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- [Craig] Martha Lewis understands what it means to get a good night's sleep, but she's had to learn how to sleep well and is now a Certified Child and Adult Sleep Consultant.

- Sleep does so many things that we don't even know about yet, but studies show that getting fewer than seven hours of sleep a night means that you're at an increased risk of many chronic diseases.

- Martha Lewis, and all things sleep next on Wyoming Chronicle.

(lively music) - [Narrator] This program was funded in part by a grant for Newman's Own Foundation.

Working to nourish the common good by donating all profits from Newman's Own Food and Beverage products to charitable organizations that seek to make the world a better place.

More information is available at newmansownfoundation.org.

Funding for this program is made possible in part by the Wyoming Humanities Council, helping Wyoming take a closer look at life through the humanities, thinkwy.org.

And by the members of the Wyoming PBS Foundation, thank you for your support.

- And as we begin this Wyoming Chronicle, I'm pleased to be joined by Martha Lewis.

Martha, thank you so much for joining us today.

We're gonna talk about all things sleep while we're awake.

- Sounds great Craig.

- Glad that you're with us today.

We all sleep, but I would venture I guess to say, not all of us and most of us probably don't sleep very well.

Just as we start things today, why is sleep so important?

Things that we may not know?

- Yeah, definitely.

I mean, for so many reasons, sleep is important for in the short term for being able to focus and concentrate and remember things, to be in a good mood.

Yeah, all of those things.

And then in the long-term, sleep does so many things that we don't even know about yet, but studies show that getting fewer than seven hours of sleep a night means that you're at an increased risk of many chronic diseases.

So everything from diabetes to depression to Alzheimer's to certain kinds of cancer.

So it really impacts our health in such a big way.

And I always like to think about it, if sleep wasn't important, then we would have evolved out of it as a species a long time ago, but we haven't, we all need sleep, it's one of our basic needs.

- So what about the myth that, okay, during the week I'm getting 5-6 hours, but on the weekend I am catching up.

So when you add it all up, I'm right there.

Is that a good way to think about things?

- Well, it'd be hard to make up for only five hours of sleep a night, all week long.

There's something called sleep debt that we accrue.

So this means that for every hour of sleep you miss, things don't just start over the next day.

So if you need eight hours of sleep and you get six hours of sleep, then you're starting that next day with two hours in debt.

And then if you sleep eight or six hours again, then you have four hours of sleep debt.

And again, and again, by the weekend, you're having 10 hours of sleep debt, that's a lot and you can't really make... - It's a very long nap, I would say.

- Yes, yes.

- But of course that's not reasonable to think.

Did you become involved in helping folks sleep better because perhaps you weren't sleeping as well as you hoped to be?

- Definitely.

- [Craig] That's why you're doing what you do?

- Yes.

- [Craig] give me that history.

- Yeah, I was always a great sleeper and I always have valued my sleep, because I don't do well if I'm sleep deprived.

So when I had my son, he wasn't a good sleeper.

And when he was, you know, a baby, less than three months old, he was waking up every two hours all night long and I was miserable.

- Every parent's going "Yup, mm hmm."

- Yeah, but this was still happening when he was three months old and I'm like, "I have to go back to work.

I'm not gonna be able to function like this."

So I ended up hiring a pediatric sleep consultant to help.

And within four nights he was waking up once a night.

And by the time he was six months old, he was sleeping through the night.

So I became a pediatric sleep consultant because there was no one in Wyoming doing it.

And I really wanted to help families with this.

And then the ironic thing was that after he was sleeping, I wasn't, and my insomnia actually started in late pregnancy but I figured it would go away after I had him.

But it lasted for another two years after he was born, before I finally said, I have to do something about this.

- You do most, if not all, of your work remotely but yet you're able to give some good advice.

- Yes, definitely.

And you know, what I've learned has changed over the years.

I initially helped people look at diet, look at exercise, look at stress, all these, you know, very general but important things that impact our sleep.

And that helped me for a while as well.

And then I went through another stressful period in my life and those things didn't work anymore.

And that's how I found out about lab testing.

And so finding out that there are things that can happen to your body that can keep you from sleeping.

And so now that's how I help people now is looking at everything in their body and their mind that are keeping them awake.

- Let me tell you my issue with sleep, if you don't mind.

I sleep great except when something's coming up, it's on my mind and I'm talking like a week out.

And then I'm thinking about it, you know, as I'm getting ready ready for something during the day, it's on my mind, I wake up in the middle of the night and there it is.

And I struggle with that.

If I have nothing in my near term future, it seems fine.

Is that something that you see?

- Yeah, definitely.

I mean, I think that's normal and you're probably pretty fortunate, but I also think it's during these stressful times that we tend to neglect really taking care of ourselves or taking breaks during the day, you know, focusing on relaxing activities and things like that, and that's when we actually need it the most.

And so doing things like journaling before bed or meditating during the day, like all those things can help lower that stress so that it's not affecting you at night.

- I find that when I'm working, I don't work as well in the morning as I do in the afternoon and into the evening.

And that probably should be reversed when it comes to sleep.

Would you agree with that?

- No, because everyone has their own circadian rhythm.

And so that's actually normal for more night owls to feel more tired in the morning, and to feel more alert in the afternoon.

Whereas I'm the opposite, I'm more of a morning person.

I'm a definitely more productive and able to focus in the morning and afternoon get less, so by eight o'clock I'm done, there's no way I'm doing any work.

So it is different for everyone.

- Dave Letterman, Jimmy Fallon, I enjoy their monologues and I watch them.

That's probably about the worst thing that someone can do right before they go to sleep?

Is that true?

- Yes, I mean, you know, we all know that blue light isn't good for us before bed.

- I don't know that everyone does Martha because people have their phones.

I think some people have heard of that, but you have to turn that on on your phone, or you have to get an app to help with that or an app to help with your computer.

Give us a little more detailed what that is.

- Yeah, definitely.

I mean our circadian rhythm, first of all, it's not exactly 24 hours.

Like we live in this time where we determined 24 hours a day but sleep researchers have done studies where they have been in a cave with no light, and some people's rhythm is less than, or clock is less than 24 hours, some people is more.

And so light is what really regulates our clock, our body clock, and blue light that comes from the sun that also comes from screens is what tells us it's daytime.

And it's gonna keep us awake, it tells our body to release cortisol.

So if you're watching screens at night, then your body is confused.

It's not winding down.

It's not producing melatonin because that blue light blocks melatonin.

And so it can keep you awake at night.

- So I'll just take some melatonin.

(Martha laughs) Some people probably say exactly that, or they do take melatonin.

We'll talk about a lot of things, but I'll ask you that question directly, is melatonin a good thing to take and how do you know if you need it?

- Right, you know, I like to test instead of guess.

And so one of the tests I do for hormones also looks at melatonin.

And so if someone is low in melatonin then that's what I recommend in the short term.

There are no studies showing that it's safe to take in the longterm.

I think hormones, you don't just wanna supplement with willy-nilly because they all work in balance together.

And so that's why I say, if you need it, then yes, take it.

But I also see melatonin as an indicator of gut health because your gut, the good bacteria in your gut are supposed to make melatonin, and other things like dopamine and serotonin and GABA.

And so if your gut isn't healthy it's not producing melatonin.

So if I see someone's melatonin is low, I work on yes, supplement in the short term, while we work on restoring gut health so that your gut produces melatonin on its own.

- Some people watching probably know what gut health is and others probably don't.

That seems it's kind of scary to some maybe, what are you talking about?

- Yeah, so your gut tend to refer to your digestive system but a lot of times it's to our large intestine or colon.

And we talk about the bacteria living there.

We have more bacteria in our guts than we do cells in our body.

They're trillions, and they're supposed to do things like make these chemicals that I talked about.

They make certain vitamins and they're a big part of our immune system.

And so it's very important to have a healthy gut, to be healthy in general, and to sleep well.

So if your gut isn't healthy that means you might have a pathogen in your gut, like a parasite.

- So probiotics, or is it not that simple?

- It's not that simple unfortunately.

(chuckles) There is definitely a part of it.

But if you do have a parasite, for example, all the probiotics in the world aren't gonna help.

They're not gonna get rid of that parasite.

And a parasite is nocturnal, and so it's at night that it's eating and excreting and releasing a lot of toxins and causing a lot of inflammation.

And cortisol is an anti-inflammatory hormone, so whenever there's inflammation, your body releases cortisol and that's gonna wake you up.

And this is a big reason many of my clients wake up around three or 4:00 AM because they have something like a parasite in their gut.

- Interesting.

My dad took a nap every day of his life, you know, 20, 30 minutes or so, whether he was at work or whether he was at home.

Good thing?

- I think so.

- Yeah, is there a too long of a nap?

Not long enough of a nap?

What if I just lay down but never fall asleep, is that still helpful?

- Yeah, so, I mean, we have a normal dip in our circadian rhythm in the early afternoon, after lunch.

And that's why so many cultures historically have taken a nap.

You hear a lot of sleep advice for people who have trouble sleeping, not to take a nap.

And I do think that a long nap can, you know, impact your or make it harder to fall asleep at night, so it can sabotage your sleep.

But I think a 30 minute power nap is great.

It can be really rejuvenating.

There all kinds of studies showing the benefits of a nap how well you can focus after and remember things.

And so it can be really beneficial to take a quick nap.

And I do think that resting, even if you don't fall asleep is great too.

'Cause you're still giving your mind and your body a break.

- Martha earlier, you talked about your son and how four days later he was sleeping better.

Can it be that quick for adults?

Can adults be trained to sleep?

Is that how you view what you do?

Are you training someone to sleep?

Are you giving them tools to sleep better?

How do you view what it is that you do?

- Yeah, I don't think we can really train ourselves.

In fact, the harder you try to sleep, the more you're less likely to sleep - [Craig] That's so true.

- Yeah.

- [Craig] Yeah, I believe that.

- Yeah, so it does take a little bit longer especially when we're talking about health.

I mean, I do have clients who sleep better within a month and some it might take six months, so there is a range there, but even just, you know, making simple changes like avoiding screens before bed, you know, to minimize our blue light, things like that.

It's still gonna take a little bit of time.

- Caffeine, is there a cutoff time or is there like, "Nope, you shouldn't have caffeine at all or no, caffeine is a good thing because."

- I usually recommend that my clients don't drink caffeine at all and I don't drink it anymore either.

I think it's, especially if you aren't sleeping, that means your body is stressed in many different ways.

And caffeine is a drug and your body has to detoxify it and it can be hard on your adrenal gland.

- You just lost a lot of coffee drinkers who were watching.

- I know, right.

- You know, right?

But it's important.

- Yeah, I think in general, having a cup of coffee once a day in the morning is not a big deal.

And everyone's different as to how long it takes them to process coffee.

So it has a half-life of 6-8 hours which means it stays in your body for up to 6-8 hours after you drink it.

And so the more you drink, the longer it's gonna stay in your body.

But then we all have different metabolisms as well, so women especially metabolize caffeine slower.

And so it can be in your body longer.

So I like to say by noon, for sure, no caffeine.

- Other things that come to my mind, white noise.

You see these devices that are sold to folks to help you sleep better.

Helpful?

- I think so.

And I recommend it for babies and kids.

It can be helpful for adults.

- [Craig] Even for children?

- Yeah.

- [Craig] Interesting.

- Yeah.

- [Craig] So they're not distracted maybe as much or?

- It's more of so that, you know, they don't hear other loud noises, movement around the house, things like that.

And so that's white noise for adults can be helpful especially if you live in a noisy neighborhood or a busy city or whatever it is.

It's great to block out those other sounds.

- And white noise is just this, to me If I were to describe it, my interpretation there's pink noise, there's brown noise, there's white noise, but it's a constant bit of background noise, that's what you say, filters out things.

- [Martha] Yeah.

- Is one better than the other?

If I'm looking on an app for my phone or for my Alexa app, is there one that's more magic than the other as far as being helpful to sleep all night?

And should you leave it on all night long?

- Yes, I do recommend leaving it all night long if you're gonna use it.

I don't think there's necessarily one more helpful than the other.

I mean, just an old fashioned fan will do the trick as well, but there are apps with rain and the ocean sounds, I tend to like steady rain.

And if there's thunder, you know, which some of them have.

- Kind of counterproductive there.

- Yeah, exactly.

But I also think it's whatever works for you, whatever you prefer.

- What about aroma therapy?

- It can be helpful.

You know, I like essential oils too, I like lavender before bed, camomile, things like that.

There are a lot of great smelling sleep winds out there.

So I mean, studies show that lavender can improve the quality and the length of your sleep by a little bit.

So I think it's helpful, but I think all of these things are more of a bandaid and not necessarily the root cause of why people can't sleep.

- So give me some advice for tonight.

All right, I'm gonna get home maybe about eight, 8:30, nine o'clock after traveling most of the day, how should I wind my day down to get the best night's sleep?

What advice would you give me?

- What time are you going to bed?

- Probably about 10, 10:30.

- Okay.

- Depends on how funny Jimmy Fallon is.

- Yeah, right?

- No, but let's just say I've learned I shouldn't really watch Jimmy Fallon, I'll DVR, I'm gonna watch him tomorrow.

What should I do?

- Yes, well, I actually think it would be fine if the first thing you did was watch some Jimmy Fallon, and maybe that's 30 minutes or an hour before you go into bed and then do some things without screens, so... - How about reading on my Kindle?

I like to read a lot and that is also something that I do right before bed, but it makes my mind work too, I have noticed.

- Yeah, I think reading before bed is great.

If your Kindle is a screen, you know, it depends, there's a Paperwhite Kindle that doesn't have that backlight.

That's what I use.

- [Craig] That's what I use.

- Okay, so I think that's great.

What you are reading might... - Right.

- Might make a difference.

- Whether it's light or whether it's intense or what have you.

So I take your advice and I just fall right to sleep.

But then I look over and it's 3:00 AM, like we were talking about earlier.

What advice do you have for me then?

And I'm talking, this is all short-term stuff, and we'll talk maybe about some more longer term things too but in the moment, Martha.

- Yes.

- What's your advice for me?

- So if you wake up at three and I don't recommend looking at a clock, first of all.

- [Craig] At all.

- Ideally not.

- [Craig] That would be hard I think.

- I know, right?

But no matter what time it is, it's not a good time.

- True, but I wanna know how much closer I am to six maybe.

- Yes, but then your mind starts going, right?

"Oh, I've only slept this much."

- That's exactly what happens.

- Yeah, "Oh, if I go to sleep now, I'm only gonna get this much sleep."

So that's why I recommend not looking at a clock.

And then if it's been about five or 10 minutes, and you still aren't falling back asleep, or you could try counting backwards from 100 and if you get to zero, then I suggest getting out of bed.

- Getting out of bed?

- Yeah.

- That surprises me.

- Yeah.

- To do what?

- Do something relaxing, with the lights dim read something.

If your mind is racing, write stuff down, you know, write your thoughts down.

- Can you meditate at 3:00 AM?

- Sure, if that's what you like.

- If you have those apps that are your Peloton subscriber, they're right there for you to do that kind of stuff then.

- Yeah, ideally your blue light blocker's on on your phone.

But yes, that's a great thing to do in the middle of the night.

And then wait until you get sleepy and then go back to bed.

And this is so hard to do, it's so hard to get out of bed but you want your brain to have the strong association between bed and sleep.

- [Craig] Right, right.

- And for people who struggle to sleep for a long time, they've lost that.

And so that's why I say, get out of bed then go back to bed.

If you fall asleep, great.

If it's been five or 10 minutes again, and you're not falling asleep, get back up, do something relaxing until you feel sleepy again.

- I've taken the advice to put your phone charger in a different room.

Is that right up there in the things that you suggest to folks, don't leave your phone in your room?

- Yes, or at least have it on airplane mode if it is in your room.

- Mm hmm.

- Yeah.

- You talked a little bit ago about melatonin.

And I think that anecdotally, I guess I've heard that, you know, well, if I'm having trouble sleeping maybe I should go to my doctor.

Okay doctor, thank you for the prescription to X, Y, or Z.

And I'm talking Ambien, the things that I've read about, Sominex maybe over the counter and that kind of stuff.

People use those things Martha.

I'm guessing you're thinking that's probably not a great long-term solution?

- Yeah, again, it's another band-aid and those things aren't giving you real sleep.

That's one of the problems.

- Tell me what that means?

- So they're sedating you.

- But I'm not awake.

- Yeah, but you don't go through the same sleep stages or stay in those sleep stages the same amount of time as normal sleep.

And so that's why, you know, those things can lead to dementia and Alzheimer's because it's not true sleep and your brain isn't doing the functions that it's supposed to do during sleep.

- So there's something different about sleep than being anesthetized?

- [Martha] Right.

- And that has to do with deep sleep or REM cycles.

My wife has a Fitbit and she's always very interested to see the different stages that she was in.

Are those a good idea?

Because if I've told her, if I had that thing, I'd be worried about, I'm so analytical, I'd be worried about the results and it be on my mind.

Well, geez, you know, there says three o'clock, are those a good thing to record your sleep patterns?

- Yeah, so that's the thing, I think it depends on the person.

I know for a lot of people with sleep issues that causes more anxiety than anything.

And I think what's most important is how you feel the next day.

So those trackers can take us away from that.

And then people freak out.

"Like I was in bed for eight hours, I thought it was sleep the whole time, but only slept seven, oh no."

And that's actually normal.

But then you're thinking you didn't get enough sleep, and then you feel like you didn't get enough sleep.

And so it's not helpful when that happens.

- Martha you were telling me off camera that Jackson Hole High School has not the latest starting time, among the latest starting time in in Wyoming and perhaps in the region.

But you view that as a really great thing when it comes to sleep?

- Yeah, teenagers have a later body clock.

It can literally be a couple hours later than they do as kids.

So if your teenager isn't tired at 10 o'clock, it's not their fault, it's just how their body clock is.

And so in 2014, Teton County School District voted to be part of a study and to make school times later.

So high school was starting at 7:35 and they moved it to 8:55 and they found that grades increased, that tardiness decreased, and that car accidents for 16-18 year olds decreased by 70% because of that.

- Kids, it seems to me, I mean when I was a kid I think I remember that, you know, when I was five or six I had to go to bed at whatever.

And then when I was seven or eight, I got an extra 1/2 hour and maybe eight or nine, then another 1/2 hour and stuff.

I'm not sure that that equated to having to wake up any earlier or later on the backside of that.

What advice you have for parents, summer's coming along, you know, their kids probably were getting to sleep earlier during school, but now they wanna stay out.

It's lighter longer till 9:30 or so or more.

What do you tell parents with, you know, maybe not 17 and 18 year olds, but you know, 10, 11, 12 year olds?

- Yeah, I mean kids until they're teenagers need 10-12 hours of sleep a night.

It's a lot.

- [Craig] Yeah it is.

- So if you're fortunate enough to have a child who can go to bed late and sleep late, then you're probably good.

And you know, with my son we kind of move our schedule like that, but he will sleep later in the summer, so it works for us.

But if your child gets up at seven or six, which many do, then they need to go to bed earlier to get all the sleep they need.

- I found it surprising that you're able to work with people remotely, Martha, and that's the great majority of your practice.

When someone reaches out to you what should they expect to hear from you in your first initial visits I guess you should say?

What are you gonna ask them about?

What are you gonna ask them to do for you?

- Yes, well, for adults initially, you know, the first call is finding out if we're a good fit to work together.

So I'm asking questions on what's going on with their sleep, what's going on with their health, how they want to be sleeping?

And then I'm telling them how I can help them find out why they aren't sleeping and work together to do that.

- You came to Jackson Hole, the story goes, with maybe a few hundred dollars in your pocket, and that was it from the East coast.

What drove you here?

- I came out with a friend after graduating college to kind of explore the West, and look for a place to live for the summer, and I never left.

- Martha, a lot of people like to come home after a long day's work and have a beer or maybe have a nightcap.

How does alcohol influences sleep, even in moderation?

- Yeah, alcohol definitely impacts our sleep.

Depends on the person too.

I'd like to recommend that people be at 0% blood alcohol level when they go to bed.

So instead of a nightcap, I might recommend more with dinner or before dinner.

- So let me just translate that for folks.

If I have a beer at dinner, at six o'clock, at 10 o'clock probably okay.

- Yeah.

- If I'm having a nightcap at nine or 9:30, for whatever reason that's probably gonna really not help our sleep.

- Exactly, yeah.

- Why is that, yeah?

- Yeah, because your liver has to detoxify that alcohol and so about four hours after you drink it, then it's doing the work of detoxifying that and so that is why people tend to wake up around 2:00 AM especially.

And if your liver is unhealthy already, which many people I work with it is, because it's dealing with so many toxins from say a pathogen in your gut, like we talked about, or from alcohol, then it's gonna have an even harder time detoxifying it.

And those toxins are gonna be circulating around causing lots of inflammation.

And then your body's gonna release cortisol which is gonna wake you up.

So for most of my clients with sleep issues, I actually recommend quitting drinking for a period of time.

And I have people who start sleeping better immediately just from doing that.

- So I think the bottom line if I were to summarize the discussion, Martha, you would ask people to not focus pretty much in any way on these band-aids or short-term solutions, but rather to take sleep as a kind of a lifelong issue with a long range plan.

Am I right about that?

- That's exactly right.

- Very interesting.

Well, the name of your practice is Complete Sleep Solutions.

People I think can reach out to you, Martha you're here in Jackson, but you serve people all around the region, I would assume.

- Yes, around the world even.

- Well, best wishes to you, and we really appreciate your time stay on the Wyoming Chronicle.

Thank you so much for joining us.

- Thank you, Craig.

(lively music) - [Narrator] This program was funded in part by a grant for Newman's Own Foundation, working to nourish the common good by donating all profits from Newman's Own Food and Beverage products to charitable organizations that seek to make the world a better place.

More information is available at newmansownfoundation.org.

Funding for this program is made possible in part by the Wyoming Humanities Council, helping Wyoming take a closer look at life through the humanities, thinkwy.org.

And by the members of the Wyoming PBS Foundation, thank you for your support.