Unlocking the Secrets of Sleep Health for Women with Dr. Valerie Cacho: Overcoming Sleep Deprivation and Achieving Restorative Rest

Are you struggling to get a good night's sleep? Join us as we welcome Dr. Valerie Cacho, an integrative sleep medicine doctor, to uncover the secrets of sleep health for women. Through her personal experience with sleep issues, Dr. Valerie provides valuable insights on the science of sleep, underlying sleep conditions, and how to harness stress to improve your rest.

Discover the critical role sleep and rest play in maintaining our overall health and well-being. We dive into the consequences of sleep deprivation, the connection between mindset and sleep quality, and the importance of a holistic approach to sleep – considering factors like medications, pain, and other medical conditions. With Dr. Valerie's guidance, learn practical tips and techniques for enhancing sleep quality, such as napping, caffeine consumption, and creating a wind-down routine before bed.

Finally, we explore natural sleep aids and mind-body practices that can help you achieve the restorative sleep you need for a happier, healthier life. Tune in to this enlightening episode and start prioritizing sleep health for yourself and the women in your life. Don't let sleep deprivation turn you into a "hot mess" any longer!

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Transcript

Terri Kellums: 0:03

Hello and welcome to what women want today. Podcast season three, the soul sister series, where we will tackle tough topics straight from our heart to yours. I'm Terry Kellams, your host and coach for women who struggled find meeting and fulfillment in midlife.

Amanda Kieper: 0:17

I am Amanda Keeper. I am your new regular contributor. I come straight from the Midwest Rockford Illinois. I'm a public speaking teacher and leadership development professor. I'm also a coach and clinical mental health counselor. I am so thrilled to be here, and let's get started.

Terri Kellums: 0:34

Let's do it. Hello and welcome to this week's episode of the what women want today podcast. I'm your host, Terry Kellams.

Amanda Kieper: 0:44

Hi, I'm Amanda Keeper and I'm your co-host today.

Terri Kellums: 0:47

So today, amanda and I are pretty much like geeked out on what we're going to discuss. We have a guest on the show, dr Valerie Cacho, cacho, cacho Oh, he's murdered people's last names, no, worries me too. Dr Valerie is an integrative medicine doctor. I just lost my whole training thought. I'm so sorry. Dr Valerie, why don't you tell us what you special like, then make it easy on the other?

Dr Val Cacho: 1:16

one. No worries, thank you, terry and Amanda. I'm very happy to be here. So I am an integrative sleep medicine doctor, so my background is in internal medicine Through doctors for adults, which is a three year residency program. Then I did another year fellowship in sleep medicine And then, through the University of Arizona, through Dr Andrew Wilde's program, i did his online integrative program, and so the way I practice is integrative sleep medicine, so just teaching people how to sleep better, people who have a hard time falling asleep, staying asleep or have issues with their energy throughout the day.

Amanda Kieper: 1:49

That's amazing. And, dr Valerie, there's so many sleep related disorders and questions, so let's try to hit as many as we can. As a career woman myself, i always like to ask professionals like what are you preoccupied with these days? What group are you really preoccupied with?

Dr Val Cacho: 2:08

Yeah, and you know ladies who are, i'd say, like myself. You know Dr, sealed by itself. I feel like a lot of doctors go into the field of medicine that calls them but also maybe that they struggle with. So definitely throughout my years I've struggled with different forms of sleep issues. When I was a medical student, i had a lot of insomnia. I was really anxious And I, you know, didn't really know how to control my emotions very well. I would stay up all night studying for exams And then I really didn't know much about sleep, health and performance and fall asleep during my tests. So, yeah, and I feel like almost that prepared me, because when you're in residency program, then you're working you know this is before the work hour restrictions you know 30 hour shifts And shift work disorder, and then I became a mom And so you know it was breastfeeding and you know all that that plays a role with their sleep disruption. And then, believe it or not, i developed sleep apnea myself.

Dr Val Cacho: 3:01

So I feel like I've gone through the whole gamut of you know different types of sleep conditions, but I think really what it is and you know being a woman and just there's so much gender bias in life but also in medicine, specifically sleep medicine, often times women come in with, probably, signs and symptoms of sleep apnea, so that's people who have a hard time breathing because their tongue falls back And guess what?

Dr Val Cacho: 3:24

You know, the doctor, you know undenounced to them because, honestly, only about our medical school is about two hours of training in sleep and about two hours of training in menopause, if that. So just not a lot of doctors are really aware of this, but for women, we're given a blood test to get a thyroid checked, or maybe we're given an antidepressant and we're told that, oh, you just depressed, that's why you're tired. But right, you know, we have tongues and mouths that can relax. At night. We could really could just be a mask or a sleep apnea. So it's really just helping women understand the science asleep, helping them roll out any underlying sleep conditions and really focusing on, i think, the stress aspect. Stress is so prevalent, but I think it's learning how to use stress as a tool and then learning about how you're. You can actually control your emotions, and so I really love teaching people how to sleep better and different tools like mindfulness, self compassion. So I think those things are super beneficial and things that we really just didn't learn in school.

Amanda Kieper: 4:26

I love that. It comes from a very personal place, and it's so interesting to me that you are connecting emotions with sleep, because I'm actually I just started training for emotional IQ today emotional intelligence And Sherry and I were prepping for you being on the podcast today And we one of the things that we really want to talk to you about is what happens when a person can't sleep and next day we are a hot mess, or emotionally, we are a hot mess.

Terri Kellums: 4:55

Yeah, it's irrational. Like the tears come more easily. What's happening to us And you?

Dr Val Cacho: 5:01

know what. I'm human too. Yeah, knowing everything I know about sleep. I know what I get up for not sleep. I'm a lot more snappy and yelling. I'm having a hard time focusing at work And you know our brains and our bodies and our souls were meant to rest. You know even computers have a sleep mode And if we're just going going going too long, guess what? We're getting burned out. You know we're empty. Our batteries are, like you know, on low power mode. I think really that's how it comes out In sleep fellowship we were taught.

Dr Val Cacho: 5:32

You know, if you don't get a good night of sleep, sometimes your mood is one of the first things to go right And you just don't have as much emotional. You know regulation without a good amount of sleep And because you're tired, right, you know, when you don't have those reserves, it's just a little thing can really sort of make you snap in so many words. So yeah, because part of what sleep is right, there's different stages, right. If you go to the science of sleep, there's stage one, stage two, stage three and then REM sleep. So stage three is really important. It's deep sleep. I mean, all of them are important, but stage three is really important.

Dr Val Cacho: 6:08

So we have a poor night of sleep, especially if it's disrupted and we're anxious about something, we're worried about something. You may not be going into those deeper stages. The deep stage, stage three, is really important because I like to think of it as when the trash collectors come out, or the lymphatic system. If you've heard talks about this. Some sleep doctors, some researchers call it the shampoo that comes out. So throughout the day, we actually have toxins like soot that builds up in our brain, and when we go into the deeper stages of sleep, this is when the shampoo gets released, And so, if we're not right, we're not getting good quality sleep. No, we have more toxins built in building up and it just our brains don't function as well, and so I think that certainly plays a big role into it.

Amanda Kieper: 6:55

So you're saying that sleep is actually like the cleaning agent?

Dr Val Cacho: 6:59

no-transcript. Yeah, deep sleep, Yeah, So we're not getting enough deep sleep, Yeah, Okay, There's also a core amount of sleep that we should get. So for adults, seven to nine is ideal. I definitely have a lot of people who can function at, you know, six or greater, which is fantastic. I'd say less than five. You know you're really short changing yourself from a lot of health reasons, even beyond your emotions. Your heart, your heart, is also working a lot harder. Sometimes people have higher rates of high blood pressure when they're not getting enough sleep. I know a lot of patients that come see me. It's like you know, I really have to get my insomnia sorted out, because every time I only sleep a couple hours and I get really sick And that just really, you know, makes you know for a bad week until they get better.

Terri Kellums: 7:44

So is there such a thing as being able to like catch up you know, quote unquote catch up on sleep, And what do you think about naps? I'm curious what you think about both of those things.

Dr Val Cacho: 7:52

A definitely love naps. I'll go into that a little bit later But the first question is is can you catch up on sleep? And I think the answer is yes, but it depends a lot of medicine. it depends because you do have this core sleep right. You know there's a minimum amount of charge that you need to have. You think of sleep. as you know your battery about five, five and a half hours, is ideal, and we need a certain amount of REM sleep.

Dr Val Cacho: 8:16

So sometimes what happens if you're sleep deprived, for whatever reason? you go on a trip, you're traveling a lot, you're, you know, a parent of young kids, you have a big project at work and you're staying up. You can make up for some of that, for sleep. Sometimes, what it comes out to, if you're taking a nap, you know you go into a dream state right away. you go into REM. we can dream through our other stages of sleep, but REM is when we have our most vivid dreams. So if you are, you know, either going to sleep at night or taking a nap and you're instantly dreaming, typically it takes over an hour to go into REM that may be a sign that you are sleep deprived. On a whole, though, it's best to be consistent. You know we are creatures of habit, so some amount of sleep loss is probably okay, but chronically, you know, if you're going, you know probably weeks, months, years without adequate amount of sleep, then we see people who have issues with their heart, right, higher blood pressures, as I mentioned, higher risk for even dementia, right, because you know a lot of us are worried about our memories, especially as we get older, but that cleaning system doesn't come out And so those proteins, those toxins, are actually getting built up. So you can make up for some amount of sleep loss, but I think it's, you know, it's better to take a look at your life as a whole, because if you can actually get a good amount of quality sleep And one of my things to always encourage people is how much sleep do you need to feel good, right?

Dr Val Cacho: 9:41

So are you more of a seven hour? you know six and a half person, and you can go and do all the things you need to do without, you know, having extra cups of coffee in the afternoon or meeting the nap, and that's really fine. I personally am more of like an eight, eight and a half hour. I can get seven, i can function, but you know, my brain works a little bit slower. It's like I got to read that email maybe a couple times, or sometimes I got to use a spell checker a little bit more fast, because when you're not getting enough sleep, your brain just doesn't work as efficiently. So it's like you know, is it worthwhile to stay up an hour later where, if you just get maybe more an hour more sleep, you can do your tasks faster. right, you can be more present. you do your meetings, you can be more present with your kids, and isn't that more worthwhile?

Amanda Kieper: 10:25

Yeah, the benefits are so vast. So when you have a new patient come in, what kind of assessment do you take them through?

Dr Val Cacho: 10:34

My assessment is pretty long. I have a pretty thorough questionnaire. I like to break it down to the framework of mind, body and soul. So, mind, know, what are your thoughts about sleep? What's your mindset about sleep? Sometimes people come in and they say I'm a bad sleeper and I'm like, well, you know, sleep is natural. It's like breathing, you know. Are you bad at breathing? Yes, you know. Or are you bad at? yeah, are you bad at drinking water? I mean, actually some people don't drink enough water, but it's like a slot that they have. So, and also taking a look at if they have any anxiety, depression or PTSD or any past traumas right, you know, that happened, maybe during sleep. So, taking a look at you know there are thoughts around sleep.

Terri Kellums: 11:12

Yeah, when I when I let me just interrupt some here When I was I had like 10 years of insomnia when I was going through many perimenopause And it got to the point where the bedroom I felt like was the enemy, like when the end of the evening would come and I knew it was going to be time to go and lay in that bed, i started feeling so anxious and so much dread of just walking in that bedroom and trying to get a good night's sleep. It was. It was horrible. So I do agree with you that you know I probably talked myself into some of my nights of no sleep by my attitude as I'm walking, you know, actually into the bedroom to get a good night's sleep.

Amanda Kieper: 11:50

Yeah, I love that. So what are your thoughts around? sleep is for your programming right.

Dr Val Cacho: 11:55

You know sleep is your enemy. You know I've had someone say that sleep is my enemy. One day it's going to kill me, and I'm like, oh man, yeah, let's, let's take a look at that, let's dissect that, because if you really believe that, then that's your truth, that's your reality. Yeah, so take a look at their mindset and then body. Being a medical sleep doctor, i'm definitely going to roll obstructive sleep apnea. I'm going to roll out things like restless leg syndrome and abnormal movements at night, leg kicking, and those are, you know, some of them are more common in women, especially like restless leg syndrome and in and around pregnancy, and then other things too. You know medications that someone's taking. You know, as we're getting older, we have, you know, other health issues. So maybe we're on medications for diabetes, maybe that's making us urinate at night, or maybe on medications for blood pressure that can interact with our sleep and our energy levels. So, taking a look at that, sometimes we have pain that can make us up at night And sometimes it's really just taking a lot of these things in sort of the holistic viewpoint, because it's not just one thing. I mean, if it was one thing then, you know, probably make my job easier, especially if it's just sleep apnea, because that's really straightforward We can, you know, diagnose it with a home semen and put someone on treatment. You know, if our goals well, they do.

Dr Val Cacho: 13:02

Well, but right, sometimes it's more than that. It's the mind, it's what's going on in their body And then the soul art. You know, as we're getting older, sometimes women are in the same careers for the past 20, 30 years of their life and they're looking on to retirement, or maybe looking on to start another business, or maybe just looking on to, you know, what else is out there and available for me, and sometimes that can keep us up at night because we don't feel as fulfilled, or maybe we think like, wow, this is it. And so those are just really, really important things to take a look at when someone comes in. Because, yeah, i really just think that if I just focused on their snoring and then you know they had insomnia because they were just, they didn't like their bedroom, they weren't comfortable there. Maybe they had a traumatic experience as a childhood No matter what mask I give them or a pressure settings I have for their sleep apnea, it's not going to be a good fit.

Amanda Kieper: 13:56

So I love this, i love I'm so just a background enemy. I'm also a clinical mental health counselor, so everything you're talking about I'm like, oh, this is so, this is so aligned to. Everything that you're talking about is aligned with what I care about as well. So you are really your eyes on holistic treatments. Talk to us a little bit about what are some of your evidence based, most your toolbox that you love to teach people about for holistic treatments.

Dr Val Cacho: 14:25

Yeah, great question, and I think I need to go back to Terry's question about napping. So I'll answer that I love napping because a it's free And I think a lot of the tools that I used to help someone sleep I also like to recommend really free tools If you're needing to nap and you know I go back and forth with this because technically, if you're an adult, you don't need to nap after kindergarten, but sometimes you know, life happens And I'm a big point of napping because I'm also really sensitive to caffeine. I think a lot of people don't realize how much caffeine can play a role in their sleep quality. Either it's falling asleep or staying asleep. It does last, maybe about four to six hours. After that half of the caffeine is gone, but for some people it can last 10 plus hours, even the whole day, depending on how much caffeine they take and then also the formulation. So if you have the opportunity to take a quick nap during your lunch break or early afternoon, it can be really beneficial. Even like a 10 minute nap has been shown to be beneficial and it doesn't have those lingering side effects. As you know, if you would drink caffeine. The thing about naps is you want to do it earlier in the day, so somewhere before two to 3pm. If you do it after work, if you're going home at five or six falling asleep on the couch for dinner for half an hour an hour, we worry about that because that can affect your ability to fall asleep at night, because as the day goes along, you're actually building up the sleep pressure to make you tired, and so if you're relieving that pressure a little bit too late in the afternoon or evening, that can keep you from falling asleep and it's almost like you're playing catch up. Yeah, if you're staying up later and then you know having a hard time waking up because you slept later, yeah, so that's one thing.

Dr Val Cacho: 16:04

What you do during the daytime can really impact your ability to sleep at night. So I always like to talk about lifestyle. So lifestyle things I think about is what are you eating? how much caffeine and alcohol are you taking? the quality of food that you eat is also really important in terms of I like to think of what's good for your heart and what's good for your brain is also good for your sleep, and so some of the best in diets are such a controversial topic these days. It's sort of funny because it's just food but we make things really complex.

Dr Val Cacho: 16:37

But when you take a look at what foods best support our sleep plants high fiber, avoiding too much processed food and avoiding too much saturated fats they've actually done studies. I don't know where the whole milk and cookies thing before you sleep came up, but actually milk has some sleep-promoting properties. The cookies not so much because you want to avoid things that are processed, but also high sugars because that can wake you up the night. So more fiber Fiber is good, healthy, be full and also avoiding saturated fats. So if you do get the munchies at night, try to avoid the drive-through. Maybe have some cucumber or some carrots and some hummus. That helps hold you over. Yeah, so high fiber foods can keep you asleep.

Dr Val Cacho: 17:21

Then, if you have a hard time falling asleep, i would say, like within the hour before, maybe two hours before, take a look at where your mind is Meaning when you go to sleep. I like to think about just exercising. I use a lot of analogies when I speak. So if there's person that goes to the gym and lives weights, are you going to go and start bench pressing the heaviest weight when you get there Or are you going to have a warm-up. You're going to hop on the treadmill, maybe do some jumping jacks, get your blood flowing, get your muscles warm, because when you are lifting those heavier weights then it'll be easier. You're already warm-up.

Dr Val Cacho: 18:01

Or, let's say, if you're going to go have a nice dinner and you start off with steak and potatoes, or do you have your mousse bouches, do you have a little bit of soup, do you have a salad, and then you work your way into it. I feel like the way our society is. It's always on the go, and I think high-achieving, busy moms are working professionals. We go from one task to the next, right Like our Google calendar or iCal, whatever we use. It's just sort of like booked out. And if we don't have those moments around the daytime to hit the pause, and especially if you don't have in the early afternoon or evening, our brain is just used to firing and it's just going to keep going and going and going. And so I think we're trained and this is sort of.

Dr Val Cacho: 18:42

I sort of tell my kids okay, stay in your room, put your head on the pillow and just go to sleep. You got to have that wind down, so you got to make sure okay, we do the bath, you brush your teeth, you have those rituals. You're reading a book, you're listening to a story, maybe you're doing some reading exercises, so you have that wind down routine. So there's clear boundaries between this is my work and whole life, and this isn't me getting ready for sleep. You know, i really encourage my patients to use that last hour of the day just for yourself, right, just to relax, just to do something that brings you more joy and peace. And ideally it's not extra emails Yeah, exactly, that's when the emails that work, yeah. So having that wind down routine is really important. And then also staying asleep Sometimes that's one of the biggest questions I always get.

Terri Kellums: 19:26

That's the hardest for me staying asleep. We tend to me and my husband both tend to wake up somewhere around two o'clock in the morning, whether it's a trip to the bathroom or it's just that time of night, i don't understand But yeah, and then the rest of the night is just kind of, you know, not quality.

Dr Val Cacho: 19:41

And it's really interesting. Terry, i'm wondering what time you go to sleep, because sometimes what happens if you go to sleep on average maybe nine or 10 or 11, and you're waking up around two, you know you could be like two or three sleep cycles in right, you may be already hitting that more sleep time. And so same thing, the longer you're awake the sleeper you get. The more sleep you get, the less sleeper you are. So you could be relieving some of that sleep pressure. So when you do wake up for whatever reason, hear a noise, have to go to the bathroom maybe someone's snoring, maybe you're snoring and you don't know it's hard to go back to sleep because you're not as tired. So sort of learning the science of sleep. But then also sleep happens when our brain waves slow down. So what are the tools that I can use to help my brain waves slow down? So I'm a big fan of breathing exercise Because I did train with Dr Andrew Weil. He talks a lot about the four, seven, eight breathing technique. So you inhale for four, hold for seven, slowly exhale for eight. You do that four times. Sometimes by the third or fourth breath I'm already yawning.

Dr Val Cacho: 20:38

Another thing I like to recommend is guided imagery. I'm a real big fan of guided imagery. So imagining yourself in a place where you had the best sleep of your life. You know, maybe you're back in your childhood bedroom where it was so cozy and comfortable and you were just surrounded by your favorite stuffed animals and you had no fear in the world. You didn't have to think about bills, you didn't have to think about presentations, or maybe there was a really nice vacation that you went on. And so when you have that place in your mind, then you bring in your five senses.

Dr Val Cacho: 21:05

Because a lot of us, what happens in the middle of the night? we wake up, then we start to have these automatic negative thoughts, these self judgments. Why am I awake? It's dark, oh shoot, it's opening too. Why did I get up so early? I have to count down. Okay, i get three more hours of sleep, i'll probably be okay. But if I don't fall back asleep, should I wake up? should I take something? I'm like, oh, should I go on Facebook? There's all the things that happen.

Dr Val Cacho: 21:28

But if we can get our state of mind into a place that's relaxing, that's calm, you know, i like to recommend the I don't know if you've heard of the five senses exercise. So if you can think of the place, that's really relaxing. And then you go to your five senses, because if you can anchor your brain in something calm and relaxing, it's really helpful. So imagine, you know, i'm a big fan of Hawaii, i used to live there, and so I just think that, like seeing the ocean, being, you know, in an apartment or in a hotel room where you can see the ocean, because I'm there in a bedroom seeing the ocean there are five things that I can see.

Dr Val Cacho: 22:00

So I go through those senses. And then four things that I can feel the warmth of the sun, right, and I can feel the wind blowing, right And then you know what's the next sense Three things that I can hear, you know two things that I can smell And then one thing that I can taste. And if you're really focused on going through that exercise, it's super hard for your brain to keep firing. Oh, yeah, yeah, oh, it's only two o'clock Now, it's only three o'clock, so that one breathing using the power of your imagination.

Terri Kellums: 22:32

I'm also. I try 99 bottles of beer on the wall, but it doesn't work very much.

Dr Val Cacho: 22:35

Oh, it does work. Oh, okay, i mean, sometimes I can't. So the thing about these different mind-body practices just like regular exercise, it's the one that you'll do Exactly. And it's about, like, when you're exercising right, you're exercising your biceps, right, it's the continual practice. Right, you have this part of your brain called the parasympathetic response or that parasympathetic drive. It's the opposite of the sympathetic drive, right? Sympathetic is our stress response, parasympathetic is our relaxation response. So, if you find an exercise that you like, something that you can do on a regular basis, it really helps when we have these awakenings at night because we can more quickly turn down that dial, turn down that stress response and then turn up that relaxation response. But those are probably two of my favorites.

Amanda Kieper: 23:19

Yeah.

Terri Kellums: 23:20

Yeah, i love go ahead.

Amanda Kieper: 23:21

Amanda, Oh, you go ahead Teri.

Terri Kellums: 23:23

I was gonna say I'd love to know what you think about like supplements and sleeping pills. Let's touch on that briefly.

Dr Val Cacho: 23:30

Yeah, it depends on the reason. So, prescription sleeping pills, i like to think of their utility, as I do like opiate medications or pain medications. They definitely have their place. you know, you fall and you break your arm, your bone is broken. You know it's really painful, so we're going to give you some pain medications when you go in the hospital, but it doesn't do anything to fix that broken bone, right? It takes some of the pain away, takes some of the symptoms away, just like the sleeping pill. So sleep happens when your brain waves slow down.

Dr Val Cacho: 24:02

Sleeping pills really can work. I'd say a lot of the patients that I see have tried four, five, six, seven, you know, 10, all of the FDA approved and non-FDA approved medications first. They've been still can't sleep. So that tells me it's. The answer is not in the pill, it's trying to figure out. You know, why is their brain so hyper aroused, right? How can we help them slow down? How can we work on that parasympathetic response to make it more of a reflex instead of something that they struggle with With? that said, right, you know, death in the family, post-hospitalization, right?

Dr Val Cacho: 24:35

There's a lot of reasons why people can have difficulty with their sleep. It's just if they're on it a long time they can. There can be side effects, especially for women. So Zolpidem, also known as Ambien, is the first FDA approved medication that had a lower dosage recommendation for gender for women. Why? Because women can metabolize the medication differently and women can have more complex sleep behaviors.

Dr Val Cacho: 25:01

So this medication works on a part of your brain called the GABA system, which is a neurotransmitter, and sometimes what can happen is you know you're unconscious, you're asleep, but your body can still do funny things. So sleepwalking, sleeptalking, sleep-eating. I had a patient that told me she went, drove to 7-Eleven, bought an energy drink, came home, had no idea how she got in her car and drove, had no idea how she paid for the energy drink that she did. And it's so scary to see hear that because you know and you take a look at the research, some of these sleeping pills really only give you about 20 to 30 minutes more sleep. That's all the side effects. So, yeah, not a big fan of them. For long term three weeks or more I mean more than one month you have insomnia. Cognitive behavioral therapy for insomnia is really what's most helpful. Hypnotic supplements so things like magnesium can be really beneficial, especially if you have an underlying restless leg syndrome or if you have some muscle pain like people, like athletes, it can be helpful.

Terri Kellums: 26:03

Which form of magnesium is that?

Dr Val Cacho: 26:05

Oh yeah, there's so many different forms of magnesium, but magnesium glycine or magnesium treonite are more helpful, or no one's that. I tend to recommend more because they cause less GI upset Magnesium oxide, you know magnesium citrate can cause a lot of diarrhea and that definitely can keep you from sleeping, so you don't want to use that one. And then magnesium glycine is just absorbed better, right? So some of them aren't as absorbed as well as others. You know I'm a big fan of chamomile. You know there's a lot of research done more in Europe.

Dr Val Cacho: 26:36

German chamomile, i think, can be really beneficial for people who have anxiety. There's actually a really good study where they took salivary cortisol people who had general anxiety disorder and their morning cortisol levels are a little bit lower after taking some chamomile, which is really interesting, right, you know. So some of our natural plants can help slow down our brainwaves. So chamomile, german chamomile, well, i think I don't know if that was. I don't think that study was in Germany, but you know, i actually had a person who was German recently in German chamomile. But I think they're just different formulations. Yeah, i mean different, I don't know formulations, but just different. Plain varieties, yeah. Plant varieties, yeah. Thank you, terry.

Terri Kellums: 27:18

So I'm guessing, though, if you're going to drink chamomile tea, you're going to want to do that closer to after dinner rather than closer to bed, because now we would have another reason to get up and use the bathroom.

Dr Val Cacho: 27:27

There's also tinctures or supplement form. L-fining is actually really popular. Let's see passion flower hops, lavender I'm a big fan of lavender. Lavender also works on GABA A lot of times in the past. Doctors use a lot of benzodiazepines anti-anxiety medications that are sedating to help people sleep. There's been studies in nursing homes where elderly people we don't want them to be on benzos because they can wake up and fall and break their hip because it makes them feeling really drowsy and unstable And so they've actually used lavender in terms of satchels or near their bedside or diffuser, and they actually help people fall asleep faster, stay asleep, and it helps with the withdrawal symptoms of the benzodiazepines as well. So it's really phenomenal and you don't see the same side effects. So plants are really really powerful in that sense?

Terri Kellums: 28:18

What about melatonin? I've heard so many varying opinions on melatonin.

Dr Val Cacho: 28:23

I just made a video on my YouTube channel about that. So I could talk a lot. But in short, as we get older melatonin we have less melatonin secreted deep inside our brain, in the pineal gland. So the ages from around 55 to 60. Melatonin is part of our circadian rhythm and that's based on light, darkness and melatonin. So our circadian rhythm basically it's our internal clock. So from a medical standpoint, people who can benefit from melatonin are people who have issues with jet lag, maybe shift work. There's a condition called REM behavior disorder where people act out their dreams And that's where melatonin you typically use it.

Dr Val Cacho: 29:02

We don't often use melatonin for insomnia because it doesn't work. I mean, if you're a night owl trying to live a day person's life, you know you think you have insomnia, but it's really a circadian rhythm issue. What's stronger to change? our circadian clock is actually light, and so if you follow a lot of the people who talk about sleep and social media, they're always like get out in the morning, get that sunlight, because that's really important to reset your clock, and then, an hour before desired bedtime, go ahead and avoid light.

Dr Val Cacho: 29:29

The thing about melatonin is well, i know we're running out of time, but you know it's really adultered. You know there's a lot of issues with quality in the US because it's marketed more as a food rather than some countries I think Australia is one of you actually near prescription to get melatonin And even a study more recently for kids. You know melatonin gummies had CBD in it And you know the manufacturers aren't telling us that. So you've got to be a little bit careful. There may not even be melatonin in there. But I'd say for most people it doesn't necessarily work, unless you're shift worker, you're jet lag. But those other things you know, like magnesium and passion flower and chamomile, i think those are a little bit more beneficial.

Dr Val Cacho: 30:14

One thing though for women if you are going through menopause, you do have some difficulty with sleeping. Some reports do show three milligrams of melatonin help. It can help with actually anxiety and even our bone health. So there's benefits for melatonin beyond sleep. So I think melatonin there's more research that's going to be available about it. Hopefully, if you do, you take it. It's a high quality melatonin but it can lower blood pressure, it can cause weight with dreams, it can cause like a hangover effect the next day. So it's not without any untoward side effects, even though it's a supplement.

Terri Kellums: 30:49

And isn't this sort of like? you know, a lot of people think that my husband is one of these and I'm throwing him under the bus right now but, like, if one milligram works, then 10 milligrams must be great. So I mean, it's not one of those things you want to like jump into 10 milligrams, like you want to just start out a low dose, right.

Dr Val Cacho: 31:05

Yeah, because really how much your brain is emitting is 0.3 milligrams. The thing about this is is we don't really know how much is absorbed and actually how much crosses the blood brain barrier to go into. You know where you need it, so it's a little bit of a tricky situation. Yeah, so always talk to you know licensed healthcare professional if you're going to start a new supplement or, yeah, a supplement that looks like candy. Just be careful.

Terri Kellums: 31:32

And you mentioned CBT too. I'm sorry, Amanda, just I just want to just touch on CBD real quick before we move on. Did you think CBD was one of the ones that could be helpful? You mentioned that.

Dr Val Cacho: 31:42

Yeah, definitely. I mean I think that can be helpful in the right person. CBD as opposed to THC THC have more of the psychoactive components. we actually have built within us this full endocannabinoid system, so we have receptors for cannabis And if it helps you relax, good. typically. I've seen some older patients who use it because they have under like neurologic conditions and they tried all the sleeping pills and it didn't help. the thing with cannabis or CBD Also, if you're on the same strength for a while, you need to either take a drug holiday or lower the dose and then slowly increase it again. CBD, i think, is really popular, but there's other different components in the cannabis plant, also CBN. I think there's going to be more research and more about that coming out. Yeah, it's still unfortunately part of the schedule one, so it's sort of a felony right for doctors to prescribe it, but I think some states do allow it for different medical reasons.

Terri Kellums: 32:44

Hey, sorry, Amanda.

Amanda Kieper: 32:47

Oh, that was such an important question because I know, like I live in Illinois and right now it's legal and so you know a lot of people are using it for different reasons and that's when. But I am fascinated by some of the disorders. Can you tell us about night terrors, like people that wake up with night terrors Specifically? I've had a lot of people and I've had experience with it too, but it like starts with children And there's some special cases that like, for example, my son is 17 and he's still having them.

Dr Val Cacho: 33:21

Yeah, it's so interesting. I feel like I've been hearing a lot more about night terrors within the past week or two, so I've been looking at some of the more research to make sure I'm up to date. Night terrors, right, it's people who are unaware. We can wake up screaming, yelling, and if you try to talk to them you know it could make it worse And then the more they just have no recollection, no recall. Yeah, it's classified under parasomnias, which is just abnormal event at night. It's sort of the generic term, what it is it's.

Dr Val Cacho: 34:01

You have different stages of sleep, right? So stage one, stage two, stage three and then REM. Typically they happen during stage three sleep, which is our deep sleep, where our brain areas are really really slow but our muscles can still do things. So kids have a lot more deep sleep up until they go through purity. That's why kids do a lot more sleepwalking, sleep. Talking From a medical standpoint, we want to make sure that seizures are rolled out, because sometimes seizures can look like this But really it could be stress, it could be alcohol, it could be stimulant medications, but it's fragmented sleep.

Dr Val Cacho: 34:43

So if you have disruptions in those sleep stages, i'd say probably most commonly is sleep deprivation from stress or even untreated sleep apathemia. You can have these sort of vocalizations that are really really scary. Before we moved back from Hawaii to California, we spent a month in California just visiting friends And my daughter she was four at that time. She had like a whole week of night terrors And so, being in a new environment, her sleep schedule was off. She's probably sleep deprived And it was funny because I didn't even realize what was going on the first two nights You just wake up, start screaming, we try to bring her to the bathroom or try to, and she just like had no idea. Eventually she would go back to sleep.

Dr Val Cacho: 35:30

So, making sure that someone is safe if someone in your household does this, making sure that you're getting enough sleep, you're controlling your stress. I've seen some other sleep doctors recommend neurofeedback or biofeedback as a way to sort of control your stress levels, and sometimes medication can be helpful for the right population. But it's always like make sure there's not an underlying condition like obstructive sleep, apnea or seizures, or it could be induced by some medications. Actually that can disrupt your sleep. Yeah, yeah, question, but it's really scary for someone who doesn't know what's happening. Another thing, too, is everything. If everything's been rolled out, sometimes for kids or even for adults. If it happens in and around the same time typically it's in the first half of the night you can set an alarm to sort of like wake you up, to reset the clock So it keeps you from going into that same stage of sleep. Yeah, Fascinating.

Amanda Kieper: 36:22

Yeah, I'm getting ready to put my son into a sleep study because it's been going on from like two to 17.

Terri Kellums: 36:28

And yeah, Like consistently, Amanda, with no breaks in between. Like consistently.

Amanda Kieper: 36:33

Yeah, yeah, and he's been to the doctor about it and they're just like, well, they outgrow it. And you know, always I'm just like. you know he's embarrassed because every time his friends are over, like he wakes up at three single night and he's like it's always competitive, he's like playing Fortnite or he's. you know he's an anxious kid.

Dr Val Cacho: 36:51

I think you know, and he's not like a vivid dreamer, so he's like we were making his dreams when actually yeah.

Amanda Kieper: 36:57

Yeah. So another question I have, and I think I might be more related to perimenopause. But so I have this thing where when I lay, when I put my head down, it feels like someone has like kickstarted my heart and I have more adrenaline than I had all day long Interesting Well, not actually.

Amanda Kieper: 37:17

My husband actually has having issues with palpitations like your heart's going when you're laying down, or it's like you just woke up like more adrenaline than you've ever had in your life, but it's when you put your head down on the pillow. It's bizarre.

Dr Val Cacho: 37:32

I'm wondering if there's a specific timing to it. So there's a nice graph that I like to show patients. It shows on one side the homeosatics sleep drive. Right, that's the longer you're awake, the sleepier you get. And then the other one is our circadian rhythm, which you know if you live in countries that take a nap in the afternoon the whole CS2 time you do have a little dip in the afternoon and then a second win. So sometimes our circadian rhythm it peaks before it goes down. So I'm wondering if you're just having that second win Or, i don't know, if your sleep is disrupted and there's maybe unconscious or subconscious thoughts about sleeping that can cause that.

Dr Val Cacho: 38:11

And then, yeah, fluctuations in our hormones sometimes can cause palpitations, can cause insomnia. When we lose that progesterone, we lose that estrogen, it can come up with difficulty falling asleep, difficulty staying asleep. 40 to 60% of women in and around perimenoplasm have difficulty with their sleep And that number is way too high because there's not enough of us out there to help people and teach people. So yeah, from a one-on-one standpoint, i should say Yeah.

Amanda Kieper: 38:40

I think it was interesting and we've heard this in multiple reports now that the people doctors or specialists that actually had time in studying menopause is so so rare, so rare, like you said, what a two hour class on it or something, or two hour module, exactly Yeah.

Terri Kellums: 38:57

I think we're starting to make progress, but I feel like we have a long way to go. I've been doing these talks with women for almost three years now And it's just, it's crazy, the fluctuation of information from one person or one area of the country to the next. I feel like there's so much more we can do to educate women, but it's going to have to start somewhere higher than us because we don't have the knowledge. So I think it's interesting now that, especially like in the UK, they're really, i think, a little bit ahead of us in the United States as far as menopause goes. But I love these conversations. I really appreciate you sharing your knowledge with us today about, yeah, about how that's all impacted for women in midlife. But I want to I have one more question before we wrap up today. Can you just talk briefly, because you kind of touched on it in a few different spots, but I like to kind of like wrap it up in a package, like what's the importance of sleep hygiene?

Dr Val Cacho: 39:55

Hmm, Talk about that a little bit. Yeah, so it's so fun. I have a blog and I'm going to write about sleep hygiene, i think next month. I was just doing my programming And I'm like, should I even use that word? sleep hygiene Is that a sugaring word for people? now?

Dr Val Cacho: 40:10

Sleep hygiene basically just refers to the habits that you do at night before you fall asleep, and so people who have insomnia are the best at sleep hygiene. Right, they sleep in a dark room, they sleep in a quiet room, their pillow is comfortable, their bed is comfortable. Maybe they've tried three or four beds. right, they stopped drinking caffeine, they stopped drinking alcohol. They really changed all their habits. And so I would say for most people, i think, understanding what you're doing, that's keeping you from you know, good quality sleep is really important, because for any behavior change, that self awareness is really helpful. I think I'd say for a lot of people, if I could put money on it, if I was a bedding person, i would say too much caffeine, too much light, not enough stress management and then not putting up movement. Yeah, i would say, probably, those are the big ones, those are huge ones, but those are probably the big ones.

Terri Kellums: 41:02

I saw something on your Instagram account, too, where you were talking about, you know, like the bedrooms for two things right?

Dr Val Cacho: 41:10

Oh yeah, firstly, yeah, because I think that's the thing about it. We have our brain works in terms of associations. So you know, if you have young kids, you know when your kids were little they probably had their favorite stuffed animal, their favorite blanket, and they use that to help suit them to go to bed. A lot of times now I think we're taught and trained and marketed that our bedrooms to be comfortable, we should have the most comfortable bed And, with that said, now our beds have become recliners, but we're on our phones. Maybe you know for people who were going through the pandemic and working from home, we're working in bed, we're eating in bed. they were doing all the wakefulness things in bed. And then when your brain starts to make that connection with the bed being a place to be awake, guess what? It's going to be a harder to sleep at night. So you really want to make sure that your bed is just for sleep and intimacy. Yeah, and even your bedroom if you have that opportunity.

Terri Kellums: 41:58

Right. No, try not to have your desk in there that you work from. try not to have your exercise machine, your treadmill, your bike or whatever. That was one of my favorite tips I learned really early on in my insomnia cycle, because me and my husband used to literally wake up and then he go grab us a cup of coffee and we would sit in our bed and drink coffee.

Dr Val Cacho: 42:15

Yeah, because it's comfortable right, especially outside.

Terri Kellums: 42:18

Yeah Yeah, it's cold, you're comfortable. You don't want to get out of bed anyway, so I get it.

Dr Val Cacho: 42:23

But yeah, if you have insomnia, you definitely do any type of weight. Who likes to do these outside? No, so for my patients, if they don't have a lot of space, can you just sit on the floor, put a pillow on the floor and at least you're not in your bed. Right, it's a little bit of a barrier between them.

Amanda Kieper: 42:36

Yeah, dr Val, this was so packed full of just nothing but great tools, tips, information, education, like I can tell, like you're an educator by heart. So thank you so much for sharing all that with us. And if we wanted to find you, where are your platforms? Where can our audience members find?

Dr Val Cacho: 42:55

you Well. Thank you, amanda and Terry, for having this platform for folks like myself to talk about the importance of sleep health. So my platforms I do have an Instagram. It's sleepphoria, so the word sleep and H-O-R-A, like euphoria and sleep, smush together. So I'd say active on Instagram. Also, youtube I have a YouTube channel where I, twice a month, i have many webinars about different topics. To latest when I did, i was all about melatonin. I'm starting a new series there that's called Sleep Basics, where I just talk about really quick five minutes or less, just sleep science, little tidbits. So yeah, i'd say my Instagram, my YouTube channel and then my website, sleepphoriacom, where you can learn more about this information, and then I have blogs that I write about as well.

Amanda Kieper: 43:42

So I'll put all of that information all that information.

Dr Val Cacho: 43:45

This is the latest lady. You know what I mean.

Amanda Kieper: 43:46

Yeah. so we have one final question that we always wrap up with, because Terry and I we call each other Soul Sisters and we are doing the Soul Sisters series. So we like to ask all of our guests I know that female friendships are very important in your life too. What are the qualities of a Soul Sister in your life?

Dr Val Cacho: 44:06

Ooh, what are the qualities of a Soul Sister? When I think of that, i think of you know, my good girlfriends. We don't see each other frequently anymore, but when we do, we share good food, we share good laughs and we just have a joyful time. Yeah, so I think it's just like people that like make you smile till your tooth's hurt. I think that's a good Soul Sister.

Terri Kellums: 44:30

I love it, I love it.

Amanda Kieper: 44:32

If she makes you smile until your cheeks hurt, she's a Soul Sister. There you go.

Terri Kellums: 44:38

All right, everybody. Thank you so much for being here with us today, taking time out of your busy schedule, and till next week, everybody. please remember to take good care of you.

Amanda Kieper: 44:46

Bye.

Terri Kellums: 44:49

Well, that's a wrap for this week. Thank you so much for joining us. We're so glad to be here with you.

Amanda Kieper: 44:54

And just remember, we're here to serve. Reach out, connect with us on social media platforms and dig in deeper.

Terri Kellums: 45:01

All those links will be in the podcast show notes. So join us. We can't wait to continue the conversation with you over there.