Dr. Cindy Geyer
Appearances
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Stress itself is not bad for us. It can be good for us. And so just dividing things up in our mind to think about, is this an event? Is this an episode that I can recover from? Or is this a situation in my life that I'm going to live with forever and I have to get used to?
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
So these chronic stressors like having a child with a chronic condition, having a conflictual relationship, job stress, these are the types of addiction, loved ones with addiction, health problems. I mean, years and years and years go on where we need to be coping with it in a different way because it's not about getting rid of the situation.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
The acute stressors are really pointing us to just thinking about the stress response in the moment in dealing with an episode within a day. What does that stress response look like? And as you were saying, when we think about
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
The peak stress response and the recovery and how our body does that, it's like a phenomenally beautiful biological process that we are fully equipped with to have over and over without harm, without harm. And in fact, when we shape those stressors to our body to be short-term, brief stressors,
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
and not, you know, kind of moderate, not too extreme, they're not only not harmful, they're creating all sorts of restorative and anti-aging effects in the cell. And you write about that so well in your book. And that's just, we so easily forget like, oh, we could use this for good.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
We can actually do things like HIIT or sauna or cold exposure and be conditioning our nervous system, not just our cardiovascular system, but our actual emotional and physiological stress response can get conditioned.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
I think it's important to start where you did, which is naming. We're in a different era. We're in a different place. We have our personal dramas. We're trying to manage the inherent stress of life and being a human in this modern world. And then on top of that, we do have this layer of more existential stressors, of global stressors, climate change, war.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
famine, drought, you know, the climate events that are going to becoming more and more frequent. And so how does our human mind deal with all of that at once? we're not quite well equipped, but we're not that far off from being able to kind of adopt a new mindset for this new era and strategies.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
And uncertainty tolerance is core to how we can remind ourselves to not let this primate body overreact, create accelerated aging, make our life miserable, given that we are just surrounded by
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Uncertainty of the future, volatile uncertainty, meaning not just the inherent uncertainty that we don't know what's going to happen tomorrow, but just the dramatic shifts that we're going to see based on climate and politics and how we create societies as humans. So the ability to simply be comfortable with not knowing is now a core survival skill. And we're all different.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
We've come with different levels of what we call tolerance or comfort with uncertainty. And those of us who are on the edge of it, the really actually being intolerant and feeling really anxious about when we can't, we don't know exactly our plans tomorrow, how things will go, that is a tremendous vulnerability factor for anxiety and depression. We've always known that. We measured that.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
During COVID, we followed 500 people and the people who were most rigid about uncertainty and tensed up and couldn't feel ease and relaxation with uncertain situations, they had much more trauma from COVID, fear of COVID, climate distress.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
It's a really good question. We all come with a different level and what creates that level? Part of it is personality and openness to new experience. Part of it is really our life experience shaping us. And so when we've had a lot of early trauma, we tend to actually have more of a threat response to things that happen and to things that haven't happened.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
So that vigilance about ruminating about the past, but also worrying about the future, feeling that more is at stake, feeling more threatened. So there are lots of ways to overcome that. In your diagram of stress, in your new book coming out in February, I love your triangle of understanding all the influences on us and our aging biology.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
And you had one layer of stress that people don't usually think of, which is we're born into this world wired differently because of intergenerational trauma. shaping our epigenetics, as well as our experience in the womb for nine months, the level of maternal stress that we've been exposed to.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
It's absolutely real. Like, I just want to say, we actually, I mean, Rachel Yehuda's work and others have actually shown our stress response system, you know, even three generations out from being from a Holocaust survivor as a parent, as a grandparent, we are different.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
And we now know the pathways, and yet we still don't take it seriously. And that's why it's called the stress prescription, because we're not going to get rid of stress, but there is a way to live with it better that is absolutely medically relevant. It's a prognostic factor for getting mental and physical illnesses. And all of the data, including a recent APA survey, show
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
We are more stressed now than in previous years and decades, but even worse, I think of our youths, like 70% are, you know, reporting stress that they... such extreme stress, they don't know how to manage it, it's interfering with their life. These are really serious red flags. We know what that means biologically.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
It's a leading indicator to the wear, you know, the wear and tear on our cells, on our brain, the conditions we're always trying to avoid. So it's a serious prescription that we don't have to live each day with this excessive level of stress, which really rules out those states that you've been cultivating, which is the restorative states.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
And it's a beautiful example you gave how you are consciously changing them. Because it's not our fault. There's no judgment. We all come out with different levels. That question about why do some people expect... negative things to happen that can't stand ambiguity, that uncertainty feels intolerable. That's part of it.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
It's like partly from how our stress response systems are shaped from all these different influences before our life, including our life starting in the womb.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Yes. So you want to hear about these mind states.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Yeah, we've been thinking about stress from a different perspective, we and others in the field. So usually we think about how stressed does someone get in the moment? How quickly do they recover? And that's important. We want a quick peak and a quick recovery. And that's a healthy, resilient stress response. But it's not just the action during stress, during events, during tough times.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
The question really becomes, what are you carrying in your body and mind when nothing is happening, when you are at rest, or at least you think you are? And that's a window into the unconscious level of stress that we're carrying. So when we talk about uncertainty stress, that's where it is. That's because it's a little bit vague and we can catch that.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Mindfulness, mindful check-ins help us just in this moment, like just ask, are you tensing up? Do a check-in with your body, your hands, your face, your eyebrows. So often we are tensing up. And we sometimes can identify why. And sometimes we can just remember, oh, right now, it's not only okay to relax. It's important for my body. I'm not needing to cope with something.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
So it's that baseline state or rest state that we're learning is really different in people and is a sign of chronic, low-grade chronic stress that we can actually get to and release through different techniques. So red mind is what we've been discussing about coping in the moment when you're fired up and you need the energy, you need the stress response.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
And we just don't want that to kind of go on and on and have sluggish recovery, but otherwise we need that. It's beautiful. It's why we're here today. That's our survival response. And of course, we're triggering it too much as humans with an overdeveloped cortex and the more chronic ambiguous threat we feel. So then there's yellow mind state, which is when we think we are relaxed.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
It's just how are you walking around during the day? Typical day, where are you at? What's your baseline? You probably do some monitoring. You know what your autonomic nervous system is set at. And that is probably higher than we need to be at.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
And so that's what we think of as our default baseline is actually carrying around a lot of both cognitive load from our thoughts, from different information screens demands. So we're a bit activated. Then there's also the unconscious stress that we can become aware of and release. So we want to bring down that yellow mind state to a more true resting state. And that's the green mind.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Yeah. I've learned a lot from monitoring, and I think that's one way to raise awareness as well as asking ourselves to become mindful of our emotions and our bodily, where we're holding stress in the body, where we're tense. The heart rate tells us a lot of things.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
But the heart rate variability we think is more specific to that balance between parasympathetic and sympathetic, so more related to psychological stress, not just metabolic demands. So that's super interesting. So Costa Rica leads you to a different yellow, maybe green mind state, better baseline.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
I monitored my, with my aura ring, I monitored my heart rate variability during a meditation retreat. And we know that when people slow their breathing, immediately they have, they can have a decrease in all the sympathetic activity markers. And sometimes in heart rate variability during studies.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
So it's no mystery that doing these practices and doing them for longer can lead to these improvements. And that those are what we call deep rest states when we're really allowing ourselves to feel safe and to let down and let ourselves go into restorative mode. But I was surprised at how long my heart rate variability, my baseline heart rate variability took to change.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
So it was only two weeks later toward the end of the retreat that my sleeping heart rate variability really improved.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
tools or techniques or doorways other than meditation obviously is powerful but there's there's more than that let's explore that yeah we we have these red mind states that we don't want on all day drains our batteries stresses our mitochondria we have data on daily mood and mitochondria showing it is really sensitive to daily affect this was a um
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
study with Martin Picard of Columbia and we were measuring the enzymatic activity and so when we when People woke up with more positive emotion and went to bed with more positive emotion. They had higher mitochondria which we measure kind of in the middle of the week of monitoring and when they particularly at night. So there's this idea of how are we recovering from the day?
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Can we maintain positive affect at the end of a stressful long day? And we certainly found the chronically stressed participants, these were caregivers, had lower mitochondria overall, but this mood effect pretty much mediated that and overrode that. So that's this pointing us to
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
we actually know how to increase positive affect quite quickly with gratitude exercises and other ways of thinking and being. And so how amazing to think that our mitochondrial activity might be under our control in this short-term way.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Yeah. Well, to get back to your question about the, how do we live a day without chronic stress? So we might think of red mind as like having, you know, drinking coffee all day and just keeping us in that activated mode. And we want that stress response, but we just want to, you know, use it parsimoniously, not take it for granted. When we ignore it, it can just be on all day and rush, rush, rush.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
I mean, rushing and packing our day is probably the most common pernicious way that we stay in yellow and red mind.
The Dr. Hyman Show
Encore: Eat Smart: Quality Foods to Improve Sleep and Reduce Stress
Yeah, that's good. Yeah, they don't have much of that, do they? We must look so weird to them.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Right. Well, there's a lot of the chemical sunscreens like Avobenzone. I don't even know all of the names of them, the chemical sunscreens. And many of those are potential endocrine-destructing chemicals as well. The flip side is, Mark, I'm one of those people who grew up in the South, had more than my share of sunburns, had my first skin cancer when I was 37.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
So I also want to slow down skin aging and wrinkles and skin cancer. So we kind of have to say, well, how do you get the protection you want? without putting yourself at risk. I personally am a real fan of the zinc and titanium, the mineral-based sunscreens, or even just a hat covering your skin, staying out of the sun in the middle of the day.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I mean, I think there's a lot of other things we can do that are going to be safer for us and safer for the planet. One of my favorite one-stop shopping places to learn more about safety levels and which either skincare or sunscreens contain things we do or don't want is the Environmental Working Group. And I know you've been a big supporter of their work for years.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I think they were some of the pioneers really raising awareness. And what I love about them is they have a safe cosmetics database that you can search by type. So you could search sunscreens. Or you could search by brand, plug in your favorite brand and see how it rates to others on their list.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Yeah, so that's another one. I mean, you know, work in the Berkshires, ticks are everywhere. So for those of us who love to be in the woods, you always have to be mindful of enjoying your time in the beautiful woods and hiking. without putting yourself at risk for getting a tick-borne illness. So how do we navigate that balance as well?
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
For people who are super concerned, I don't know how you feel about this, but if you tuck your pants into your socks and put a little deed around where they join, maybe that's enough. I don't know. I don't do it. I mean, I hike all the time.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And the other nice thing about being in the Berkshires, I can come home, strip on my front porch, stick my gloves on the outside, go in and do my tic-tac, because I think that's probably the most important thing. The other interesting piece, though, is there's emerging science-based evidence that some essential oils may be almost effective at repelling ticks.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
There's been some research on lemon eucalyptus oil, on thyme oil, on citronella. So I think that is another reasonable option to try to get some of the tick repellent benefits without causing harm.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Well, I'm glad you pointed out that we absorb things through the skin. So we think we put it on our skin and it's just going to stay on the outside, but it can potentially get inside our bodies. And one of the challenges, Mark, is trying to do good research to actually prove cause and effect when you're looking at some of the carriers or products
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
preservatives that are added to the things like the the cosmetics that we put on our skin um you know our old model of what happens with toxicity is the dose makes the poison you know you have to have massive amounts for it to have a negative impact but there's so many things that are in our skin care products like phthalates or parabens that have been dubbed endocrine disrupting chemicals
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And what that means is even tiny amounts, especially at critical windows may actually muck up hormonal signaling and have long lasting impacts. That's less related to the dose, but the cumulative exposure over time. Um, yeah. So it's hard to tease out.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I mean, you might be having exposures every day in teeny tiny amounts that don't seem immediately problematic, but down the road when you're struggling with insulin resistance or breast cancer or uterine fibroids or thyroid issues, it could be related to these endocrine disrupting chemicals that have wreaked havoc on our hormone balance.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
It's a great question. So, parabens typically are added as a preservative to extend the shelf life of your skin creams or your topical creams. Rancid. Yeah. So you can keep it on yourself for a year or two and it won't smell funny or it won't go bad. And so you don't get bacteria. I mean, some of them are trying to keep contaminants out.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Phthalates tend to be embedded with fragrances to make things smell pleasing to us. So we put them on our bodies and those are also endocrine disrupting chemicals.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
That's a great question, Mark. In studies that are trying to tease out how they influence our health, they often look at urinary levels to see how much people are exposed to. It's a little bit challenging, however, because it turns out that all of us show evidence of exposure to these chemicals.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
So it's a little bit hard to know what to do with measurements other than trying to do it from a scientific standpoint, say, do the levels track with health outcomes? In clinical practice, I have not done that. I don't know if you found it helpful or not. And when I was first looking at it, we ended up coming back to the same recommendations anyway.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
We need to reduce exposure and find ways to support your body's getting rid of them.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Yeah, I think that's really important to understand that there are critical windows or critical timeframes, but it's even more important to reduce exposure. And one of those classic timeframes is when a woman is pregnant. Even little bits of exposures in utero may affect the fetus, and then those impacts persist into adolescence.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
A study a few years ago, what they did, a lot of the data has to be correlative, but they measured urinary levels of phthalates and parabens in women. two different points in their pregnancy. And then when their babies were born, they tracked them for nine, 10, 11 years.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And they found that higher levels of phthalates and parabens in the urine, the daughters of women with those higher levels ended up going into puberty earlier, which now that doesn't prove cause and effect, but you know, sometimes you can't ethically design a study. And when we see research like that, that it does correlate with endocrine challenges down the road, We have to take that seriously.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
We have to take that seriously. There's been some other research linking exposure in utero in particular or early childhood to phthalates and parabens to higher incidence of ADHD-like symptoms in adolescents, so even neurodevelopment.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Again, a lot of the data is correlative and epidemiologic, but we can't really design a placebo-controlled double-blinded trial to willingly expose one group of women and not expose another and track their children for 20 years.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
You know, Mark, before we jump into that, I want to come back to something that you just said about the fat biopsy. And I know that urine levels can sometimes be really helpful at motivating people to say, oh my gosh, I need to look at this.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
But we have to be aware that even if they're not showing up in the urine, if we've had old exposures, they do tend to get positive in fact, and we're not doing fat biopsies on people. I just want to point that out. So don't use an okay looking urine to say, okay, not a problem for me.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
And it's been a concern as well if those are all residing as deposits in fat tissue. If somebody really rapidly loses weight and starts to mobilize all those stored toxins, it could potentially put extra burden on a lot of different processes in the body. So it's just food for thought. And you had... And you have done a lot of podcasts on detoxification, and it really is coming back to the basics.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I mean, how do we get rid of things? We break a sweat by going out in the woods or exercising or sitting in a sauna. We really have to focus on optimal gut function, fiber dense diet, a healthy microbiome and specific foods that support all of our detoxification pathways. We can talk about a few of those. drinking enough water.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
I mean, it's really, I don't know that there is a super magic for these endocrine disrupting chemicals, except it's really important to make sure our detoxifying enzymes have the new chance they need to do their job.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Yeah, we need B vitamins. We need magnesium. We need the sulfur containing amino acids that are rich in foods like broccoli, kale, Brussels sprouts, garlic, onions, the allium family. Um, antioxidant rich foods can kind of fill the gap.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Some of the deeply pigmented fruits and vegetables, you know, similar thing, I think that's come up in other areas, but those are some of the foods that are most important. Prebiotic rich foods that can select out a healthy, robust, diverse microbiome that can also kind of, if we have detoxified and mobilized things can help us get rid of it and clear it out of our system.
The Dr. Hyman Show
Why Your Skin Is Begging You to Heal Your Gut First
Do you have any favorites yourself?
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
It's definitely playing a role.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So sleep is when we're repairing the powers of both the mind and the body. Sleep is when we reduce inflammation, repair tissues. The discovery of the glymphatic system in 2012, 2013 is this passive channel that runs alongside our arteries and veins in the brain that fills with fluid when we're in deep sleep and allows a washing out of debris we may have accumulated during the day.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So all those bad thoughts get washed out? Well, not the bad thoughts. No, but the amyloid plaque, that sticky plaque that we secrete in response to inflammation or injury, if it accumulates, of course, it can damage surrounding neurons and is associated with neurodegenerative disease and Alzheimer's disease.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
It's definitely playing a role. And this concept of bidirectionality, we know that sleep disruption, circadian rhythm disruption, sleep apnea is present in two thirds of people with insulin resistance, prediabetes, diabetes. And it is a chicken and the egg thing. It is driving the bus. We used to think, well, you get the sleep apnea because you have insulin resistance and gain weight.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
But the amyloid plaque, that sticky plaque that we secrete in response to inflammation or injury, if it accumulates, of course, it can damage surrounding neurons and is associated with neurodegenerative disease and Alzheimer's disease.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
But if you have disrupted sleep, your insulins are higher, your cortisol's are higher, your glucose is higher. You're looking for highly processed, quick, energy dense foods and less able to resist them.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
And cancer. And dementia. And flares of autoimmune conditions.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
And chronic pain and fibromyalgia. And anxiety and depression. I mean, it really affects everything.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
but the more you worry about it, the harder it gets to sleep.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Right. So I do think that there's a need to address underlying contributors to anxiety and depression, independent of their impact on sleep. So talking about what's going on, bringing in some kind of breath-based practice, whether that's yoga or Tai Chi or meditation, just to ratchet everything down. That's another important component of it.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
And thirdly, you've already touched on a little bit about the dopamine with the phone, but it's also the dysregulation in our circadian rhythms. You know, we think about how there's been a lot of research about how important it is to avoid light exposure at night, for example.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
But everything we do during the day and when we do it is ultimately going to influence our ability to go to sleep when we want to and get the rest that we want to. So in other words, when we're eating all day long and snacking late at night and watching TV at night, that's signaling. Yes. And on our computers, that's telling our bodies and brain that it's day, it's day, it's day.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So we want to actually could reestablish a consistent circadian rhythm meal timing. So we're having eating earlier in the day and then building in a fasting interval before we go to bed.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
No. Interestingly enough, there's as you know, there's a connection as well with digestive function that eating late at night not only disrupts your sleep, but it's contributing to higher reflux, which can also interrupt sleep. So everything's interconnected.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
It's interesting. They even looked at LED streetlights disrupting the circadian rhythm of animals and insects too. So it's not just humans that are being impacted by this.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Well, one of the conditions is restless leg syndrome. It's hard to diagnose. It's more of what we call a clinical diagnosis. People describe this creepy crawly sensation in their legs or this irresistible urge to rub their feet together. Typically, it's treated with dopamine medications. It's connected to relatively low dopamine levels in the brain.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Dopamine, yes, revs you up, but dopamine also seems to play a role with movement. So it's treated with some of the same medications they used to treat Parkinson's disease. But it turns out that that can be more prevalent in people who have autoimmune conditions, in which case we want to address the underlying autoimmune conditions.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
There are some nutrient deficiencies that are going to make the symptom of restless legs more significant. Low iron, low vitamin D, low folic acid, low magnesium. So we really want to look at somebody's nutritional status.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So if we identify a nutrient deficiency, for example, the next step is why? What's the why that somebody's nutrients might be low? And there we come back, like so many other things, to the function of the gut. And interestingly enough, there is a higher correlation in people who have small intestinal bacterial overgrowth also having restless leg syndrome.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
maybe because it's contributing to ongoing inflammation, maybe because it's also contributing to difficulty absorbing those nutrients from your food. So we're even going to go a step further and say, is there an underlying issue with digestive function, absorption and assimilation of nutrients?
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Right. Lead, mercury, things that that are under the radar for many, many people and unfortunately can be a problem.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
What happened with your sleep?
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Well, I think it's the time to take a history and really understand all of the other interconnectedness that could be going on. For example, somebody with sleep concerns might also have digestive concerns, and then we might be thinking about assessing their digestive function, looking at a nutritional assessment.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
But I think there's a time and a place and there's tremendous value in screening somebody with a portable sleep study because that gives you a tremendous amount of information. And we're using it, yes, to diagnose sleep apnea, but also to say, how often do you wake up during the night? How much percentage of time are you spending in REM sleep and deep sleep?
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Are you tossing and turning all night long? So it can give us a tremendous overview in terms of somebody's sleep throughout the night. And from that, we can also decide, okay, what else do we need to explore?
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So this is somebody that, and one of the things I wanna plant the seed for is sometimes we start with what we think is the most likely issue and we gradually uncover more potential contributing issues and peel the layers of the onion. And this was a woman that I had known for years. She was pretty healthy in terms of her lifestyle. She exercised. She wasn't overweight. She ate a healthy diet.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
She didn't drink any alcohol. She was treated with antidepressants. She was on a serotonin reuptake inhibitor and Welbutrin for her depression. And she was also on hormone replacement therapy. She was post-menopausal in her 60s. And she started complaining of fatigue and difficulty concentrating and just felt scattered. And by Sunday, she would had the need to take a three hour nap.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So well, that's unusual. So we did some of the usual testing for causes of fatigue. We tested her thyroid, it was okay. We looked at her iron levels or sugar levels, they were okay. So I decided to do screen her with a sleep study. And it turned out you would not have looked at her and said, oh yes, she is the poster child for sleep apnea.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
She turned out to have one of the most striking positional components to sleep apnea I've ever seen. When she was on her side, her sleep was normal, but when she was on her back, she had respiratory events that count as either a slowing of airflow or a stopping of airflow more than 60 times an hour.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
That's a lot. No wonder she was exhausted, right? So when you see a positional component like that, I have people who don't want to do a sleep study because they don't want to, I'd never wear that stupid mask. But for her, we said, okay, well, let's start with retraining you to learn to sleep on your side. And she tried that. There's some commercially available positional devices.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
There are all kinds of strategies you can do.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
or the fanny pack with the pillow stuffed in it. Yeah, there's all kinds of strategies you could do. And of course, it's big business, right? You can buy a slumber bump or a bumper belt.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Even more sophisticated, there's now a biofeedback device that's a strap around that vibrates when you roll on your back. So it's sort of autogenic nighttime training to get you. So that's what she used, interestingly enough. And it helped a little, but she was still tired. So as we're peeling the layers of the onion, she had some digestive symptoms, a lot of bloating, a lot of discomfort.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
And we had done a full sleep study. She had restless legs and periodic limb movements. She turned out to have a very abnormal breath test for small intestinal bacterial overgrowth.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Where they don't belong, right.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Absolutely. And low iron. Her iron wasn't terribly low, but one of the sidebars here, I think the other thing we do in functional and integrative medicine is understand the difference between a normal blood test. I should put, quote, normal blood test and an optimal blood test. Ferritin is a classic example of that. Ferritin looks at your total tissue iron.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
In your iron bank, your iron stores, right. And normal can be anywhere from 15 to 250. Yeah. So. It's a big range. It's a big range. And what we know the threshold is for somebody who's got restless leg symptoms is you actually don't want to be normal.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
You want to be over 100 because there's some evidence, even comparing it head to head with those dopamine drugs we mentioned earlier, getting somebody's ferritin over 100 was as effective as the dopamine medications.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
That's amazing, right? As simple as correcting a nutrient deficiency, not to the normal range, but the optimal range for that condition.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
And Mark, I think from the internal medicine standpoint too, it's equally important to say don't just correct the iron, figure out the why. You don't want to miss blood loss somewhere. Absolutely.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
You know, there was one other piece related to her story that I think is also important to call out. Addressing all of those things, her sleep quality was still not what she wanted to be. So we had a conversation and she relayed the fact that when she was growing up, things were pretty unsettled in her home of origin.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
There were a lot of late night parties, a lot of noise and bedtime became a time where she didn't really feel safe and quiet and comfortable. So we also talked about referring her to a life management behavioral therapist to really talk about what it meant to be safe and regaining that sense of being okay being in bed. And I think that goes hidden as well that a previous
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
History of trauma or not feeling safe can also show up with insomnia and difficulty sleeping.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Sure. I think first and foremost, we have to recognize that sleep, you know, you and I trained in an era where sleep deprivation or how little sleep you could get by on was a badge of honor.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So we need to shift that internal dialogue that we all have that, oh, if I'm sleeping, I'm wasting my time and I'm not getting my stuff done. So first, honor the importance of sleep for your overall health and well-being and even your ability to stick to your intentions around choosing healthy foods and sticking to your exercise plan.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Then create a sanctuary that's really conducive for rest and relaxation. dark, quiet, cool, ideally electronics out of the bedroom or turned off if you can, getting rid of all of the light exposures, even your chargers, you know, that had that little light.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
I used to, I had a patient who told me she traveled around with black electrical tape whenever she went to a hotel and she would put it over all the little light sources in the hotel room.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So those two, quiet, calming. And I think this idea that you go, go, go, go, go, go, hop in bed and turn it off like a switch, that doesn't work either. So building in a transition to rest and relaxation. If you can do an hour, that's great. And getting off the devices, not watching TV, maybe reading a book or journaling or doing something, taking a bath, stretching in the tub.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
I mean, there's all kinds of wonderful ways to ease into rest of the relaxation.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
That's my favorite as well. And then you go to your cool bedroom and you do your legs up the wall yoga, restorative yoga position and bingo, you've got your transition to rest and relaxation.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Yeah, that's a tough one. That's a tough one. So the rough analogy is this. It's funny, when they asked partners of people with insomnia how many of them were suggesting that they have a drink to go to sleep, it was about a third of them. So people think alcohol is going to help you sleep. And it might make you fall asleep. But then as it clears out of your system, there's an arousal.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
It can exacerbate hypoglycemia. It makes you wake up. It's going to make sleep apnea worse. If you're a woman in midlife, oh boy, it's a bladder irritant. It's a hot flash trigger. So it's really affecting sleep in a lot of ways. The rough equivalent is there's about an hour of sedation followed by an hour of arousal.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
So if you had a glass of wine at 6 and you go to bed at 10, it's probably not going to impact your sleep as much as if you have two glasses at 8 or like your late dinner last night if you had a glass or two of wine. I had a beer.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
That has another impact on your sleep.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
It's really interesting.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Yeah, absolutely. And we're all different in terms of our caffeine metabolism ability. Some people are really fast metabolizers. I happen to be one of those. But if you're a slow metabolizer, half of your cup of coffee from noon could still be in your system at nine o'clock at night. And most of the time we're not thinking back to that new cup of coffee.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
With food, it's really about quality, quantity and timing of food. It's all three. Yet another area that's impacted with the health of the gut microbiome is sleep. And data is suggesting that people who eat a wide variety of colorful fruits and vegetables
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
tend to have better sleep quality, whereas a highly processed standard American diet is associated with more sleep disruptions and less deep sleep. So quality matters. We already touched a little bit on the timing of eating. So eating your calories earlier in the day also helps re-regulate those circadian rhythms.
The Dr. Hyman Show
This Is Why You’re Not Sleeping Well—and How to Fix It Fast
Clocks in the brain and the clocks in the body that are ideally going to be working in sync with each other, they're influenced by light, by movement, and by food. So when we line all those things up during the day, it's going to help us get the rest that we need at night.