Snooze for Success: Sleep's Influence on Endurance

On this episode, we explore a topic often underestimated but vital for endurance sports – sleep.  In a world where nutrition and exercise usually claim the spotlight, we're here to shed light on the underrated role that sleep plays in optimizing health and fitness. 

But why focus on sleep?  Have you ever considered that sleep might be more influential than both food and exercise combined? The renowned Shawn Stevenson, a nutritionist and former collegiate track athlete, suggests just that. 

To help explain how sleep impacts your endurance journey.  we brought together Dr. Lori McGee Koch, an occupational therapist and lead coach for CES's run program, and  Dr. Elise Toth from Align Modern Health, a functional medicine provider known for a holistic approach to health.  Your host, Ryan Caturan, CES's lead coach at Lincoln Square and Director of Community Partnerships with Aligned Modern Health, guides this discussion.

Episode Transcript

(00:03):
Welcome to the Chicago EnduranceSports podcast.
On this episode, we featurecontent from our recent seminar
on sleep.
A much overlooked and underratedfactor in endurance sports
performance.
Enjoy.

Coach Ryan (00:17):
So thank you everyone for joining us whether
you're joining the recording orjoining us live, why are we
talking about sleep?
I saw an awesome podcast, thisnutritionist, collegiate track
athlete, named Shawn Stevenson.
And he's the author of the book,Sleep Smarter, says that sleep
is arguably more beneficial foryour overall health and fitness
than food and exercise combined.

(00:38):
Is he right?
I do know that our panelists arebig advocates to improving one's
sleep habits, and they will helpus understand and unlock a lot
of the key benefits to sleep.
So I would like to welcome ourpanelists today.
I have with me the lead coachfor Chicago Endurance Sports run
program and occupationaltherapist, Dr.
Lori McGee Koch.
I also have from Align ModernHealth, a functional medicine

(00:59):
provider who practices out ofour Andersonville and Vernon
Hills locations, Dr.
Elise Toth.
Thank you for joining us today,both of you.
And my name is Ryan Caturan.
I'm the lead coach, for CES atLincoln Square, and I'm also the
Director of communityPartnerships with Aligned Modern
Health.
And if you're not sure of whatAligned Modern Health is, we are
an integrative health andwellness company here in

(01:21):
Chicagoland.
We have 18 locations where wepractice all four services of
functional medicine and clinicalnutrition, chiropractic physical
medicine, acupuncture andcupping and the hurts so good
clinical massage therapy.
We take a non surgical nonpharmaceutical approach to the
medicine we practice and, ourapproach is always to get to the
root cause and treat from theroot cause out.
So if you ever need us, we'rearound the Chicagoland area.

(01:43):
We also do practice viatelemedicine for functional
medicine.
Alright, so let's start here.
Doctors, how many people wouldyou say lack in sleep and
quality of sleep?
I'll leave it out there for bothof you.

Dr. Elise Toth (01:57):
That's always one thing I ask in my new
patient intake.
I'm like, how was your sleep?
And they're like, what?
That's always the pause.
I'm like, okay, let's talk aboutit.
So I would say in my experience,it's very rare that someone
comes in, they're like, I sleepgreat, fall asleep, great stay
sleep, great, feel amazing whenI wake up.
That's the minority in myexperience.

Coach Lori (02:15):
I was trying to put a percentage on it and I think
she nailed it.
It's more than less.
Even if people tell me oh I haveno problems falling asleep, they
will still report to me thatthey're not actually getting the
recommended hours of sleep.

Coach Ryan (02:28):
Yeah, absolutely.
Would you even say that, even ifsomeone says that they, yeah, I
sleep well, if we ran tests onthem, it would say otherwise?
And what percentage would youthrow out there?

Coach Lori (02:40):
Of who does not probably get the recommended
quality of sleep?

Coach Ryan (02:43):
Yes.

Coach Lori (02:43):
Probably 60 70% of people.
Wow.
Now, I don't know.
Yeah.
Okay.
Someone could Google it and finda different number, but based
on, just working with athletesand working in kind of a more
professional world where there'sa lot of stressors going on and
the people I interact with, Iwould say that is a number that,
I think it is.
And some people don't knowreally what quality of sleep is.

(03:05):
So we're going to kind of talkabout that today.

Coach Ryan (03:10):
Dr.
Koch, why is sleep so important?

Coach Lori (03:12):
So it is kind of this magnificent events of
activities that take we weresupposed to, in theory, spend
about one third of our livessleeping, which we really do.
You think about 24 hour day,you're supposed to get seven to
nine hours of sleep, but it'snot just that, it's a nice
little time to cuddle up with ablanket and then turn off the
world, there's a lot of reallyincredible things actually

(03:33):
happening during sleep.
This is definitely when, we talkabout memories and, learning and
those being consolidated.
So being consolidated isbasically like anything that you
learn during the day, especiallythis is great when you're in
school, those things, actually,are enhanced by quality of
sleep.
And it's not just like gettingsleep the night before and being

(03:57):
well rested.
It's also getting the sleepquality after you learn an
activity.
That's what they talk about withmany memory consolidation.
That's where a lot of eventsthat you learn the day before
actually come together and amore comprehensible way later
down the line.
The mental health and physicalhealth is huge.
You can talk about Just thosetwo aspects, for hours, but

(04:19):
mental health wise, it's just,if you get lack of sleep, this
is where, you're at a higherrisk, of developing some sort of
anxiety or depression or havingsome short term anxiety and
depression because you didn'tsleep very well.
Your metabolism is regulated sosome people gaining weight or
having the ability to maintaincertain weights is going to
oftentimes regulated by thequality of sleep that you're

(04:43):
getting, concentrating andattention, if you haven't slept
very well, the night before,everybody kind of knows it's
very hard to concentrate withoutgetting an obsessive amount of
coffee, or they just havedifficulties next day.
And then a lot of this when alot of our athletes are
listening, the muscle repair andrecovery is huge on this.
I feel like there's a lot ofathletes that I have interacted

(05:05):
with and their poor quality ofsleep in general, I think it
puts them at a higher injuryrisk, takes longer to recover.
And that's just because I thinkwe talk about the next slide
stages of sleep and how thosecoordinate together.

Coach Ryan (05:18):
Dr.
Toth, same thing for you, why isthat such a main question that
you ask your patients?

Dr. Elise Toth (05:23):
Yeah, sleep and exercise, a lot of the patients
I see are athletes.
And I find a lot of times thatpeople feel the exercise is more
important.
So they are like, okay, I'mgoing to cut my sleep short.
I'm going to get up and exercisein the morning and then like Dr.
Koch said, they're not repairingas well, their tissues, our
muscles aren't repairing aswell.
And the analogy that I use andpeople roll their eyes at it,

(05:45):
but if you're skipping sleep toexercise, you're basically
stepping over a hundred dollarbills to pick up quarters.
And the first time I said thatto somebody, they looked at me,
they were like, oh my, yes, andso, because I mean, sleep as it
pertains to muscle repair, likegrowth hormone, is released from
our brain into our bodies whenwe sleep, which helps to repair,

(06:05):
muscles, bones, blood vessels Werecover from inflammation better
because we know inflammationhappens when we're exercising.
It stimulates, like I said,muscle repair and then, the
glucose and glycogen that ourmuscles store up and our other
tissues store up, it helps torestock that when we're sleeping
because if we're cuttingourselves short, we're stopping
in the middle of the healingprocess and so we may feel a
little bit better, but not thatmuch better the next morning.

(06:27):
We get up, we do it all again.
We're like, man, why is myendurance not great?
Why do I not feel recovered?
It's because we cut thatrecovery process short.

Coach Ryan (06:34):
You just dropped a quote of the webinar right
there.
I, that, that one hit hard.
You're stepping over$100 billsto pick up quarters.

Dr. Elise Toth (06:43):
Yeah, I read that somewhere I can't take
credit for it.
I just don't remember whoexactly said it first.

Coach Ryan (06:48):
Oh, well, I'm giving you credit because you relayed
that on to everyone that's goingto be listening to this webinar.
That's amazing.
So, all right, let's keepmoving.
Great.
That was good.
Okay Dr.
Koch, so what happens when wesleep?

Coach Lori (07:00):
Yeah, again, I kind of mentioned it's really, it's
not like just your brain turnsoff and that's it.
There's this coordination ofevents and it's actually defined
mostly by electrophysiologicalactivity.
If you do like an EEG, it'lltell you what these certain
stages are, but you hear aboutREM sleep and non REM sleep.
It goes back and forth betweenlike talking about light sleep

(07:21):
and deep sleep.
So there's differentterminologies to do this, but
when you first fall asleep, yourbrain activity goes into these
very deep cycles.
And if you look at theelectrophysiological activity,
your brain waves during the dayare like going crazy, very fast
paced, because your brain has alot of activity going on, but at
night there's this, and nobodyreally knows, it's still kind of

(07:42):
a mystery of exactly what it'sdoing, but, it coordinates these
long, slow waves of activity,and it is a coordination of
events, and there's othersignatures in there, and people
will probably read articlesthroughout time and say like,
slow wave sleep and sleepspindles, but all of those
things have signatures andsomething that's actually going
on.
So, when you're first fallingasleep to stage one, that's what

(08:04):
slow rolling eye movement is oneof the first signs of that, and
probably people who have taken areally boring class or try to
stay awake during somebody elsetalking and they're super tired
or experiences.
So you're kind of dozing off.
It's that slow rolling eyemovements, but muscle activity
slows down, your breathing slowsdown.
And then when you're actuallyfully, fully on a sleep, it's

(08:26):
called more of a stage two sleepand your, breathing patterns,
your heart rate slows, and thenwhat happens is your temperature
also decreases at night too.
I think we talk about tips lateron how to make you sleep a
little bit better, buttemperature plays a huge role
and actually, sleep quality and,fitting into people that might

(08:49):
have, a little bit more strugglein sleeping and physical
activity fits in that bodytemperature too, but I think we
talked about that a little bitmore and then stage three is
really where I'm talking aboutthat slow brainwave activity.
The thing about non REM sleep isthe stronger your activity is
during the day, whether it'sphysical activity or you put a

(09:10):
lot of mental effort insomething, there is a strong
association and having, deeperquality of stage three sleep
when you fall asleep.
And that's where a lot of growthhormone is actually released as
well.
And that's where, you know, thestart of the coordination of
activities, while you'resleeping actually plays the role

(09:30):
into the rest and recovery thatsleep is doing for your body.
Then there is a stage four typeof sleep.
It's also kind of related tostage three.
It gets a little bit deeper.
And then there's the REM sleep,25% of the night is actually the
REM sleep.
So you actually do a lot morenon REM activity in the
beginning of the night, and thentowards the end of the night,

(09:51):
you are having a lot more REMactivity, and if you look at an
EEG on that, your brain activityis actually moving very fast,
but your body, your actualmuscle activity is almost
completely paralyzed, so yourmuscle activity completely
decreases as well.
And there's just so manyfascinating signatures to talk
about when these stages I couldgo on and on.

(10:13):
That's all going to tell youthat sleep is serving an
absolute essential role ineverything you're doing.
And it should not be neglected.
I

Coach Ryan (10:23):
mean, that's such an amazing answer you just gave
that so much color to the sleepcycles.
Let's kind of keep this going alittle bit.
So what are some physiologicalchanges that happen during
sleep?

Coach Lori (10:35):
So yeah, so just the cognitive functioning type of
thing.
So, you know, if you're gettingpoor sleep, your learning and
memory or your concentration isaffected, your mood is affected.
So people are many a times moreirritable if they haven't had
sleep.
I mean, I think that's whatunderstands that now there is
different, changes ininflammation in the body as
well.

(10:56):
And so immunity can be affectedby that um, You're not getting
good quality of sleep.
Appetite, metabolism, obviouslyvery, very affected to, we can
talk a little bit more aboutthat.
I'll tell you, Dr.
Toth talked up a little bit moreon those things.
There are some incrediblewebinars out there now and
materials that talk about cancerrisk.
So people that are not eithergetting the good quality of

(11:17):
sleep or they're not sleeping atthe time that our human bodies
are naturally thought about.
So they call that shift work.
There is, many, many materialsout there will tell you your
cancer risk is increasedsignificantly.
And then the heart health.
There is a, professor out therewho served on my PhD committee
in the very beginning of my PhD.
His name is Matt Walker.

(11:38):
He talks a lot about the hearthealth, but he has a statistic
out there that for daylightsavings time, that when we lose
an hour of sleep, the amount ofcardiovascular problems, heart
attacks actually increased byabout 20%, 20, 25%.
And when we get the extra hourssleep, they actually decrease by

(12:00):
a certain percent.
And they also talk about caraccidents and, just mindful
things that happen in themorning when you lose that hour
of sleep and it's just kind of alot of research is done across
the board.
So it's an interestingstatistics to look up for people
that are more interested in thatkind of work.

Coach Ryan (12:17):
That is really interesting.
I mean, so it is going to be apretty good benefit when we do
away with it.
Daylight savings pretty soon.
I think it's supposed to becoming up this next year, right?

Coach Lori (12:26):
Maybe.
Dr.
Talbot, do you have anythingelse to add to that?
I know that you can go into alot of the biology as well and
knowledge of with working withyour patients.

Dr. Elise Toth (12:36):
Yeah, so yes, actually, I'm going to elaborate
on quite a few points that youbrought up.
So the first one, especially asit pertains to, like appetite.
I know that was one of thethings you brought up as far as
that's concerned.
So our hunger hormones versusour satiety hormone.
Sleep plays a big role in bothof those.
We've seen research that peoplethat get less than seven hours
of sleep at night, the nextmorning, that satiety hormone,

(12:58):
which is.
I'm like, I always get the twomixed up.
Leptin tells you that you'refull.
Ritalin tells you that you'rehungry.
Leptin gets, not overwritten,but basically it's not as
sensitive.
You're not as sensitive to it ifyou don't sleep enough.
So that's why oftentimes ifyou're sleep deprived the next
day, you're really like sweetfoods, carb, heavy foods, salty
foods are usually what we'rereaching for.

(13:19):
And when we feel like we're justeating, eating, eating, eating,
eating, because that hungerhormone is going, unopposed and
we're really not creatingprotein rich and fat rich foods
that we know we should be andwe're kind of just reaching for
garbage to kind of keepourselves going throughout the
day.
So that's definitely one, bigthing about sleep deprivation.
And also, as it goes back aslike, you had brought up with

(13:40):
heart disease when you're sleepdeprived our body goes into
fight or flight mode, which isfine in short periods of time.
It's fine when, you know, we'rethreatened physically, mentally,
emotionally, whatever it may be.
But chronically, when our stresshormones are released, cortisol
specifically, it causes ourblood pressure to increase.
Growth hormone gets shot off,which right if we remember

(14:01):
growth hormone helps to repairour blood vessels.
So if our blood vessels aren'tbeing prepared, right, we have a
greater risk of things buildingup in their atherosclerosis or
hardening of the arteries.
And also our cells, when there'sa lot of cortisol going on, our
cells aren't as receptive toinsulin.
And that means there's higherblood sugar going on, which
could also increase our risk ofdiabetes.

(14:22):
So there's, there's all sorts ofcrazy, studies that have been
done tracking people that sleepless than six hours a night.
And they found that there was agreater than three times the
risk of those people ofsuffering from a cardiovascular
or coronary event, includingsudden cardiac death, which is
And sometimes even just cuttingan hour or two out of our sleep

(14:43):
and I go like, not a big deal,I've got a lot of work to do I
have a big paper to like,whatever, it actually speeds up
the contracting rate of aperson's heart, which will
increase their blood pressure.
It'll increase their heart rate.
And even if their cardiovascularsystem was super healthy the day
before, just like one littlenight of too little sleep can
start to play a role on theheart, which is kind of
frightening.

Coach Ryan (15:02):
Yeah, that is.
I know we're talking aboutentertaining hours out of your
sleep.
And, when that happens, a lot ofus would tend to go to a nap and
we, take these little, you know,little power naps, wherever they
might be.
How does that affect our sleepat night?
Is that a good thing to do totake naps during the day?
Is that ideal?
Or, like, how do you, how do youboth feel about that?

Dr. Elise Toth (15:22):
Dr.
Koch, I'm going to defer to youon this one.

Coach Lori (15:24):
From the perspective of the athlete, I want to tell
you a lot of like professionalathletes, they, they eat, they
sleep, they run, they eat, theysleep, they run.
And the reason why they do a lotof sleeping and napping in
general goes back to a point Imade about the stronger, the
activity you do during the dayand when you fall asleep, the
stronger, the evidence of youare trying to sleep very hard.

(15:48):
I guess for lack of a betterterm or more deep sleep, because
of all those activities.
So from the perspective of theathlete, the napping component
actually probably puts you in abetter place when it comes to
recovery and repair, of yourbrain, of your cardiovascular
system and then your muscles.
In other cultures, othercultures nap during the day, and

(16:10):
it's totally a cultural fineactivity.
Our culture still, even thoughthere is good stuff out there
about, We should sleep, weshould sleep.
And so much education isavailable for us, we're in a
culture where, you know, sleepseven hours a night, six, seven
hours a night, and don't napduring the day because we got to
keep going, going, going, going,or if you're on an intense

(16:33):
schedule where you have a verystrong goal for like Chicago and
maybe you're doing two a days orsomething you don't think
napping is going to fit inthere.
But napping in general in themiddle of the day, for sure, I
think puts you at a higherability to help make these
other, components that areobviously coming together to
repair your body and make itoptimal, important.

(16:55):
So now most of us don't havetime to take a nap during the
day.
So that doesn't really helpanybody.
We're like, Oh, maybe I shouldtake a nap during the day.
But, I do think it puts you in abetter place.
Otherwise, then you have to makesure you're falling asleep at
night and getting the optimalsleep and on top of it.
What other questions would youhave about that?
What I just said, veryspecifically.

Coach Ryan (17:14):
Yeah, you know what, that's so very fascinating and
interesting because it soundslike if you need a little bit of
a power nap, it's going to beokay if we do when we do.
And if you have the time andability to do it.
But there's probably a thresholdwhere, like, there is a
consequence where it will cutout from, like, your ability to
fall asleep at night.
Is that right?

Coach Lori (17:34):
That's true.
So if you did take a nap, somepeople would have a harder time
falling asleep until a littlebit later.
But I think also again, justgetting the good quality sleep
at night as well.

Coach Ryan (17:48):
That's good.
Seriously, these are wonderfulanswers.
I love this.

Coach Lori (17:50):
Sometimes too, when changing in age, like children
take naps all the time.
The amount of sleep thatchildren are supposed to have
are very different than when webecome adults, and then sleep
changes quite a bit to the olderyou get, and a lot of the times
it's not really has to do withlike your sleep is technically
changing.
It's more about a circadianrhythm, which is your circadian

(18:10):
rhythm and sleep.
They're not really the samething, but they coordinate
together and they go in hand inhand together.

Coach Ryan (18:18):
And we'll definitely dive deeper into that.
But, I want to throw this outthere.
This one actually hits a littlebit closer to home.
I had a couple runs that I canremember over the last year
where I was coming off of justreally poor sleep.
You know, I just couldn't sleepat night.
It was like two to three hourswent out for a run and I felt
like my muscles were seizing oreven feel like I felt like they
were restraining a little bit.

(18:38):
Can you tell me how our physicalabilities are affected by the
lack of sleep?
Dr.
Koch, we'll start with you.

Coach Lori (18:43):
Oh, so just like the cramping, I mean it goes back
into the coordination of likejust there's inflammation going
on in your body and then eventhe lack of sleep can probably
even make you a little bit moredehydrated or you're just at a
different disadvantage.
Your cardiovascular system,again, is so affected by,
changes in your sleep rhythm.
So I, sometimes I feel likecramping or other physical

(19:04):
effects that you've noticed thatseem to be correlated with, I
didn't sleep very well lastnight.
It has to do with all thefactors are saying that sleep is
helping your body completelyrestore for day to day use.

Coach Ryan (19:17):
Right.
Absolutely.
All right.
I know we want to dive deeperinto this, and this topic.
This could be a few differenttimes.
So let's just get right intothis piece.
Dr.
Toth, what hormones are affectedby sleep?

Dr. Elise Toth (19:29):
Quite a few.
So, during sleep, cortisol,norepinephrine, those two, so
those will help us wake up, helpus stay awake during the day,
and then melatonin is theopposite of that.
It helps us fall asleep and stayasleep overnight.
Cortisol and melatonin areopposites of each other.
They both have their own role wejust have to make sure that,
kind of going back to what Dr.
Koch said before, that's kind ofhow the circadian rhythm also

(19:52):
plays a role.
Not that it's the same thing,but the two kind of play into
each other so that way, youknow, our bodies are following
correctly what we're supposed tobe awake, stay awake, fall
asleep, stay asleep.
So cortisol is dominant duringthe day.
It should spike about an hourafter we wake up in the morning.
It'll be a little bit lowerright when we first wake up as
melatonin is still at itshighest, but that's usually when

(20:12):
we feel a little bit groggy whenwe wake up and then after about
half an hour to an hour we'relike, okay, I feel like a human
again.
Things are fine.
I can actually keep on goingwith my day.
Cortisol should kind of spike,so kind slow down, be the lowest
before you go to bed at night,and that's where melatonin takes
over.
So backtrack for a second.
Cortisol is stimulated by thelight.
Some lights, artificial light,whatever light that is entering

(20:34):
your eyes and hitting certainparts of your brain, it's going
to stimulate cortisol to bereleased.
Melatonin is the opposite.
Darkness is what stimulatesmelatonin.
So as the sun goes down ourlights in our, houses should be
following that mimicking itbecause with the dark same thing
hits the back of our eyes hitsdifferent parts of our brain
Helps us to feel drowsy helps usto fall asleep helps us to stay

(20:54):
asleep overnight So oftentimeswhen things like either, you
know Having we talk about bluelights a lot if we're having a
lot of either overhead lightblue lights Whatever shining
into our eyes our brain is like,oh, hey Cool, it's daytime and
it's like, no, it's two in themorning.
Or if we're exercising too closeto bedtime, this exercise is
going to release cortisol.
So a lot of times people do toolate of a workout.

(21:15):
They're like, I was amped.
I was up the entire nightbecause it throws off our
cortisol curve a little bit anddoesn't allow melatonin to come
out when it needs to come out.
And that's where on the oppositeend of that, a lot of times
people, they so where byblackout shades, which is fine,
that's not an issue.
But oftentimes we need thatsunlight coming in or something
to let our brain know, Hey,light is here.

(21:35):
It is daytime.
Otherwise the blackout curtains,we could sleep until noon and
not have any idea because thatdarkness is still there
stimulating meletonin.

Coach Ryan (21:43):
Dr.
Koch, we're just talking aboutlights and different blue lights
and things kind of coming in.
I think that makes me think oflike fragmented sleep, you know,
waking up in the middle of thenight.
One can sleep eight hours anight, but get up one to two
different times during themiddle of the night.
How does that differ thansleeping for eight straight
hours?

Coach Lori (21:59):
They're having sleep disruptions.

Coach Ryan (22:01):
Yes.

Coach Lori (22:03):
I think they're okay.
So that goes back to like whenwe were talking about the sleep
staging and I was talking aboutas a coordination of events.
So you're going to go intodeeper and lighter stages of
sleep all the time.
So you do wake up throughout thenight.
You just might not be aware ofit.
But if you do wake up in themiddle of the night and you
can't fall back to sleep, thatends up being a problem.
This plays into the circadianrhythm too.
Some older adults actually havea lot of problems with the

(22:25):
circadian rhythm.
It starts.
It's at one point it was called,it was deteriorating over time.
And so then, and you make, youknow, people make, Oh, you know,
and I've gotten this age now andI wake up at four in the
morning, but it is true.
It's because those, coordinationevents, and I think it has a lot
more to do with circadian rhythmthan actually your sleep,
breaking down, but, it's naturalto wake up in the middle of the

(22:46):
night.
Now, if you're finding out thatyou're waking up in the middle
of the night because you have togo to the bathroom three times.
That could disrupt your sleepand it takes you another 20
minutes to fall back to sleep.
You know, you have to addressboth of those problems or
address that problem.
Maybe you're not drinking waterright before you go to bed or,
you know, figure out what allthose issues are.
Because you definitely don'twant to wake up like four times

(23:06):
in the middle of the night andthen be up for 20 minutes each
time.
That will disrupt sort of thecoordination of events that
should naturally happen whileyou're sleeping.

Coach Ryan (23:14):
That's so fascinating because, you know, I
did hear, something along thelines of like, we don't wake up
from needing to use thebathroom, we wake up and by
routine use the bathroom is howmuch truth is to that.
And like, Yeah, Dr.
Cook Dr.
Toth, if you can bring any lightto that.

Dr. Elise Toth (23:31):
When my patients tell me they're waking up a lot
to use the bathroom, that'sessentially the question I ask,
does your bladder wake you upovernight?
Or do you wake up and thenyou're like, oh, I should
probably go pee?
If their bladder is waking themup, that's something like Dr.
Koch said, maybe they'redrinking too much water too
close to bedtime.
Maybe there's something going onwith their bladder in, older
men, prostate issues.

(23:51):
But oftentimes I've found whereif they're waking up and,
they're just like, Oh, like outof habit, they're going to the
bathroom.
Um, it oftentimes could besomething going on with their
stress hormones, with theiradrenal glands.
It could be, sleep apnearelated, you know, and maybe
they have to be worked up forthat, or there's different
things there too.
And it's funny because I'll askpatients that they're like,
that's a great question.
I have to stop and think aboutthat for a second.

(24:11):
So it's basically just findingand addressing root cause of
that disruption to sleep.

Coach Ryan (24:15):
So what might be some root causes to, waking up
in the middle of the night likethat?

Coach Lori (24:19):
Well, sleep apnea, and that is one that's actually
a problem that needs to beaddressed.
Because that means it's probablyhappening throughout most of the
night or definitely duringcertain sleep stages.
Cause here's another thing aboutsleep staging.
If you keep just going back intonon REM sleep throughout the
night and you keep gettingdisrupted, you never go into REM
sleep.
And that's a problem becausethat coordination of events
actually needs to happen for youto have a proper night's sleep.

(24:42):
Here's something that's kind offascinating too, or if you ever
noticed about yourself, Have younoticed that maybe you dream,
you're like dreaming, and youusually wake up out of a dream?
And it's usually later in thenight, but you don't remember
dreams earlier in the night?
If you're really sleep deprived,this happens to a lot of people,
and you've had like three badnights of sleep, and those three

(25:02):
bad nights of sleep you keptgoing into the non REM activity
that needed to happen in yourbody, and then you really
finally fall asleep, your bodywill actually go into REM first
because it needed it so bad.
This is like how smart ourbrains and our body is and how
fascinating just biology is ingeneral.
The odd can nerd out about thatforever, but sometimes you might

(25:22):
fall asleep right away and youhave this like really crazy
dream.
It might mean that you were REMdeprived.
Nobody really knows exactly whatdreaming is and where it goes,
but a lot of times most peopleonly remember their dreams in
REM sleep.
But your brain activity is kindof going crazy during that.
So your body will try to repairitself I guess this is my point
too, but then your circadianrhythm that does go a long line

(25:46):
with sleep and you keep wakingup to the middle of the night,
all of those activities thatneed to happen in your body
completely go off and then allyour other organs are affected
by it too.
There is a whole science nowabout biological sleep rhythms
and sleep.
Circadian rhythm in generalisn't thought to just be in your
brain.
It's thought that every organ inyour body has its own circadian

(26:06):
rhythm.
So if Your circadian rhythm iscompletely off your liver has
its own circadian rhythm of howit wants to operate in itself.
And then when it comes to thecortisol and melatonin has its
own rhythm of how it wants tooperate for itself.
And when those things don'toperate properly, it might
affect your kidneys in adifferent way.
It might affect in each one ofthem.

(26:26):
It's thought that they havetheir own rhythm of activity,
and it all has to coordinatetogether for your body to work
properly.

Coach Ryan (26:34):
Super intriguing.
Dr.
Toth, it looks like you might,you might have had something
else to add into in terms of,what else might be a root cause,
to breaking one's sleep?

Dr. Elise Toth (26:41):
Sure a lot of times, the most obvious one and
the one that everybody rollstheir eyes at me until, when I
ask until they finally are like,oh, caffeine.
Caffeine is a big one.
The mistake I've made many atime where we drink caffeine
just a little bit too latebecause we need that boost.
And we forget it takes our bodyabout six to eight hours to
actually like the half life ofit to actually like release it

(27:01):
out of our bodies.
And so I was the queen of thisback when I was in grad school
was, go to Starbucks, get thestrongest coffee with whatever
espresso shots I could at 5 pmfor a study session.
And then I had like gas Iconvinced myself I had insomnia.
And then I was like, wait, no, Ijust had my coffee at 5 pm and
I'm trying to go to sleep atmidnight and that clearly isn't

(27:23):
happening.
So oftentimes, bringing ourcaffeine intake, curbing it
back, stopping it around noongives us enough time to release
it from our body and that is avery simple thing that I quite a
few of my patients when I havethem do that, then they're like,
Oh, yes, you know, I'm fallingasleep better, I'm staying
asleep better overnight.
Different stress just going backto adrenal health different

(27:43):
stressors whether it's workstress family stress life stress
different infections.
The newest thing that I've beenlearning more about and treating
more is mold toxicity and moldalso messes with your sleep big
time.
That's a whole other.
rabbit hole to dive down on adifferent day, but, different
things like that will also, playaround with sleep, both falling

(28:03):
asleep and staying asleepovernight

Coach Ryan (28:05):
yeah.

Coach Lori (28:05):
Oh, I didn't know about the mold.
That's the first time I everheard about that.

Dr. Elise Toth (28:09):
Yeah, it hijacks and that's where CPAP machines.
And so that's where the exposureis for people.
And so there's sleep apnea isgetting worse and worse and
worse.
And can't figure out why it'shappening.
And yeah, it's pretty insane.
I've been taking on quite a fewmore mold patients recently.
And, that's almost every singleone of them sleep is affected in

(28:30):
some way, shape, or form.
Because the mold hijacks prettymuch all of our hormones,
cortisol, melatonin also.

Coach Lori (28:38):
So now, I have a question for you.
The sleep apnea part becausethere's different, there's two
couple different types of sleepapnea.
There's kind of like a centralapnea, which is like more,
about, having a neurologicalproblem and breathing throughout
the night.
And then there's kind of likethe mechanical problem where,
somebody has gained a lot ofweight around their neck or
just, you know, how physicallythey're built, they might have
some sleep apnea.
So does the mold effect whereit's more of like a neurological

(29:00):
type of apnea or is it both?

Dr. Elise Toth (29:02):
It could be both, just because it's
basically, it's the route ofentry as it's going in, like
through their mask and going inthrough their nose and through
their mouth.
And so their rest of theirbody's now exposed.

Coach Lori (29:11):
Oh, because of the CPAP machine.

Dr. Elise Toth (29:13):
Correct.
It's not being cleaned properly.
It, it can be route of exposure.

Coach Lori (29:16):
Gotcha.
Okay.

Coach Ryan (29:17):
I love it.
I love this banter we have goingon here.
You know, I think we, we didtouch base on this a little bit,
but maybe, go back to a littlebit more.
What should it like a typicalnight of sleep look like?
And then conversely, I want toadd into that what about night
shift work and night shiftworkers?
How does that affect our sleepand life in general?

Coach Lori (29:39):
Well, there's two loaded questions, but in
general, you would sleep sevento nine hours.
Some people are geneticallypredisposed to that they're just
fine with seven hours, but I'mseven to nine hours is pretty
much hits most people, you wakeup at a certain time and you
have a routine and then you goto bed at the same certain time,

(29:59):
but throughout the day you havemoments of like, you feel a
little drowsy, that's where youget that five o'clock coffee,
depending on what you're doing.
If you're still at work, you'reat school.
and the reason why I don't giveyou a time is because
everybody's circadian rhythm isalso slightly different.
You, he'll hear people that areowls or larks.
Like that's a term that's used.
So if you're a night, nightowls, right?

(30:20):
So some people are justnaturally night owls and some
people are just early morningrisers.
And we talk about that amongsteach other all the time.
It's like, I wish I was more ofa morning person.
Oh, I wish I could stay up atnight.
But that all has to do with howyour circadian rhythm also plays
into your day.
But ultimately whenever you wakeup, that's When your blood

(30:40):
pressure is at its highest.
And that goes back to thehormones that Dr.
Toth talked about.
And then that changes throughoutthe day, the melatonin.
So melatonin is going to helpyou relax and fall asleep at
night, but that's going tolower, cortisol is going to sort
of go up.
You have the highest alertnessafter you wake up, after you've
been up for a couple of hours.

(31:01):
And then you have a dip duringthe day where your melatonin
actually goes up and it, itmakes you feel a little bit
drowsy.
The body temperature thing issuper interesting in this
because it also is in more andmore pieces of information that
we have about when it comes tosleep and circadian rhythms,
because the temperaturecomponent also can fluctuate
throughout the day.

(31:21):
And for some people temperatureis not a sensitive thing for
them.
For other people, temperature isa sensitive thing for them.
So a lot of athletes that try towork out at night and then they
can't fall asleep afterwards.
There is a component, is thoughtthat is because their
temperature has rised in theirbody.
So like for those athletes, yourtemperature is supposed to drop

(31:41):
a certain degree or two to fallasleep quicker and, fall asleep
in a way that you're enteringsleep stages more optimally.
And that's why sometimes, I say,Hey, if you can't fall asleep,
turn down the temperature inyour room.
But those things, again, theyall coordinate throughout the
day.
What an optimal day should looklike.
Dr.
Toth, what would you like tokind of add to all of that?

Dr. Elise Toth (32:01):
I don't think anything.
I think you hit everything thatI was going to bring up.
So fantastic.

Coach Lori (32:06):
Yeah, so I was doing some research studies before we
were trying to actually monitorpeople's temperature to see,
especially it was in a rehabinstitute perspective, to see
if, after people had someneurological illness in the
rehab place that it was at,whether or not their body's
ability to change temperaturebecause of maybe like a stroke
or a TBI if those changes is oneof the reasons why they were not

(32:31):
getting optimal sleep on top ofit, or if we can help improve
their, temperature changecapacity to see if we can
improve their quality of sleep,but temperature, I think has
been more of a popular term ortopic to talk about and, just
that whole aspect of improvingsleep quality.

Coach Ryan (32:46):
We touched base on this earlier, you know, we live
in a digital world, there's bluelights in our face all the time,
right, from our phone alone toiPads, computers, TV, things
like that.
So, Dr.
Toth, are there any tools thatwould you say that can help?
Offset the amount of digitalthat's in our face.

Dr. Elise Toth (33:06):
Sure.
Sure.
Yeah, the easiest thing Irecommend blue blocking glasses
so they can either be inprescription.
Like I know, I got all myglasses on Zeny, I just, I like
them and that's an option.
You can actually select blueblocking glasses, and so if you
take off the glasses and you seethe light hit, you'll see it's
kind of like a yellowish tint Onthe lens because yellow blocks
out the blue, and they may havea prescription non prescription.

(33:27):
You can buy them over thecounter.
There's a whole bunch ofdifferent ones out there.
The other option is like withour phones, we can set it to
night mode.
So that way it's not as brightof tones hitting, not like the
blues and the whites.
It's more of like the pinks andthe warmer hues, because they're
not as harsh and they're notemitting the same amount of blue
light as some of those otherthings are.
There's also, the Flux app, FL.

(33:48):
UX.
You can go and you can installthat.
And it's kind of cool where, youcan install on your computer.
I don't know if there's a phonecompatible version of it, but I
know computers and tablets youcan install that.
And it actually, it will gobased on what the light outside
is doing, what the sun is doing.
At certain times, it will startto turn everything in the
background more of like a warmhue.
It'll tune out more of the bluelights.

(34:09):
And then during the day when thesun's the brightest.
It will have the blue lights andthe lights and all of that.
So that way it also follows, sunrhythm.
It's supposed to help with yourbody circadian rhythm as well.
And that's your, we can't avoidworking on our computers later
on into the night.
That's kind of a way that we canoffset a little bit.

Coach Ryan (34:25):
I love those.
Those are actually tools I use.
There were like game changersfrom my sleep habits.
Dr.
Toth in your practice, what aresome ways that you do test for
sleep?

Dr. Elise Toth (34:33):
So initially, it's really part of the
questions I ask in my intake.
So I'll ask when we talk aboutsleep, I'll ask if there's any
trouble falling asleep, anytrouble staying asleep
overnight.
I like to ask what time a persongoes to bed, what time do they
wake up in the morning?
Do they feel rested upon wakingor are they still exhausted?
Is their first thought, when canI go take a nap?
So that's kind of, sleepmelatonin, and then I'll ask

(34:53):
kind of piggyback off of it,we'll ask about energy.
So I asked, what time of the dayis your best energy, what time
of the day is your worst energy?
As Dr.
Koch said, right, best energy,most mental clarity for most
people who have their circadianrhythm and their cortisol rhythm
is working properly.
They'll say, oh, mornings are mybest, you know, usually right
after I wake up until maybeabout like 10 noon, depending on
how everyone's body clock isshifted a little bit.

(35:15):
Most people will say thatthere's like a three or four
o'clock dip five o'clock.
Maybe everyone's a little bitdifferent And then I ask if they
get a second wind of energy andsometimes they look at me like
i'm nuts and sometimes they'relike Oh, yeah, I usually get one
around like 7 or 8 p.
m And so those are the questionsthat I ask.
If the answers to thosequestions Are something that's
really really off.
I refer them out for a sleepstudy if it's necessary because

(35:36):
sometimes it could be sleepapnea Or, look and see if
there's any medications they'retaking that is possibly,
interacting with their sleep.
Or like I said, if I'msuspecting some sort of like an
infection or a mold toxicity orsomething to that degree, start
to, to work on that a little bitmore or get to the bottom of
that.

Coach Ryan (35:52):
That's good.
What are some devices that canhelp with monitoring, one's
sleep?

Coach Lori (35:56):
Yeah.
I mean, it's impressive.
If you would ask you this fouryears ago, I'm like, yeah, you
got your watch on and he'smonitoring that, but I never
really believed that it wasactually monitoring it properly,
but I really do think thatthey've gotten the algorithms
down.
So the most popular ones that alot of people use is their
smartwatch, whether it's anApple Watch or a Garmin or, you
know, just whatever smartwatchdevice that is out there.

(36:19):
It does a pretty good job ofmonitoring your sleep.
What it's basically doing isit's monitoring your heart rate,
and changes in your restactivity and how that,
fluctuates throughout the nightand it's also monitoring
movement too.
So some watches try to go downto as close as saying that they
know how you've been in REM andnon REM sleep and I think that

(36:41):
what the algorithm is actuallydoing is earlier I talked about
how when you're in actual REMsleep your body's actually kind
of completely paralyzed so youwouldn't have much movement at
all in REM sleep but you mightactually have more movement in
non REM sleep and the algorithmsyour watches learn what your
heart rate activity looks likeand what that movement looks
like, through that.
Other ways to monitor sleep, ifyou are really having, trouble

(37:04):
with it, sleep behavioraltherapists, actually do exist
out there and they would haveyou do a sleep diary.
So you would.
actually write down every timeyou fell asleep, went to bed and
what your routine actually is.
But I will say the devices havegotten really nice these days to
be able to manage that.

Coach Ryan (37:25):
For the ones that they sell over the counter,
things like the Garmin,

Coach Lori (37:27):
Yeah, I actually do.
I've been pretty impressed.
Again, if you would have askedme four or five years ago, I'm
like, I don't know if they'regonna be able to hit that, but I
really do think it hits itpretty nice.
There are professional gradeones that they will actually
give you in sleep clinics.
So typically if you went to geta sleep consult, you might go to
a sleep clinic.
They might say, okay, I want youto write a sleep diary down and

(37:48):
here we're going to give you awatch.
And they're usually called likeActa watches.
They've existed for a reallylong time.
But what they're really doing isthey're monitoring movement and
they're monitoring the amount oflight that you're actually
getting during the day.
So then sleep professionals willactually look at the amount of
light coming in, through thereport because they also want to
monitor where your circadianrhythm activity is and see if

(38:10):
light is affecting that.
Because Again, Dr.
Toth talked about light reallyinfluences the way the rhythms
of your, hormones are workingwith your body.
And then you would go in andactually like sleep for the
night and they would hook you upto all the fancy stuff.
Cause I kept talking about likeEEGs still the most gold
standard way to monitor actualsleep is putting the electrodes
on your head and monitoring thebrainwave activity and breathing

(38:34):
to see if you have sleep apneaand then they also put EMGs on
your legs because there'sanother thing called restless
leg syndrome too and monitoringmuscle activity.
Sleep it's complicatedeverybody, you get it?

Coach Ryan (38:47):
In that book.
I'm Sleep Smarter I believe itwas a study that was done at the
University of Chicago.
They were talking about lightand they had, you know, certain
amount of lights and they wereshowing that even like the
smallest bit, like a nickelsworth of light on the back of
the knee would still affect yoursleep.
Something crazy like that.
Have you experienced anythinglike that or learn anything

(39:08):
about that?

Coach Lori (39:09):
Yeah.
I mean, I wonder who the groupis in the University of Chicago
because half of mycollaboration, all the sleep
work I've done was University ofChicago.

Coach Ryan (39:15):
I would dive back into that book or encourage you
to look at that book too,because he pulls a lot of
interesting studies about that,so.
Dr.
Toth, let's talk about how foodaffects sleep.
How should we be eating andthings maybe potentially that we
should be avoiding, and how tojust better optimize our sleep.

Dr. Elise Toth (39:32):
So, depending on what we're eating and at what
time, there's going to becertain things that affect our
sleep.
So, like we said before,caffeine 100% will affect sleep
because the half life in thebody, it takes a while for us to
flush it out.
Blood sugar stability is goingto play a really big role in
helping us fall asleep and stayasleep.
Oftentimes, and I don't know ifanyone else is like this, but I
know I tend more towards lowblood sugar.

(39:52):
And I know that if I'm kind ofhungry, like if I'm going into
my room, so I do my nighttimeroutine, I know I'm either not
going to be able to fall asleepor I'm going to be up at three
in the morning starving becauseI didn't have enough to eat
overnight, you know, before Iwent to bed.
And so, sugar is another thingkind of going back to blood
sugar stability before we diveinto strategies.
Sugar spike and drop our bloodsugar if it's unopposed, if

(40:13):
we're eating sweet things beforebed, if we're eating fruit on
its own before bed or justanything, that is just, you
know, has sugar in there.
So that too, it can causetemporary feeling of satiety,
but then after a while, and I'vehad patients before too, where
they're like, I cannot figureout why I'm waking up at three
in the morning.
There's no, I don't have to goto the bathroom.
There's no stress.
There's nothing going on.
And I recommend them like, okay,I want you within an hour going

(40:37):
to bed because most peoplerecommend to stop eating like an
hour or two or three beforebedtime, which for a lot of
people, they have stomach issuesis wonderful sound advice.
However, and those of us whohave lower blood sugar, or, were
really super active during theday.
I tell those people havesomething with protein and with
a complex carb an hour beforebed.
So whether it's a spoonful ofnut butter or some whole grain

(40:58):
toast with like a nut butter andbanana, or I always keep my
fridge, I have deli turkey, Ilike to wrap it up in like a
pickle spear or something.
Have a little bit of that beforeyou go to bed, not to the point
where like you're over stuffedand full, but enough where
you're satiated.
And I found more often than notpatients come back to me after a
few weeks, they're like, yeah,I'm not waking up at three in
the morning anymore.
It turned out I was just hungryovernight and that was my

(41:19):
brain's way of telling me that Iwas hungry.
So kind of to foods to embraceare gonna be things like lean
proteins, complex carbs, havewhatever it is that your
preference is with that, butsome sort of combination of it
within an hour, going to sleepovernight so that way you can
fall asleep easier, stay asleepbetter.
It gets your blood sugar morestable overnight instead of your
brain waking you up to tell youwas hungry.

Coach Ryan (41:39):
That's good advice supplements that you would
recommend that would help ussleep.

Dr. Elise Toth (41:46):
There's a whole bunch of them.
So for some people, melatonin iskind of the obvious where people
go to it all the time.
Melatonin is great.
one downside to melatonin is ifwe take too much of it for too
long, our brain stops creatingits own melatonin.
And so melatonin I like torecommend on a very case by case
basis.
Sometimes people need it.
Oftentimes people don't.

(42:07):
A really good way to help thebrain to stimulate and create
its own melatonin is cherryjuice.
And I know that's kind ofexploded a lot, on Tik Tok and
then things like that.
Tart cherry juice is just greatbecause tart cherries have
melatonin in them.
It helps, your brain to createits own.
It's also in a time flammatory,right?
I know, athletes have been knownabout like, duh, yeah, I use it
for my muscle recovery andinflammation.

(42:27):
Like I've known about this foryears, but it does help with
sleep.
There's been studies done,double blind placebo trials
where half, it's all people thathave some degree of insomnia.
I don't recall off the top of myhead what, you know, how severe
it was, but half the group drank16 ounces or two glasses of tart
cherry juice a day for twoweeks.
The other half of the groupdrank a controlled crystallite
Kool Aid, something like that.

(42:49):
At the end of the two weeks, thegroup that drank the tart cherry
juice, they reported back onaverage experiencing about 80
minutes more of restful sleepper night.
Which is not nothing if youthink about it, just has to be,
you know, you have to becompliant with it, granted it
was a self report.
So there is there's definitely,you know, there's room for error
there as well.
It's not like the best designedstudy, but it's fairly good, at

(43:09):
least in preliminary studies.
Something else that's reallyhelpful supplement wise,
magnesium, going back to therestless legs, like Dr.
Koch said, restless legs.
I've also oftentimes found theroot cause of that is low
magnesium.
We need it to support our nerveendings.
We needed to support ourmuscles.
It prevents muscle cramping.
So a lot of times when magnesiumis deficient, which oftentimes
it is, if we're not eating,green leafy vegetables and

(43:32):
things like that.
You could take it orally, but Irecommend magnesium spray.
The Now brand sells it in like abottle Just spraying it on your
legs, feet, anything like that.
I was a dancer for many years,and so I would get those calf
cramps that woke me up out of adeep sleep, and I found
magnesium not only helps withthat, but also will help with
falling asleep, help withstaying asleep, and that
combination of tertiary use andmagnesium sprays when I start

(43:53):
with any of my patients thatcome in to see me for insomnia,
that's generally right where westart, and then if that doesn't
work, We'll bring in things likemalaria.
Maybe you'll bring in somechamomile.
Maybe, you know, there's othermore potent herbs out there, but
those are usually the twobaseline places.

Coach Ryan (44:08):
That's good.
Other things to help, improveour quality of sleep.
I think we touched base on thisa little bit earlier.
Dr.
Toth, what temperature shouldsomeone play with, to help
improve their sleep?

Dr. Elise Toth (44:17):
I have a range, like a wide range, just because
everybody's body is a little bitdifferent.
The range that I have that Ifound is between 65 degrees to
73 degrees.
Now some people like to sleepcolder.
Some people like to sleephotter.
I myself, I like my room is atlike 73 degrees because I'm the
type where like I'm bundled upin my sheets and my nose is cold
and I can't fall asleep versuspeople that I know they're like,

(44:39):
nope, if it's not at 65 degrees,I don't want to hear about it.
So that's a good place.
I made this recommendation for apatient of mine earlier.
She just sleeps hot.
Her partner sleeps cold.
Chilly pads when you're on yourbed, that's kind of a nice
compromise because that way oneperson can sleep colder, one
person can sleep hotter but inthe research we're seeing is a
pretty decent place for the roomtemperature to be.

Coach Ryan (44:58):
We touched base on this earlier too, hard training
might not be so great, rightbefore sleep, but are there
specific times that someoneshould get a workout in to get
better sleep?

Coach Lori (45:08):
I think you can answer this question in two
different ways.
For some people, if it's been apart of their routine forever
and they already were gettinggood sleep and it's completely
fine for, other people, if youare somebody that is more prone
to having some more insomniatype of, symptoms, then you're
probably going to want to getyour workout in the morning.

(45:31):
Because, if you're somebody thatlikes to go to bed a little bit
earlier, and that's part of yourcircadian rhythm, then, hard
training can disrupt that, andagain, I think it goes back to,
some people are more prone tobeing insomniacs and for someone
like that, I would say gettingyour training in earlier in the
day, it's going to be morebeneficial to you because you
might be more sensitive to thecoordination of activity that

(45:53):
should go on in your body tohelp you fall asleep sooner.
So I know I probably didn'tanswer your question.
Like, are you asking for like5pm, 6pm, 4pm?
It goes back to the samecaffeine thing.
It's like, okay, for people thatare sensitive to those factors
you'll hear the commonrecommendation is cut your
caffeine intake before 2 pm.

(46:15):
And so that would maybe the samething too, if you notice in your
routine that, oh, wait, yep,every night that I, I had a
problem sleeping, it was becauseI did this certain hard workout
or I did this extended workout,at this time.
So that could be an indicator ofwhy you were not falling asleep
very well.

Coach Ryan (46:31):
Let's talk about creating a good sleep sanctuary.
Do either of you have, any goodtips to creating that sleep
sanctuary.

Dr. Elise Toth (46:38):
Lighting is the first thing that I always go to.
So the lights going on insideshould mimic what's going on
with the sun outside.
So if right from the sun that isbrightest, we can have lights on
super bright inside.
As we're getting closer tobedtime, as the sun starts to go
down, the lights inside shouldalso follow.
So whether that means, we turnoff overhead lights, we bring in
string lights, we bring in pinkHimalayan salt lamps or

(46:59):
something softer of a glowbecause there's nothing worse
than trying to get ready forbed.
You've got these bright lightson overhead.
You get turn them off.
You get into bed.
You're like, why am I not tired?
Well, you're not tired becauseyou're bringing daytime still.
So that's that's 1st andforemost, both in living space,
bathroom, bedroom, wherever thatneeds to be cooler temperatures

(47:19):
like we had talked about before.
Keeping work out of the bedroom,right?
If our brain associates the bedof work, and that too, I'm
guilty of doing this as well, ofbringing my laptop into my bed,
because I'm like, oh, I'm comfyhere.
I want to work.
But then after a while, if we'reworking or if we're studying or
if we're stressing about things,our brain makes that association
and we have a hard timeunwinding, a hard time sleeping.

(47:40):
So work devices should stay out.
Phones, there's an argument tobe made with that.
You can argue for and againstit, but minimal phone time,
screen time, should be, youknow, should be followed.
Wearing, if you need earplugs,like let's say if you're, if
you're on a noisy street corner,like I live at a really, really
busy street corner, and sosometimes earplugs just to kind

(48:00):
of keep the traffic noise out.
Or if your partner stores orwhatever that may be.
Eye mask if necessary if you forwhatever reason can't keep
ambient light out, fans, chillypad, whatever that may be to
keep the temperature where youneed it to be.
I know some people that swear bywhite noise machines.
It helps them to fall asleepstay asleep.
There's some really fancy alarmclocks out there that actually
have, like, alpha waves and,like, different sounds and

(48:22):
different sleep storiesprogrammed in there, so that
way, you know, they're usingthat to help them fall asleep
and stay asleep.
But those are just some, like,basic ideas of what I recommend,
and there's always ways that canbe elaborated off of that.

Coach Lori (48:33):
I think that's covered the full package.
Some people argue about nothaving a TV in your room, and
especially, again, if you go,goes back to somebody that has.
Tendency to have insomniasymptoms, then the TV should
probably go, not looking at yourphone.
And then, this goes back to thework related thing though, but
making sure that your bedroom isalso sort of stress free and

(48:54):
that could be not so clutteredor something that's going to
stress you out because it's amess and trying to maintain that
environment so it does notstress you out either is going
to also help kind of your braintone down a little bit better.

Coach Ryan (49:07):
Those are great.
I do have a question and thismight be a little tough.
So, what if you're carrying justa lot on your shoulders and
mind, I think a lot of us carryjust stress with us in general,
but you know how that can bewhen you have just a lot of, you
know, work on your mind, familydrama,.
It can be something bigger,right?
Like something, that's more indepth, like you maybe lost
someone, and things are just onyour mind and you're stressing

(49:29):
you out.
Is there anything that you cando to help improve your sleep at
night?
So, Dr.
Toth, I'll start with you.

Dr. Elise Toth (49:36):
Sure.
Anything that's going to help,if the stress is the root cause
of that difficulty sleeping, sowhatever helps manage stress,
whether it's exercise, whetherit's working with a mental
health professional, tomedication or therapy or
whatever, whatever tools in yourtoolbox to help with that.
Also when a patient comes intomy office and is dealing with a

(49:56):
lot of things and they'realready addressing that I work
with an acupuncturist in myclinics, so I if they're not
already undergoing acupuncturecare for a lot of the stress and
the emotional component of it, Isend them across the hall and be
like, hey, I highly recommendyou start off on this because
oftentimes, right, I can throwany herb at them that I want,
but if we're not, if we're notaddressing the emotional
component, which I knowacupuncture does very, very

(50:18):
nicely, the, the co managementof that I find works a lot
better than just, you know,either of us doing it, working
on it solo.
And even just having some gracewith yourself.
Like there, there's a lot goingon in your brain.
There's a lot rattling aroundright now.
And right when we're that ampedup, right, there's a lot of
stress hormones going on in ourbody, right?
Stress hormones are preventingus from falling asleep.
And so it's not any sort ofmoral failing that we have.

(50:41):
It's just a matter of workingthrough those stress hormones.
So that would be feel our bodiesfeel that's in a safe place to
actually fall asleep and stayasleep and allow melatonin to
actually do its thing.
And help us to become tired andbe able to fall asleep
effectively.

Coach Ryan (50:53):
That's good.
Dr.
Koch, what about yourself?

Coach Lori (50:55):
I think it's all about the toolbox as well.
Just making, some otherenvironmental type of things
where, you know, a physicalactivity is something that
relaxes you and you enjoy that.
Then the physical activity is areally good one because physical
activity will actually help youinduce being tired and being in
a, in a better biological rhythmin general.
So trying to make sure thatyou're fitting that in, and

(51:16):
especially if it's somethingthat you enjoy.
just activities that you enjoy,it helps you relax, be cognizant
of that, and then that's goingto also kind of tone down some
of those stress hormones that,are associated with maybe some
people having trouble fallingasleep and staying asleep.

Dr. Elise Toth (51:31):
Something else I just thought about that I
actively resist, but I've beenreading more and more about
having a good cry.
Crying basically balances outour stress hormones, and that's
why we feel very relieved kindof like the calm after the storm
after we cry.
A lot of times we cry ourselvesto sleep is what the, you know,
what the saying is.
So that being somebody I cannotstand crying, crying is like the

(51:53):
one thing I will do anything tonot do.
But it has a time, it has aplace, it has a purpose.
And sometimes that can be theonly thing that, with all the
other tools in your toolbox andnothing else is working.
It's allowing yourself, having agood cry, letting your body work
through the emotions.
And oftentimes we feel really,we kind of exhaust ourselves
afterwards and we fall intothat.

Coach Ryan (52:11):
Yeah, awesome.
We've come to the end.
Thank you everyone for forjoining us.
If you would like to meet withDr.
Toth, she practices out of ourAndersonville and our Vernon
Hills locations.
However.
We do have 18 differentlocations around the city and
suburbs, the whole Chicagolandarea where any of our providers
are happy to help.
If you ever want to meet with,Dr.
Koch, come out to a ChicagoEndurance Sports run and, and

(52:33):
catch her on the run.
Doctors, that was a lot ofinformation.
That's a lot to take in.
So what's one big importantthing, that maybe encompasses
everything that we justdiscussed?
So one bit, one bit of advice.
Dr.
Koch, I'll start with you.

Coach Lori (52:46):
It's just, Make sleep a priority and have a full
understanding of how it fitsinto everything else that you're
trying to accomplish.
And when you make that apriority and understand how your
own body works within that, alot of other things are going to
fall into place even better thanyou think.
And from an athlete perspectivetoo you'll be really surprised
at how much it's going toenhance goals and

(53:07):
accomplishments, that you'retrying to pursue.

Coach Ryan (53:10):
That's good.
Dr.
Toth, what about yourself?

Dr. Elise Toth (53:13):
Yeah, what I always say is, it comes down to
between sleep and exercise,sleep should win every single
time.
It's hands down, it's much more,not that exercise isn't
important, but between the two,sleep is way more important for
all the reasons we have justtalked about.

Coach Ryan (53:27):
Well, thank you again so much to our panelists,
Dr.
Elise Toth and Dr.
Lori McGee Koch for sharing somuch wonderful knowledge.
I love the conversation.
We learned so much today, andeven though we've done this
before, I would keep on learningmore and more things from all of
you.
So everyone hope you enjoyed it.
Feel free to go back and listenagain, but don't forget to
prioritize your sleep.

(53:48):
Pick up those hundred dollarbills.
Leave the quarters on theground.
Thank you so much.
Y'all
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