Caitlin Whyte: After a bad night's sleep, you may be feeling sluggish and your brain might be a little foggy, but not getting good enough sleep affects your body in even more ways than you think. To tell us more about the impact of sleep on your overall health, we are joined by Dr. Joseph Berg, a family medicine physician at Upland Hills Health Mount Horeb Clinic.

This is the Inspire Health Podcast from Upland Hills Health. I'm your host, Caitlin Whyte. Well, Dr. Berg, I'm sure many listeners know that they are not getting great sleep, but just how important is sleep to our overall health?

Dr. Joseph Berg: Sleep is absolutely essential to our overall health. If we don't sleep, we can't live. You know, you got to sleep. It's very, very important.

Caitlin Whyte: So, what happens in our brains when we sleep? What's going on at nighttime?

Dr. Joseph Berg: So, that's a good question about the brains, right? So, you know, when we sit around, our body is resting. When we sleep, we don't really necessarily need all this resting of our muscles, right? Our muscles don't need that much time. But our brain needs us to sleep, and not be like sedated like when you have a surgery, you need to sleep. Your sleep is a special process where your brain is bathed in special chemicals and kind of reboots and stores things in different places and makes room for new things. It's a really cool important process that we've only started to understand in the last many years.

Caitlin Whyte: Oh, that's so interesting. Well, it sounds like it's some vital stuff happening, you know, overnight, getting us recharged for the next day. So, what happens if we aren't getting enough sleep?

Dr. Joseph Berg: So if we don't get a lot of sleep, there are a lot of consequences. I mean, a lot of people talk about like, "Okay, how much sleep do I need?" And it's most of the time adults need about seven to eight hours of sleep. Anything less than six hours is oftentimes a problem. And that's fairly consistent no matter who you are. I mean, everything is a bell curve. So, some people need a little bit less sleep and some people need a little bit more to function better, but everybody needs probably around seven to eight hours of sleep and less than six hours of sleep is bad for everyone.

So, a lot of things can happen. Sleeping is involved in almost every process in your body. Your immune function, your mood, your recovery from exercise, learning, your weight, your hunger, everything is related to your sleep and is affected in some way if you don't sleep. So, for example, if you don't sleep enough, you won't be able to interpret your hunger signals very well, so you'll eat more.

The way we know this is they've actually done studies. They've like put people in a hotel and one group of people that gets a good seven, eight hours of sleep, and the other group of people, they wake up, right? They wake up halfway through the night or they only give them four or five, six hours of sleep. And then, they have an identical buffet set out for them to eat and they measure how much food each group eats and the group of people that didn't get enough sleep eat 10% to 20% more food to feel full or satisfied than the people that got enough sleep. So, that's just one example of, "Hey, if you don't sleep, you just eat more." Not because you necessarily are hungry or your body needs more, but because your body is having trouble interpreting the signals correctly and using that information right, because it didn't properly reboot, recharge and get everything reset and ready.

Caitlin Whyte: Gotcha. Can you talk about the importance of quality sleep? You know, seven, eight hours could mean different things. If one person is in a dark room and it's quiet, or maybe seven, eight hours of someone who had a couple drinks and they're tossing and turning, and does that really count as sleep? Or you know, how should we be vying for that really good quality sleep?

Dr. Joseph Berg: Yeah. Good quality sleep is important as you said. If you're under the influence of some substance, like alcohol is probably the most common, that's not good quality sleep. Your sleep goes in a special cycle. It kind of starts right when you're falling asleep and someone can talk to you and you kind of wake up right away, and you can be alert. And then, it drops into like two or three more levels to get really deep sleep where it's if you'd wake up, it'd be really hard and you'd feel really groggy waking up. And then, it kind of resets and goes up into something called REM sleep. REM sleep is called rapid eye movement sleep, and all the magic stuff that happens to your brain in sleep mostly happens during this REM sleep. So, this is about a 90-minute cycle. So if you're drinking alcohol, your body, your brain doesn't get into that REM sleep. It stays in that deep kind of sedated sleep where it's hard to wake up and doesn't go into REM or if you're using some kind of other sedative, and a lot of the medicines that we use for sleep are more sedating and don't allow for this good REM sleep to happen.

Caitlin Whyte: Oh, wow.

Dr. Joseph Berg: So yeah, that's about 90 minutes. And you got to be kind of fully asleep for this 90 minutes to get that special REM sleep and then for that sleep cycle to reset and to do it again. And so, you get these kind of cycles of 90 minutes throughout the night. So, like you said, if you're sedated for a part of it, you don't get the REM sleep. If you get woken up in between by, you know, a four-year-old to your room because they had a or a loud noise or feeling anxious and having trouble staying asleep for those reasons, those can all affect how often you get those good REM sleep cycles and then you do get all that accumulated time to get your brain reset and ready to go.

Caitlin Whyte: Well, that brings me to my next question. You know, you mentioned that anxiety of sleep. I know if I'm having bad sleep streaks and, you know, it's late at night, I just keep thinking about, "I have to wake up soon. The time is ticking." So, what can someone do if they're struggling to get good sleep? I mean, what are some tips and strategies to improve it? I know it's such a big question, but anything just kind of off the cuff we could do maybe later tonight?

Dr. Joseph Berg: Yeah. So, there's several things you can do. First is make sure you have a good environment for sleep, that's one of the main points. So, make sure your room that you sleep in is dark, is quiet, and is cool. We sleep best in the dark, like as dark as you can get. Again, quiet is important because we have ears and wake up, and cool as well. Warm makes you wake up and prevents more deeper sleep. And if you need an outlet for warmth, make sure your head is not covered and make sure you don't have socks on. I know that sounds weird to some people, but if you are excessively hot, your body will vent excess heat from your head or from your feet. So, make sure you're environment is good. Make sure that your sleep area is only used for sleep, right? So that your brain connects that area with sleeping time. So, you know, I tell my patients, your bed is only good for sleep or sex, that's the only two things you should be doing in your bed. You shouldn't be reading, you shouldn't be watching TV, playing video games, looking at your phone, anything like that. When you get into bed, it should be like brain time, you should associate that with sleep. So, the environment should be important.

Next thing you can do is get your brain ready for sleep. Brains have momentum, right? So if we start watching a movie, I don't know, you've maybe had this happen to you in your life where you've been engrossed in a book and you read it. And you got really into it at the end of the night, and then you went to sleep and you actually dreamed about it, and then you woke up early because you just kept having this book run through your brain.

Caitlin Whyte: Yeah.

Dr. Joseph Berg: So, our brain remembers what we are doing and it kind of keeps this momentum going, so we need to try to wind down and prepare our brain for sleep. So usually, I recommend a 30-minute period before you go to bed to get your brain ready to go. So, stop reading, turn off the TV. Stop playing, you know, the game you were playing. Stop looking at Facebook or Instagram. And just do something mindless. Put the dishes away. Get your lunch ready for the next day. Fold clothes. Tidy up the living room. Take a really long time to brush your teeth. Take a shower. You know, give yourself 30 minutes to kind of just prepare your mind, clear it out, kind of like a walking meditation or something like that, just to kind of clear your mind. So, all that stuff from the day, all the stimulating things are out of the way.

Other things to make sure you're not stimulated are don't eat and don't exercise before you go to bed. So, prepare yourself for bed, right? Don't stimulate it, wind down. And then, the last probably most important thing you can do to help your self get to sleep is to have a regular sleep and wake time.

Our bodies are chemical machines and they respond to certain signals. And one of the main signals, one of our main rhythms in our body is called our circadian rhythm. So, our body wants to go to bed and get up at the same time every day, and it'll release special chemicals in our brain to make us tired and then, in the morning, release other chemicals to rouse us and to wake us up. And those are on a timer in our brain. And if we go to bed late one night and then get up early the next day or, you know, we kind of keep switching it around, our brain gets confused and the chemicals don't come out at the right time for us to go to bed or don't come out at the right time in the morning to wake us up.

So if there's anything you remember from this conversation, it's pick a time to go to bed and pick a time to get up every day and stick to that schedule as best you possibly can, so that your brain will know when it's time to go to bed and when to get up and you'll naturally go to sleep and wake up everyday.

Caitlin Whyte: Well, you make it seem so easy, but I know that that is such a crucial part. Well, I know you just said that was kind of your last key takeaway, but is there anything we didn't touch on that you want people to know about getting enough sleep, getting to sleep, just all the sleep stressors that we go through each night?

Dr. Joseph Berg: I mean, there are other things that you can do, and everybody's different in how they can sleep. And there are certain medications that can make a difference for certain people. So, don't forget if you're doing these simple things at home, talk to your doctor. There may be a medication you can try or maybe there's something else causing you having difficulty sleeping. Maybe you have an anxiety disorder, maybe you're depressed. And the treatment for that is slightly different. So, we can work on that.

The other thing to know is most of the time medications aren't the answer, and there are actual sleep therapists that more and more sleep experts and physicians are recognizing as the kind of first line treatment for people that are having insomnia or difficulty falling asleep and staying asleep. So if you know of a sleep therapist in your town or your community, oftentimes therapists don't need referrals from physicians, so I'm not saying not to go to your doctor, but that there are those options if you're having trouble sleeping and you want something right away, you can, you know, look for a sleep therapist in your area. Or, of course, talk to your doctor and they can help you navigate this, figure out if there's something else causing your trouble sleeping, maybe consider a medication, help you kind of fine tune your process and what's the best to focus on for you to get to sleep and then to get to sleep later.

And I also forgot, hey, there are certain substances that you can put in your body that will prevent you from sleeping. And the number one of that is what you can probably guess, is caffeine. Caffeine is good and can help people be alert and be more productive. There's often benefits to certain types of caffeine, like in coffee, have a lot of like positive health benefits. But if you have caffeine after noon, that's probably not good for your sleep. So, try to make your caffeine intake in the morning. Yeah, that's my last.

Caitlin Whyte: I've made my cutoff too, but I've really started trying to at least have a cutoff.

Dr. Joseph Berg: That's good.

Caitlin Whyte: Little by little, right? Baby steps.

Dr. Joseph Berg: There you go.

Caitlin Whyte: All right. Well, doctor, some really great tips and resources here. Thank you so much for joining us and sharing today.

Dr. Joseph Berg: Yeah, it's my pleasure.

Caitlin Whyte: You can find more about Dr. Joseph Berg, how to make an appointment with him and all of the Upland Hills Health Family Medicine physicians at uplandhillshealth.org.

This has been the Inspire Health Podcast from Upland Hills Health. I'm Caitlin Whyte. Be well.