Episode Transcript
[00:00:00] Speaker A: Foreign.
Welcome to the Comeback with Boomerang Healthcare, your podcast for relief, recovery and restoration. I'm Dr. Peter Abachu.
[00:00:21] Speaker B: And I'm Dr. Sarah Guzet. As doctors, we know healing isn't just about treatment.
It's about having the right tools, mindset, and support to move you forward.
[00:00:31] Speaker A: You can have pain, you might be injured, even hurting on the inside, but with all that you got going on, you can still have a really great life. And that is what we are here for. This is the Comeback. Let's get started.
[00:00:46] Speaker B: I am excited about today's topic as it is something that I talk about all the time and definitely something that I personally value, and that's sleep. How are you feeling about today's episode, Peter?
[00:00:59] Speaker A: Well, I would say that next to pain that patients, you know, come to to talk about, the second biggest complaint my patients always have is they can't sleep well. And, you know, one in seven Americans have insomnia. It's a huge problem in our society. It seems like it's getting worse, not better. And I'll tell you, Sarah, when I was talking about preparing for this podcast, I was talking to my wife, and she said, I have two guests that should be on the show with you. I said, who's that? She said, the two people that have to sleep with you guys. I'm like, okay, I'm sorry about that.
So hopefully we can dive into.
Into sleep, what it's all about, and, you know, how to sleep better, because that's what we all want and maybe how to make it better for whoever our partners might be who are trying to sleep at the same time. We are.
[00:01:56] Speaker B: Absolutely. Absolutely.
Um, and so I think it's always important when I talk to. To patients about sleep. And you're right, it is definitely one of the most common issues that individuals have. Sometimes they don't meet the full criteria for insomnia, but sometimes it's really just disruptive and it's broken. Pain interferes in the way, or they develop this, like, broken pattern that's hard to get out of. Sometimes we have anxiety getting in the way. All sorts of things are going on. But it's always so important just to get down to why it's why sleep is so critical.
[00:02:30] Speaker A: I always ask patients the first time I meet them, hey, how's your sleep? And a lot of times they'll look at me and say, well, I don't, you know. And, you know, it's such a huge problem in our society and certainly with our patient population.
So, Sarah, when you're Working with a patient and, you know, sleep is a big concern.
How do you explain what is it? What is sleep? Why do we need to sleep and why is it so important to our health and our longevity?
[00:03:05] Speaker B: Great, great questions. And so one of the things that I always talk about, and everybody kind of knows, knows this from experience, which is you feel rested when you sleep. Your body truly gets an opportunity to slow down. It slows down, right? We know that it slows down breathing, it softens and relaxes muscles. It helps our immune system. And for a lot of our patients in chronic pain, I point out to them, sleep is so important, it also speeds up recovery and healing.
And especially if they're working with PT or in a rehab program, sleep so important that they're getting that time to recover. Because oftentimes I get patients tell me like, my sleep is lousy, and I'm kind of just like, they're defeated. They're like, I've tried a couple apps or I tried, you know, I tried over the counter sleep aid once and it didn't work. And therefore I'm, I'm, I've just accepted this as my sleep. And I'm like, no, please don't. You know, because it's so important for our mental health, our physical health, our immune system, our, the way we learn and encode, and our memory and cognition all process so much faster when we sleep. Not to mention we're a lot more pleasant the next day when we get sleep. Speaking as a significantly sleep deprived mom, when I first had the twins, I am lucky my husband is still here because that was some serious sleep deprivation. And things that didn't upset me would upset me. I was emotionally easier. Some of that, of course, was postpartum. But like that, sleep deprivation, I was like, oh my goodness, everything hurts all the time.
And it was just so exhausting. And all you want to do is sleep, and then when you lay down, you have a hard time falling asleep and staying asleep. And so I bring it back to the basics of sleep is so important.
Let's see what we can do. And there's so much that we can do to help individuals with sleep. And so I'm curious, how about for you, Peter, what are some of the things that you talk about with your patients and why sleep is so important?
[00:05:00] Speaker A: Well, you know, I like to, you know, break it down a little bit into your, your emotional health, your physical health, your cognitive health.
So we know that our brains consolidate information. We learn better, we, we function better mentally when we sleep at night. And in particular, there's certain stages of sleep that help facilitate that process.
So I like to talk about that with patients, about how we learn and how we focus, because everybody's having a harder time with that when they're, when they're hurting.
And it seems like it's that REM sleep cycle, that rapid eye movement cycle that's really critical to forming neural connections to retain information.
So good quality sleep becomes really important part of that. And, man, I think nothing ruins your mood more than a couple of bad nights of sleep, you know, yet we, we all get them, and I think we can all relate to that. So our, our emotional well being, our ability to communicate and connect with others, I think is directly impacted by our sleep.
And then the biggest thing is a lot of research seems to show that how we feel pain, how we experience pain is influenced by how well we, we sleep at night. And when we don't sleep well, we're more sensitive to pain. You know, during the day, we're more likely to experience more intensive levels of pain. And so it becomes like this vicious cycle of the more we hurt, the less we sleep. The less we sleep, the more we hurt more the next day. So, so trying to get a lid on that and a box around that and getting that under that whole process, breaking that cycle down, becomes an important part of, I think, how we want to help patients just feel, Feel better and feel more.
[00:07:00] Speaker B: Well, absolutely. And I, I like what you pointed out about that, that cycle.
[00:07:06] Speaker A: Right.
[00:07:06] Speaker B: And I kind of compare it, you know, those, those cycles start and they are kind of sneaky where we're not, you know, we're in pain, something hurts, our sleep is disruptive. Maybe it's a lot of little bits of sleep. And I get a lot.
Tell me, I'm in bed for eight hours, I'm like, but are you sleeping? And what happens is it starts being so disruptive now they're in pain the next day, the pain the next day makes it worse, and that spiral becomes downward. But I think it's also important to remind our patients it can also be an upward spiral. And you're not going to climb out of this so quickly. And so the things that, you know, the tools that we'll talk about today and the things that you can learn, whether it be, you know, through therapy or by practicing, some of the things that we're going to discuss can be so helpful. But it is going to take a little bit of time before you start to see that pattern. But it can be an upward spiral as well.
[00:07:56] Speaker A: Yes. I'll share one story.
Some of my sleepless residency nights when I was doing my anesthesia residency, we would work all night long, usually with minimal sleep break. And then by the morning you would, you'd be done and you'd be able to go home. And I remember after one of those all night calls where I've been working all night and when, you know, when we would take call at LA County Hospital, it was pretty intense trauma. You know, you're kind of resuscitating and you know, people who are shot or, you know, stabbed and all night long, you know, and so you go through this process. And then I was, I was driving home to my apartment and I, I was living in Pasadena at the time and I was driving in an intersection and to make a turn and I fell asleep in my car at the intersection.
No, I did.
And luckily someone started honking at me and I woke up and I looked up and it was one of my classmates in his car. And so it kind of, kind of woke up and started driving again and. But yeah, we'll talk more about, yeah,
[00:09:06] Speaker B: thank goodness it wasn't worse. You got home safe. Talk about a little wake up call.
[00:09:11] Speaker A: Yeah, yeah, I have a few funny stories about that. But
[00:09:17] Speaker B: so, yeah, the cycle can be sneaky and sometimes you think you're, you know, safe enough to function, to drive, whatever, and that sleep deprivation, it will catch up with you. And so let's, let's start by doing a little bit of myth busting. One misconception I hear all the time is that we, we need eight hours of sleep.
What are your thoughts?
[00:09:37] Speaker A: That's never gonna happen. How much, how much sleep should we get? Sarah?
[00:09:42] Speaker B: So research shows that sleep is not a one size fits all. It's anywhere between six to nine hours per person. And for some individuals it can even be out of that range. But most individuals on average need between six to nine. And the truth of the matter is when I'm working with patients and they're telling me how bad their sleep is and I'm adding up all the bits of sleep in their little pattern, I'll ask them, what was your average before you got injured?
What was your baseline normal? And it might be. And I've had a lot of, for example, I get a lot of individuals that have like shift work at, you know, odd hours. And so they're like, I do the overnight, I'm a nurse in the hospital, right. Like yourself, they were doing a lot of overnights. And so they'll tell me, they're like I can't sleep past 4am to save my life. And I've always been that way. And I'm like, okay, so is five hours your average? And they tell me, yeah, I feel rested. I didn't nap. I was like that for, for 20 years. I'm like, all right, that's your normal. Now that's my goal, to get you closer to that. And so it totally varies.
And for some individuals, if they get a minute less than nine hours, they're a bear to be with. So it completely, completely fluctuates, one for the individual and two, for the time of their life. There are different periods of your life where you might need more sleep or you might need less.
[00:10:55] Speaker A: Age matters, right?
[00:10:57] Speaker B: Absolutely. Absolutely. And so we know that, right? For example, infants need a lot of sleep. If you're lucky, they'll give it to you too. And then you go into the adolescence and they need even more because you go through this dip where, you know, when they're elementary school age, they're closer to nine hours or 10 hours. And then you go back into high school. And what we found is they actually need more sleep.
[00:11:21] Speaker A: Bodies are growing, brains are growing.
[00:11:24] Speaker B: Absolutely. I mean, that frontal lobe doesn't fully develop until 25.
And I've definitely met some young adults where I could agree with that.
[00:11:32] Speaker A: I'm still working on mine.
[00:11:35] Speaker B: You're such a young spring chicken. You got time, Peter. And so they absolutely need more sleep, which is one of the reasons why there was so much criticism with school starting earlier and earlier. Right? School starting at 7 with a practice, maybe even in the morning at 6, where parents were like, that's it. My kid's, you know, so sleep deprived. And so that culture of, you know, grind and hustle is not healthy. Some individuals, and sometimes of our life, we do need more, and you might need less. And then as we get older again into our later years, the geriatric population, right, we see more sleep changes. And so a big part of that is to be aware and to listen to what your body truly needs. Because one of the things that makes sleep worse is stressing out over it.
[00:12:19] Speaker A: Amen to that.
[00:12:20] Speaker B: Yeah. So. So, Peter, tell me a little bit about what, what where you common start, where you commonly start with patients, when you're working with them, when they're telling you that they're having sleep, what's next?
[00:12:33] Speaker A: Well, you know, there's usually a few reasons for the problem. One is usually people are stressed about their situation, right?
They're not getting better. They're in a lot of pain. Time has passed. They've maybe already tried different treatments or things. And there's this, this undercurrent of anxiety about, you know, I'm not getting well, I'm not earning money like I should, or I'm not, you know, doing sports. I should be. You know, there's all these things.
So we, we start to have the chatter, you know, in the brain that stands in the way of, of sleeping good. So we have, you know, how do we, we kind of calm the, the nervous system and the processing, you know, the cognitive processing about what's going on, how can we, we shift that? And then of course, you know, what things can we do with the physical body?
You know, we're gonna have a treatment plan to help your body rehabilitate, move better, get stronger, you know, maybe address trigger points or problem areas. You know, so we're gonna have a, a physical treatment plan, you know, for the physical body that hopefully will eventually lead to a body that can relax and sleep better. So, you know, part of putting together a plan to, to getting well is helping somebody sleep better because nine times out of 10, they're not happy with how they're sleeping. So it, it's gotta be part of the plan.
[00:14:10] Speaker B: Absolutely. And I will say, having worked with a variety of populations as, as have yourself, I'm sure, seen time and time again, that's something that a lot of healthcare workers miss is asking, how is your sleep? And I think once we get that, I always refer to sleep as the foundation to your health. If I get your sleep to improve, everything else, to start to fall in line will be so much easier because now your foundation is solid.
[00:14:38] Speaker A: So. Sure. One of the challenges that I have when I, when I want to address this is I think the key to helping people sleep better is to get them working with a behavioral health person. You know, it's so critical, the work you do to improving this specific topic along with, of course, other aspects of their, of their health.
You know, sometimes I gotta explain that a little bit so that they understand, hey, this is gonna be really helpful for you, and part of that's gonna help you sleep better.
Maybe talk us through a little bit about when you start working with a patient and they're not sleeping good and they're probably dealing with other challenges as well.
Talk us through that and maybe even, you know, I think the cognitive behavioral therapy approach to sleep, which is statistically shown to be the most effective tool that there is for, for treating insomnia. I mean, what the work you do is so important in this topic.
[00:15:37] Speaker B: I, and I appreciate you bringing that up because I think it is so important and sometimes overlooked. And so, and to your point, sometimes it matters, the framework that the physician says and explains this to the patient. If it's a matter of, well, we tried this medication and it didn't work for your pain. So let's go ahead and just try, like, don't give it this dismissive, like it's a last line. It should be your first line intervention when it comes to sleep. Absolutely your first.
So I had the pleasure of being at a conference with the head of a large sleep department out of ucla and I was listening to the presenter talk to a room filled with pain specialists. There were a couple mental health providers, a lot of neurologists, and they kept asking about interventions. They were waiting to hear, you know, what, what is it? Is there, is there a new medication coming out? What should we do? And time and time again the answer was CBT for insomnia. And so let me start by explaining what that is.
So CBT stands for cognitive Behavioral therapy. It is a type of psychotherapy that has been around for decades. It is the most effective intervention for mood disorders as well as chronic pain. And recently there's been a specific line, specific for insomnia. So you'll see sometimes CBTI in the literature. And that's just cognitive behavioral therapy for insomnia. And CBTI is so important because it gets to your thought patterns. So as the name would suggest, CBT examines your thoughts and your thoughts impact the way that you feel physically and emotionally. And in turn, if we can change your thoughts, we can change the way that you're feeling and you're behaving. And so the idea is to get to the root of the problem. That combined with some psycho education on sleep hygiene, there are a lot of tangible things that we can, we can get into about what you can do for your sleep in your bedroom and your lifestyle. That will absolutely help as well. But at the end of the day, you can have all of that. And if your thoughts aren't at peace, you will have issues because that's the trigger, the internal trigger that's going to keep waking you up.
And so it is indeed, you know, evidence based and a first line treatment for insomnia. It's more effective than sleep medications without worries of side effects or authorizations or co pays or pharmacy lines, which is always great. And it's also just so critical to invest in your mental health because not only does it help you for insomnia it can also help the way that you're examining other things throughout life. And so one of the things that I always point out is think about what happens during the day. During the day, our thoughts are externally stimulated. We're thinking about work, we're thinking about our families, what we're going to make for dinner. Do I have enough chicken? Do I have time to go to the store to pick some up? Right. We're thinking about all these things. Oh, and don't forget so and so has a piano lesson tonight, or you've got that deadline coming up on Friday. Our mind is racing. And then we go home and it's the end of the night and we crawl into bed and we're physically exhausted. And now all the lights and the sounds and the thoughts that we had all day long and the conversations, that external stimulus is gone.
So what do your thoughts do? Well, if you don't give them something to think about, they'll turn on you and they turn inwards. And then they often overanalyze. And if you're not careful, they become a little neurotic. They'll start getting really anxious. Because usually what happens is your brain is trying to figure out problems that haven't even happened yet. It's thinking about all those things for the project that's due on Friday and whether or not there's enough chicken for tomorrow night's dinner and all these other little things because we've taken away all the stimulus. You're in a dark, quiet room. And so what's important is to find a way to kind of control your thoughts and give yourself permission to calm those thoughts, replace them with neutral thoughts. Because we're not going to say, oh, don't worry about it, right? That if that worked, I wouldn't be here. And so what you do instead is you learn how to challenge that thought of, you know what? Worrying about the project isn't going to help me. Let me set time aside tomorrow where I can actually work on the project. Then I won't be so worried about it, right? And to have that ability. And so those are the things that we do in cbti, really getting to the root of things. And a lot of times patients will tell me, oh, my gosh, you're right, I notice a pattern. I worry about my finances every night. And I'm like, have you solved them? They're like, no. And I've been doing it for two years. I'm like, well, it might be time to try something new. And so your anxiety will trick you and it's a waste of your, essentially your imagination worrying about things in the future that you can't solve or reliving things from your day that didn't go on well. And so cbt, I can be extremely, extremely helpful. But you do need to work with a trained psychotherapist. And we see benefits in as little as 10 to 15 sessions. And that's an investment that can last a lifetime. And so it's really important. So I think it's great that, you know, that you encourage that of patients. And I'm curious about the patients that you've had who have gone through that. What, what are some of the, what's some of the feedback that you hear, Peter?
[00:20:40] Speaker A: I think the feedback is great.
I think what I see with CBT for insomnia is it's very successful.
It doesn't take very many sessions, you know, and usually once that's, the sessions are done, sometimes maybe even six or seven sessions, everybody moves on. And, you know, that part of their health challenge, I think, becomes significantly better. And I think for a lot of people, you know, if you're sleeping an extra 30 or 60 minutes a night in a higher quality way, or if the time that you are in bed is a higher quality sleep, that's a home run, you know, for, for, for most, most folks. So sometimes little victories lead to really big victories. And, and, and sleep can be, you know, part of that when we can just get a little bit better.
[00:21:41] Speaker B: Oh, absolutely. And you touched upon the quality. Can you talk a little bit more about that, about why the quality of your sleep matters? It's just, it's not just a matter of the hours that you spent in bed, but the quality of your sleep.
[00:21:54] Speaker A: Well, so I've been geeking out on this for a while. I've had this oura ring, you know, for a couple years now. And there are different monitors that are out there on the market. And I think we've talked about this is the one that I ended up with, Apple watches. There's others. But one of the things that some of these sort of monitors that we wear wearables have is they analyze your sleep cycles and they start to break it down for you and you. So when you wake up in the morning, you know, you can look at your sleep cycle and see how it went. And I think a lot of people can criticize that and saying, you know, do you need to keep doing that and do you need, you know, and how's that really helping you?
But I think for listeners, it's helpful. Whether you want to monitor your own or not. It's good to kind of understand what are healthy sleep cycles and what we're striving for when we want to improve our sleep. The first couple of stages of sleep is just sort of this light falling to sleep stage and you hear people talk about your room temperature, your body temperature, and that's when we start to cool down a little bit.
And then as we, we kind of slide into some, some real sleep, then we can start to get to some of the deeper stages of sleep that are probably going to be the more restorative and where our bodies can heal, our minds can grow, those kinds of things happen.
We start to get into what's called deep sleep, where we're, we're, we're in a real restful state in a real deep, deeper sleep sleep with our brainwave activity. And that usually happens more in the earlier stages of sleep. And I, I've known by watching my own cycles, I only really get deep sleep in the very beginning of when I go to sleep. And then I usually don't come back to it later.
And then at least for me, usually later in the night, I'll start to get the REM sleep, the rapid eye movement sleep, which is, you know, really interesting. We start to see how we consolidate information that we're exposed to during the day. We also see this emotional processing that takes place during REM sleep. And you, you were talking about how when we're under a lot of anxiety or stressing about things that interferes with our sleep. But also we can use REM sleep as a way of lowering our anxiety, I think improving our stress. Kind of the old adage of, hey, sleep over it, you know, and see how you feel tomorrow.
There's something really that happens between our, our cortex and our hippocampus and how it processes the way, you know, we feel about what emotional things we were exposed to during the day, how we process that and it becomes part of who we are at night while we're sleeping.
So getting some good REM sleep, the rapid eye movement sleep where we have the vivid dreams and maybe if you want to talk about night terrors, because I get those. And so, so monitoring all that and understanding it. So I can say by understanding that a little bit better, it's helped me make sleep hygiene changes to try to improve my struggles with sleep. And, and one thing that I think I've learned is besides age changes, there's also a lot of genetic variation to sleep.
And I am not a Night owl. I have to go to bed early because I always wake up early. I never set an alarm clock. You know, I wake up at like 4 o' clock in the morning and I'm wide awake. And so I know if I'm going to sleep well, I have to go to bed at a good time every night. And when I, you know, push those boundaries, it causes all kinds of trouble.
One of the challenges that I've been trying to, to work through is on Monday nights I take a class and the class is pretty challenging for me. I won't go into the details, but the teacher always runs way overtime. So by the time it wraps up, it's like 8:30, 8, 48, 45.
And by the time I get home, my. I'm so activated now and my mind is racing with what I was trying to learn during my class that I have a really hard time turning it off. And then I can't sleep well. I can't get into the, the better stages of sleep. And then when I look at my, my sleep data in the morning on my aura app, I'm like. So I've been, I've been consciously trying to work on ways of exactly what you were talking about with your patients.
How can I take some of that noise that activates me out? It's not easy to do, you know, flipping a switch on what's going on in your brain is, is not easy for anybody, certainly not for me.
But it's been, it's been real interesting trying to understand that. And one sort of trick that I've learned to help myself, which it's, you can tell me if it's a good tool or a bad tool, but I'd been relying on it a little bit, maybe too much is sometimes when I wake up early in the, like in the middle of the night and I can't go back to sleep, I will listen to a podcast and like I'll leave the room and I'll go on the couch. I'll listen to a. There's a specific podcast that seems to help me fall back to sleep.
And it's not like it's a boring or the voice of the host is actually pretty entertaining. And why listening to this particular person knocks me out like that and where others don't, I couldn't tell you, but I sometimes rely on that to get some extra sleep before, before I start my day. And it's probably not, probably not the best, but you tell me it's not,
[00:27:53] Speaker B: it's not your traditional, you know, and wouldn't be my first suggestion, but I got to say something interesting one. I appreciate you sharing about your circadian rhythm. And I think everybody needs to be aware of we all have this internal clock. And if yours wakes you up at 4, then so be it. Right. And it has absolutely a big part of our genetics to. To do with that. The, the other thing that you pointed out is you didn't just give up. You woke up earlier than you even wanted to. And I love that you thought, I need to do something to see if I can try to get some more sleep. And so I appreciate that you got up, left the room. I'm sure your wife did too. Thank you so much. On behalf of wives everywhere, we get together and we talk. We've agreed that we appreciate that you go to a different room.
[00:28:35] Speaker A: Tell them to leave the room, please.
[00:28:37] Speaker B: Yes. And quietly. And close the door behind you. Yes, yes. And then you go and try to take care of yourself. And you have found something that thankfully doesn't include a lot of blue light. I'm sure there's a little bit as you're trying to set it up and essentially. But you can dim your phone as much as possible. They've got the blue light shield. You turn it on and then you're probably able to put it face down or let it go into sleep mode. I do wonder if the individual's voice is soothing for you, but I also wonder if the topic is something that is like, neutral or positive for you and so it prevents your brain from.
[00:29:14] Speaker A: Right.
[00:29:14] Speaker B: Racing internally. And so now you have a positive association of. Doesn't matter what this host is talking about. It's going to be relaxing. And my brain has an unconscious memo that it's okay to fall back asleep listening to this podcast. And I really hope it's not our podcast.
[00:29:28] Speaker A: No, no, rest assured.
[00:29:30] Speaker B: Yeah. But that being said, you know, I've. I've had a lot of individuals try different things. I remember in grad school I had a lot of weird sleep patterns. Had to do a lot with exams. Sometimes I had evening classes. I remember once I signed up, I don't know why, I took a assessment class where I had to learn essentially how to give the rock and hand score it seven to 10 o' clock at night in Alameda. So by the time I got home, it was like 11 o'. Clock. And now I'm wired and awake.
Now I'm seeing ink blots everywhere. And so for me to like, fall back asleep was really hard. And I swear my statistics book was just Lined with melatonin, because that book put me to sleep faster than anything. And so sometimes it's a matter of finding something that's neutral or, dare I say, even boring to do. And that helps you fall asleep. And there's actually a lot of research about that. And so let's talk about, like, what are some things that we can do? So if you can't fall asleep or you wake up and you're not falling back asleep after about, like, 15 minutes, just go ahead and quietly get up out of your bed. And it may not even be 15 minutes. I have some patients that will tell me they wake up, and within five minutes, they know they're not gonna fall back asleep quickly. And so get up, go to a different room. I don't want you laying in your bed. If you lay in your bed for longer than 15, 20 minutes to fall asleep, what sometimes happens is your brain starts to associate. Oh, my bed is where I worry. My bed is where I lie awake and I stare at the ceiling, trying to solve all the world's problems. And so instead, getting up, going quietly to someplace else. And then I want individuals to engage in something that's boring or soothing. And so the ones that I tend to recommend, I tend to recommend things like perhaps old books. Nothing too engaging. I don't want you to read a murder mystery, because then you don't want to put it down. You're like, who did it? Was it the butler? I don't know. And you just write. You stay awake. So I highly recommend maybe some old magazines. I had one patient. She ended up reading fishing and hunting magazines. And she came in, and she was so happy. She's like, it works. I. I read fishing and hunting magazines, and I fall asleep, and I was like, oh, that's fantastic. And I was like, oh, I never knew you were. She's like, I'm not. I'm not into fishing and hunting. It's my husband's. She goes, I read his old magazines. And so she's like, to me, those are boring. She's like, trout all looks the same to me. But I now know there's a couple of different types because of her magazines. And so doing things like that, or even crossword puzzles, Sudoku, something that isn't too stimulating. So making it sure it's a little easier is ideal. I have patients who will crochet or knit or cross stitch adult coloring books. One of the key things that I recommend is, even if you do have a partner, to still get out of your bed and get out of your bedroom because I don't want that association. But also go have these items ready to go. Have your, wherever your favorite spot is in the living room, or maybe it's at the dining room table. Have them ready to go because I don't want you turning on every bright light looking for this in the middle of the night. And when you know you have a plan. All right, if I wake up in the middle of the night, I have my bottle of water here. I have some of my hobbies, I have some earbuds. Maybe I'm gonna listen to a meditation, have a plan.
It's gonna be a lot less anxiety provoking. It's gonna be a lot less stressful to be like, okay, this is.
And what happens over time is individuals will tell me that the amount of time that they're awake and the number of times that they wake up in the middle of the night slowly will start to go down. And so your podcast isn't the. Isn't the. Isn't the. Isn't a horrible idea. But I do think that it's fantastic that you're getting out of the room. You're not like giving into defeat of, oh, I'm not sleeping. Right. And sometimes if your body truly does need it, you'll fall back asleep as apparently you have been.
[00:33:11] Speaker A: So that's why I found it can't. Whatever you're reading or listening to, it can't be too boring.
Because if it's too boring, then you get, you get agitated. You're like, this is boring. Why don't want to listen to this? So it's got it, but it can't be emotionally reactive. Like nothing. No politics or.
[00:33:30] Speaker B: No politics. No news.
[00:33:32] Speaker A: Yeah, none of that. Stay away from anything like that.
[00:33:35] Speaker B: Yeah, yeah, yeah.
[00:33:37] Speaker A: It's got to be a little bit more neutral on the mood swings side of things. That's kind of what I found work best for me. Well, we've got so much good stuff still to talk about. We're going to pause here and there's going to be a part two to this series, Sarah.
[00:33:55] Speaker B: Absolutely. And I just want to appreciate everybody who has joined us today on the Comeback with Boomerang Healthcare. We're grateful to have you here. If you've enjoyed today's episode and want to hear more, be sure to subscribe so you never miss an update and get to see part two of this sleep series. You can always follow us on social media for more tips, information and inspiration. Until next time, keep moving forward. Your comeback is just getting started.
