Tips & tricks for how to wind down in the evening, and prepare yourself for a restful sleep.

Note: We cannot provide medical advice. Please contact your doctor directly for specific questions about your care.

Topics

• Tips to have healthy sleeps
• Why sleep is important 
• Suggestions for how to wind down in the evening

References

• High blood pressure & COVID-19

Transcript

Scott K. Johnson - Hey, great to see you. Thanks for tuning in to another episode of Coaches Corner. I hope you're holding up all right and hanging in there. These are challenging and stressful times for almost everyone. We're full of gratitude and appreciation for everyone out there doing their part to get through this. One small way that mySugr can give back is by hosting these short conversations with our diabetes coaches to talk about, staying healthy in body and mind during these unusual times. Now, with that I have to give the standard disclaimer. We cannot provide medical advice. Please contact your doctor directly for specific questions about your care. First up today, I have a quick update from Molly around, blood pressure and COVID-19. Then I talk with Kristen and Maggie about something, I know, I don't think about often enough and that is, sleep. So, don't snooze on this one folks. Let's jump right in.

Molly Wagman - Hey everyone, it's Molly here from mySugr. I'm here with a short health update around the COVID-19 subject. So as many of you may know, there's a large number of people who are hospitalized with COVID-19 who have high blood pressure. So, the CDC says that, about 72% of people, age 65 and older, that have been hospitalized with COVID-19 have or had high blood pressure. We don't know exactly why yet, but we know that it has something to do with the way the virus acts, but high blood pressure, means that the heart and the blood vessels are compromised. So, some type of cascade of inflammation and enzyme reactions, cause the blood vessels in the heart to be a little bit more vulnerable to the COVID-19 virus.

So, medical experts are looking into whether taking blood pressure medications like ACE inhibitors, increase or decrease the risk. So, we're not sure at this point. They're finding though that there may be a correlation to risk if you're taking blood pressure medications. As the answer though is, super clear right now that if you do take medications for high blood pressure, do not stop taking them, absolutely continue them to manage your hypertension. And then, especially reach out to your doctor if you have questions about your specific medications. So if you're not sure if you're taking one, then definitely talk to your doctor. So, this is really important for us to pay attention to because almost half of Americans have high blood pressure and majority of people with type 2 diabetes have high blood pressure and many people with other types of diabetes also have high blood pressure. So, as everything that's diabetes and medication related, individualization is super key.

So, definitely again reach out to your physician if you have questions about your medications, or if you're wondering if they're correct for you. But if you want more details about this specific subject of, high blood pressure, hypertension, medications and COVID-19, and higher risk for hospitalization. We're going to post this link here, so you can read for yourself. And we know you've heard this plenty of times but here it goes again, especially if you have diabetes and hypertension, be extra cautious and follow the CDC guidelines of physical distancing right now. And, definitely, wash your hands as much as possible. And, just be mindful of who's around you and your surroundings. So, if you have coaching through mySugr, we are always available to answer any of your question so you can send us a message, but please stay well and we'll see you soon.

Scott K. Johnson - All right. Hi friends. We are talking about sleep, this time, and. First and foremost, our routines. My routine is way different now. And, that has knocked my sleep schedule all over the place. How about you two? What's going on in your worlds?

Kristen Bourque - Yes, I think. Now I'm starting to feel a little bit better but definitely I think the first. Well, now it's over a month already . We have been in lockdown but, I've definitely noticed my sleep has not been. It's been very broken, I've been waking up, kind of feeling a little anxious and stuff. So yeah, I've definitely noticed my sleep has not, it's been a little bit more interrupted than normal for sure.

Maggie Evans - Yeah, I'd agree. Usually when you have a set structure of going to work and doing these things day to day, can be easier to have that set bedtime and now when we're kind of like in no man's land, it's kind of funny where, it's so much easier just to kind of ignore that normal bedtime and kind of sneak in, into bed at later hours and. So, it's hard. It's a really tough time to kind of keep everything consistent.

Maggie Evans - Yeah.

Scott K. Johnson - I've noticed that, when I think I can kind of cheat a little bit like sneak in a quick nap in the day, which is totally fine. I'm an advocate for naps. But, what I started to notice is that on the days that I took a nap, it really disrupted my, my nighttime sleep schedule, and then I wasn't able to get what I needed sleep wise during the night so. And maybe that's a good place to start is, why is it important to get a good solid amount of sleep per night?

Maggie Evans - Yeah, that's a great question Scott. So, really, if we're looking at health in general. Sleep is that like main pillar that main foundation that, if we don't get adequate sleep at night, the wheels start to fall off in all these other areas of our life. It can affect things from our mental and emotional health. It affects things in terms of our blood sugar management both if we have diabetes or if we don't have diabetes. It can impact our eating behaviors throughout the day. So, it can really kind of slip in to all these different areas of health of our overall well being. And that's why, when I'm talking to people, even if it's a nutrition consult, sleep is like one of those number one things that we want to talk about because it can impact all of these things. Subtly but also I just think overtly. If we don't get enough sleep at night, that is going to affect all these areas, for sure.

Scott K. Johnson - And what are you aiming for when you are asking people to get enough sleep? What is enough sleep?

Maggie Evans - So typically, we recommend the basic recommendation is going to be anywhere from seven to eight hours for most adults. I am key though on quality sleep, right? So, even if we can't get that seven hours maybe we're getting six. We want to make sure that we're in a nice deep quality sleep during that six hours, cause then you're still going to, your body's still going to regenerate and kind of do the things that it needs to do during that sleep time. So, in an ideal world, yeah seven to eight. But, the quality of the sleep I think is what matters as well.

Scott K. Johnson - Great. You talked about a little bit about, the lack of sleep affecting many things. And, I know that you guys have mentioned like the hunger and hormones and I want to dive in a little bit around, the hormones for a bit because it's kind of. For me, I don't know much about this and I want to just get, kind of shine a light on that for a bit.

Maggie Evans - Yeah, so. The two main hormones that sleep tends to affect are going to be ghrelin and leptin. Ghrelin is a hunger hormone. So, when I'm talking to people about ghrelin usually I relate it to gremlins. So, the movie Gremlins when you feed the Gremlin and it gets bigger and. It's like kind of like that. So, ghrelin is produced by our stomach cells, and it kind of indicates to us when we're hungry. It'll initiate, kind of that salivation in our mouth so we're getting ready to eat. We're kind of like at that point, but it just brings on hunger. Leptin is actually produced by our fat cells, and it's a fullness hormone. So, it's going to indicate to us when we're done eating and kind of to stop, stop at the mealtime. Sleep affects those, kind of it's a double whammy, right? So, it's going to increase ghrelin, and it's going to decrease leptin. So I'm going to feel more hungry throughout the day and I'm not going to be able to feel that fullness throughout the day. So that's really where it can affect. Yet again, our weight. It can affect our blood sugar management. It can kind of seep into all these different areas because those hormones are disrupted.

Scott K. Johnson - Right, is there. What about stress hormones? I imagine if I'm running short on sleep, that my body, that I'm just experiencing a higher level of stress too, right?

Maggie Evans - Yeah, so stress, definitely our cortisol levels can go up. So if, we know that with, in terms of blood sugar management as well that if cortisol is higher, that's going to make it harder for our body to uptake glucose to manage our glucose levels. So, that can, definitely have another physiological effect on our blood sugar management throughout the day, if we aren't sleeping enough. And I also just think of like, the psychological factors of that too, right? If I get a really bad night's sleep, I am not a happy person at work. Nobody wants to be around me, right? Cause I need extra coffee and like, just the way our outlook, kind of on the day might be a little bit different when we don't get enough sleep because it just kind of has that impact on our mental health as well.

Scott K. Johnson - Yeah, Kristen you kind of talked about, your emotional health and sleeping. Do you find that, that you're feeling a little more anxiety on days where you didn't get the sleep that you wanted?

Kristen Bourque - Yeah, I think that, especially when, like I said, the last week or so. Definitely I feel like I am a lot more, even emotional maybe. In just kind of, a little bit maybe more sensitive but yes, my anxiety is a little bit higher feel maybe a little bit more sad. I've also we've had some kind of, strange weather here lately too that doesn't help but, yeah I definitely can notice when I get a good like Maggie thing. Maybe a good eight hours or so and it's a good kind of solid like nice deep sleep. I am just much more focused, I'm just much more, I don't know kind of content and, just overall less anxious, so yes. It's hard because, it's kind of that catch-22, right? You, are maybe up in the middle of the night cause you're feeling anxious, but the lack of sleep can definitely kind of, kind of peak that anxiety, a little bit too. So, it's hard to, to manage both of those things for sure.

Scott K. Johnson - Yeah, it's funny how a lot of these things, they're. I'm going to call them little big things, right? Because they're little big things that, that create this vicious cycle. That kind of feed into each other. And, you really have to chip away on little aspects of them from all angles to help bring the system back into place. Even thinking about effects on, blood sugars and weights. Maggie, what kind of foods, am I craving if I'm short on sleep?

Maggie Evans  - So typically when people are short on sleep. What I find most in my experience with coaching and nutrition coaching is, there tends to be a higher craving for simple carbohydrates, right?

Kristen Bourque - Yeah.

Maggie Evans - So simple carbs, maybe more just, generally processed foods. And when I really think a little bit deeper about that when you look at kind of what's going on, in the body too. One simple, more processed foods, they're just easier to eat, right? If I haven't gotten sleep. The last thing I want to do is cook. I don't want to do that. I don't want to bring out my frying pan and all that stuff. So it's much easier to open a bag or something and kind of snack on that throughout the day. The other thing too is that when we're tired, we're kind of seeking energy. We want really quick sources of energy. Simple quick carbs tend to do that. And so, what we tend to see is that, we're kind of craving more of these things just because our body's needing that surge of energy. So we see this quick surge, spike in blood sugar, and then it's going to drop, and then you're searching for that thing again. So, we tend to see these big rises and falls of blood sugar because we're just kind of continuing to eat more of the simple kind of refined carbohydrates, or just simple, just more processed foods cause they're just simple to consume.

Scott K. Johnson - I also find. I kind of want that, that reward like that treat that feel good food to just get me through like oh my God this. I can't believe it's only, 10 o'clock in the morning, it feels like it should be like okay maybe if I have a little snack, a little treat it's going to boost me up a little bit and get me through a bit. And so, those things they totally destroy my blood sugars and weight and all of that stuff so. And it's hard to recognize in the middle of that that, all right, if I would have just maybe gone to bed, put my phone away and gone to bed. An hour earlier or even a half hour earlier I might be feeling a bit better right now, so. It's clear that sleep affects all kinds of different things.

Maggie Evans - And I think that's one thing too that we don't necessarily always think about too. It's really bringing mindfulness to all of our habits, right? So, someone may say like, ah, I don't know why I'm craving these things all throughout the day like, I just want to eat chips or I want to just keep snacking and snacking. And, really taking a deep dive into what you're doing, right? And you may not even recognize that, hey yeah I did get only is five hours of sleep last night and that could be what's contributing to this eating behavior too. So just more mindfulness around those habits can really help us kind of dig deeper and figure out like where are those, where are changes that I need to make, just to help myself feel better throughout the day too.

Kristen Bourque - Yeah.

Scott K. Johnson - Yeah, that's a great point. Another thing that comes to mind as we're talking about this. I notice on nights where my blood sugar is not on target or close to target when I'm sleeping, I feel more tired the next day too. So it's another, another good reason to, do everything we can to have in range blood sugars overnight and I say that, in my mind I'm going, like yeah Scott, it's just that easy just have in-target blood sugars overnight. And of course I know that's not true but. I just want to acknowledge too that, when your body is resting and trying to rebuild and repair and do all of its restful stuff. It's easier to do that when blood sugars are in range so, there's that part of it too. So, yeah.

Kristen Bourque - But you're right though Scott. Cause it is kind of this, like cycle in a way. But I think it's good to recognize these things, and, again, and even how Maggie said it. Just paying attention more to those impacts and like yeah. My food intake, my sleep, my blood sugar and seeing if you can kind of make any, kind of correlations and look back and make some positive changes in the future to kind of help. And again, if I do this, all those things will kind of help to kind of, follow suit more or less too. I mean, again, easier said than done but every little change can help I think too.

Maggie Evans - And that's why it can really be helpful to work with your coach too. That's our, part of our job is to, kind of assess these areas of your life and just kind of see, where is maybe that chain-link little bit broken and how can we fix that to help you run smoothly. So, kind of having someone look at it from a, third party just neutral perspective and just kind of help you, work through kind of different aspects of your life that can just help you stay healthier, stay well, those types of things too.

Scott K. Johnson - Yeah, I love that. So let's do that right now. What can we do, if we are trying to fix our sleep at night and build a routine, or get on the right track?

Kristen Bourque - So, I like the idea, this term sleep hygiene. So, the idea of having healthy habits, to kind of work on. And I think it's also important to remember is, even if you try to incorporate one of these things I do think there'll be some sort of positive impact. So, one that I am going to say because I have to work on, is electronics. So, again, I think we're so attached to our phones, our TVs. We have technology all around us 24/7, right? So, I think, minimizing that time, especially before going to bed I think is a really great place to start. Because again, there's some research about the, the type of kind of lights and you hear about the blue light and all that sort of stuff too but, that can kind of awaken us or keep us awake. Also, again, some people they say they sleep better with the TV on but generally I think you're going to have a more restful sleep, a more complete and get to bed sooner if you kind of have all those things, minimize ideally I would say, 30 minutes if not sooner than that. And then maybe replace it with something different. Maybe it's taking a bubble bath or reading a book or something like that. But again, I think the idea is that technology kind of keeps our brain going a little bit and doesn't help us to kind of wind down which is what we should be doing before we get into that routine there. I would start with that one for sure.

Maggie Evans - I can't stress the technology piece enough. Because I even noticed that myself, those nights where I'm watching Law & Order: SVU to like midnight, and I'm just so ingrained in that show, and it's going to take you an hour or two to finally, calm down from that, right? And so, then that's, you're not getting to bed till two or three in the morning. So, when we're watching shows when we're on our electronics. Our brain is active and is going. And so, when we're thinking of, kind of getting ready for sleep we want to really be kind of unplugged from that stuff to really allow our natural body cycles, our circadian rhythm too, to do its job to help us get ready for sleep. And so, really disconnecting from some of that stuff can be helpful. I know it's hard, I struggle with it too. I have my laptop in bed sometimes. But, I do know, hey there's nights that I don't have that laptop with me or I turn the TV off beforehand that sleep is going to be so much better that night, and I'm going to pay, that's going to benefit me that next day. So, kind of looking at the cost benefit analysis of that. Yeah, I can get an extra episode of Law & Order in, but how am I going to feel tomorrow? So, that I think is something to think about. And then, also just the routine. I love what Kristen said about, taking a bubble bath, maybe doing a warm shower, doing some type of self care thing maybe that doesn't involve that technology piece. That just makes you feel good and kind of relaxed before bed. It could be meditation. It could be stretching or yoga. Maybe putting on a nice lavender lotion, something like that. Just even like half an hour before bed can really kind of change the game, in terms of your sleep to really help get that nice deeper sleep for yourself.

Kristen Bourque - And, I like what you said Maggie about like 30 minutes before cause this is something again. I'm going to take some off these tips myself and work on but. And sometimes, you just lose track of time. I think, again, because we don't really have the structured schedule and so though I'll look at my phone and say, oh my gosh it's 10 o'clock, I'm going to get ready for bed. But it's, starting that routine maybe closer. So if you normally go to sleep at 10, trying to start, kind of that more or less routine around nine. So start like you said, the hot shower or anything like that that's going to help you get in your PJs. So kind of starting that routine ideally like, a little bit before versus being like, oh, it's 10 o'clock I have to, brush my teeth, get into bed. Cause you're still maybe wound up a little bit. So kind of maybe planning for okay my bedtime is this but still having that quote-unquote sleep routine. 30 minutes, 45 minutes, whatever it is for you before that to start that process. Because I notice for me, if it is then 10 I'm trying to shut everything off, then it's not going to happen. I don't fall asleep probably till 11. So, put that as part of your bedtime routine. Whatever time you end up. I think that's also a very good thing and like Maggie said, whatever is going to be for you. But, just having something to kind of help you wind down. A face mask, is one I recommend. Getting around eight o'clock get some things going and then ready for bed at that time.

Maggie Evans - I think making your bedroom too a place where you want to sleep, and you want to be, right? Like I call it a sleep sanctuary. So, sometimes that helps if you remove some of more those distractions. I mean I think in a very ideal world, maybe we wouldn't have our phone or our TV in the room, and just kind of dedicate our bedrooms to sleep itself. That way you know, don't work in bed don't do more of these kind of stressful activities in the room, cause then when you go in there, you're going to automatically be relaxed and you're ready for sleep. So, kind of setting your room up to help you be successful with sleep. Keeping your blinds drawn so it's nice and dark in there. Keeping it at a cool temperature, typically anywhere from, I think it's like 60 to 65 degrees is kind of like the ideal temperature. You want your room to be at least a little cooler at nighttime that helps promote better sleep. Maybe get a nice set of sheets and things like that. So it's comfortable and you want to be in that bed. I love sleep, I love my bed. I look forward to my bed every single day and sometimes I don't even want to get out of it. But, yeah. So if you can set that room up to be a place where you really want to be, it might actually be more motivating to turn off that TV or, those other activities and get yourself into bed at that time. To be able to sleep.

Kristen Bourque - And just a couple more things around. Our meal time and again, same thing kind of with that winding down. Again, like Maggie said, we're watching some, re-runs or something. A lot of times we are more likely to want to snack late at night, but we want to try to limit, snacking especially also like fluid intake. I've been there too, where you end up drinking a little bit more late at night and then you're up in the middle of the night. So again, we want to try to have as restful a time. So again, kind of resting our digestion let's say as well, So, trying to kind of stop eating a little bit more, earlier in the evening and then the other one which, again, kind of hard sometimes given that, this trying to break this cycle, but is limit the caffeine intake. So ideally I would say, quite a few hours or so before bedtime because that still can be in your system. So, even if it's something like you normally have tea, make sure it's a decaf tea or something like that that you might sip on in the evening time too. So again, our. Our food intake, our hydration all those things can also potentially impact your sleep for the night as well. So again, going back to that routine, thinking about things ahead of time so that it sets you up for a better sleep schedule at night.

Scott K. Johnson - Good stuff, I love it. Well I am looking forward to, working on many of these tips and tricks myself as well.

Kristen Bourque - Me too.

Scott K. Johnson - And again, just a quick reminder that, these are a handful of suggestions and, please try some. But if they don't work for you then they don't work for you and you should not feel bad about that but I think it's all about kind of building up a toolbox of tips and tricks that you can build into your routine in increasing your awareness and education about how you can, maintain and keep a healthy sleep routine and just being aware of, how much sleep affects everything in your world when it's off track so. Thank you both for, educating me a bit more about that and all of our viewers as well. I think this has been a really insightful and educational talk. All right, and we'll see you both very soon for another session.

Kristen Bourque - Hi guys it's Kristen from mySugr just checking in to share a few, healthy tips that I have been doing to help with my sleeping routine. So, the first one is kind of starting to wind down for the evening and starting to get ready for bed a little bit. So, I've been trying to do a, herbal tea before bedtime. So maybe something that, again, is more of a calming flavor. So, this chamomile is great. Of course, make sure it is caffeine free cause you want to avoid that before bedtime. So this, I generally will have maybe an hour or an hour and a half or so before I'm getting ready for bed. And it kind of helps to start winding me down for the evening time. I'm part of a book clubs that helps me keep accountable with reading. But, having something like a little bit of light reading before bedtime I think is great. And also, especially since we recommend limiting electronics, it can be a great kind of swap out so that you're still getting a little bit of, kind of part of your routine and established and doing a little something before bedtime, but yet kind of turning off those electronics. Lastly, something I very much swear by, is an eye mask so. I think this really is helpful especially if you have someone that you share space with maybe that might have, a little bit more lights on or things like that, but also in the morning time, although again it's helpful to, kind of wake up with the sunlight sometimes that can be very early. We might want to get a little extra sleep in there. So, I really like swear by an eye mask at night. I definitely I feel like I get just a better quality sleep. When everything is kind of blocked out so. So those are my three tips. Again, having some sort of a bedtime routine established, little tea, little reading, and then the eye mask and I am good to go. I hope those tips are helpful for you guys and have a great rest your day.

Scott K. Johnson - All right, there you go. Good stuff, right? I know that I loved the discussion there. Lots and lots of comments about, having trouble staying asleep through the night. And, that's something that can be, super super frustrating. I thought Tracy had a real good idea. Hi Tracy, about, if you have to get up to use the bathroom or whatever. Don't turn the light on full blast, it'll kind of trigger your brain to start, releasing your wake up hormones. Although, be careful walking to and from the bathroom. Some, tips and tricks around that. If you can be strategic about, placing nightlights or if you've got your iPhone or something like that that you can turn on a dim, a lower light to help get you to and from some of those things can't hurt but. Mandie, Carol, Kathi, Tracy all of you mentioned trouble staying asleep through the night. So something that is definitely a recurring theme. We'll touch base with Molly and see if she's got any additional tips and tricks to offer there. Other than that, please have a great rest of your day. I hope you'll come back on Friday, where we'll be taking a little stroll with Kristen to talk more about de-stressing and the things that she does, to keep herself calm through everything that's going on. And hey, leave us some more questions. We'll be happy to address them in an upcoming episode. Until then, stay well and we'll see you next time. Bye.