Terry Streetman (Host): Hello, listeners. Thanks for tuning into the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Terry Streetman. And joining me today is Kathleen Gallagher, our manager of Pulmonology and the Riverside Sleep Center. And we're going to talk today about managing fatigue. Thanks for joining us, Kathleen.

Kathleen Gallagher: Thank you for having me.

Host: So, this is a topic near and dear to my heart as a chronically exhausted person. But before we jump into the subject, can you give our listeners a quick reminder of your role and your background?

Kathleen Gallagher: Sure. So like you said, I manage Riverside Pulmonology and the Sleep Center. I've been working in the field of Sleep Medicine for the past 19 years. It's been a long time. I really, really feel wholeheartedly that sleep is related to everybody's overall health and well-being. So, I like to educate people on things, maybe they need to know about how to get better sleep.

Host: Awesome. Well, as you said, it affects kind of everything to do with people's health. And generally speaking, are people getting enough sleep?

Kathleen Gallagher: No, they're not. I think according to the CDC, one in three people are not getting enough sleep. People are not getting enough sleep because there's so much going on in our lives. You know, before the light bulb was invented, people got a lot of sleep. But look at all we have today. We're so busy. Families don't usually sit together for the family meal. People are busy with sports. They've got technology. They've got so many other things at their fingertips that people are connected to constantly. So, a lot of that leads to why people are not getting enough sleep.

Host: Okay.

Kathleen Gallagher: We're our worst enemies.

Host: Yeah. Oh, that's definitely true for me. So, you talked a little bit about some of those things, how connected we are and the electric light bulb, bane that it is. Are there other conditions or factors you want to highlight that contribute to that lack of sleep?

Kathleen Gallagher: Sure. We can look at what happens when we're at work. We have long hours. We have long commutes. Sometimes it's tasks we do that lead to being fatigued. Noise, stress. People are stressed. And you know what? Sleep isn't just putting your head on the pillow. Sleep really is, you know, what's your gender? What's your culture? What's your beliefs? What's your family? What's going on globally? What's your financial situation? There's so much that contributes to our sleep, and we take it for granted. It's one of the pillars of health. So, we really need to think about—and we'll talk about planning—what our sleep looks like.

Host: Okay. Well, with those contributors and that lack of sleep, what are some of those short and long-term health effects, the ways that it affects all of those things as a pillar?

Kathleen Gallagher: So on the short term, it decreases your reaction time. It leads to mistakes. It leads to injury potentially. Like here we are in healthcare, but if you're fatigued, you worry about injuring a patient or you're coworker. If you're working in a factory, are you potentially causing a problem for yourself or somebody else? You're tired, you're exhausted, you're mentally drained. Your focus, like I said, reaction time, it affects all that kind of stuff; your memory. It takes you twice as long to do a task when you're tired than when you're actually feeling rested. We know what we feel like. Even if we get that hour less sleep, you can really be dragging the next day. And it's not fun.

Host: No. No, it is not. I can say from experience. So, we've identified the problem, right? Not enough sleep, some of these other things. What then can people do to improve their sleep quality and the amount of sleep?

Kathleen Gallagher: So first of all, I want to go back to some things we can do when we're at work. If you are that person who's sitting at your computer all day long and you're feeling fatigued, get up and move. A lot of people don't take that time to take that break. Get up and walk around if you're doing something monotonous.

Hydrate yourself. People don't think about drinking throughout the day. But our body does get dehydrated, so we want to make sure we stay hydrated. And I don't mean the coffee fix or the caffeine fix, because that's very short-lived. Water's a good one, maybe Gatorade, something like that along those lines. But yeah, I think that we just need to focus on better nutrition too. So, we're the snackers. Maybe it's the chips and the candy, but those are also not the greatest. You end up having a crash. So, look for the nuts. Look for yogurt. Look for better, healthier choices.

Host: Okay. You see me laughing over here because I'm guilty of that pretty severely. So, yeah, that's good to avoid that fatigue. And in a minute here, we'll jump into some more strategies. But first, we're going to take a quick break to discuss the importance of primary care.

At Riverside, our primary care providers are right here in your community, offering personalized care for you and your family, close to home and connected to the specialists and services you may need. Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life from annual checkups and preventative screenings to managing everyday concerns when they pop up because remarkable care should never be out of reach. Remarkable care right where you live. To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

All right. We'll jump back into it. You talked about some of the things to help during the workday. Are there other strategies that you'd recommend for people to manage their fatigue?

Kathleen Gallagher: Well, we're going to talk about now building some good sleep strategies, okay? So, you really need to have some good habits. Like, you need to have a plan. Maybe the person who has, we call it, bedtime revenge, you know, procrastination as you're on your social media, you're watching Netflix. And there is this thing called Netflix phenomenon or something where all these series, they start again, that you have to click the button to start it. So, they leave you hanging, want you to watch the next episode. You're stuck staying awake because you're curious or you're watching those videos when you're scrolling on Facebook or something. And you really need to have a better plan. Because by staying up late, you're really cheating yourself out of the sleep for your next day. So, what's your plan?

It might not just be the Netflix or the social media. People have family demands. People take work home with them. So, where can you be a little more disciplined for yourself, so you can have a plan? Maybe it's even, "Can you gain an extra 20 minutes in your morning for sleep if you plan maybe what you're wearing the night before? Put it out there so that you don't have to think about it the next day. Anything that's a time-saver, maybe meal prep, because if you're sleeping an extra 15, 20 minutes every day, by the end of the week, you've got an extra hour plus sleep, which is more than what you had before. And then, maybe that can turn into be a little bit more.

Having a good wind-down routine is really important too. If you're too busy and you're too stressed, what do you do? Maybe do some breathing exercises. Go sit and relax. Dim the lights, play some relaxing music. Go sit and meditate. Whatever says calming. Having your room cool, dark. Getting off that social media, like I said, the blue light. So, it's not just, you know, your tablets. People like to read, go read a book in bed. Not the tablet, but go read a book, an old-fashioned book. And really set a plan to at least get seven to eight. Nine hours might be a stretch, but a good seven to eight because maybe you'll get something like that. I know most people are really not. They're getting around the six-hour mark. When I talked to some of the teens out there, it's even less than that. They need more. We are really, truly our worst enemies.

Host: Yeah, that sounds accurate to my life. And definitely, it's mind-blowing that scrolling the entirety of the world's knowledge as you're trying to fall asleep, how does that not help? So for somebody like me then, whose plan has not worked out so well, there are ways people try to deal with it. You already mentioned caffeine, not super effective for long-lasting— Naps, are those effective? Are those recommended?

Kathleen Gallagher: They are actually. And when you're talking about foods that you eat, there actually are sleep-promoting foods as well. So, things like avocados and pistachios and dark cherry juice. There are some things that you can eat that actually help with producing melatonin. So, you can look for things like that that are healthier to eat.

Naps are really good if you take a 20-minute power nap. If you take a nap that's too long, you might mess up your sleep at night, especially if you take a too late in the day. And they say about a 20-minute nap. Because if you were to set your alarm for 30 minutes, let's say, you might be in your deep sleep. And you're going to wake up and feel this sleep inertia where you're going to be very confused, because you shouldn't be waking up in your deep sleep. You really want to wake up before you get to that point.

But it's interesting, I've learned about caffeine naps. So for people, let's say are doing shift work and maybe take that nap before they go to work at night. Drink some caffeine, take a 20-minute nap so that when you wake up, that caffeine will kick in. So for some people, that situation would work well. But if you're just a regular person who works throughout the day, that's not something you really want to do before you go to bed at night. But that caffeine nap, I'm not a napper and I don't know that I could fall asleep in that quick a time. But for some people, I think it would really work.

Host: Okay. Yeah. My father-in-law calls that a power snooze.

Kathleen Gallagher: Yes.

Host: So, yeah, I usually make the mistake of napping for too long. And then, I wake up and I don't know what day it is.

Kathleen Gallagher: You have to remember that, you know, we have melatonin that we have throughout the day that builds up in our body that makes us drowsy, that's the hormone of sleep. But we have a chemical in our brain that works like a pressure cooker. It's that feeling that when you just can't keep your eyes open because, you know, like, "That's it. I have to go to bed." Too much of that caffeine or taking a nap will actually let off that steam.

Host: Okay.

Kathleen Gallagher: So now, when you want to go to bed, you can't. Or if you're the person who asleep in front of the TV, and then you decide you're going to go crawl in bed and you can't fall asleep, it's because you just let off some of that steam and your body's thinking, "I just had a nice nap. I don't need to go to sleep right now." So if you're that tired, just go to bed.

Host: Okay. I like that pressure cooker kind of analogy. That's a cool way to think about it.

Kathleen Gallagher: Absolutely.

Host: All right. So, we've talked about all the issues and these things. If someone is experiencing some of this chronic sleep issues and this fatigue, what should they do? What can Riverside do to help?

Kathleen Gallagher: You know what, patient's have a primary care physician. Have a conversation with your doctor. Tell them how you're feeling. Let them know that you're not feeling so well rested. Maybe it's a sleep disorder, so maybe you need to get that checked out. Even if you are saying that you can't sleep, like you have insomnia or something, even if you had a sleep study for that, it's also telling. But really, it starts with a conversation about how you're feeling.

Host: Okay. And as a reminder for folks listening, if you don't have a primary care provider, you can find one at myrhc.net/acceptingnew. Okay. So, we're at the end here. This is something I ask everybody. I think it's a great question. What is the biggest thing that listeners should take away from this episode?

Kathleen Gallagher: That sleep is a pillar of health, and that we need it. And I want to throw in there, there are some natural ways actually to wake up in the morning as well. People might not think that they can go without caffeine, but here's some things you can try.

Like I talked about earlier, that we get hydrated throughout the day. We actually get dehydrated when we're sleeping at night. So, drinking even a bottle of water before you even feet hit the floor will actually help you in the morning. Cold shower, maybe at the end of your shower, you blast that cold. I don't think that I want to do it on a freezing day to like today, but maybe it would help wake you up. Do some jumping jacks in the morning, get your body moving. And sunlight, I know we don't see it very often, but sunlight, it's up there somewhere, even throughout the clouds. Getting outside in the sun actually turns off our melatonin for the day and resets our circadian rhythm. So, no sunglasses and not through the windshield. Actually go out and say hi to that sunshine.

Host: Okay. Well, all good advice. And I'll try to start doing some of that as soon as possible. But yeah, thank you so much for sharing this information. As you said, a lot of people suffer from fatigue and chronic sleep issues, and I think this is really helpful for our audience. So, thank you so much.

Kathleen Gallagher: Thank you.

Host: Okay. So if you as a listener would like to learn more about the Riverside Sleep Center, you can visit myrhc.net/sleep. Thank you for tuning into the Well Within Reach podcast with Kathleen Gallagher and with me your host, Terry Streetman. Be sure to like and subscribe to Well Within Reach on Apple, Spotify, or wherever you get your podcasts. To learn more about the services of Riverside Healthcare, visit riversidehealthcare.org.