Anshu Bahanda: This is Anshu Bahanda on Wellness Curated. Thanks for joining me on this podcast. My mission is to empower you with health and wellness so that you can then go and empower others. We have Kate Mikhail, who is a London-based freelance journalist and editor. She’s written a wide range of features for the likes of The Guardian, The Observer, The Telegraph, independent newspapers, other publications and for decades, she wasn’t able to sleep properly. And then she had a great great uncle. She read something that he had written. His name was Richard Waters and he was quite a pioneer in cognitive therapy and in clinical hypnosis. So that’s what made her realize that she was a chronic insomniac and that opened the gate for her research about sleep. Basically, that’s what caused her to write this book- Teach Yourself to Sleep. And she explores the biology and science of sleep. Kate, tell me what is wellness to you?
Kate Mikhail: Mind, body, equilibrium and really being strong both physically and emotionally. And of course if you can have quality sleep then that really helps with that. Because if we’re well rested and we get a good sleep, work life balance- the three in good balance- then you know we are healthier, we are physically stronger, we are emotionally stronger, we’re more resilient, we’re more on emotional sort of an even keel, we have more energy, we’re cognitively sharper, we make better decisions. I mean, everything about our day has improved, therefore our wellness. As a result, we’re able to be on top and get the most out of our day. So I would, say that sleep really is the foundation of wellness.
AB: I couldn’t agree more. I mean, I know people who can do with less sleep but if I don’t get enough sleep, I’m like a zombie. But I have never come across a situation where so many people have been having issues with sleep as in the last two years, particularly since the pandemic. Why do you think that is?
KM: Well, sleep is a problem for so many people and it is getting worse. And unfortunately, it’s just too easy for us to get disconnected from our natural sleep-wake cycle. Just modern society, the pace of life, the demands that are constantly being made on us, our indoorlife, our diet often work against that. We might grab something fast, release energy on the go. A big one is light. Our relationship with light, we spend so much time indoors these days and we really need natural light signals to sync our circadian clocks on a regular basis. As human beings, we’re hardwired to line ourselves up, sink in with the rising and setting of the sun. But of course, too often we just get up, get to the desk or short commute into an office. And we’re not getting that daylight, so we’re not sending the light signals we need that our brain then takes and reacts accordingly. So that’s one big thing. I did discuss this with Professor Brainard, who’s a NASA light scientist. I had talked to him for the book and it’s fascinating how sensitive we are to the light around us and all those signals are being relayed constantly. Our body, we react physiologically. So later at night, obviously we need our melatonin levels to rise. How quickly we can suppress that with the wrong light signals, that’s one big area. Another one is our cortisol levels. I think the pace of life these days is so fast, our cortisol levels are stressed. Chemicals can be pushed up and we don’t necessarily have to feel “oh, I’m so stressed”. But it’s even just the relentless demands, the relentless messages, alerts, things we have to respond to, noise pollution, these are all pushing our cortisol levels up and that can stop us sleeping well at night. And of course, as you mentioned the past two years, COVID, it’s caused huge anxiety, a lot of pain and it has on a day-to-day basis disrupted routines, blurred those boundaries between work and play. And unfortunately, one of the post COVID symptoms of those who have caught COVID is insomnia. So it is a big problem and it’s how you get back on track.
AB: It’s very interesting what you’re saying about light and how important that is because also, what’s happened with a lot of people since the pandemic is they’re not going out to their offices. So you’re getting less time in the light, your bedroom to your study or going into your desk in your own bedroom.
KM: Yes, exactly. Your commute can be 1 minute and the light indoors is so dim compared to outside. Obviously, one of the tips, if you can do it… A lot of people obviously are not even getting dressed for work in their loungewear, but do pretend to commute around the block. Just try and give yourself a bit of daylight. But even just sort of sitting next to the biggest window in your home and looking up and taking in the light, we really do need it, our body needs that. That’s what we are hardwired to take in.
AB: I do yoga and in yoga, you have the sun salutation, which you do facing the sun. So you’re constantly looking up in the sun and you’re looking down and then you’re looking up again. So it’s something you’re meant to do with the rising sun.
KM: Yes, I mean that morning, bright morning light.
AB: So you’re saying light, cortisol and COVID side-effects are the three.
KM: Yeah, those are three. I mean, it’s the pace of life as well. As I’m saying it’s a constant demand of majors so that we don’t sort of have time to switch off. We’re sort of chasing our to-do list too often.
AB: So tell me, Kate, what do you recommend for all these people who are having a problem going to sleep?
KM: Some people have trouble falling asleep as you know. Some people wake in the night, some people wake too early. But the big thing starting off is sort of knowing the basic biology of sleep and how your mind and body works. I mean, this is really vital because then we can work against it without even realizing we’re working against it. So if you know how it works, then you can work with it. You can support your biology, your body and your whole sleep rate pattern. So that is key. Also, looking at the causes, it’s not just in the moment, it’s things that have been happening in the day. Is your mind worrying? Are you thinking about problems during the day? Is your bed uncomfortable? It might be something like that. Or is there light pollution coming in? It’s working out what is stopping you and then dealing with the causes. I was chronically sick for years and years. And I tried some sort of regular thing, I had my lavender oil and did lots of relaxing routines towards the end of the day or just before bed. But I had no concept, really of how my sleep was formed or what. So I really had no control of the situation at all. I realized now, without that understanding, you know you can’t, particularly. So it’s a matter of realizing that our night and day are completely intertwined and everything that happens in our day impacts our sleep at night. I now am very conscious of the light I take in particular in the morning. I will, as I said, take in that light, go for an early morning walk if I can. I also have a light box on my desk.
AB: What is the light box?
KM: Mine is emitting 10,000 lux of light, which is the unit you measure lights in. And my room, I was surprised to discover, is a very dark room, as most of our rooms are. It’s about 100 and 5200 lux maximum. So if I put on my box for maybe an hour in the morning, that gives me 10,000 lux very, very clear light signals to my brain to sync my circadian clocks and give me a serotonin release and make me more alert for the day. So I use different tactics like that during the day to send the right light signals because, funnily enough, we need to actually reset our body clocks every day because we run slightly longer than the 24 hour clock outside our body clocks. So these light signals are very valuable. Also, cortisol. How do you get your cortisol? Got a whole chapter on this science-based stress buster, as I call them. And it’s not necessarily stress, it’s tension or just being overstimulated during the day, our minds are overly engaged. So what can we do to counteract that? As I said, different things work for different people. Nature was a huge one for people these past two years and continues to be, and that’s got proven results. It brings cortisol down. It pushes up our happier hormones. It really makes a physiological difference, a positive difference to us. I use different tactics in the moment to balance out my hormones in that way. One of mine is I look at the four happy hormones-dopamine, oxytocin, serotonin and endorphins. And if you can look at those, there are little things you can do to sort of just give them a lift and then yourself a lift in the process and counteract the anxiety or the stressful hormones that are being released. And also the third thing I thought is really important is the words and thoughts that we use. I mean, this is what I found fascinating, researching the books which came, as you said, from my great great uncle Richard Waters, just the power and the effect that our words and thoughts have on us, they actually change us. They sort of change our expectations and us physiologically. Do not call yourself a bad sleeper. This actually feeds into your experience of it. The neuroscience behind this is extraordinary and there’s one particular professor, Alistair Wood Brooks at the Harvard Business School, she’s done some extraordinary studies in this and how the words we use change how we actually feel and then how we subsequently behave.
AB: So that’s really interesting. The things that you’ve said today which I don’t hear people saying. There’s a very important point you made that your day and night are intertwined. So what I hear a lot of people say is that, “okay, 3 hours before sleep, you should do this”, but nobody has said to me before, till I read your book, that the day and night are intertwined. So what you do in the morning will affect your sleep at night.
KM: Yes.
AB: And your light box theory was very interesting. Of course, you talked about hormones and then the other thing, which is very important, and I really believe what you’ve said about your power of suggestion: Be careful what you think. Don’t keep saying, “oh my God, I’m not going to be able to sleep again” or you’ve convinced yourself of that, or you convince your subconscious mind that you’re a bad sleeper. So Kate, coming onto the next thing which you had mentioned-it’s one thing falling asleep, but then people wake up in the middle of the night and they’re like, “no matter what we do, we can’t go back to sleep”, so what do you suggest for that?
KM: It’s called fragmented sleep when we wake up in the night and it can make us really tired the next day. Again, it’s looking at causes and taking preemptive action during the day. They can be things as simple as caffeine and alcohol. They disrupt and fragment our sleep, as does cortisol, cortisol fragments our sleep. So it’s looking at the causes. What can you do in the day to help set that up and stop it from happening? Also, of course, it can just become a habit after a while. So even if you take away those things, the habit is there. So dismantling that habit, which I have a chapter on the science of habits. I talked to Dr. Carl S. Smith. He’s a habit expert. Absolutely fascinating how habits establish themselves in the brain, why your brain reaches for one habit over another and what we can do to dislodge one and set up another one that we do want. But I mean, one thing to remember if you do wake in the night is really… Might sound easier said than done, but it’s just not to worry about it. It is perfectly natural to wake up between sleep cycles. We sleep in these roughly 90-minutes sleep cycles. So we go from being awake into a light sleep, into a deeper sleep, then we go into our REM, rapid eye movements, dream sleep, and then we can surface between that and our next 90 minutes sleep cycle. So it’s not the end of the world, it is perfectly natural. So you can just tell yourself, you can use suggestions, just “I don’t have to worry about this”. I will just go back and have however many more sleep cycles I’m going to have tonight. Because obviously, worrying it triggers our fight or flight and then that triggers the hormones that come with fight or flight. So that is going to wake us up, make us mentally alert. Of course, not reaching for a blue white light is another that is a complete no no because that will send wake up light signals, you know, keeping it dark, doing some controlled breathing. You can increase your slow brain waves if you can reduce your breath to sort of breathe into five out five or even up to ten in and out, reducing your breath to sort of right down to six or three a minute can increase those slow brain waves. I mean, my problem going to sleep often was I’d start thinking about things. I didn’t give myself enough time in the day to think about things clearly or I was running, running, running and then just stopping. Likewise, in the middle of the night, might wake up and have worries that have woken you up or “oh my goodness, I’ve got this to do tomorrow”, or stress or the news is obviously a huge stress trigger. So with any habit, if you remove an element of it, there are various building blocks. If you remove an element, obviously you create a vacuum. Like with smoking, people often chew gum or something to replace that. So you can fill in that. If you take out the rumination and the worrying, you can put in listing anything you’re grateful for, anything that went well in your day or your week, and that will fill that vacuum and then help you relax and offset any fight or flight so that you can relax into rest and digest, which is a state we need to be in to then drift back to sleep.
AB: Basically gratitude, deep breathing, not reaching out for the blue light for your phone or putting on a television, those are the three big ones if you wake up in the middle of the night.
KM: Yes.
AB: Okay, the other thing you hear from people is when people say, “I’ve slept the whole night but I wake up exhausted”, which means the quality of their sleep was not great. And that’s why you find lots of people wearing the aura ring, because they’re trying to monitor the quality of their sleep. Why are they so tired in the morning?
KM: We need what they say a minimum of 7 hours if you’re going to sleep and your sleep cycle is 90 minutes, that’s going to be seven and a half hours. So say, you have got your seven and a half or even 9 hours and you wake up exhausted. I mean, it’s fascinating. Interestingly, insomnia is classified as a subjective disorder by the American Academy of Sleep Medicine. And what that means is, it comes down to our personal perception of how well we’ve slept, how much we’ve slept, how long it took us to get to sleep. Because interestingly, when they’ve done studies on this, insomniacs often take less time to fall asleep than they thought. They wake less often than they think, and they do have deep sleep. But like you say, they wake up feeling exhausted. So first of all, remind yourself that insomniacs do get more sleep. Reassure yourself you are getting enough sleep. You are getting more sleep than you consciously register.
AB: Okay.
KM: I have sleep scripts in my book.
AB: Oh, wow.
KM: A sleep script is extraordinarily powerful. It works as a sleep habit. It changes our mindset, our expectations, our perceptions, our physiology, our behaviour, and in this case, ultimately our sleep. I have four, one by my great great uncle which was only a very short— 1 minute. I recorded myself reading that in the first person. So it turns into an auto suggestion where you’re telling yourself what to do, which is very, very powerful. This is like a positive affirmation of what should be happening in your mind and body as you prepare for sleep, as you sleep, and then how you will feel when you wake up in the morning. And so it will help change that mindset and change your relationship and your perception of sleep. So I came across Professor Worrell and Dr. Hassan at the Manchester University NHS Foundation Trust who are working with clinical hypnosis. Incredible what they’re doing. And they’re using it for their patients to treat insomnia, but also to reduce pain and discomfort and a huge number of symptoms, phobias, all sorts. And it’s a very, very powerful tool that doctors and scientists are increasingly exploring and using in the world of medicine. And we can use that in our everyday life and to improve our sleep.
AB: It’s a positive affirmation, and it sounds like cognitive behavior therapy, where there’s a lot of suggestions, and sometimes I’ve even known therapists to give them to you so you just play them?
KM: Yes, you can play and you can listen. Exactly. So I sort of recorded myself reading that script and then listened to it once a day, about 5 o’clock, very short. So then your brain, you know where you’re going, starts that sort of evening countdown so that you’re ready for bed when the time comes.
AB: And how long does it take? I mean, if someone’s had a sleep pattern that settled into their life for a while, how long would it take them to change their sleep pattern?
KM: Well, there was a study done on this. How do you set up a new healthy habit, a desirable habit you want? It was carried out by the UK’s Health BehaviorResearch Center, and they found that it takes a minimum of 18 days to set up a new habit, and an average of about 66 days. It can take longer. But the fact is there’s progress all the way. So even if you are someone who is 66 or longer, recognize that you are making progress and focus on that progress you’re making so that that will cement that new habit even more and make it even stronger until it becomes automatic.
AB: In terms of melatonin, what is your view on that? Because there’s a lot of mixed reports on that, Supplements?
KM: Yes, they’re supplements. Yes, I mean supplements, there’s a lot of evidence to say that they can really help, obviously, in the short term with jet lag. And if you’ve had an upset stomach or been ill or stressed, it can help. Ideally, get a brand recommended, possibly from your doctor in this country. In the UK, it’s on prescription. In other countries, you can get it over the counter, but just maybe be sure of the brand you’re buying so that the quantity is correct, the quality is correct. Although I would say push up your own melatonin levels. There’s so much we can do to maximize our melatonin levels. One would be increasing tryptophan in our diet. Tryptophan, you find in protein foods, high protein foods, animal products, but also beans, pulses, that sort of thing. And oats, a wonderful source of tryptophan. And tryptophan, the body needs to produce serotonin, the happy hormone, which in turn we need to produce melatonin, the sleep hormone. So if you have lots of tryptophan in your diet, that’s a really good starting point. I mean, I’ve got a whole thing on kolo nutrition, the ideal time to eat certain foods for sleep. But tryptophan is a very good starting point. And then also to protect your melatonin levels at night so that they’re not suppressed by blue white light, particularly up close phone screens, then your body will release melatonin which starts going up about 09:00 p. m. usually.
AB: How can we ensure that people who don’t have a problem with sleep, like children, that their sleep patterns remain healthy?
KM: I know it is very worrying and because it really impacts them physically, but emotionally it’s huge. And of course, just on a base level. Obviously, it impacts their learning as well because we learn while we sleep. So yes, with children, it’s sort of just trying to keep their circadian rhythm strong, strengthening, trying to make sure they are getting those bright light signals which means coming across the screen, not gaming too late into the night. Or if they are gaming, I mean, teenagers, it’s a battle, isn’t it? Then can they wear those? Can you convince them to wear the blue light blocking glasses so that at least their melatonin levels are being protected? Of course, they’re still being engaged mentally and it’s that overstimulation that needs to be counteracted as well. Not using the phone as an alarm, if you can have another radio alarm. I bought it for my boys so that they can just be working with music and not use their phone as an alarm, things like that. Anything we can do to sort of strengthen their circadian rhythms and try and avoid the social sort of debt lag they call it, where you sort of have huge lines, the weekends and they’re up at sort of seven, half-six for school midweek. If you can try and iron that out a little bit then that would really help them.
AB: What you hear from a lot of people is that when there is a sudden stressful situation in their lives, then their sleep gets disturbed and we’ve all seen that. When we’re worried about something, we’re constantly thinking about it. So how can we help with something like that?
KM: Going for a walk is a fantastic one. Forest bathing, as it’s called, is wonderful. The research on this is there, it stands up that being surrounded by trees actually does make us feel better, it does calm us down. We need to try and activate our parasympathetic nervous system and we can be proactive about that to try and help ourselves. We can’t control the stress that’s thrown at us so often but we can control how we respond to it, how we manage it. Like I say, yes, walking outside, trying and increasing your rest and digest state and also, when you go to bed, you might feel stressed but you can say to yourself “don’t worry about that”. I will look at that while I dream. I’ll think about that while I dream because dreams are actually wonderful for processing intense emotions and emotions that are really upsetting during the day. We can look at those or we do look at those while we’re asleep, but from a non emotional standpoint. So it gives us that perspective, that distance, and actually makes us more able to cope with it.
AB: And what is your view on power naps or naps during the day to rejuvenate yourself?
KM: Well, naps can be very useful if you’re chronically sleep deprived or if you just need a top up. Keep it short so you don’t get into a deep sleep. So that might be about 20 minutes. If you can do regular nappers, you can do those short ones quite easily. If you’re chronically sleep deprived and you’ve hardly had any sleep cycles during the night, then you could give yourself a whole sleep cycle, a whole 90 minutes during the day. But not to take it too late in the day is key. They say, sort of 1 o’clock really should be the cut-off. So the earlier, the better. So yes, naps are wonderful, but shorter and earlier.
AB: Okay. And any advice?
KM: So, running just sort of my top five from what we’ve been going through, I’d say everything about our day feeds into our sleep. They are interlinked. So your bedtime routine starts when you open your eyes in the morning. Second one, get outside as much as possible. Get natural light in your life as much as you can. Be proactive about managing your cortisol and doing what you can to reduce the tension and overstimulation in your life. Diet. There are lots of diet things, but the one that I would say for now is tryptophan. If you can increase your tryptophan, then more serotonin, more melatonin. And yes, the most powerful, possibly with light, is to choose your words carefully and your thoughts. Listen to a sleep script. Give yourself that support to rewrite your mindset, your behavior. Neuroscience shows that our words and thoughts are also everything- our feelings, our physiology, our hormones, our expectations, our perceptions and our behavior. You may have said badly in the past, that does not have to be your future.
AB: This is someone who’s saying she wakes up in the middle of the night to always eat at the same time. What is your view on that?
KM: Have a little slow release snack 30-40 minutes before she goes to bed. And my number one snack would be porridge, jumbo oats. It’s slow release, it’s packed with tryptophan. So it would stop you being hungry in the middle of the night and would carry you through and would give you that melatonin boost. It might be habits, so then maybe you might just have a little sip of water.
AB: Why do we feel thirsty at night?
KM: Thing is, we often are dehydrated. So just if you can keep hydrated, keep hydrated all day long. But for the two or so hours before bed. No, you don’t drink a lot, otherwise that can wake you up, fragment your sleep. Sleepy teas I don’t have in those 2 hours before bed because that’s a lot of liquid you’re taking in.
AB: What would be an ideal time to eat dinner to ensure that you sleep well?
KM: Two-three hours. Only 3 hours before bed, so you have time to digest.
AB: Okay, what is the best time to sleep for maximum repair and for how long?
KM: Well, that is very individual. We have to work out what our body clock is like. What’s your natural chronotype? Some of us are early chronotype, some of us are late, some in between. So research says maybe 10:30 p.m. But that’s not going to work for everyone. Some people want to go to bed much earlier than that and some later. And they can work, their timetable can work with that. The minimum, they say. Really, the latest is 7 hours minimum. So whatever time you go to bed, if you can keep it as regular as possible around life, I mean, life is not set in stone, is it? As regular as possible. And if you can give yourself seven to 8 hours, seven and a half to 8 hours, I would say a maximum of nine. That’s really perfect.
AB: Some women are asking about the time their sleep has been affected when they’re going through menopause.
KM: I’ve had readers write in about that too, that their sleep is disrupted since menopause. And then thankfully, got back on track after reading my book, which is really wonderful, wonderful to hear. Yes, obviously we can overheat a lot during menopause, and we need our body temperature to drop a couple of degrees at night. And that helps us well, that makes us go to sleep and stay asleep. If we overheat, then we wake up. You really want your room at about 17 degrees centigrade, really light bedding. Bedding you can throw off layers, light, natural fiber. And if you do wake up, you’re overheating hands and feet, the extremities, they’re called, get them out from underneath your bedding. That will cool your core body temperature down pretty fast, which will then allow you to go back to sleep. Controlled breathing is very effective for this through hot flashes. Use that and remind yourself that this is effective and it’s proven.
AB: That was wonderful, Kate. Thank you so much for your time. Thanks for joining us. Hope you enjoyed the Wellness Curated podcast. Please subscribe and tell your friends and family about it. And here’s to you leading your best life.