other things you can do to

improve your sleep is a short nap

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but only in the middle of the day.

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So I would not advise having a nap

firstly for longer than about 20 or

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30 minutes in the daytime and then

secondly later than about 2, 2.

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30.

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And that is because you're going to impact

on your sleep pressure and It makes it

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harder to go to sleep the following night.

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Most of the advice around sleep is also

trying to stick to a bit of a schedule,

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even at the weekends, so that you are

trying to get up early at the weekends

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if you get up early during the week.

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So you keep the same routine, and that

is about stabilising that production

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of the melatonin and your sleep cycle,

and trying to keep it consistent.

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Because, um, Sometimes it's called

social jet lag, where you sleep in

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at the weekends, particularly if

it's like a long weekend and you have

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three nights of sleeping in late.

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When you try and get up on Monday

morning, it's like your body clock

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has shifted to the weekend pattern.

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And then on Monday you've got to try

and get back to your work pattern

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and you can feel really tired.

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You can feel like you're jet lagged

because your body has been used

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to waking up at 10am but suddenly

you've got to wake up at 6.

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30 and get to work.

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So trying to keep a stable pattern even

at the weekends is really beneficial

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for getting good quality deep sleep.

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Other things that help improve your sleep

include activity during the daytime.

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Exercising ideally for about 30 minutes a

day preferably outside, because then you

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are also getting exposure to daylight.

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And you might have heard me talk

about this before, but when we

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see daylight in the morning, that

helps to suppress the melatonin.

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When your eyes are exposed to the bright

sunlight and this does not help by getting

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a bright light and inside the house it

just won't work there's a very different

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sort of light that comes from the sun.

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The best thing to do is just to go

outside even on a cloudy day you will

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be exposed to higher lux that's how

they call it Calculate the light.

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I don't actually know what it stands for.

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Ha ha.

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Lux.

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And that is gonna be higher and

it also stops the production of

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melatonin in the morning which

then kicks it off again at night.

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So when you stop it in the morning,

it comes back stronger at night.

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And that is what we want to

regulate your sleep and wake cycle.

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In babies that sleep and wake

cycle is not established.

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When first come out of the womb and

there is all over the place and that's

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why babies wake up a lot during the

first year of their life and possibly

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more but it takes a long time for this

wake sleep cycle to regulate itself.

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Exercising during the day, um,

ideally at least 30 minutes.

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And it doesn't have to be full on

exercise, just a nice walk with

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your dog or popping around to

the shops, you know, that's okay.

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Um, but just getting a bit of

movement in because that also helps

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your body realize what you're doing.

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We're awake and active in the day.

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We're better to sleep

and be calm at night.

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So exercising, but not too near bedtime.

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For people who exercise within two to

three hours of bed, sometimes you might

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still have raised cortisol levels.

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So when we do engage in exercise, that

um, you know, really stresses your

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heart out and you pumps your blood

round and you're really getting going.

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That is fantastic for your health but it

can also raise up your cortisol levels a

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little bit and then you might find it's

harder for those cortisol levels to fade

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away to allow you to go to sleep on time.

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So if possible try to get your exercise a

bit earlier in the day., , and if possible

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in the morning I would say but obviously

it doesn't work for everyone's schedule.

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Now sleep hygiene.

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It's also very important.

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This is about making sure your room

is dark, so if possible blocking out

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all your street lamps, turn off any

electric lights, make sure that your

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eyes are not exposed to daylight.

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When the room is not properly dark, your

body May still be noticing light coming

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through your eyelids and to the retina

the back of your eye and Still sending

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some messages to the brain that there is

something going on It's not time to sleep.

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So having it as dark as you

can really really helps.

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And try to have the room as cool as you

can like around 18 degrees Apparently

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is a good temperature So whether

you have the window open if you need

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to wear earplugs as well to make it

quiet or an eye mask to make it dark.

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That's helpful for some people and

I know at the moment right now we're

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in the middle of the British summer

and it's light by about four o'clock

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in the morning and at the moment we

haven't got our blackout blinds up

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and I'm having to put an eye mask on

as soon as I wake up and realize it's

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4am and I want to go back to sleep.

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Put my eye mask on and

try to go back to sleep.

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Try not to keep checking on the clock

as well, or looking at the phone,

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because partly the light wakes you

up a little bit, but also it can

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make you feel really anxious if you

wake up a lot through the night.

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Try, if possible, to just go back to sleep

and don't worry about what time it is.

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If we think about eating and what you

can do in terms of diet to improve your

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sleep, one of the first things I would

say is think about your caffeine intake.

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When you're very tired, obviously

you may want to rely on caffeine

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to wake yourself up in the morning.

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There is some advice as well that

says, try not to have coffee or tea

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first thing, like if you can wait

for an hour or so, then you are

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actually maximising your usefulness

of the caffeine hitting your brain.

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So when you first wake up, your

body may be quite high in melatonin.

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And that's the sleep hormone.

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You might feel quite groggy

and you need that to clear.

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So one of the best things you

can do is go outside and get that

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daylight, as I was mentioning.

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That helps you.

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And then also, any kind of movement

that you can do in the morning,

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it helps to wake your body up.

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Have a drink of water, do a little

bit of movement, a bit of exercise.

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Just in your pyjamas in the

kitchen is fine, it doesn't have

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to be going for a run or anything.

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That helps to wake you

up without the caffeine.

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Then, if you have your caffeine a bit

later on, you're probably not going

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to need as much caffeine throughout

the day, whereas if you have one as

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soon as you wake up, probably by mid

morning, you're going to need another

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one as that caffeine will have worn off.

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Try and keep your caffeine to

before lunchtime if you can.

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So if you do drink tea, coffee, green tea,

and also things like coke and pepsi that

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have, caffeine in them, or energy drinks,

then try to keep those in the morning.

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Because caffeine has a very long half

life, that means the time it takes

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to leave our body through the liver

processing it is around six hours and

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then if you have a cup of coffee at 12

o'clock at six o'clock at night you've

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still got half the amount of caffeine

there on average some people will be

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much faster metabolizers of caffeine

than others however that is still a lot

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of caffeine to have in your body now

if you push that back a few hours again

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and we're talking about four o'clock

you have a cup of coffee then at 10

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o'clock at night you've still got half

that Caffeine sloshing around your

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blood may be interfering with your sleep.

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Now, even if you're someone who

says, I can drink coffee at tea time

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and I still go to sleep alright.

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Some people can because they are, like I

said, very fast metabolizers of caffeine.

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However, you may find you

don't get a good quality sleep.

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So that caffeine is still there in your

body and you might, the sleep pressure

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allows you to fall asleep, but it

could disrupt your sleep wake cycle.

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Also in the evenings you want to try to

avoid alcohol, that can be a sedative,

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so it may help you fall asleep quite

quickly but then you probably will wake

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up early hours of the morning, maybe

feeling a bit dehydrated, maybe with a

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blood sugar dip, so alcohol feels like

it's relaxing and soothing but actually

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can probably impact on your sleep.

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You may also find your liver is working

a little bit over time and you wake up

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very hot about three or four o'clock

in the morning, I know that definitely

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happens to me . Now I spoke about when

to ignore my IBS advice in episode 56.

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One of the things I mentioned is having

a night snack if you're someone who

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wakes up . So this is good advice,

and you do not need to always follow

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the recommendation to fast overnight

if you're someone who wakes up a lot.

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So if you find yourself regularly

waking up early, maybe you're

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not eating enough during the day.

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So I would definitely consider upping

your protein to The minimum, which is 0.

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8 grams of protein for every kilo

of body weight that you have.

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You can work it out

depending on your body size.

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Go and listen to the episode on

protein, episode 46, which goes

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through all the calculations and it's

got all the information on there.

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Ideally, you want to try and allow about

three hours before bed to digest your

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food, to allow the food to go down so

that when you lie down, there's no chance

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of additional reflux issues because the

food is starting to move out through your

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stomach and into your small intestine.

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If you go to bed after a big meal, You

may find you're getting some heartburn,

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maybe even more nausea, and also sometimes

people feel they don't sleep as well when

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their food is still in their stomach.

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Everything sort of slows down when you

sleep including digestion, so you're

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not going to get that processing of

nutrients as effectively and it's just

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kind of sitting in your gut for longer.

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:

Some people find taking a magnesium

supplement may be helpful,

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:

particularly the form of magnesium,

glycinate or bis glycinate.

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:

This is very relaxing on the nervous

system and can be helpful before bed.

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:

Check with your health provider

whether that is suitable for you.

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:

If you have low blood pressure,

I would, consider whether that is

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:

suitable because magnesium can lower

your blood pressure, but it also

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:

may interact with other things.

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:

You don't want to take a lot of magnesium

if you've got kidney issues, for example,

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:

or, on certain types of medication.

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:

So do check, but it can be very relaxing

and people find they get a better, deeper

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:

sleep, through taking magnesium at night.

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:

That was a little whistle stop tour

through some ideas for better sleep, but

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:

not all of them will be applicable to you.

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:

If you want individual personalised

help with your diet and your IBS, then

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:

please get in touch for details on how to

apply to my 3 month gut reset programme.

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:

That is where I work with people

on a 1 to 1 basis over 3 months

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:

with lots of 1 to 1 coaching time

and support to improve your diet.

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:

So if you're interested in that, please

email me or get in touch via my website.

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:

The email address is

info@goodnessme-nutrition.com

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:

thanks for listening to this

episode of the Inside Knowledge.

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Better digestion for everyone.

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