125 Sleep Makes Everything Better: Prioritizing Sleep, Signs Of Sleep Issues, And Practical Tips To Improve Sleep Quality With Founder Of Sleephoria, Valerie Cacho M.D.
I recently had the pleasure of SPEAKING WITH Dr. Valerie Cacho, an integrative sleep physician and women's sleep expert. LISTEN FOR INSIGHTS on prioritizing sleep, signs of sleep issues like snoring, and practical tips to improve sleep quality. Dr. Cacho Has been featured in SELF, POPSUGAR, Wall street journal, MINDBODYGREEN, and more.
“ Snoring...
is certainly not normal. It can be associated with high blood pressure, can be associated with metabolic syndrome, actually can cause disruption to the endothelial lining.”
Find out more about Dr. Cacho : SLEEPHORIA.COM
Main Discussion Points:
- Dr. Valerie's background and what inspired her to start Sleepphoria (00:01:51 - 00:03:08)
- Most common sleep problems Dr. Valerie sees in her patients (00:04:25 - 00:06:10)
- Dr. Valerie's personal experience with physician burnout and changing her lifestyle (00:05:06 - 00:07:00)
- Sleep studies and options for treating sleep apnea (00:22:00 - 00:27:11)
- How much sleep we really need and the importance of consistency (00:28:37 - 00:34:48)
- Tips for improving sleep as a busy mom (00:39:15 - 00:40:22)
- The importance of sleep for kids' health and school performance (00:39:00 - 00:41:00)
- Key takeaways on prioritizing sleep from Dr. Valerie (00:41:37 - 00:43:02)
#sleephealth #womenshealth #sleepapnea #sleepquality #sleephygiene #insomnia #burnout #worklifebalance #integrativemedicine #lifestylemedicine #mindbodyspace #fallasleepeasy
The following transcript is automated:
Dr. Juna: [00:00:00] Hi. Welcome to the MINDBODY Space Podcast, where you can boost your resilience just by listening. Whether you're watching this on YouTube at my fall asleep easy channel, or on a podcast platform, please subscribe and share to support this free evidence-based content curated just for you. I'm Dr. Juna, a board certified radiologist and lifestyle medicine specialist.
I'm here to help you stress less and thrive in today's complex world. Join me as I meet fascinating experts in meditation, neuroscience education, and lifestyle medicine. To get special tips and tools, head on over to mindbody space.com and sign up for the newsletter. Links are below. Today, I am so excited to have Dr.
Valerie Cacho with me. She's an Integrative Sleep md, a women's sleep expert, and a writer and speaker on Sleep Health. She's the Chief Executive Officer of Sleep Foria Health, which is a resource promoting women's sleep health and whole health living. She's an integrative sleep physician and she practices in UA Beach, Hawaii.
We're all jealous, [00:01:00] right? She's a board certified physician. Who trained at the Loma Linda University in California and she's fellowship trained in integrative medicine at the University of Arizona. I'm so excited to talk to her today about how we can all get some restful sleep in these stressful times.
Hi, Valerie. Hello. I'm so excited to see you. Thank you, Valerie. It's so nice to see you. And you're
Dr. Val: all the way in Hawaii right now? Actually, I moved to California, so about almost two years ago. Two years in November, I moved to California. We originally from California.
Dr. Juna: Okay, great. I saw that you went to Loma Linda.
Yes. For medical school, they did all those studies on the Blue Zone, right? Yeah.
Dr. Val: The Adventist pretty healthy diet lifestyle. Yeah. The
Dr. Juna: Seventh Day Adventist. Mm-hmm. Yeah. So Loma Linda's famous for all of that. I wanna talk about how you started Sleep Foria. Mm-hmm. And when you started, I know it was part of a personal journey,
Dr. Val: right?
Yeah, definitely. So, sleep Foria was really an outgrowth of what I saw. Women going through, in my clinical practice when I was living in Hawaii, I was [00:02:00] a medical director for one of the busiest sleep labs, sleep departments in the state. And there was a lot of women coming to see me, really to rule out obstruct sleep apnea or maybe they had insomnia and their doctor gave them some medication and that was pretty much it.
And they were still having a hard time sleeping. And so as I dug deeper into learning about. Really midlife women sleep. There was just not a lot of data out there and just not a lot of resources. And so I felt like Chucks, that's not cool. I mean, I think in in general, women just get sort of outcasted thrown to the side.
A lot of the medical literature research isn't done on women. I think more so now that there's a lot of people discussing it. You know, Oprah has sort of made menopause one of her platforms, which is really helpful. Oh, Oprah has a menopause platform. That's amazing. Yeah, exactly. Yeah. With her and to check it out, Maria Shriver.
Yep. Uh, they, they did a whole panel with Dr. Heather Hirsch. It was pretty phenomenal. But yeah, I think just more and more people are talking about it as, as women get older. I think after we're done having our babies, I feel like. [00:03:00] Like our culture or maybe our healthcare system forgets about us. And I think that's certainly not the case because you know, well if Oprah
Dr. Juna: can't sleep, yeah, maybe we're gonna have some good research on it now.
Maybe so. And you know that's funny what you brought up about the mothering. So you
Dr. Val: have kids, right? I do. How old are kids? I have a three year old and a six year old. So I youngest, oh my God,
Dr. Juna: it's so cute. Okay, so I'm a mom. My kids are like, In college. Oh, that's so nice. I think a lot of us just kind of wake up a lot during the night and then you kind of forget that it's not normal to wake up throughout the night.
So like when they're little Yep. You're oftentimes waking up through the night and then the rest of your life you're kind of thinking that that might
Dr. Val: be normal. Exactly, and I think that's one of my favorite things to talk about. It's because you don't have to be tired. I mean, certainly. If you choose not to sleep for multiple reasons, if you have a side hustle, if you're watching shows on Netflix, you know, that's something else.
But the sleep revenge thing, right? Yeah. Revenge, bedtime, [00:04:00] procrastination. But I think yes. Who our peers, a lot of people our age are just really tired, but it's so commonplace. They think it's normal. Mm-hmm. And I'm here to say that, you know, there could be an underlying medical condition or you know, a disruption.
I like to think of it as a disruption between the whole mind, body, and soul axis. And sometimes that can disrupt your sleep, so, wow. I love that. That's really like the way I approach my patients and some of the information I put online for euphoria,
Dr. Juna: people always say, I'm so tired, I'm exhausted, and they think it's normal.
And sometimes it's even like a badge of honor. Like Ariana Huffington used to always say like, she never slept until she had a Yeah. I don't know, some health crisis. Mm-hmm. So you're saying that we don't have to feel tired on a day-to-day basis? No,
Dr. Val: exactly. No's
Dr. Juna: Really? So even you have a three and a six year old.
Yeah. Do you get your sleep and, and tell us about how you started on this journey? 'cause I know it was because you had your own burnout, right?
Dr. Val: Yeah, exactly. So, It's just so interesting. I think for me, I don't know how far back we wanna go, but a lot of what [00:05:00] you do or what you think is the programming, I think that your parents instilled in you.
Mm-hmm. And you know, firstly speaking, my parents are immigrants. They're from the Philippines. My dad is actually a cardiologist. He's a little older now, so he doesn't do interventions anymore. Mm-hmm. But he was working, I don't know, like. 16, 17, 18 hours a day come home, there would be a stemi. He'd go back to the hospital in the middle of the night.
And then my mom raised three kids and it was pretty much, they were always on the go. She helped him in his practice as well, um, doing billing and office management work. But I think it was just instilled in me that you would just work like all the time. And when I had, um, my first couple jobs being employed for hospital systems, I would just do the same, you know, when I started to have my kids, you know, they go down to sleep, I would just continue doing my notes, continue doing patient messages, read sleep studies till like midnight, and then go back to work 6 37 o'clock.
Tell patients to sleep. And then I started to feel like this isn't right. I feel like such a hypocrite, but I didn't realize that programming was [00:06:00] pretty much instilled and it was just like you sacrificed your health to take care of others. And then it really got to be where I was also the medical director of doing, uh, pediatric sleep.
And I just started feel guilty that I'm taking care of other people's kids and then not even taking care of my own kids. 'cause I would have a sitter come on the weekends so I could, you know, catch up on the studies, catch up on the messages, and really build the program. And I think that just got to me in a sense that.
I'm all about taking care of your health. And then I was able to, 'cause I was just working so much so that whole self-care component and I didn't even realize it was burnout. I just felt numb. Which sounds a little bit funny because I think it's one of those things, everyone around you is working just as hard.
I think I was talking to a cardiologist and sort complaining about, oh, I have 15 notes to do and you know, I just don't like that, how it's like sitting on top of me and he's like, you know what, Val, I have a hundred notes to do. He's like, you just need some person. Perspective. I come in here every Saturday and I'm like, no, that's not cool.
I'm not okay with that. And then the pandemic hit and it was just like, okay, something has got to change. [00:07:00] And it's
Dr. Juna: common, right? For especially, I mean, I myself feel like that, you know, sometimes I get off balance, but it's all about getting back on balance too, right? We can't be perfect. I definitely recommend a lot of things that sometimes I get on and do those things and sometimes I don't.
Like I fell off on my eating schedule for a couple of months, you know, when I was like super stressed. But you're right, what we know about. Our brain and how the neuroscience works of training our minds through seeing our parents. Yes. And how they raised us. Right. So you were talking about those kind of habits and obviously your parents had insane work ethic and that is an excellent thing.
And suffice to say, they're still lot, right? Yeah, definitely.
They're
Dr. Juna: in their seventies, so sometimes it's hard to say, you know, when you see things like that, like. Well, they didn't sleep and they're still healthy in there, you know? But it does take a toll, obviously. And they had a different way of looking at life maybe.
Yeah. But definitely burnout is real. And tell us about what you did to switch out
Dr. Val: of that. Yeah. I felt guilty about my own [00:08:00] kids, but then also I felt guilty for my patients, which also seems funny, but I think it just goes back to my programming. Mm. A lot of it was just self-sacrifice in service of others.
And so I talked to a couple other older physicians within my group, and I remember one pediatrician who was probably working there for 30 years. She was like, Val, you know what you need to do? You need to take 50 minutes every day for yourself. And I looked at her almost in like disbelief. I was like, how am I gonna five 50 minutes?
I can barely have five minutes to go to the bathroom. And that just hit me. And she, and I was like, well, she's been doing this for so long and I'm sure she's come through, you know? You know, peaks and valleys within her own life and she's recommending 50 minutes. So I really started to reflect on that.
That's
Dr. Juna: really nice though. You had a boss like that. And it was just like, I had a boss who was incredibly successful and smart and awesome, but she actually. Told me she didn't drink fluids because she didn't wanna go to the bathroom. She had an insane work ethic, but, but I'm glad that she said that to you.
Yeah.
Dr. Val: Well, I, I, sometimes I think part of this is, oh yeah. I think [00:09:00] part of it's being in Hawaii, you know? Mm-hmm. It's a little bit more chill and relaxed and I'm probably bringing my mainland work ethic there. That's probably why the organization liked me so much. But then the pandemic hit, and then I had my second child and I was just like, With two kids.
There's no way going back to that lifestyle where staying up till 1112, going in early, and then really just feeling like a hypocrite. Telling people to sleep, telling people to exercise, take care of their body and health when I wasn't doing it. And I think that was probably the big turning point. Um, I did practice, I do practice a lot of meditation, um, like self-reflection really just through the, um, integrative fellowship and started to.
Go back to those practices that just got so busy and ignored for so long. And then it's really when you have that time and space, when you give yourself permission to take that time and place space, it, it's just interesting what your brain starts to offer up, where you realize you don't have [00:10:00] options.
But there's so many options available to you and you don't have to sacrifice yourself anymore. And you can help people three days or two days, you know, however, maybe even help them
Dr. Juna: more. Exactly. But also like, I just love that you mentioned this boss, because it does sometimes take an outside voice and you know, when, when they show the research on burnout, it really isn't.
Yes. You can control certain things about your own stress and you know, that's. A lot of what I teach, like changing perspectives and meditation, self-care, exercise, sleep, all that. But when you're in a system burnout research, it's the system that the people you're working for or the system you're working for.
If they don't allow you to take that time for self-care or somebody doesn't say, you know, you should really take 50 minutes for yourself, then. You actually don't have that out. Like you were saying, you said you started to look for things and ways to take care of yourself, but when you're in that system, it can really feel like you're trapped.
So, but I [00:11:00] love that your boss said that in Hawaii. Yeah,
Dr. Val: I remember I had a different boss, my, uh, chief medical Officer and. I think he just asked me how it was going. And you know, I think he seemed to care, but not enough to hire me help. But I just told, I remember telling him there's not enough Prozac in the world for this job.
And then he was like, well, what do you wanna do? And I was like, well, I don't know. And he's like, well, you know what? You could work at Starbucks. Ouch. Well, we love Starbucks, but I was like, I have more skills
Dr. Juna: than that. Yes, you went to medical school and you, you did an into grade of medicine fellowship. Um, yes.
Dr. Val: So I think that helped too. Just like, no. Okay. You know, sometimes when people think, say things like that, it's like, oh no, I'm gonna prove you're wrong. There's so many other things. I have so many other talents, I can figure this out. Yeah.
Dr. Juna: But tell us now about sleep Foria. Yes. And how you got started on that, and how you switched from full-time to part-time.
Dr. Val: I left, I started my own practice, and it wasn't busy in the beginning. And given my whole programming, you know, I, I was itchy to do more. So you just
Dr. Juna: [00:12:00] put up a shingle, like you just opened, you rented a space.
Dr. Val: Yeah, we actually bought some property in Hawaii. So my clinic, even though I'm physically located in California, I do telehealth for California and Hawaii 'cause I'm more established there.
I was there for almost seven years. So I just have a lot of referrals and it's a doctor shortage state, so I feel like they really need me and people are really nice and so. I'm comfortable there. So I do everything remotely. I have staff there, um, and I do that about three days a week, three and a half, depending, and I just hired someone else.
So
Dr. Juna: you're still licensed in Hawaii and California, so that's amazing.
Dr. Val: And if my kids are sick or if we're, you know, they're outta school, then I can just cut back my hours and it works. Pretty fantastically. Yeah. And so my side hustle, or really what I wanna get into more is teaching women about the importance of sleep, prioritizing sleep health, and just whole living.
So ideally they don't have to go into the same place as me, but almost. To know that there are options where you don't have to be tired. If you have [00:13:00] problems with your energy, could it be from your sleep? Could it be from, you know, the way that you're living your life? And PHO is really an online resource.
It's really educational. I do, um, a lot of podcast guessings write blogs. I have a YouTube channel. Um, and all the patient, I, sorry, not patient, I guess public facing material is free. Um, because I feel like. A lot of things that I say in my clinic are things that other women and other people want to hear.
And so it shouldn't just be, you know, the one-on-one interactions I get. Tell
Dr. Juna: me how you got started, like writing, um, blogs for, I know you do some work for MINDBODY Green and things like that, so how did you get started on that? Did you pitch them?
Dr. Val: Oh, that's a really good question, and. I had a friend who left the organization that I was working at before me and she said, you know what, Val, like once you leave all these opportunities come, and I'm like, what?
What do you mean you have some nice
Dr. Juna: people and I'm moving to Hawaii.
Yeah,
Dr. Val: yeah. They're really supportive. And I was just thinking like, what do you like? I didn't understand that. [00:14:00] Like, and I think it's just the energy you put out, it's like what you attract. So soon after I started just a professional Instagram page.
And they got picked up by Athleta. So the, it's the women's athleisure brand for Gap. And they were starting this whole platform called Athleta. Well, and they were looking for a sleep guide. And so they had a yoga person, a meditation person, a mental health person, and they, you know, did their market research and found that women, you know, adult women really wanted to learn more about sleep.
And it was a hot topic.
Dr. Juna: Wonderful. So what did you do for them?
Dr. Val: Uh, create content. Yeah. So videos, um, questions. There's like live questions that we would do, um, short form content. Yeah, it was pretty great and I think it was really that invitation, that opportunity that got my feet wet and I was like, I. I can do this, like people want it because I'm pretty a shy person Actually.
I'm, I'm really an introvert, so I haven't really pitched to people [00:15:00] and I think probably that's the next step where I wanna go with sleep Foria. But yeah, it's just, you know, through connections, through network and it's been great so far. So
Dr. Juna: they, they're reaching out to you like MINDBODY Green reached out to you through at Athleta.
Dr. Val: Yeah, through that partnership. And then you just meet writers and then they meet other writers. And you know, I think one writer, I said, oh, how did you even find out about me? And she's like, oh, I just posted in Twitter. I needed a sleep expert, and your name came up. And I'm like, I'm not even on Twitter, but I guess within the writing field, writing world.
So I get asked by journalists. YouTube and Instagram, and actually Pinterest. I have a, a, uh, virtual assistant that does a lot on Pinterest. What I like about Pinterest is that it links directly to your website. So if they click on your pin, they can go directly and read that blog or go directly and read the YouTube.
Dr. Juna: Do you come up with your blog ideas from like your patients asking you questions?
Dr. Val: Yeah, exactly. I think, you know, knowing who your client is, your customer is, and just, you know, serving their needs. [00:16:00] But also, I have a friend who is a, a nurse practitioner in the menopause space, and same thing. She's like, well talk, make a video about restless leg syndrome, or make a video about melatonin, make a video about clinical hypnotherapy for hot flashes.
And I'm like, okay, because you know, she sees them day in and day out and they're asking the. The questions and then I create the videos and then she just shares it with them. So it's just really fun, collaborative environment. I love
Dr. Juna: it. I love it. So what is the top question that you get, and what is the biggest problem that people have when they come to see you?
Dr. Val: Energy. Yeah. Well, in my practice, sleep apnea, snoring. Um, so their spouse is
Dr. Juna: telling them they're snor snoring.
Dr. Val: Yeah. Their spouse. Or maybe they go on a trip with girlfriends, and maybe they're in denial, but they're, they're snoring. They're snoring, and then they're just so tired despite how much sleep they get.
Dr. Juna: Oh. So from the
Dr. Val: snoring, Yeah, definitely. Or I mean, sleep deprivation is also a big part of it. [00:17:00] Um, but snoring definitely. So as we get older, as women go through perimenopause and menopause, we start to lose estrogen, progesterone, and that really does make our airway more floppy. So the rates of sleep apnea double to triple.
And I read
Dr. Juna: that like you had written, that even just 10% weight gain can cause sleep apnea. And that's, that's very little. So if you're like 120 pounds, if you gain 12 pounds, 12. Yeah. Or it certainly can happen. Yeah. I'm not 120, but just hypothetically. So if you're 150, especially
Dr. Val: if it's dis, I mean it depends on the distribution, but typically it's around the, the neck and throat.
Dr. Juna: I see. So I have to say that, you know, one of the reasons some people don't get sleep, and this is me included, is 'cause your spouse snores. So it was getting so bad. And my husband, I mean, he's the, the best guy, but he was snoring so much. Like I had to, um, actually, and, and there was a miracle cure. [00:18:00] Our dentist gave him this very, very flexible, it's not even like one of his friends was like, go on C P A P.
And we're like, no, we're not doing that. 'cause my husband had a sleep study, which we'll get into 'cause you do those right. Yeah, yeah, yeah. That's, it was not pathologic. It was close, but not Oh, okay. Borderline. Yeah. Like, not even, yeah, he, he just couldn't get past like an actual pathology, which is great news 'cause I'm so happy he doesn't have anything.
Anyways, so he, you know, finally after me nagging him, he finally got this thing, which I guess it costs, I guess it cost a lot. Like, it's like a thousand dollars. I don't know. But it was worth it 'cause it totally stopped him.
Dr. Val: Forno. Oh, that's awesome. It's.
Dr. Juna: Yeah. Plus he lost a little bit of weight. Yeah. Oh, that's good.
Mm-hmm.
Dr. Val: But yeah, those oral appliances, the dental devices, it just moves the tongue forward a little bit. You only really need to move the tongue, a couple millimeters, you know, when you move the mat forward, there's more space in the back of your throat. So, yeah, it's fantastic. Um, it can move the teeth and jaw [00:19:00] around, so hopefully he's seeing a good dentist.
Uh, sometimes it's just positional. I'm actually getting together a talk. For grand rounds in Hawaii about all the alternative options for sleep apnea. And some patients, 50% of their snoring and sleep apnea could be related to position because they're sleeping on their back. Yeah. When you're on your back, gravity's pulling back on the tongue.
So sleep on your side. If you can get adjustable bed, pop yourself up. It's really interesting talking about, um, snoring. There was a recent article that I was reviewing about snoring in women, and the, the premise was, Do women snore as loud as men actually did, you know, check the decibels in the lab and it was like, I bet not.
Yeah, no, they do. They do. They do. Yeah, they do. It's just as loud. It depends on so many things though,
Dr. Juna: right? Yeah. Alcohol. Yeah. Right, because you get the laxity in the throat. Yeah, for sure. And I mean, I investigated this 'cause I, I needed my husband to stop snoring, right. I realized I was being woken up at 3:00 AM and that's, that's tough for me, right?
So, um, and it's like bad for my health. [00:20:00] Then it was reflux. So he needs to not eat close to bedtime and, uh, three hours or so and especially spicy foods or things like that. And then he lost a little bit of weight. Um, and then he has to sleep on a side. I got him like a body pillow because I just wrote a blog, um, sleep position.
Yes. And dementia. Oh, so there is a, a correlation. They don't know if it's causation, but there is a correlation of sleeping on your back and Alzheimer's or neurodegenerative disorders. So they think that it might have something to do with the jugular vein pressure and the drainage with the glymphatic.
Yeah.
Dr. Val: In your brain. I've heard that. Yeah. It just doesn't, well,
Dr. Juna: yeah. See, that's interesting that you talked about the sleep position. So give us a tip about how do you get somebody who's always on their. Slipping on their back to go on their side. Like I got 'em a body pillow and sometimes I have to nudge 'em.
But Do you have any other tips Exactly?
Dr. Val: Well, just, I guess it depends on the type of person you are. There is technology, there's like a belt that you can wear that vibrates and it can sense when you're on your back versus [00:21:00] your size. There's actually apps that say they can do that as well. I like pregnancy pillows 'cause I think they're more comfortable back in the day.
You know, like I said, old enough where we would say, so an old tennis. So a tennis ball into a a t-shirt to get you off your back. But how do you do that? You know, basically you wanna be off of your back. So if you have tennis balls like, you know, vertically in, in a shirt, it'll be uncomfortable to be on your back.
Some people wear soft backpacks and put like a football or a soccer ball. So I, yeah, but there's more comfortable things. There's like things like bolsters, it's like a belt and it's like an inflatable thing, so it keeps you off your back. I'm gonna
Dr. Juna: do that to my husband. Put tennis balls in
Dr. Val: his shirt. I don't think he's gonna like that.
I know that's just, I think pregnancy pillows are probably the most, anyway. He
Dr. Juna: actually cured his story. No, thats amazing. Because I guess, 'cause he was borderline, he did all those other lifestyle things, you know? I even had him singing.
Dr. Val: Oh yeah. Myofunctional therapy, singing musical instruments, especially wind instruments.
They've actually done studies with the dig ou, right. Dig [00:22:00] ou. What's
Dr. Juna: that?
Dr. Val: Yeah. The aboriginal instrument, you know, in Australia, New Zealand goes like, whoa, whoa, whoa. You know, basically it's a huge pipe you have to push a lot of air through, so the muscles of your upper airway, your or pharynx, have to be pretty strong.
And so it's, it's cured like up to moderate sleep apnea studies in Switzerland and Australia.
Dr. Juna: Nice, nice. Okay. I love that. So what about a recorder? Can someone use a recorder, you think? Like what are those little things that, I dunno if there's research
Dr. Val: for recorders. The most research for wind instruments are singing, so people in a choir.
And then, uh, wind instruments typically like the Digi redu, um, like maybe the saxophone
Dr. Juna: or the nice, okay, I'm getting my husband a digit digit ru. Dig.
Dr. Val: You like the sound of that? I love it. I mean, he
Dr. Juna: enjoyed sitting in the
Dr. Val: shower, so Oh, okay. That's awesome.
Dr. Juna: But if you are the snorter, you definitely have to get checked out because.
Could you tell us more about that?
Dr. Val: Yeah. Well, because [00:23:00] it can be associated with high blood pressure can be associated with me, metabolic syndrome, um, actually disruption to the endothelial lining. So snoring is certainly not normal.
Dr. Juna: Can you explain to the general public, like endothelial lining?
Dr. Val: Yeah, so the, your blood vessels, right, can have stress from snoring, right?
Is it from the vibrations? Is it potentially, because you're waking up from snoring, you can have something called snore arousals that can disrupt your sleep, which is stressful for the wash. You just like wake yourself up. Sometimes people
Dr. Juna: do that, and the endothelial lining is the lining of the blood vessels.
So once somebody tells you like, wow, you're snoring. You need to call a sleep doctor and you need to get, uh, a sleep study, which entails you can do it at home now. Right?
Dr. Val: Yeah, definitely. They're, they're pretty straightforward to do. There are some that are so simple. Let me see if I actually have one here.
It just goes on the tip of your finger. It's like a little button where you can just put it on [00:24:00] the tip of your finger. Yeah. This is f d a, approved for sleep apnea. Yeah, it's called the Night Owl. I'm more traditional. I like the flow sensor with the nasal cannula in the nose, the belt around your waist.
Uh, but certainly technology is so good now that this is an option. There's another device called the watch pad that just goes on your wrist and then a pulse oximetry on your finger. So just depending, you know, what's available in your local area. Um, yeah, you know, I think I told a podcast. Um, host once that everybody should get a sleep study.
And she was like, what? I'm like, well, I'm so biased 'cause I see it so frequently. I'm more surprised when the study is normal rather than when it's positive. Especially the people who I see are a little bit older, right? I'd say forties to fifties. If you're above 40 and you're tired, definitely worthwhile to rule out sleep apnea.
It's so easy to do in the comfort of your own home. Um, certainly the home tests aren't a hundred percent, but it's a good enough. Some of them are about 80%, 90%. [00:25:00] Yeah.
Dr. Juna: So once you have some issue mm-hmm. What, what are the steps? Like what do you need to do? Depending on severity, obviously, and obviously all the lifestyle things we talked about, like weight gain, alcohol reflux, all those things.
Dr. Val: I think one of them too is if you have allergies, you know, get that cleared because certainly a lot of times snoring and sleep apnea in the tongue. But if you have a lot of nasal, nasal congestion, um, you know, treat that. And if it really is moderate to severe, meaning if you have difficulty breathing greater than 15 times an hour and up, you have a higher risk for things like high blood pressure, regular heartbeat, heart failure, strokes.
So those folks should really be on the C P A P machine. Um, I know it's not comfortable, it's not sexy, but it really does in fact work and it can make you feel better. The number one reason why patients have a hard time or people have a hard time is 'cause the mask doesn't fit well or it's uncomfortable, but there's so many different types of masks out there.
So, you know, I always say give it a good college try. Um, there are oral appliance. You can see dentists. Um, [00:26:00] for this, there's actually a newer type device that's actually been around for 10 years, but now it's covered by insurances. It's the hypoglossal nerve stimulator. So what happens with that? It's an implant, sort of like a pacemaker with a wire that goes near the lungs.
So when it senses your lungs moving, there's another wire that goes to the hypoglossal nerve, which is the motor nerve to the tongue. So instead of your tongue falling back, it gets it a stipulation to move it forward. So my people in Hawaii say, you look like a gecko because your tongue is moving forward.
Instead of, oh my god.
Dr. Juna: Do you, so they implant this, where does it go?
Dr. Val: Yeah, they implant it in the right chest, sort of like a pacemaker. They put it on the right side. So in case you need a pacemaker on the left, you have that space. But yeah, it's just in your right chest. That doesn't
Dr. Juna: sound good to me. No,
Dr. Val: but I would, I, I can tell you, I saw a lady recently, she struggled with sleep apnea for over 10 years.
It runs in her family. She tried the mask, she tried the mouth guard was only sleeping four or five hours, five, four to five hours a night. Now with this device, she can [00:27:00] sleep eight hours. She can go on trips with her girlfriends and they're all happy 'cause she's not snoring.
Dr. Juna: That's amazing. It depends on your, the severity and like how much you can change your lifestyle or not.
Right. Because honestly, if you can't sleep well, then you also can't lose weight, et cetera. Yeah. Okay. So Valerie, tell us more about being a mom and, you know, what are you teaching your kids now that you know all of this? I mean, so when I had my two babies, my first baby, it's been like this ever since birth.
So even as a baby, he really didn't want to nap. Like I think six months. He dropped his second nap. Like, he just wouldn't sleep. And he was fine. He's super high functioning, no issues. He, he still doesn't need as much sleep. You know, my daughter, on the other hand, she was born at like 5:00 PM she had to go to bed at 7:00 PM every single night when she was a baby.
Or you would think that she was, somebody was being murdered because she would scream like, and she's still like that. She's very. [00:28:00] You know, scheduled and she needs her sleep and now she's at college. And that's like kind of been messed up a little bit and caused her problems. So people definitely have a range, right, of like what they need and some people are on the border edges, but what do you think, like you've seen so many people that, um, do you think that there is a little bit of controversy coming out now, like that you actually need eight hours of sleep and.
Some people who sleep more than eight hours, they've associated with increased death. And then, so I'm wondering, do you really need seven hours of sleep or is it the quality of sleep? Like what is it that we need or do we not know yet?
Dr. Val: That's such a good question. Well, it always depends, right? In medicine, the answers are, it depends on who you're looking at.
So I. I would say for adults, right? 18 years and above, the research does show seven to nine hours in terms of mortality or morbidity, right? So death or being sick. [00:29:00] Um, but where are you along that curve, right? So less than seven is certainly not ideal, but from a cardiovascular standpoint, people who have high blood pressure, regular heartbeat, really the studies show at least six hours and above is beneficial.
So sometimes, I don't like people to feel like so guilty because they read something online. It's like, oh, if I don't sleep eight hours, I'm gonna develop dementia or cancer. And then they're so worried that they can't sleep and it causes insomnia. So I sort of try to give them, well, you know, where are you along the spectrum?
And some days it may look a little bit different than others. You know? The question is, how do you feel when you wake up in the morning? Do you have enough energy to get through the day? Do you need to nap? Do you need to drink more caffeine? Certainly for me, I do feel better between eight, eight and a half hours, but I also have big tonsils and I have sleep apnea, so having big tonsils can block up the airway.
And now that my three year old son is sleeping independently in his room, um, I've been. Putting my c a on, and I do [00:30:00] notice I feel a lot better, especially in the afternoon. So there is something to it. Yeah. I do use the C P A P. I'm a little bit nervous to get my tonsils out because I have a lot of patients who have them removed and then still have sleep apnea also.
Dr. Juna: Like they've stopped taking it out so much because they've noticed that. It doesn't really help stuff like you said, so it may
Dr. Val: not be a cure-all, and it's really, really painful. So
Dr. Juna: you use a C P A P, so what's the downside of C P A P though? If it's forcing air in, is it causing any hypertensive issues like pulmonary or any downsides?
Dr. Val: No, it really shouldn't. I mean, if you don't clean it, it's a little humbug to clean. 'cause there's, you know, different parts in the hose and if you don't use the right kind of water, there can be calcifications and all that stuff goes into your lungs. You could get infection then. Awesome. Yeah, certainly you can get infections.
So I'm a little bit cautious in like, immunosuppressed people who use it and you're like, you gotta be really good about cleaning it. But generally there isn't. I mean, some people who have a mask and they move around a lot, they make it really, really [00:31:00] tight, and then they get headaches and pressure can push on their jaw.
Um, but I would say there are workarounds for that. You know, there's little, it's, there's a lot of nuances to medicine and especially sleep. Finding a mask that's comfortable for you, making it a little bit loose, lowering the pressure. I'm always about some treatment is better than no treatment. You know, if you can enhance the quality of your life by getting, you know, a little bit more sleep, then that's, um, certainly good.
Dr. Juna: But I think going back. Sounds like somebody should invent a better um, mask or something.
Dr. Val: Yeah. You know, I think they're working on it in University of Michigan, but I think they're trying to look into facial recognition where they can actually like three d, print a mask based on.
Dr. Juna: Your face. Nice. What about just like increasing the oxygen level around your head?
Does that work?
Dr. Val: No, because you need forced air. So you know those balloons with like the waving arm balloons usually by car dealership. That's really what it's, because if you imagine like your throat collapsing at night, we actually have to force air in because some people, you know, don't wanna use a mask.
So they're like, can I just have oxygen? But it's like, [00:32:00] yeah, we can give you oxygen, but at the same time, if your tongue is blocking it, the air can't go through. So it's not like the same. Yeah.
Dr. Juna: If you're not sleeping, then even that 10% weight loss that you need to do that might actually be a problem because we all know that now sleep has a lot to do with metabolism and weight loss and hunger issues, right?
Like with ghrelin and definitely
Dr. Val: ghrelin and leptin. Ghrelin makes you wanna eat more LEP to break putting the break on your appetite. So leptin makes you feel full. Yeah. And we know that because they slept deprived college kids and they tend to eat more junk type foods because it's quick fuel. And then, you know, nurses who work night shift tend to have higher bmi, um, more metabolic syndrome
Dr. Juna: because we mistake it.
Right. Because we mistake that tiredness for like needing food or something.
Dr. Val: Exactly. Yep. And when you're up longer, you just, you have more opportunities to eat
and there food around. Yeah, exactly. There's not.[00:33:00]
Yeah, but I think going to question about your hours. Is it the duration of your sleep? It's a couple things. So there was a study that I reviewed about kids in college and during finals week, those who actually slept eight hours, uh, reported better sleep quality. Um, and then also were more consistent.
'cause that's one of the things, a lot of us. You know, college kids and probably working adults. What we tend to do is maybe shortchange ourselves on sleep during the week and then try to make up for it on the weekends. Um, or the same thing too, you know, sleep, you know, uh, the minimum amount during the week and then stay up later on the weekends.
We call that actually social jet lag, and your body actually doesn't like that, where creatures are routine. The more consistent we can be, the better it is overall. Um, and m i t, they took a hundred chem students and they put a Fitbit on them and they said exactly the same thing. Those with consistent sleep, those who slept longer and actually for them they'll slept [00:34:00] longer, was a little bit over seven hours.
So what doesn't necessarily have to be eight? And also reported better sleep quality, like did better. And the variance was about 24% did
Dr. Juna: better at at school, right? Got better grades.
Dr. Val: Yeah. If you want that edge, exactly. If you want that edge, try to get at least seven hours. Be consistent. And, you know, make sure the quality of your sleep is
Dr. Juna: good.
And by consistency we mean like within 30 minutes, right? That's like the C B T I for insomnia. 30 minutes. But what about within an hour even, right? That should be good enough if you don't have insomnia.
Dr. Val: Yeah, it's so, it's so funny. Like I am. Like really strict. Someone like, oh, okay. Within half an hour I have a friend who's a pediatric sleep doc and she does more adolescents and teens, and she says, okay, within an hour she gives a little bit more wiggle
Dr. Juna: room for things.
Kids. Yeah, because it's almost impossible. I mean, like college life. Wait till your kids get older. I mean, it's so hard, but I love going into this performance part, so, so memory consolidation with [00:35:00] naps. Naps will help you, uh, memorize things that you didn't know very well. Whereas it will actually, you will actually forget things that if you're just napping throughout the day before a final, you might forget things that you already knew.
The naps really help you with the things that you kind of know. You need that six to seven hours of sleep continuously to get that the knowledge that you know already to consolidate. 'cause your hippocampus is like playing it like a tape recorder onto your cortex. So that's what I thought that was fascinating.
I did not know, I think it was the m i t researchers who wrote that. Pretty sure.
Dr. Val: Yeah. MIT's great. I think it's all about, you know, memory consolidation. And I'm old enough where I remember filing cabinets. The way I think of it is your brain at night is putting all the files away where they're supposed to go.
I love that. And if you're short changing yourself on sleep, you're gonna, you know, miss that consolidation and what you are looking at before you go to [00:36:00] sleep. Also gets like filtered down from your conscious to your subconscious. So it's really interesting, you know, so. Let's say, I dunno, have you heard of Tara Swart?
She's a, she actually works with, at m i t, she's a neuroscientist and a psychiatrist. Um, she wrote a book called The Source, but basically it's a, it's a neuroscience about like manifestation and so she recommends for her clients, um, she does executive coaching to take your vision board or your action board, however you call it, and look at it at night before you go to sleep.
Those visions, those pictures that you see will filter down and it's like training your brain. This is what I'm gonna think about at night.
Dr. Juna: So it's like integrating into your, um, long-term me memory. Short-term memory, yeah. Oh my God, that's so cool. Because everybody always ask me about manifestation. I was out with some friends and they were asking me about that.
I'm like, well, so, 'cause my research was in neuroscience. Oh, okay. When I was in medical school and um, I, I worked in the [00:37:00] m e G lab. I don't know if you know the magneto encephalopathy. It's like, oh no. It measures mag magnetic waves from your brain. And they still use it for research because the timing.
It's so specific and in milliseconds you can see where there's activity, whereas it's like, oh, the m r I machine, there's a lag. 'cause they're, they're
Dr. Val: just looking at blood flow. Oh, uhhuh.
Dr. Juna: I was like, well, manifestation is really, you know, your brain starts to pay attention and focus on something you're interested in and so therefore you start to see things that you're interested in.
Yep. And so let's say you decide, oh, now I'm interested in sleep medicine. Yeah. You start to like read uh, Valerie's blog and then you start to listen to this podcast and. All of a sudden you meet people who are in sleep and you're like, wow, this is happening. Like, look at all these people I'm running into.
But it's actually your focus, your attention and, and what exactly what you're looking and open to, because obviously we can't, we can't, um, We can't make sense of everything that comes in sensory wise 'cause that would be overwhelming. [00:38:00] So I, I love it. I'm gonna get that book. Yeah, that sounds great.
Dr. Val: It's very smart.
Let me send it to you. Mm-hmm. It's a great book. Oh my God, you're so sweet. Send me your address. Sweet. Yeah,
Dr. Juna: you're the sweetest person. I love it. I can't wait. I hope to meet you in person. Yeah. Let know
Dr. Val: Kelly, or you're in New York that.
Dr. Juna: Connecticut? Yes. Do you ever come to New York?
Dr. Val: No, I'm, I'm, I'm sort of like a West Coast bratt.
Like I stick to Canada. I Okay, well, you, I, Hawaii
Dr. Juna: because of Hawaii too, right? Yeah. Wait, you grew up in the west
Dr. Val: coast? Yeah, I grew up in Northern California.
Dr. Juna: Okay, well you gotta come visit New York with your kids. So I was there in December, so next time I go out there, I'll, I'll let you know. Oh, that's good.
But let's go back to so high achieving Yes. Professional, which you are. Um, and your kids are probably, you know, like you probably care about their schoolwork and all that. 'cause you're, I know, physician moms and lots of other moms, uh, but physician moms in specific, so, About their health and wellness?
Mm-hmm. Like what can you tell your [00:39:00] kids? What are you gonna tell them about the positive impact that. Sleep can have not only, you know, on their grades, but like relationships, their, you know, happiness. I mean like what would you tell your kids
Dr. Val: or already do? It's so funny, and I already do, I think it was my daughter who's six when she was two years old.
I was basically telling her the connection between sleep and emotions. You know, she's a little bit more of a sensitive kid and I think early on she picked up, when she didn't sleep, she was a lot more angry, like she would have more tantrums. And so yeah, we read a lot of books about emotion and emotional regulation, so I'm like, if you wanna be in a better mood, you gotta get better sleep.
Because it just makes you feel better's. Awesome. And so that's certainly something I wanna teach her. Um, you know, she doesn't have a lot of homework yet, but yeah, I think I'll send
Dr. Juna: you this link for, um, there was a study showing like, The brain and how it works and emotional regulation. Mm-hmm. For on subjects who had sleep and subjects who didn't.
So, you [00:40:00] know, I'm going to make it like into a little kitty thing and send it to you.
Dr. Val: Yeah. So they, I think they know daughter, they know that's how important sleep is and Uhhuh. Yeah. I tell them I help. I help parents and kids who have a hard time sleeping and how important sleep is. 'cause it makes you feel better.
Yeah. It gives you more energy to play. You'll have more fun if you're well rested. Yeah. Mm-hmm.
Dr. Juna: And then sports, like I guess your kids are little still, but. If you're an athlete, sleep is a big deal, right? So
Dr. Val: important for, yeah, I mean, the studies are from the uk, some of the football teams, the soccer teams, where if they are traveling and then they do some of their exercises, um, and then they take a nap during lunch, the ones who take a nap and then do the afternoon exercises are less likely to, you know, get injured.
Um, you know, they're. Times are better, their performance is better because your muscles need to relax and rest too. And recover. Yeah. Mm-hmm. So sleep is really for
Dr. Juna: recovery. Yeah. That's [00:41:00] amazing. And they had that study with the um, tour de France right? Where they just tweaked sleep. Mm-hmm. And that whole team did so much better and it, that's all they had to tweak.
Wow. Because they're talking about one variable microseconds, I guess. Right. Like one hair on their leg, slowing them down.
Dr. Val: It's amazing. 'cause sleep is free. Right. It's accessible to all of us. I, I'm so sorry, Tina. Well, I think people don't think it's free. They, oh, you have to go think I do. Oh gosh. Have a patient.
I know. I'm sorry. I can't talk.
Dr. Juna: Alright, can we just wrap up two seconds? Sure. Okay. So, um, one more thing ju Oh, can you give us a key takeaway from this? Like, if you had one, two, or three things that you wanna tell people, like tricks, tips, what would you say? Yeah,
Dr. Val: so, My biggest recommendations around sleep is to figure out how many hours you need to feel good.
And then we talked about this earlier. Is it seven? Is it six and a half? Is it nine? And the way you know [00:42:00] is you feel better the next day, right? You can do the work you need to do efficiently. You're not wanting to nap. I think that's really important. Self-awareness is always number one. And then can you, after that figure out.
The best timing for your sleep. Oftentimes, I see a lot of people who try to go to bed at eight o'clock or nine o'clock maybe, because that's when their family goes to bed, um, or they need to wake up really early to commute into town for work. And then on the weekends they don't go to bed till midnight.
And so. For three, four hours during the week. They're so frustrated that they can't sleep. But it really more is more of an issue with your circadian clock. Mm-hmm. And there's ways that you can actually shift your clock. So figure out how many hours you need and then match it with your own innate.
Internal clock with your circadian rhythm. That's super helpful. Probably the last is prioritize sleep. You know, we talked about how important sleep is for your brain health, your cognition, your performance, but really sleep. You know, I'm so biased, but sleep makes [00:43:00] everything better. Um, your heart health, even for women who wake up urinating at night, you know, it's nothing that.
I really touch on, but obstructive sleep apnea can lead to nocturia. And sometimes if you don't even snore, you don't think you could have sleep apnea, but waking up to urinate two to three times a night is not normal and it could potentially be from your airway, so, wow.
Dr. Juna: Yeah. So there's sleep like basically affects every single part of your life.
Everything. Everything. I mean, if you know somebody who doesn't sleep and is alive, you don't, that's why everybody needs sleep. Everybody needs sleep. For sure. This was so much fun talking to you. You just like have the most amazing energy. I feel like I made a friend and that's always the best thing about doing this podcast.
Oh, you're so kind. More questions coming up. So I know you have to see a patient so. Maybe I can send you those questions and you could just send me a recording, like an audio recording,
Dr. Val: or we can do a part two. I'm happy to do a part two, guess because we didn't even go to like actionable steps on like what to do.
Yeah, let's do it. Let's do it.
Dr. Juna: Okay. Talk soon. Bye. Thank you so [00:44:00] much for listening. Forward this to a friend, a family member, anyone who needs to stress less, and soon enough you'll be surrounded by more Zen people. Your support is literally what makes this possible. Subscribe and head on over to YouTube to my fall asleep easy channel.
Sign up for your updates@mindbodyspace.com and get special tips into your inbox once a month. Until next time, this is Dr. Una wishing you wellness.