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Learn about sleep hygiene and hormonal/blood sugar-balancing strategies to get a good night’s sleep. 

Dr. Marnie Wachtler joined us at Practice with Clara Virtual Yoga Studio to discuss the lifestyle changes that promote better sleep. 
The discussion included tips and tools to educate individuals on hormones, sleep hygiene, neurological processes, napping, snacking, and blood sugar balancing. 
What You Will Learn:
  • Balance your hormones for a great sleep.
  • Understand hormones such as progesterone, cortisol, and melatonin and how they affect your quality of sleep.
  • Nutritional tips are a powerful way to get a great night’s sleep.
  • Blood sugar balancing is not just about diabetes! 
  • Sleep hygiene strategies.

Meet Dr. Marnie Wachtler 

I will walkthrough through some of the strategies that I found helpful in the clinic with women, especially around perimenopause and all the overall hormonal changes that happen, so being in fertility years as well as postmenopausal.

I’m a naturopathic doctor. I’ve been working with women and women’s health for 16 years. I have two children, ages 9 and 11. I have gone through menopause a little bit early, but I have also shared that.

The pain of hormones and the transition is essential for me to understand and reflect on how my patients come to me in their trials and tribulations. So I feel your pain, and I know that sleep is the one thing we all need to endure, you know, to reduce our inflammatory response and lead a life of longevity and activity. Sleep can help immensely reduce chronic disease, inflammation, and all of the different age-related disorders and help people work through any chronic conditions.

From the Sleep and Hormones Lecture:

The Importance of Sleep

There are acute things that come up earlier in life. One of the things that I wanted to note is that sleep is reasonably necessary.

I was at a friend’s, and we talked about her sleep patterns. She’s an Ironman triathlete and will sleep six hours a night. And it’s incredible how different people are in their capacity to sleep and cope and not be able to cope.

The essential thing about having sleep is detoxifying everything we’ve done throughout the day—the activity, the foods, the environmental stressors—and then rejuvenating our body.

Repair happens when we’re sleeping, and one of the things that occurs with sleep is that our cortisol also goes into a downward curve. So, we want to find sound sleep so that our cortisol doesn’t stay high.

Cortisol is the bad guy that creates an inflammatory response in our body, and inflammation is not good in the long term. You want to have some cortisol, but avoid having it 24 hours a day. 

Also, regarding repair, all connective tissues can get reconstituted, especially if you’re an active person who does yoga and pushes your body to perform, build muscle, and maintain all that mass. There are a lot of causes of insomnia, but one of the main ones that I’m going to focus on is hormonal influences.

Hormonal Influences on Sleep

The main hormonal influences that are transitioning through menopause are hot flashes and night sweats. So those body temperature regulations or dysregulations come from the hormones and the lack of them, where we, in menopause, find that there’s a lack of menopause, estrogen, and progesterone, mainly.

In a cycling female, those hormones change a lot throughout the month. So, the stability of hormones is reached in a menopausal woman. However, estrogen rises in the first half of the female cycle, and progesterone increases in the second half. And many women will come to me and say, I get night sweats at night.

When I’m sleeping, when I’m menstruating, and that mimics the low hormones in menopause. So, we all have those transitions that are going to happen.

It’s how gracefully we can transition through them and how our understanding of our hormones before going through menopause or the cycle if we’re looking at a fertile woman.

If your hormones rise too high and then crash at the menstrual level, then you’ll have the side effects of hot flashes. It’s the same thing as what I find in menopausal women: they’ll have more hot flashes if their hormones were at a higher level when they were cycling females. 

A lot of the time, with the downward amount of estrogen, we get brain inflammation and brain inflammation can be caused by estrogen reduction.

More of the body’s inactivity can create the monkey mind, where it just keeps rolling on you. You wake up for unknown reasons and then start thinking about insane things. 

A circadian disruption is cortisol, which is high at night.

We cannot secrete melatonin, which rises at night when cortisol is low, so that is a very important aspect. In the allopathic world, there are many diagnostics of sleep issues.

Obstacles to Deep Sleep

Teeth-grinding can obstruct our soft palate, leading to more snoring and a cutoff of oxygen, which is apneas. What we often have people do is laser the back of their throat to shrink any enlarged or slack tissue, which will help allow for that oxygen flow.

So oxygen is vital, and if we find that it’s not part of an endocrine system response, it could be an oxygen saturation problem.

Insomnia or waking at night could be due to waking up from snoring, but also, that lack of oxygen causes an inflammatory response in our body, and we’re unable to get the R and R and repair that we would love or need to have at night. 

Neurological Patterns and Processes

There’s lots of neurological signaling that happens in the brain at night. So, our bodies go through phases, such as sleeping. There can also be some ignition of the brain and some sleepwalking or dreams that we do not want to have, which can be an interruption.

We often see that more in younger adolescents and the elderly, where they sleepwalk at night. Unfortunately, a lot of the elderly are on sleep medication.

Sleep medications are a very prominent thing that people will have in their elder years, and they’re very disruptive to the circadian rhythm, albeit necessary. Some people, but if we can prevent that as long as possible, that’s a great goal. 

Finding the Root Cause of the Issue 

One of the significant things we need to do in the clinic is find out if there is a hormonal imbalance and then exactly which hormones we need to help. Sometimes, melatonin doesn’t always work. Everybody knows about melatonin, but because we have a high cortisol level, melatonin does not help with supplementation.

It’s essential to understand the core cause and treat it appropriately. There was a hormone urine test; you can do salivary and cortisol testing with urine and saliva. The big thing about sleep is that I don’t see it as a focal point of your sleep, which we must work on.

It’s more about how the whole day goes and ensuring enough activity to challenge our bodies, ensure that our system has outputted enough energy, and work our brains. So the challenge is in the body on a moderate level as well as the brain, and that’s different for everybody.

Because it will mimic the normal circadian rhythm of the cortisol being high at night and then needing to dive down into the low levels at nighttime for sleep, so, if you don’t do yoga, you can alternate doing weightlifting, walking, or walking for an hour on that day.

There has been a lot of research recently on the blue zones and longevity. Yoga is excellent for the body and the mind, and it allows you to not stress your body systems, such as your joints and tendons, so they don’t break down. We don’t get osteoporotic reactions. 

Why We Wake Up At Night

So, I wanted to address waking up at night. So, the middle of the night waking can be caused by some things. Many people will come to me and say, I fall asleep well, but I’ll wake up at 1 to 3 a.m. every night, and I can’t get back to sleep. And where I’m. Often seeing the issues in women in particular, as well as where those hormones are sitting, whether they’re menopausal or recycling, the blood sugar regulation is huge.

So, we live in an age of processed and packaged foods. We need to look at the nutrient density of foods and healthy fats.

Healthy fiber and lots of protein are the main things that regulate blood sugar.

I had an interesting experience with one of my patients who was using a continuous glucose monitor, a clip that allows you to monitor your blood sugar throughout a 24-hour day.

They wear just a small needle, mostly for people with diabetes. Her blood sugars were volatile, going up and down within the range, but up and down. So was her mood, and her sleep was dysregulated. I asked her to go away and add a simple tablespoon of coconut oil to her diet daily.

When she came back and showed me the blood sugar scores, they went from up and down throughout the day to a flat line, which was beautiful because it allowed her blood sugars to be stable, not going too low or too high. She found that her mood and energy throughout the day were quite a bit better, as was her sleep. 

These are really important nutritional factors. Hot flushes at night—there are a lot of hormones that can contribute to that. So, generally, there’s a low level of progesterone and a high level of FSH. One of the things that you can do naturally is apply cold to the body when it’s hot.

So, hot flashes can be helped with this cold procedure, which applies cold, wet, rung-out cotton socks. Covering those wet cotton socks with wool socks and sleeping with those at night is an old folklore where you can also reduce fevers.

If water helps with energetic cleansing and you like water, the other thing you can do when you wake up in the middle of the night is breathe deeply. Breathe in for seconds, breathe out for seconds, that box breathing.

Ways to Encourage Relaxation

We’ve done lots of breathing in yoga and controlled that, which can quickly change the neurological system and allow the body to relax again.

One of the most important things to remember is that at night, when we wake up between 1 and 3 a.m., our liver can be very active, which is essential for detoxification.

Suppose you find that on the clock every night; you see that 1-3 AM. We should look at things that might contribute to the toxic load in your liver daily and help with liver detoxifiers. On a note, I recall that I didn’t put it in the presentation here, but it’s really important not to have a lot of devices in your bedroom when you’re sleeping.

So, having a big clock that tells you what the time is can create some anxiety for people. Suppose you have devices like phones in your room beside you. In that case, it can be disruptive with the signaling, like Wi-Fi or cellular signals, and some people are so sensitive that they are interrupted in the sleep cycle because of those stimulations.

Ways to Reduce Stimulation

We are constantly stimulated, so it’s important to reduce that as much as possible.

First and foremost, reduce and eliminate stimulants like caffeine, alcohol, and nicotine.

We talked a little about blood sugar levels, with healthy fats helping your body achieve stable blood sugar.

But also, snacking at night can be a really hard issue to let go of with women. I would say that high-glycemic foods such as taco chips, potato chips, or anything else, even fruit, can be tough on blood sugar regulation. If you are hungry at night, heavier, fatty foods, not necessarily proteins because they’re a lot, take longer to digest.

But the fattier the food, like nuts and seeds, the more helpful it could be for staying stable at night. If you do snack, ideally, it’s best not to snack before bed or in the evenings. This is just a really good example of our nighttime meal. It was like veggies and guacamole—that’s the word I’m looking for—guacamole, goat cheese, and a salmon burger.

It is light and easy to digest, ensuring your body doesn’t have to overload. 

Dr. Marnie’s Top Tips to Unwind for Better Rest

Chamomile tree tea is one of my favorites in tea and capsule form. It gets overlooked because it’s so mildly treated. But if you get the real flowers, like the real mokoi chamomile flowers, you can steep two tablespoons of them in one cup of water for 20 minutes.

It is very therapeutic. It allows for that nerve vine and the reduction of that nervous stimulation that some of us have daily.

And then CBD oils. Or now that THC and CBD are available over the counter. Lots and lots of research has been done into CBD. The basics of that are that it’s anti-inflammatory.

So, an anti-inflammatory effect for the body can help with muscle, joint, or tendon issues, causing you to wake up in the middle of the night. CBD can be found in many doses, but the higher the dose, the more you must request. The higher the dose, the more you need to request specifically when you pick it up.

That’s why I put the dose there at 25 milligrams per night. You can titrate it up. The CBD gets absorbed within half an hour but peaks at six hours. It has a long treatment period and can help you stay asleep longer into the evening. Start with a lower dose, like 10 milligrams, and titrate it up.

Just see what works for you, and then take a break every once in a while. One of the things that I wanted to make sure you could reflect on today is taking long-term supplementation.

It is okay most of the time, but sleep needs to be helped in patternization. If we can reestablish our sleep patterns, we can eliminate all these supplements and not rely on them to sleep every night.

Suggested Sleeping Aids

The bio strap is a tracking analytic similar to what you would have on a watch like an Apple watch.

This one, in particular, works with heart rate variability. It allows you to see how much stress is in your system. That’s physical stress, where the neurological stimuli from mental stress can affect the heart and how well your heart is recovering. These are neat analytics that allow you to look at your system.

So this is my weighted blanket of silk and snow. You can see this tight, loosely woven, heavy cotton blanket. This one weighs 15 pounds. It feels very soothing to have the neurological system calm down at night, where the weight allows for that sedation or Shavasana, and where your body can get into that weighted grounded ability.

I love this blanket, and many people benefit from weighted blankets. My kids love it, too. Wearing a sleep mask can also be beneficial, especially when our days are getting longer and there is more darkness.

A sleep mask is not for everybody, but it helps people fall asleep and stay asleep longer in the morning. The other thing that many people will tell me in the clinic is that they’re woken up often by noises or their partner, and so usually I’ll say, can you wear earplugs and feel comfortable with that?

Or can you put your buds in and have meditation-type music coming to you so that it’s like white noise and drowns out any activity happening in the house or around them in society? I could not believe the amount of activity that happens at night there. It was difficult for me to cope with sleeping ten years ago when I went there. The other thing that can be great for the mind and resting the mind is journaling.

Journaling is just an avenue for expressing your emotions and frustrations, letting go of the day, and doing that before bed. If you wake up in the middle of the night and have those lists of to-do’s, it will be very important to write those things down in some dim light to let go of those thoughts.

The Best Time To Get Ready for Bed

So, 9 pm and 10 pm are the best times to fall asleep because they allow your body to unwind. Sleep before midnight is quite important.

If people are falling asleep after midnight most of the time, I’ll ask them, can you shift it an hour or an hour and a half beforehand? It allows the body to get to the peak of sleep earlier rather than later in the morning. 

So, turn the lights down low, and avoid watching computer TV right before bed.

One hour is a good time to have the spread. If you watch a TV show, make sure you have an hour after that to unwind and have dim lights. My husband is amazing at turning on all the lights in the house before bed.

Waking up at the same time most mornings is good. If you do sleep in, it can interrupt your sleep at night.

I’ve done that before, where I slept in and had the opportunity to do so, but then it would delay the ability to fall asleep earlier in the night. I guess it is.

So, I’ll get to sleep later, perpetuating a shorter sleep cycle. If you wake up in the middle of the night, you can write down your thoughts and release those. Also, a really fun thing to do is to get into dream journals and write down your dreams every morning or when you remember them.

Deep Sleep Versus Napping 

Most of the common questions that I get are: What about napping? Is napping healthy? I think it can be healthy in some societies. If you travel to Europe, many people will have a siesta in the afternoon when it’s cold. And they don’t do anything besides lay around anyway. They shift their bedtime a little later, allowing them to sleep better.

I’m unsure if those are healthy habits, but they seem quite prominent for that society. We’ve got some international people here today, so maybe they can comment. But for us in Canada and North America, we wake up, work all day, have our nighttime supper, and then go to bed at night.

Early kids need sleep unless we’re looking at some of the senior population or the pediatrics. 

The Effect of Alcohol on Sleep

I wanted to talk a little bit about alcohol. Alcohol is inflammatory to the body. It’s a customary thing that people will have as a regular night, nighttime, or nightcap.

One of the things that is important about understanding what alcohol is doing is that it will drop your blood sugars at night because alcohol is a high-octane fuel.
When you consume alcohol, your blood sugar spikes quite high. This causes a rebound reaction, where your blood sugar goes very low in the middle of the night.

This is something to be very conscious of if you’re finding that alcohol helps you sleep better or fall asleep better, but it will often wake people up in the middle of the night and prevent them from having that full, solid sleep.

So, the better thing to do would be to avoid alcohol, have a more solid sleep, and then be able to recover your sleep fully. And then, as I said, with the fats, the healthy fats, and the blood sugar regulation, if you are on a keto-like diet, you’re eating more fat and more protein, and you want to be able to help your blood sugars stay solid throughout the night.

Many people take a bit of coconut oil or MCT oil at night, which helps them fall asleep. The big thing about fats and healthy fats is that they’re only sometimes great for you if you’re not in ketosis.

It’s a different conversation about the keto-like diet, and I would not recommend it.

Seraphina Dawn

Seraphina has a BA in Literature from Simone Fraser University and participated in the Creative Writing Program at UC Berkeley. She is a Kundalini teacher, writer, and poet. She admires Clarice Lispector’s prose, Octavia Butler’s fiction, and Simone Weil's philosophy. Seraphina currently lives in Istanbul.