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The Impact of Hormonal Changes on Sleep During Menopause with Dr. Woganee Filate
Episode 1519th February 2025 • My Third Bloom • Tricia Blake
00:00:00 00:32:12

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The episode features a profound dialogue between host Tricia Blake and esteemed guest Dr. Woganee Filate, an adult respirologist and sleep medicine physician. Central to their discussion is the exploration of the myriad sleep disturbances that women frequently encounter during the menopause transition, a phase marked by significant hormonal changes.

Dr. Filate elucidates the intricate relationship between estrogen levels and sleep quality, highlighting that up to 60% of women may experience altered sleep patterns during this critical period. The conversation further delves into practical strategies for ameliorating these sleep challenges, emphasizing the importance of sleep hygiene and lifestyle modifications.

Ultimately, this episode serves as an invaluable resource for women navigating the complexities of aging and seeking to enhance their well-being through improved sleep practices.

Takeaways:

  • The journey through menopause significantly impacts women's sleep patterns, resulting in various disturbances.
  • Hormonal changes during menopause alter sleep quality, particularly affecting REM sleep and circadian rhythms.
  • Lifestyle modifications, including sleep hygiene, can greatly improve sleep quality during the menopause transition.
  • Alcohol consumption can disrupt sleep patterns, leading to fragmented sleep and morning fatigue.
  • Women experiencing sleep issues during menopause should consider consulting a specialist for appropriate interventions.
  • Exercise plays a crucial role in promoting better sleep, but should be timed appropriately to avoid stimulation before bedtime.

Transcripts

Speaker A:

Welcome to the My Third Bloom Podcast where we get into unfiltered conversations about the powerful journey of aging gracefully during perimenopause and menopause, breaking taboos and embracing transformation.

Speaker A:

I'm your host, Tricia Blake, founder, CEO and Chief awesome Officer of My Third Bloom where we are on a mission to empower those experiencing perimenopause and menopause.

Speaker A:

We're guided by empathy and fueled by innovation.

Speaker A:

We provide support, education and resources.

Speaker A:

Whether you're navigating the rollercoaster of hormonal changes or seeking a supportive community, you're in the right place.

Speaker A:

Buckle up and get ready to bloom with strength, wisdom and grace.

Speaker A:

Hey listeners.

Speaker A:

Welcome to the next episode of the My Third Bloom Podcast.

Speaker A:

Our guest today is a passionate and dedicated adult respirologist and sleep medicine physician committed to providing comprehensive, evidence based and patient centered care.

Speaker A:

She has a wealth of experience in diagnosing and managing respiratory and sleep disorders.

Speaker A:

Her recent interests include educating patients on the changes in sleep during the menopause transition and what can be done to optimize sleep during this key life stage.

Speaker A:

Dr.

Speaker A:

Felleti is a founding partner with Loom Women and Health, an elevated healthcare destination for women founded by female MDs to empower healthy aging in a preventive, personalized and holistic way.

Speaker A:

Please join me in giving a warm podcast welcome to Dr.

Speaker A:

Wagani Faleti.

Speaker B:

Hi, how are you?

Speaker A:

Hello.

Speaker A:

Hello.

Speaker A:

Thank you for joining us.

Speaker B:

Oh, I am so excited to be here.

Speaker A:

Great to have you here.

Speaker A:

I'm super excited to have this conversation and I we're just going to jump right in.

Speaker A:

I want to know, you know, I'm sure our listeners want to know about what sparked the journey for you to be the sleep doctor and or the lung doctor.

Speaker B:

Such a great question.

Speaker B:

And it's like with most things in life, it kind of just happened.

Speaker B:

So I knew I always wanted to be a doctor.

Speaker B:

So that was something that I it was a part of me from a really early age.

Speaker B:

And as I went into medical school and residency, I did internal medicine as a as my specialty.

Speaker B:

And internal medicine allows you to see all the different subspecialties, cardiology, gi, renal, all of these things.

Speaker B:

And you rotate them and you try to find what I say.

Speaker B:

Find your people, right?

Speaker B:

Find the discipline that resonates with you, find the community of doctors that you are most aligned with.

Speaker B:

And believe it or not, those were the lung specialists.

Speaker B:

It was something about their approach to patient care, their thirst for knowledge, the ease with which they see patients and their warmth made me Feel that this was.

Speaker B:

These were my people.

Speaker B:

So while I was doing my respirology fellowship, one of the disciplines that we rotated through was sleep medicine.

Speaker B:

I had never in all of my years heard that sleep medicine was its own field.

Speaker B:

And I spent two months in that rotation and was so amazed to see the transformation of patients.

Speaker B:

Right.

Speaker B:

They would come in with a sleep challenge or a sleep complaint.

Speaker B:

We would run tests, work with them, and then see them at the outcome, how much improvement they felt and how much better they felt about themselves and their outlook on life.

Speaker B:

And I said, this is where I need to be.

Speaker B:

This is where I feel like I can affect the most change.

Speaker B:

And so then I did extra training and sleep medicine, and that was almost 12 years ago now.

Speaker A:

Oh, wow.

Speaker A:

Well, we're.

Speaker A:

We're happy.

Speaker A:

We're happy to have you.

Speaker A:

I know from a personal standpoint, I have some sleep challenges.

Speaker A:

So this interview, if I could take notes at the same time, but I haven't recorded, so it's okay.

Speaker A:

But, you know, just thinking about what are some of the most common sleep challenges women face during the menopause transition and what causes them?

Speaker A:

And.

Speaker A:

And I think.

Speaker A:

I think of things like, how much sleep do we really need as we age?

Speaker A:

Yeah.

Speaker B:

So let's start there, and then we're going to work backwards.

Speaker B:

So, you know, the general recommendation, if you really take all of us and you lump us together, the average adult needs between seven to nine hours of sleep.

Speaker B:

And those numbers came from, you know, looking at all the research looking at the optimal outcomes for various disease processes.

Speaker B:

And it was found that seven to nine hours was kind of like the magic recommendation.

Speaker B:

But like with everything in medicine, there's exceptions.

Speaker B:

So, yes, that may be including 80 to 90% of us need to sleep that much.

Speaker B:

Not everyone.

Speaker B:

Some people do well on less, some people do well with more.

Speaker B:

But I would say the general rule is seven to nine hours.

Speaker B:

So, you know, that's the recommendation.

Speaker B:

And, you know, what happens at midlife and during the menopause transition is that things change.

Speaker B:

Change.

Speaker B:

Just like things change with our body, our physical body, our symptoms, our sleep changes.

Speaker B:

Between 40 to 60% of women through the menopause transition will report some form of sleep change or sleep disturbance.

Speaker B:

And it can take the form of difficulty falling asleep, difficulty staying asleep.

Speaker A:

That's me.

Speaker B:

That's you?

Speaker B:

Yeah, that's me, too.

Speaker B:

And that's happened to me more than once.

Speaker B:

I have.

Speaker B:

I always say, what's your number?

Speaker B:

What's the number of the clock of your phone when you wake up?

Speaker B:

-353 to be exact.

Speaker A:

323.

Speaker B:

23, I'm 353.

Speaker B:

And you know, so waking up before you want to wake up, like your desired wake up time is another one.

Speaker B:

And just generally feeling fatigued.

Speaker B:

So those are the most common symptoms that we have during menopause.

Speaker B:

And the question is why?

Speaker B:

What is happening in our sleep that's all of a sudden creating this, this change?

Speaker B:

Well, you know, if we go back to the, you know, the foundation of, of perimenopause and what's happening is the changes in our hormone levels.

Speaker B:

And we know that estrogen actually plays a huge role in our sleep.

Speaker B:

It helps us to get deep sleep.

Speaker B:

So REM sleep, it's a big stabilizer of REM sleep.

Speaker B:

And REM is the type of sleep we get usually between 3am and 6am and when we have less estrogen, well, we have less of that glue that binds that REM sleep together.

Speaker B:

And so the REM sleep can be fragmented.

Speaker B:

Hence waking up at 3, 4, 5 in the morning, our circadian rhythm changes, right?

Speaker B:

So that is our natural 24 hour clock is also affected by estrogen.

Speaker B:

We tend to want to go to bed earlier and wake up earlier.

Speaker B:

We have less melatonin as we go through the menopause transition.

Speaker B:

And we also now start to develop new sleep disorders that we never had before or that were never on our radar for women in menopause.

Speaker B:

And the big one that I think a lot of us don't think about is obstructive sleep apnea.

Speaker B:

So when I tell patients that they should think about sleep apnea, they're shocked, right?

Speaker B:

Because they say, well, I'm not a man, right, not overweight, I don't have a thick neck, I don't have those loud snoring or gasping episodes at night.

Speaker B:

So how could I have sleep apnea?

Speaker B:

Well, the thing is estrogen, not only does it do all those changes to our sleep, but it also regulates the tone of our muscles in our upper airway.

Speaker B:

And when we have less estrogen, our muscles in our airway weight can be more floppy, for lack of a scientific word, and hence we're more prone to sleep apnea.

Speaker B:

And the thing too is we women tend to present differently than what those classic symptoms are.

Speaker B:

So I always say to women, think about symptoms like obviously, fatigue, difficulty concentrating during the day, headaches in the morning, irritability.

Speaker B:

And those are things that you want to start thinking about, well, hey, maybe there is a sleep disorder at play.

Speaker A:

So with the sleep disorders Are there steps that we can take to improve our sleep during this time?

Speaker A:

I'm not about this floppy business.

Speaker A:

And between three to six is actually when I'm awake.

Speaker B:

I always say there's things that we can do as patients and then there are things that you need to ask for help with.

Speaker B:

So things that we can all do, even starting tonight.

Speaker B:

If you're listening to this podcast and you say to yourself, I'm going to implement something tonight to help me sleep better.

Speaker B:

And it's all about our environment and what we call sleep hygiene.

Speaker B:

So what are you doing before bed to really honor and respect your body's time to go to bed?

Speaker B:

So that includes, you know, keeping your bedtime the same.

Speaker B:

Even on the weekends.

Speaker B:

You want to really turn off your phone, turn off your computer, your iPad, all of that one hour before bed.

Speaker B:

And that can be a big challenge.

Speaker B:

You want to be mindful of things that can disrupt your sleep.

Speaker B:

So, so caffeine is a big one.

Speaker B:

You want to really think about eliminating caffeine by the early afternoon, if not lunchtime.

Speaker B:

And then alcohol is a big one, especially for women.

Speaker B:

It is a big sleep disruptor.

Speaker B:

Not only does, well, the good people say to me, oh, but you know, Dr.

Speaker B:

Falate, I can fall when I drink.

Speaker B:

It helps me fall asleep, it relaxes me.

Speaker B:

And for sure it's a sedative.

Speaker B:

That's what it does.

Speaker B:

But once you're asleep and your body is metabolizing that alcohol, it wakes you up throughout the night and it wakes you up and you're not even aware of it.

Speaker B:

So you have these little, what's called wake ups or arousals, not the sexual kind, but the actually neurologic arousal in your brain.

Speaker B:

And you wake up the next morning feeling tired.

Speaker B:

And it was because you had such fragmented sleep at night.

Speaker B:

So for women who are struggling with sleep in perimenopause and menopause, I say really think about your relationship with alcohol and then even try to minimize it or cut it out during the work week.

Speaker B:

Right.

Speaker B:

So you can really focus on your sleep during the work week when you need to be most productive gift.

Speaker B:

And then you can introduce it over the weekend.

Speaker B:

So those are the main ones that we can do.

Speaker B:

And then where, where I say to get help is, are there symptoms bothering you?

Speaker B:

So especially as it relates to menopause, are you waking up because of a hot flash or night sweats?

Speaker B:

Is your mood affected?

Speaker B:

So mood disorders are a big issue as we go through the menopause transition.

Speaker B:

So symptoms of depression and anxiety can affect Our sleep.

Speaker B:

So in that case, then speak with your doctor to get treated.

Speaker B:

And if you're worried about a sleep disorder or you really just want to have an assessment, you can ask your primary care doctor to refer you to a sleep specialist.

Speaker A:

Okay.

Speaker A:

So I.

Speaker A:

I was holding back a gasp when you said alcohol.

Speaker A:

And it's like, okay, I knew it was coming.

Speaker B:

Oh, my patients hate it.

Speaker B:

They hate it.

Speaker B:

They're like.

Speaker B:

They say to me, you're no fun.

Speaker B:

You know, I have to go to bed at the same time every day, including the weekend.

Speaker B:

Now you're telling me not to drink.

Speaker B:

I can't watch tv.

Speaker B:

And I say to them, I'm fun.

Speaker B:

I'm just not fun.

Speaker B:

Monday, Tuesday, Wednesday, Thursday, Friday, Saturday and Sunday.

Speaker B:

Like, you have to give yourself some grace and say, okay, I'm going to focus on my sleep Sunday to Thursday, or whatever, you know, your routine looks like, and then allow yourself to enjoy.

Speaker B:

Have fun and enjoy yourself.

Speaker B:

This is life.

Speaker B:

It's a long game.

Speaker B:

Right.

Speaker B:

But, you know, if you are struggling with your sleep, I would say alcohol is sort of like the lowest hanging fruit that you can think about either cutting down and eliminating.

Speaker B:

And do an experiment.

Speaker B:

I tell my patients, try for two weeks, just humor me.

Speaker B:

No alcohol, and see how you sleep and really be honest with yourself.

Speaker B:

Take stock.

Speaker B:

And you may be surprised.

Speaker B:

Right.

Speaker B:

As to what you.

Speaker B:

What you see.

Speaker B:

you know, you remember March:

Speaker B:

We had our small kids in the house trying to work, and we overdid it with alcohol in the house.

Speaker B:

Right.

Speaker B:

Drinking a way to cope.

Speaker B:

The world was a scary time.

Speaker B:

And I remember saying to my husband, you know, I've really not been sleeping well.

Speaker B:

I think, you know, the stress of the pandemic is getting to me.

Speaker B:

And then we said, well, you know, could it be the alcohol?

Speaker B:

I said, no, it can't be the alcohol.

Speaker B:

No.

Speaker B:

And then we said, okay, let's try one week.

Speaker B:

Nothing.

Speaker B:

Just do it together.

Speaker B:

No alcohol, and see our sleep.

Speaker B:

And unfortunately, it made a huge difference.

Speaker B:

And.

Speaker B:

And so now alcohol is not part of my life anymore because for me, sleep is more important.

Speaker B:

And it just.

Speaker B:

And also, you know, this was something that I think happens to a lot of us.

Speaker B:

Our relationship with alcohol changes over time.

Speaker B:

Right?

Speaker A:

Yes.

Speaker B:

When you're 20, it's one thing.

Speaker B:

When you're 45, it's a very different thing.

Speaker B:

So.

Speaker A:

Right.

Speaker B:

Just to give people that perspective, that's Fair.

Speaker B:

I heard you.

Speaker B:

It's okay.

Speaker A:

So can.

Speaker A:

Can untreated.

Speaker A:

I guess thinking about untreated sleep disorders and how it exacerbates menopausal symptoms.

Speaker A:

Like what.

Speaker A:

What ways?

Speaker A:

Because if.

Speaker A:

I don't know, like, I know the ones that are common.

Speaker A:

And then you were speaking of, you know, if it was sleep apnea, but if I just live with it, what's.

Speaker A:

What's gonna.

Speaker B:

Yeah, so it's a great question.

Speaker B:

So poor quality sleep and insufficient sleep.

Speaker B:

So one relates to the quality and depth of your sleep.

Speaker B:

The other represents, like, how much time you spend asleep have really big implications in our health.

Speaker B:

And it's not something to be taken lightly.

Speaker B:

It can.

Speaker B:

When we sleep poorly, we have difficulty with memory and concentration.

Speaker B:

Right.

Speaker B:

There's also evidence to say that chronic insufficient sleep.

Speaker B:

So sleeping less hours at night can actually increase your risk for dementia.

Speaker B:

It increases our risk for heart disease.

Speaker B:

So things like high blood pressure, heart disease, strokes, there's a huge risk of chronic insufficient sleep with our immune function.

Speaker B:

Believe it or not, they've done studies where they've sleep restricted people and they expose them to the flu virus versus those that slept, you know, seven, eight hours and were also exposed to the flu virus.

Speaker B:

And those that slept less actually were more likely to be sick.

Speaker B:

And the same could be said with vaccines.

Speaker B:

So there is a role for our immune function to be most optimized when we sleep those seven to nine hours and in good quality.

Speaker B:

There's also a link with our metabolic health.

Speaker B:

So this is a big one, especially for women during the menopause, where we are changes in our body shape and size and composition and our weight become.

Speaker B:

Become a big focus.

Speaker B:

Sleeping poorly actually leads to weight gain and many reasons for that.

Speaker B:

Number one, when you're tired, we often have.

Speaker B:

We're less likely to make good food choices.

Speaker B:

Right.

Speaker B:

When you're our hormonal balance in terms of the hormones that tell us we're hungry versus we're full, are out of balance.

Speaker B:

And they've done studies where, you know, when you sleep poorly, you can consume up to 300 extra calories per day.

Speaker B:

Now, that doesn't sound like a lot.

Speaker B:

And on a daily basis, I would say 300 calories isn't a lot.

Speaker B:

But if you do that every night for a whole year, that's like 10 to 15 pounds extra right there.

Speaker B:

So that is a big one.

Speaker B:

It affects our insulin levels, can increase our risk for diabetes and insulin resistance.

Speaker B:

It affects our mood when we don't sleep well.

Speaker B:

And I would say the thing that affects the most is our quality of life, right.

Speaker B:

And our sense of well being, our ability to be productive.

Speaker B:

You know, when we sleep poorly, I would be the first to tell you, like, I'm no good the next day, right?

Speaker B:

It takes me longer to send an email if I'm reading a document.

Speaker B:

I have to like read it three times to get that sleep.

Speaker B:

Same content, because I'm tired and I can't focus.

Speaker A:

So lifestyle changes for diet, how does exercise impact it?

Speaker B:

Yeah, so exercise is really important for many, many reasons.

Speaker B:

The big one is it just exhausts the body physically so that when it is time for bed, you're, you need that recovery, right?

Speaker B:

Your muscles need the recovery, your cardiovascular system needs your, the recovery.

Speaker B:

So, you know, incorporating exercises not only good for your heart health, brain health, but it's also really good for your sleep.

Speaker B:

The only caveat I would say is not to exercise too close to bedtime because, you know, you might end up being too stimulated to actually fall asleep.

Speaker B:

But exercise in the early evening, late afternoon, or obviously earlier in the day is good too.

Speaker A:

What about supplements are there?

Speaker A:

How do you feel about supplements?

Speaker B:

I know, I knew that was coming.

Speaker B:

So you know my approach.

Speaker B:

So first and foremost, you know, my approach is what's guided in the medical literature, right?

Speaker B:

Like what has been studied, what has shown to be effective.

Speaker B:

And melatonin, which is, you know, like I was saying earlier, that hormone goes down as we go through the menopause transition.

Speaker B:

So it's easy to say, well, if that level goes down, then I'm going to supplement it with over the counter melatonin.

Speaker B:

Unfortunately, the literature is a bit wishy washy.

Speaker B:

It's not great quality evidence that shows that melatonin has all the benefits it's purported to have, but it also doesn't show that it has any significant harms.

Speaker B:

So my approach is if a patient is using melatonin and they find that it helps and they don't have side effects, I'm okay with it.

Speaker B:

I always tell people though, be mindful because the effects can wane over time.

Speaker B:

So you may get an initial benefit, but don't be surprised weeks or months later.

Speaker B:

The same dose isn't giving you the right, the same response that you were getting before.

Speaker B:

And then the other one that people often use for sleep is magnesium.

Speaker A:

Right.

Speaker B:

The research on magnesium is worse than melanin.

Speaker B:

Oh, so we don't have great evidence.

Speaker B:

But again, the, the, the take home is the same.

Speaker B:

If it helps you and you're not having side effects, go for it.

Speaker B:

But where I Always caution people is try to have that as an add on.

Speaker B:

Right.

Speaker B:

Like do all the things that we're supposed to do, like the homework of sleep, like going to bed at the time, cutting out stimulants, things like that.

Speaker B:

And then if you're still struggling, you can, you can add those and see if they help.

Speaker B:

Okay.

Speaker A:

How do you feel about this?

Speaker A:

Sleepy time tea really work?

Speaker B:

No.

Speaker B:

There's nothing in sleepy time tea that is magical.

Speaker B:

But I think where, where I find it helps is if that establishes your nighttime routine.

Speaker B:

If the simple act of making tea in the evening, you see the sleepy time box, you're.

Speaker B:

You're getting into the mind frame of bed and it's relaxing, then that's part of a good sleep routine.

Speaker B:

Right.

Speaker B:

You're doing things to signal to the brain.

Speaker B:

Okay, the day has ended and now I'm transitioning to my nighttime routine and I'm inviting sleep.

Speaker B:

And if it involves making a cup of sleepy time tea, go for it.

Speaker A:

All right.

Speaker B:

Okay.

Speaker A:

I don't have any sleepy time tea, so I do like chamomile tea, though.

Speaker A:

So sometimes.

Speaker B:

Yeah, same.

Speaker B:

It's the same concept, right?

Speaker A:

Does it help?

Speaker A:

Does it help?

Speaker A:

I don't know if they have.

Speaker A:

What about.

Speaker A:

I think about.

Speaker A:

We just had a time change.

Speaker B:

Oh, yeah, I know.

Speaker B:

I'm not a fan of the time change.

Speaker B:

Do you know they've done studies.

Speaker B:

Yes, because I want to lose an hour of sleep.

Speaker B:

So obviously accidents are up.

Speaker B:

Right.

Speaker B:

Because, you know, it's getting darker earlier in the afternoon.

Speaker B:

Admissions to hospital for heart disease have increased when you lose an hour of sleep and then the reverse, like when you gain an hour of sleep, those heart.

Speaker B:

Heart attack and heart admissions to hospital for heart disease are lower.

Speaker B:

So it just goes to show that when you take away an hour of sleep, there are bad outcomes.

Speaker B:

And when you give people an extra hour of sleep, it's better.

Speaker B:

So it's another proof that we need.

Speaker B:

We need sleep.

Speaker A:

That was.

Speaker A:

That was what I just.

Speaker A:

I liked how we just did that.

Speaker A:

If you could, let's do some myth busting some myths.

Speaker A:

What are some myths that are out there as it relates to sleep?

Speaker A:

And let's, let's.

Speaker A:

Can we debunk like five of them?

Speaker B:

Okay.

Speaker B:

So number one, people will say, I'm gonna catch up on sleep on the weekend, or I'm gonna store up.

Speaker B:

I'm gonna give back to the sleep bank.

Speaker B:

Right.

Speaker B:

I'm gonna have this debt of sleep during the week, and then on the weekend I'm gonna pay it back.

Speaker B:

Yeah, that doesn't work.

Speaker B:

We need consistency.

Speaker B:

Our circadian rhythms are very consistent.

Speaker B:

And you need to pay that sleep debt every night.

Speaker B:

It's not something you can hold on to it and then, and then try to recap or reclaim it later.

Speaker B:

So that's a big one.

Speaker B:

The myth that we actually need less sleep as we get older.

Speaker B:

I would say yes, if we're talking about the elderly, they often their sleep is less, but then they also nap more in the day, so, so they kind of end up back at the seven to nine hours of sleep.

Speaker B:

So I would say that's a myth that, oh, I need less sleep now.

Speaker B:

I'm more efficient with my sleep.

Speaker B:

I can survive on five hours of sleep as I get older.

Speaker A:

Team no sleep.

Speaker A:

There's that.

Speaker A:

That camp.

Speaker B:

Gosh.

Speaker B:

What's another myth of sleep?

Speaker B:

Yeah, that, that it, that it doesn't.

Speaker B:

That it, it's not a big deal, right.

Speaker B:

For so long, especially when we were younger, we at least, you know, from my own experience, it was like an after.

Speaker B:

I never really had to think about sleep because it came easily, right?

Speaker B:

You would sleep, you would sleep 12 hours.

Speaker B:

You'd wake up, go to class, go to work as though nothing happened.

Speaker B:

You'd go out all night, you'd be drinking, you'd wake up, go to work, put in a full day and that, that changes, right?

Speaker B:

As, as we get older, we need to work on it a bit more.

Speaker B:

And I think that kind of goes with everything else in our.

Speaker B:

As we get older, with our health, right.

Speaker B:

We need to think about exercising.

Speaker B:

Maybe when you were younger, you were just more active in your day to day life.

Speaker B:

We need to think about our diet more now because, you know, when we don't eat well, it can increase our risk for metabolic diseases, heart disease, etc.

Speaker B:

So it is, we need, I know, like people often say during the menopause and just transition.

Speaker B:

There's so much I have to think about, right.

Speaker B:

I have to eat well, sleep well, take the medications, take these supplements, work on my mental health.

Speaker B:

De stress.

Speaker B:

It's a lot, right?

Speaker B:

So I would say just pick one or two things at a time and work on it.

Speaker B:

And you know, the beauty with sleep is that we get lots of second chances.

Speaker B:

Right.

Speaker B:

If you have a bad night or you were up watching Netflix late, or you were on your phone scrolling through social media and you're tired the next day, it's okay.

Speaker B:

It happens.

Speaker B:

I'm not perfect.

Speaker B:

No one's perfect.

Speaker A:

Yeah.

Speaker B:

The next night is your second chance.

Speaker B:

Try to do better.

Speaker B:

Right.

Speaker A:

Okay.

Speaker B:

Try to say okay.

Speaker B:

You know what?

Speaker B:

Last night I was scrolling for an hour and a half.

Speaker B:

I'm actually going to turn, I'm going to set an alarm at a certain time and I'm going to, it's going to remind me to put my phone down and just kind of giving yourself that grace, like, it's okay.

Speaker B:

Every night is a new chance, a new opportunity to work on your sleep.

Speaker A:

I love that, that naps.

Speaker A:

I love naps.

Speaker A:

Like, is there a, a good time?

Speaker A:

You should, it should only be like 15.

Speaker B:

Yeah.

Speaker B:

The naps.

Speaker B:

Okay, that's a good one.

Speaker B:

That's another myth.

Speaker B:

So, you know, naps are not generally recommended because I don't want you to sleep too much during the day, that it then takes away from your drive to sleep at nighttime.

Speaker B:

But sometimes we have such.

Speaker B:

We're so tired.

Speaker B:

Or you know, you just cannot, you have something going on at night and you're like, if I don't sleep, I won't function.

Speaker B:

Sleep.

Speaker B:

But you gotta be very strategic.

Speaker B:

Meaning you want to limit it to no more than 45 minutes.

Speaker B:

And you want the nap to be more or less wrapped up and done by 4.

Speaker B:

4:00pm yes, you heard me right, 4:00pm okay.

Speaker B:

If you have an event and you're going out till midnight, okay, maybe five.

Speaker B:

But I don't want you to sleep too late.

Speaker B:

I've had patients that come home from work, they're so tired, they sleep and then they wake up at 7pm and then it's hard to go back to bed at night, right.

Speaker B:

At 10 or 11.

Speaker B:

And then you end up staying up late that night.

Speaker B:

But then you still have to wake up early the next day and you're always kind of playing catch up.

Speaker B:

So that 4pm is meant to kind of cut off the sleep so that you, you have still the sleep drive at nighttime.

Speaker A:

So when my day ends at 6, 7.

Speaker A:

So work from home hybrid situation.

Speaker A:

And I am done.

Speaker A:

I'm, I'm exhausted and I, I try my best not speaking.

Speaker A:

I personally, you know, we're protecting the innocent here.

Speaker A:

I, I feel like I need to just close my eyes for a bit and yeah, it now might be 7:30.

Speaker B:

And think about what, what, what will you do that will give you energy?

Speaker B:

What's going to be something that's going to give back to you?

Speaker B:

So if it's a nap at the end of the day, try to make it short.

Speaker B:

Maybe it's a walk, right?

Speaker B:

No one's saying go to the gym.

Speaker B:

Just a walk around the block.

Speaker B:

Find something that's going to give you Energy, Right.

Speaker A:

Like, as opposed to taking the nap.

Speaker B:

As opposed to taking the nap.

Speaker B:

So what can give you energy?

Speaker B:

Go for a walk, go outside, get some fresh air.

Speaker B:

If you have a dog or, you know, take the dog around the block, something that's going to give you energy.

Speaker B:

And if, if, you know, and I'm saying I use a nap sort of at the last resort, like if it's a matter of I cannot physically keep my eyes open.

Speaker B:

Okay, nap.

Speaker B:

But if it's sort of, you know, like a low energy state where you just like, oh man, I just finished a full day of work.

Speaker B:

Yeah, I have to go make dinner now and I just, I just can't do it.

Speaker B:

Go for a walk, go outside, put on headphones, put on a music, a podcast, a book.

Speaker B:

20 minutes, I guarantee you'll feel better.

Speaker A:

Okay.

Speaker A:

And then I may have worked myself up where I now, like, okay, I can go to bed a little bit earlier since I didn't get my nap right.

Speaker B:

Yep, you can go to bed earlier.

Speaker B:

Yeah, you can for sure.

Speaker B:

I would rather you do that.

Speaker B:

Right.

Speaker B:

Than stay up late because you Woke up at 7:30 from a nap and then you're going to bed midnight, 1:00, and then your day still starts at 6 or 6:30.

Speaker A:

Yes, because I have that.

Speaker A:

3:23.

Speaker A:

That's my, that's my number.

Speaker B:

You're up and then you have to, you're going to give yourself some time to fall back asleep and then you may not get into deep sleep till 4 or 5am and then you're gonna have to be up like an hour later.

Speaker A:

So, yes, that's usually the, that has been the challenge.

Speaker A:

So I have another question as it relates to, does hormone therapy help at all with sleep?

Speaker A:

So challenges?

Speaker B:

Yeah, it does and it doesn't.

Speaker B:

I think it's always important to remember what hormone therapy can do and what it can't do.

Speaker B:

So if you are waking up because of drenching, night sweats, hot flashes, for sure that hormone therapy will help that.

Speaker B:

You know, for perimenopause, patients sometimes report really good improvement in their mood from hormone therapy.

Speaker B:

So then that will also improve sleep.

Speaker B:

But it doesn't necessarily draw a direct line to sleep improvement in and of itself.

Speaker B:

And people will also ask, well, if obstructive sleep apnea is more common during menopause, if I treat with hormone therapy, will that help my sleep apnea?

Speaker B:

And the answer is know.

Speaker A:

Okay, that's, that's fair.

Speaker A:

Understood.

Speaker A:

So we talked about lifestyle factors, diet, exercise.

Speaker A:

Put the phone away.

Speaker A:

Keep it In a.

Speaker A:

Keep it in another room.

Speaker A:

I like.

Speaker B:

I mean, that's.

Speaker B:

You can do that.

Speaker B:

But you know, some people say to me, well, that's my only way for my kids to get in touch with me or if I have elderly parents, for sure you want to.

Speaker B:

It's just discipline.

Speaker B:

Either keep it within arms, you know, arm's length so that you.

Speaker B:

It's like physically have to get up to get to your phone or just be disciplined.

Speaker B:

Disciplined and turn it off and put it at the side.

Speaker A:

So no airplane mode.

Speaker B:

Well, I mean, it's.

Speaker B:

I just don't want you looking at the phone.

Speaker A:

Right.

Speaker B:

I'm looking at.

Speaker B:

I don't care if it's on airplane mode or whatever mode you have in.

Speaker A:

Put the phone away.

Speaker A:

Got it, got it, got it.

Speaker A:

So I think I have one more question just to wrap up.

Speaker A:

If you could go back and give one piece of advice to your younger self about, like, even the menopause, transition and sleep, you know, this is a journey we're on.

Speaker A:

We're getting a little bit older, what would that piece of advice be?

Speaker B:

Such a great question.

Speaker B:

I think I would say, do you don't worry about what somebody else's experience is like, what works for someone else, what doesn't work for someone else.

Speaker B:

You have to focus on yourself and prioritize you.

Speaker B:

And if that means, actually, you know what, I'm going to bed earlier than my partner wants to go to bed because I know what I need for me, I need to prioritize my sleep or I'm going to incorporate exercise and I'm going to go for a walk at 6 o'clock.

Speaker B:

You don't want to come with me, that's cool.

Speaker B:

I'm going to do me, I'm going to prioritize me.

Speaker B:

And you know, for too long we've been prioritizing so many others in our life and I think it's okay to say it's my time, it's my time.

Speaker A:

I love that.

Speaker A:

I love that.

Speaker A:

And finally, where can our listeners find you?

Speaker B:

Oh, you can find me on Instagram @wfulatemd.

Speaker B:

So w f I L A T E M D.

Speaker B:

You can also find me and my partners.

Speaker B:

We're opening a new women's health clinic if you're in the downtown Toronto area called Loom Women in Health.

Speaker B:

And our Instagram is @loom Women's Health Clinic.

Speaker B:

And we also have an advocacy Instagram.

Speaker B:

It's Our Time Canada on Instagram.

Speaker B:

So lots of ways to reach out to us and we'll put that in the notes if you, if you want to check us out.

Speaker A:

Yes, definitely.

Speaker A:

We'll definitely keep our, keep our listeners in the loop on all things Loom.

Speaker A:

But thank you so much.

Speaker A:

Thank you for such a wonderful discussion on sleep for listeners.

Speaker A:

I don't know about you, but I am ready to implement probably every single tip that Wagner just shared, even if it means putting my phone turning it off.

Speaker A:

I get it.

Speaker A:

Turning it off at night.

Speaker A:

It's, it's, it's, it feels like it's harder than it sounds, but oh my.

Speaker B:

Gosh, because it is hard.

Speaker B:

It's hard.

Speaker B:

That's why it's hard.

Speaker B:

Because it is.

Speaker A:

But I think with the.

Speaker A:

It's good.

Speaker A:

They say, yeah, perimenopause menopause is going to bring some sleepless nights, but we got some tips with the right tools.

Speaker A:

I think with knowledge and mindset.

Speaker A:

Mindset is very important.

Speaker A:

We can move those sleepless moments into blissful sleep and make things a little bit more bearable.

Speaker A:

Thank you for tuning in to another episode of My Third Bloom.

Speaker A:

Until next time, stay curious, embrace the journey and take care of yourself.

Speaker A:

Do you mind, body and soul.

Speaker A:

Thanks for joining us, Wagner.

Speaker A:

Thank you for joining us on this episode of My Third Bloom.

Speaker A:

If you found value in our conversation, don't forget to subscribe, rate and leave a review.

Speaker A:

Your support means the world to us and helps us reach more incredible souls like you.

Speaker A:

Remember, you're not alone on this journey.

Speaker A:

Connect with us on social media at My Third Bloom, visit our website and be part of our thriving community.

Speaker A:

Until next time, keep blooming and embracing the beauty of your Third Bloom.

Speaker A:

This is Tricia Blake signing off with peace, love, light and grace.

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