236 – Dr. Angela Holliday-Bell

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[00:00:00] Introduction

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Welcome to episode 236 of The Art of Living Proactively. In this episode, I interviewed Dr. Angela Holliday-Bell, a board certified physician and sleep specialist. And we discussed the importance of prioritizing sleep for overall health and wellbeing. Including how lack of sleep is linked to chronic diseases like Alzheimer’s and. Dr Holliday-Bell provides science-based advice for improving sleep, such as maintaining a consistent wake up time, seven days a week. Limits and exposure to blue light from electronics before bedtime avoiding large meals too close to bedtime. And many other things as well so a lot of today’s episode is around sleep and how to improve your sleep so that’s today with Dr Angela Holliday-Bell. Please do subscribe if you do like this show. Why not leave us a review it helps get the word out more people find out about the show and hope you enjoy this episode.

[00:01:04] Tony Winyard: Welcome to another edition of The Art of Living Proactively. My guest today is Dr. Angela Holiday Bell. How you doing? Dr. Bell? Holiday Bell.

[00:01:14] Dr. Angela Holliday-Bell: I’m doing well. Thank you so much for having me.

[00:01:16] Tony Winyard: It is good to see you. And we’re in Chicago today

[00:01:20] Dr. Angela Holliday-Bell: yes. yes. yes Coming from the windy city.

[00:01:23] Tony Winyard: Is it windy today?

[00:01:24] Dr. Angela Holliday-Bell: A little bit not as bad as it has been though we’re finally warming up, getting into the summer months. So it actually feels pretty good outside today.

[00:01:35] Tony Winyard: So So tell me more about the, I know that you are a sleep specialist, you are, obviously you are a board certified physician. Tell me more about you and your journey.

[00:01:45] Dr. Angela Holliday-Bell: Yeah, absolutely I’m a board certified physician.

[00:01:47] Decided to be a doctor at a young age

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[00:01:47] Dr. Angela Holliday-Bell: I decided at a very young age, at the age of six that I was gonna be a doctor. And just stuck with that, and it’s really been my life’s passion. But what I realized as I was going throughout medical training, specifically medical school and in residency, which is what we do after medical school, is it is very difficult to sleep while you’re training to be a physician, like you just don’t get sleep. And I’m someone who has always had a deep loving relationship with sleep. I’ve always slept a lot. But I started to get to a point in training where at first I didn’t have time to sleep. And then even when I had time to sleep, I just seemingly could not, and I really suffered from pretty significant insomnia and I saw what a toll it took on my life.

Both my mental health, my physical health. I was just not the best version of myself by any means. And so it started with my own quest to fix it. And I was like, okay, I can’t continue on like this. I have to fix it. And so I read all these books about sleep. I started volunteering at the sleep clinic in my hospital.

And throughout that process really fell in love with sleep and just the beauty and restoration that comes with sleep. And it’s more than just. Feeling rested, it actually affects every single facet of your life and functioning. And once I started to put those changes into my life and my sleep life and saw how it affected me, I knew I had to share with other people, with my patients, with my family and friends.

And then it just evolved over time to me really helping individuals, one-on-one, companies, corporations, and has really become something that I just take such joy and pride in doing.

[00:03:19] The crazy system we have for training young doctors!

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[00:03:19] Tony Winyard: It is crazy, isn’t it? The system that we have in many Western countries, like in, in America and England and many other countries. To train new doctors affects. Yeah. It doesn’t just affect their health, it destroys their health in many ways. It’s just a, the, it’s almost let’s start you off with the worst possible health we can give you, and let’s see how you’re gonna cope with that.

It doesn’t make any sense, does it?

[00:03:47] Dr. Angela Holliday-Bell: It doesn’t make any sense. It’s a conundrum, right? Like I spent so much of my time telling people, you have to take care of yourself. You have to get rest, you have to get sleep. While I was being deprived of that, on a daily basis. So it’s definitely an interesting way of training.

But I feel lucky, honestly, to have gone through that that journey and that process. Because when I am helping people, I come from a place of understanding because I went through it as opposed to oh, just do this because I learned that this is what you should do. I’m saying, no, do this because I went through the struggle.

I know how hard it’s, and I know that these things can help. So luckily it helps me to relate to people that I help a little bit more.

[00:04:24] Improving sleep will help almost any illness you have

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[00:04:24] Tony Winyard: I get the impression of all, I mean, there’s many different health conditions people have, but sleep is, if people can improve their sleep it’s gonna have such a major effect on almost every condition, isn’t it?

[00:04:38] Dr. Angela Holliday-Bell: 100 per cent. So, almost any significant chronic health condition and disease can be linked to insufficient sleep. So we think back, we can start at the basic level of like just obesity and weight gain that we are seeing as, an epidemic in our population. When you are not getting enough sleep, when you’re sleep deprived, the hormone that causes you to feel hungry, ghrelin, is actually released in higher quantities and the hormone that signals to your body that you’re full leptin, is released in lower quantities.

You’re also more likely to reach for higher fat, higher sugar containing foods, you’re less likely to be active. So it, it creates a perfect storm for weight gain and obesity that then creates an increased risk for all these other health conditions. In addition, when you’re not getting enough sleep, your body actually is in a state of chronic stress with chronic cortisol release because your body is like, Hey, if we are sacrificing what is meant to restore and replenish us every night, we must be under some type of threat. So let’s be on high alert. Let’s turn our flight or flight systems on because there must be something that we’re preparing to fight off.

And that if that happens consistently, then that also increases inflammation in your body, which, which weakens your heart and your blood vessels to high blood pressure. Your sugar regulation is dampened in that you are less likely to be responsive to insulin, so it increases your risk of type two diabetes.

It’s so many things that occur as a result of lack of sleep that we’re now starting to realize that, hey, maybe sleep is a big part of the puzzle of all of these things that we’re seeing increase in our society, and maybe this is something that we need to address.

[00:06:16] Sleep is my number 1 priority

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[00:06:16] Tony Winyard: Yeah Yeah I read a few years ago when I was studying various areas of health and there was a period I was going through where I was reading a lot about sleep, and the more I learned about it, the more I realized I think I need to make sleep my number one priority and that was, I can remember it was December, 2020.

And ever since then, I’ve, yeah, sleep has been my number one priority, over almost anything apart from my daughter, almost anything.

[00:06:48] Dr. Angela Holliday-Bell: I love it. And I think that’s a good way to think, right? And I think that in our society we’re so used to this hustle and grind, you gotta go sleep, makes you lazy, I’ll sleep when I die. All of these things that we’ve been taught in. In that it’s so hardwired in us now that it takes a lot more to peel back the layers and really get people to understand that you should start your day with sleep in mind.

Like you are gonna be a more productive, more efficient, happier, healthier person if you’re starting your day with being well rested and getting sufficient sleep and then everything else is easier. But it really, what I’ve, come to understand is it really takes a mindset shift to understand just how important sleep is.

[00:07:27] How eating late at night affects sleep

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[00:07:27] Tony Winyard: Yeah. One thing I’d like to get your opinion on, there’s so many strange things about the way many countries in the West are set up and one of the things that I find very strange is, For people who were working at night, be it people in entertainment or they’re working night shifts or so and so on, and it seems almost everywhere that after 9, 10 o’clock, the only things that are open where you can get food is the worst possible food you can eat.

And there doesn’t seem to be anything healthy open after 9, 10 o’clock. And that is just it’s not good to eat just before you go to bed anyway, but then eat eating really bad food just compounds the whole thing, doesn’t it?

[00:08:13] Dr. Angela Holliday-Bell: A hundred percent. A hundred. It just creates a vicious cycle, and I think it’s one of those things that kind of feeds into the fact that if you just think about a night that maybe you stayed up particularly late, or for people who’ve done, an all nighter or whatever you are way more likely to reach for that bag of Doritos or that sugary snack.

Like you, when you are in a state of sleep deprivation, you value instant gratification a lot more. So your ability to rationalize and think about long-term effects of things is significantly dampened. ’cause the frontal lobe of your brain, the part that really works on higher level judgment and executive functioning is not working properly you’re getting enough sleep, so you kinda resort to more primitive options. Thinking about the fact that I really should be eating some fruit or some vegetables or something not as high in calories; thats out the window and you’re just like, whatever’s gonna gimme that kind of instant gratification, that instant boost is what I’m reaching for.

And so I think a lot of that is a response to the fact that most people are less likely to eat healthy anyways. And then we’re just feeding into a culture and society that places less value on that in general. So it really just a vicious cycle.

[00:09:22] Why you should try not to eat just before bed

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[00:09:22] Tony Winyard: Yeah. What would you say to people who, because a lot of people ask after a late night out and they’ve been to a bar, to a club, whatever, and then they eat on the way home, and it’s generally not a good idea to eat just before going to bed. Is it?

[00:09:38] Dr. Angela Holliday-Bell: That’s right. Yeah. So really your last big meal of the day, so like dinner for instance should be about three to four hours before bedtime. And that’s because you gotta think about what happens after you eat. You’re stimulating your digestive system to send all of those digestive juice. Flowing contractions of your system to digest and even pass the food down through your intestines, and that’s a very active process.

If you do that right before you’re supposed to be going to sleep, when everything is supposed to be slowing down, then that can impact your ability to fall asleep because now one of your systems is being stimulated at a time that everything is supposed to be slowing down to prepare for sleep. So it’s really not a good idea to provide your body with that much stimulation.

One caveat to that, one thing that is okay is a healthy bedtime snack that can be eaten about an hour before bedtime, but a very small snack, rich and mostly protein and complex carbs. So something like a Greek yogurt with berries and nuts because the protein helps to keep you satiated throughout the night, so you’re less likely to wake up from like hunger pains.

And then the complex carbs from like berries makes it less likely that you’ll have a drop in blood sugar that can wake you up. So something like that is okay, but a large meal dinner is not a good idea to have that close to bedtime.

[00:10:51] Night shift workers

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[00:10:51] Tony Winyard: And what about for, I mean, ’cause there’s a lot of people do night shifts now,

[00:10:56] Dr. Angela Holliday-Bell: Yeah.

[00:10:57] Tony Winyard: And that is not, it’s not great for health in general, but what advice do you give? One for people who are doing night shifts, But I guess in some ways if you are doing consistent night shifts and you are always working at night, in many ways that’s better than if you are doing nights and in days and in nights and in days.

And.

[00:11:19] Dr. Angela Holliday-Bell: Absolutely. It’s best to not do night shifts, as you said, because the way that our circadian rhythm works, we have evolved to be in an alignment with the sun. So the rising and setting of the sun is a way that we have evolved and that is a way that our bodies work best and the genes in our body, every single cell in our body has a circadian rhythm that it follows, and it has evolved to be in alignment with this sun.

So it’s best if you are awake during the day and sleep at night. However, modern world doesn’t really work like that. I get it. Some people, for one reason or another, prefer or have to work night shift. If you do it is still best to keep your schedule as consistent as possible to retrain your circadian rhythm.

And it’s difficult to do that if you’re working mornings and then nights and then overnights, and then evenings like it. Your body can’t really get adjusted to that. Now the problem is that it’s also not that realistic for life to say, okay, I’m gonna always be awake at night and sleep during the day.

Because what happens is when people are off of work, they wanna be social, they wanna hang out with friends and family who are. Awake during the day and sleep at night. And so people end up completely switching their schedules back which is definitely not good for their health. People who work night shifts on average sleep two to four hours less than people who work day shift, no matter what, even if they’re off.

And so what new research has found is is using Something called anchor sleep is healthier for people who work night shift, and what that means is anchoring your sleep to at least a four hour period that you remain asleep, whether you are working nights or you’re off so that it gives your circadian rhythm something to, to anchor itself or and train itself around and a.

To be more normal on your days off. So for instance, I would like to use like nurses as a good example. Nurses who work the night shift may work 6:00 PM to six, they get off, they go to sleep at 7:00 AM on their days off, or I’m after work and then wake up. On their days off, they’ll be trying to go to sleep somewhere between 3:00 AM and 11:00 AM and that way there’s a four hour period between 7:00 AM and 11:00 AM that they spend sleeping, whether they’re off or they’re working, so that their brains are used to saying, okay, at this time period we fall asleep.

It makes it easier for them to sleep on their days that they’re off. And then it also allows to have a.

Daytime fatigue or work fatigue and allows ’em to be more productive and efficient as well.

[00:13:47] The Circadian Rhythm

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[00:13:47] Tony Winyard: So you mentioned about circadian rhythm, and I would imagine there’s a fair few people. Quite confused about what is the circadian rhythm?

[00:13:57] Dr. Angela Holliday-Bell: Sure. Yeah. And that’s fair. So your circadian rhythm is that internal clock is another term that we use for it that is roughly about 24 hours. And it dictates when you feel alert and when you feel sleepy throughout the day. So for most people, you wake up in the morning, you feel mostly alert, you have those higher energy.

And then as you get. Closer to nighttime, your normal bedtime, you start to feel sleepy. Melatonin is released. All of that is dictated by your circadian rhythm, which is encoded in your gene. So with your body’s internal clock, that kind of tells you when you should feel awake and when you feel should sleepy through.

[00:14:32] The link between lack of sleep and degenerative diseases

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[00:14:32] Tony Winyard: And these we were talking about the dangers of people, working night shift and so on. And from my understanding in recent, there’s more and more studies coming to light about linking lack of sleep with degenerative diseases and so on, isn’t it?

[00:14:49] Dr. Angela Holliday-Bell: Mm-hmm. Yeah. So there’s research coming out linking lack of sleep to the development of Alzheimer’s disease. And the thought behind that is while you are sleeping, there are there’s an increase in cerebral spinal fluid. So there’s fluid that covers your brain and your spinal cord, and that increase in fluid, wass away toxins that accumulate throughout the day.

So basically it cleans your brain. It’s something called the glymphatic system in the brain. So you can just think of it as like your brain’s clean service to help remove debris and toxins. When you’re not getting enough sleep, you allow those toxins to accumulate. There are some proteins specifically called amyloid proteins that are a marker of Alzheimer’s disease that we see accumulate more individuals who are chronicle individuals who have.

Think there’s a connection between that and that you’re just not allowing your brain and your body enough time to wash away those toxins and start over the next day. Things just build up on each other and accumulate.

[00:15:47] Tony Winyard: And the thing with things like Alzheimer’s, it’s not something that just happened a few weeks ago. It builds up over decades, isn’t it?

[00:15:54] Dr. Angela Holliday-Bell: Exactly. Exactly. And that’s such an important point to remember because some people, what I often hear when I talk about, these dangers and you should get sleep, people will say, oh,

Give me four cups of coffee, I’m good. But the problem is, over time, it’s that chronic, state of being undersleep that causes that chronic state of inflammation causes an increased toxin accumulation in your brain that you may not feel tomorrow, but. Over time, especially over years, it’s gonna lead to some things that are hard to hard to fix.

You can’t just be like, okay, let’s just treat this Alzheimer’s now, it’s here. So you really do have to think about the negative effects that are accumulating over time as opposed to just how you feel on the.

[00:16:40] Wearable devices

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[00:16:40] Tony Winyard: All right. What’s your thoughts on wearable devices? Like the aura, the whoop, and all those types of things.

[00:16:47] Dr. Angela Holliday-Bell: Yeah, I think they’re great if used appropriately. And so what I mean by that is I think they’re great in that they are directing people’s attention to be more aware of their sleep and their sleep habits and how much sleep they’re getting. And I think that’s great because having that awareness can be the first step you need to change.

So similar with the the step counts in your watches Being aware oh, I only had a couple thousand steps. Let me, move a little more. I think that’s great. So in general, I think they’re great. I think they can become problematic in some instances when we get into things like sleep stages and people are so caught up, I’m like, oh, how much room sleep did I get last night?

How much deep sleep? They’re really not great at detecting the differences in sleep stages. And your body is going to make up for the amount. Sleep in certain stages that you need. So you can’t say, oh, tonight I need to make sure I get this much ram sleep and this much deep sleep. Like it’s really a global picture of your overall sleep habits that dictate how much of that sleep you get each night.

So I think it can make people a little too caught up in the weeds of things that are not super appropriate. And then some people who have chronic insomnia, if they. Fixate on that too much. It can actually cause an anxiety around sleep that can make it worse. So I think it just depends on if you’re just like, Hey, I need to keep this an idea or in track of how much sleep I’m getting and oh, when I pass some alcohol, let me see how that is affecting my sleep.

Oh, it is a little bit more, fractionated or I’m not getting as much. That’s great. And just not getting caught up in too many of the details that may not be as reliable with the wearables.

[00:18:22] Tips for those with insomnia

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[00:18:22] Tony Winyard: You mentioned insomnia just now, so what would you say to people who are really struggling with insomnia and for whatever reason their doctor hasn’t been able to help them? What tips would you maybe give them?

[00:18:34] Dr. Angela Holliday-Bell: So first of all, I would say, it is normal to have occasional nights of poor sleep. Everyone has them. I, myself, Try to set myself up for the single night in I’m, I don’t as well, but insomnia and specifically chronic insomnia, difficulty falling, staying asleep, or waking up earlier than desired at three nights week for at three months.

And once you get to. Point, it typically is deeper than just, the normal sleep hygiene rules we call it. Really it’s your relationship with sleep that becomes damaged and typically there is some type of anxiety or stress related to sleep and negative thoughts about sleep that lead to negative behaviors that really have to be approached at a foundational level.

You definitely wanna start by prioritizing sleep. I say that to everyone. That’s step number one. Making sleep a priority in your life can make a huge difference. As opposed to leaving it to okay, once I’m done with every single thing else that I have to get through the day and night, then I can sleep.

Now make sleep a priority, and that makes a significant difference. But if you’re someone who has tried the typical things, and we can talk in a little bit about what typical things might talked to your physician about it or provider, and been able to address. It likely is something deeper in the best way to address chronic insomnia is actually through something called cognitive behavioral therapy for insomnia, and it’s a organized therapeutic approach that addresses the maladaptive thoughts that you have surrounding sleep, and then the behaviors that occur as a result of that to get at the underlying cause of your insomnia, as opposed to putting a bandaid on it with like prescription sleep pills or something like that.

Cognitive Behavioural Therapy for Insomnia

[00:20:18] Tony Winyard: And so do you find that most people who suffer insomnia does, is C B T I useful for most people or is there some people that even that can’t help?

[00:20:28] Dr. Angela Holliday-Bell: Yeah, for most people, so in research it’s been about 88 to 90%

[00:20:34] Tony Winyard: Right.

[00:20:34] Dr. Angela Holliday-Bell: most individuals, so highly effective. Shown to been to be just as effective as prescription sleep pills in terms of actually getting you to fall asleep, but longer lasting in terms of effectiveness. So it’s superior to prescription sleep medications.

In terms of the effects, there are some individuals that don’t have as significant of a benefit. And it could be for a number of reasons. There are sleep disorders that can be comorbid or occur at the insomnia and. Separately as well as certain mental health conditions, anxiety, depression, we all, we know that sleep is a huge factor when it comes to those things, and people with depression and anxiety typically have insomnia and insomnia, increase your risk of anxiety and depression.

But just addressing the anxiety and depression often are not enough to address the insomnia. So again, Need to be addressed. And there are some rare cases where certain sleep medications can be helpful in addition to the C BT I. So I would say for the vast majority of people’s C B T I is gonna be the most effective, but there may need to be some additional things to fully address.

[00:21:42] Sleep medications

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[00:21:42] Tony Winyard: So you talked about sleep medication and then there’s people taking melatonin and all sorts of things and there’s, I think there’s a number of people who think, oh yeah, I’ve got this. I can just take this for the rest of my life and then I’ll be fine. But it’s not really advised, does it?

[00:21:56] Dr. Angela Holliday-Bell: It’s not, no. And when you think about it, When you take a kinda a sleep pill, specifically like prescription sleep medications or a lot of people will turn to ZL or Benadryl, you’re really just slapping a bandaid on a problem that will eventually fall off. I’ll start with prescription sleep medications.

I’m very vocal in the fact that, like I said, in some rare instances, it can be helpful for the vast majority of people. They’re not gonna give the benefit that you, because. They come often with side effects, and then you tend to build up a tolerance to them in which you need higher and higher doses to get the same effect.

My biggest problem with sleeping medications though, is yes, they’ll put you to sleep, but it’s often more of a sedative state, meaning if anyone’s ever had surgery before and you’ve had to go under anesthesia, Were you technically sleep? Yes. Did you wake up feeling so rested and refreshed? Probably not.

And that’s because you’re not going through those same beautifully coordinated sleep stages that natural sleep puts you in and through. And so if you wake up feeling groggy and tired still and all those things, is it really worth it? You know that you slept for a little bit more time. So I think it’s more important for people to to work on the underlying causes of their. Melatonin can be helpful in certain instances when your circadian rhythm, that internal clock is thrown off because that is the whole purpose of melatonin is adjust that clock. So if you are traveling across time zones, it’s excellent. I think if your sleep schedule’s thrown off for some people over summer, they, their schedules are thrown off a lot.

They shift a little bit and then as the fall comes, they need to Or similar with vacation. If they have a long vacation, they may get off track. I think it’s actually great to use it for those instances short term to get things back on track and then you should not need to use it really beyond that, the one medication and the same medication because it’s not really, but the one supplement that I love that helps sleep, it’s not a sleep pill, it’s not a magic bullet, but it can be conducive to sleep Magnes. Magnesium is a naturally occurring mineral that is necessary in over 300 processes in our body. And it helps to calm the nervous system, relax the muscles, and helps to promote deeper quality sleep. So it’s an, it’s a helpful adjunct, it’s a helpful booster. It’s not gonna be a magic pill, but I think that is something that can be helpful as a part of your routine.

[00:24:12] Importance of Magnesium

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[00:24:12] Tony Winyard: And that can be helpful for people who have leg cramps and stuff as well, can’t it?

[00:24:16] Dr. Angela Holliday-Bell: Yes, absolutely. Absolutely. And we’re starting to see a lot more magnesium deficiency in general in our population. Just people not getting enough of that in their diet. So I think in general, there are so many things that can help with that. That is something that could be worth adding. Like I personally take it every single day.

Of course you should. Speak with your medical provider before starting any new supplemental medication, but I think aside from that, the other ones are really not gonna give you the answer that you’re looking for in terms of your sleep issues.

[00:24:43] Waking up during the night to use the toilet

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[00:24:43] Tony Winyard: What would you say for people who maybe worry that they wake up maybe two or three times in the night. Maybe it’s to use the toilet, or maybe it’s just because of, I don’t know, anxieties or whatever.

[00:24:56] Dr. Angela Holliday-Bell: Yeah. Yeah. And that’s so common, right? A lot of people have trouble staying asleep. I like to call it the 3:00 AM club because for so many people, it tends to happen around 3:00 AM by saying. It’s normal to wake up more than one time throughout the night. I think just giving people the permission to do that can actually take away some of that anxiety that comes with oh my gosh, I can’t believe I woke up.

As you cycle throughout sleep stages. So on an average eight hour night, which you’re just saying hours, some people need more, eight hours of sleep, you cycle through about five sleep cycles of life, sleep deeper, sleep, dream, sleep. Then there’s a time in between where there’s generally a light awakening.

Then you go back into light sleep, deep sleep or whatever. So it’s normal to wake up multiple times throughout the night. Now, most of the time, you’re adjusting your pillow, you’re taking off the cover, you’re sticking your leg out. You may not even recall the awakening, but you are awake to a certain extent.

So people should be reassured that is not the problem. The problem is when cannot fall back. Getting up to use the restroom is common, for other reasons, caffeine and alcohol are not great for sleep, but they’re also diuretics, meaning they cause you to urinate more. So if you’re drinking lots of caffeine throughout the day, especially close to bedtime or alcohol, that can lead to you waking to use restroom, alcohol in particular. So people love to have a glass of wine as a night cap and as a way to wind down and while it is sedative initially, so it makes you sleepy.

It’s actually broken down pretty quickly, and after it’s broken down, it becomes a stimulant. So it’s more likely to lead to middle of the night wakings and early morning wakings. So if you’re someone who likes to do a nightcap before bed every night, you might wanna rethink that if you’re waking up multiple times.

And then the other thing is that anxiety or racing thoughts that you talked about. So oftentimes people will wake up or whatever reason, but now because they’re awake, All those thought rush through their brain all the things that they are worried about, need to think about to keep them individuals journal. Where you pick a time during the day or evening, ideally before bedtime because you don’t wanna connect that with bed, but some amount of time 10 to 15 minutes where you take out a journal and you just write down anything that comes to your mind. So your to-do list the things that you’re concerned about, if there are action steps associated with them, write that down.

Oh, I, worried about this work project that’s due. Okay, tomorrow I’m gonna make the outline, and the next day I’m gonna make the, PowerPoint, whatever. Be specific. The reason for that is it gives your brain dedicated time to process those thoughts so that it doesn’t try to do that at night, because at night you don’t have the distractions of the day that keep you from processing it.

So your brain utilizes that time to say, okay. Now we have time to ourselves. Let’s think about all these things that we haven’t had time to think about. When you give yourself that dedicated time to process it, it’s less likely to do that at night. So I’ve seen that be a very helpful solution for individuals who have those racing thoughts that.

[00:27:55] Devices for improving sleep

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[00:27:55] Tony Winyard: Right. We touched upon wearables before, but there’s also devices such as the, was it eight sleep and all these various things that sort of temperature control. What do you think of those?

[00:28:08] Dr. Angela Holliday-Bell: I love them. I think they’re great for multiple reasons. So the first thing is your body temperature has actually decreased by one to three degrees in order to facilitate the transition to and maintenance of sleep. In the early morning hours, your body temperature starts to increase and that signals to your body that is time to wake up.

So really, that lower body temperature is what helps. What helps to permit sleep to come on and keep you in the deeper stages of sleep. So it’s important that you keep your sleep space cool. So you can do that by turning down your thermostat. Research actually recommends somewhere between 62 to 67 degrees Fahrenheit is a good range For some people, they’re like, oh my gosh, that’s freezing, and you don’t wanna be uncomfortable.

So I always say, turn your temperature down one to two degrees lower than what’s comfortable for you during the day and sleep at night. But in addition, some people are hot sleepers and they collect or absorb heat as they sleep, and so they warm up prematurely, which can lead to broken sleep. So the systems, like the aid, sleep and the other cooling systems helps to keep your body’s temperature lower in the, in a space that’s more conducive to sleep.

So I think that they’re great to use.

[00:29:11] Sleep hygiene routines

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[00:29:11] Tony Winyard: What there’s things called sleep hygiene routines, isn’t there? What could you give people some ideas of things that they could implement in a sleep hygiene routine to improve their sleep?

[00:29:24] Dr. Angela Holliday-Bell: Absolutely. So sleep hygiene, exactly what it sounds like, right? Like we, we have normal hygiene. You take a shower, you brush your teeth. It’s things that you use to maintain yourself in good working condition. Same thing. And there are some rules that you should live by the vast majority of the time, or as much as possible.

The first thing is to wake up at the same time every day. I tell people this and they’re like, okay, every day, so Monday through Friday, I’m like, no, there are seven days of the week. So every day means Monday through Friday, Saturday and Sunday, because that internal clock, your circadian rhythm does not have weekends off.

So you really need that consistency for your brain to learn when to send those alerting factors. In addition, it also helps the melatonin release at night, so keep the same wait time every single day. Getting some natural light exposure within one hour of waking in the mornings is also super helpful because light is a strongest factor influencing your circadian rhythm in a way that causes you to be alert and it automatically shuts off the melatonin release.

What that does is stabilizes your circadian rhythm to say, okay, melatonin shuts off at this time, and then we start to it again at this time at night, and really helps to regulate things. In addition, it causes a boost of serotonin, which is needed for melatonin release, so it helps to just stabilize.

Everything very well. So getting that natural light exposure within one hour of waking caffeine is huge. I think that’s one of the biggest issues that we have. I personally love coffee. I drink it every single day. I think it’s great. However caffeine that we use for it. Stimulating and alerting properties has a long halflife of about five hours.

And the halflife is the amount of time it takes for half of the amount you consumed to be excluded from your system. So if you were to drink a 400 milligram cup of a coffee, let’s say at noon, then at 5:00 PM 200 milligrams is still in your system. And at 10:00 PM 100 milligrams is still in your system.

So that absolutely could be interfering with your ability to fall and stay asleep. People metabolize caffeine differently, so some are quicker than others. So you really have to, adjust for what your sensitivity is. But a good rule of thumb is to use the smallest. Effective dose. So if 200 milligrams makes you more awake and alert, don’t drink 400 milligrams worth and then try to limit it afternoon so that it’s not really interfering with your sleep as much.

The other, I would say my last two is to avoid light exposure close to your bedtime. So we already said light is the strongest factor influencing your circadian rhythm, telling you to be alert. So if you are exposing yourself to light close to your bedtime, It’s doing the same thing. It’s telling you it’s time to be awake and alert.

It must be daytime because this is light and it’s delaying your melatonin release. So that means even the lights that you exist in your normal room, lighting is gonna be enough to delay your natural melatonin release. So dimming the lights using tableside lamps, low emission lights. One to two hours before bedtime will help to promote your natural melatonin release.

And then that blue wavelength of light in particular that is emitted from electronics like your telephone, tablet, television, has the strongest of all the wavelengths of light influencing your circadian rhythm. So you definitely want to avoid those within an hour before bedtime. Then having a bedtime routine, I cannot express enough how important that is, a 45 to 60 minute routine that you do every single night before bed, which helps to calm your mind, get your body prepared for sleep.

It helps to make the sleep process more efficient in that once you start doing those things, your brain has already connected that process, that routine to sleep. So as soon as you start dinning the lights and turning on music and. Lighting a candle and reading a book, your brain is oh, let’s send this my terin release because we know that this must mean that we’re falling.

And then there’s been some research to show that it actually is helpful against pre protecting you against stress. So there are some individuals that they had that split them up into those who followed the consist. In bedtime routine and those who did not, it then showed them purposefully stressful inducing videos right before going to sleep, and found that those who consistently engage in a bedtime routine have less sleep disturbances than those who did not.

So it really protects you against it because your brain is connecting that routine to sleep. It helps you to unwind. It allows those brainwaves to slow down, and it’s much more conducive to sleep. So following those sleep hygiene tips will work wonders for the majority of people with sleep issues.

[00:33:44] How having a sleep hygiene routine helps you be proactive

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[00:33:44] Tony Winyard: And the thing with all those sleep hygiene tips you just gave, I mean, this whole podcast is about being proactive around health and that’s exactly what that isn’t it?

[00:33:53] Dr. Angela Holliday-Bell: Absolutely it is taking the bull by the horns, being proactive, setting your day and night up for better sleep as opposed to just responding to sleep issues. Right? It’s putting yourself in a position to get the sleep that you deserve and that you desire every night so that you’re not having to come in on the back end and try to clean up when.

[00:34:14] Thoughts on being proactive

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[00:34:14] Tony Winyard: So what are your thoughts on proactivity around health?

[00:34:18] Dr. Angela Holliday-Bell: I think it’s so important. I really think that’s the way that we should live life. I think, you brought up the way that our medical system is in many places, and I think that one issue with our medical system in general is that it’s been very reactive. So now you have this disease or this problem, we’re gonna react.

By giving you some, prescriptions or giving you whatever, as opposed to preventative in that we stop these things from happening in the first place. And I think if we switched our mindset to being proactive and preventative, instead we would alleviate so many of the problems that we see. And luckily for many people, sleep is one of those scenes that’s within your control that you can be proactive about, that you can be preventative about.

And that in turn will help you to prevent these, Downstream health consequences. So I think in general with everything when it comes to your health and in life, being proactive, having a plan, preventing things from happening is gonna be the best way to address them.

[00:35:13] How to make the sleep routine easier

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[00:35:13] Tony Winyard: Some people listening might be thinking, wow, that just sounds too much. There’s so many things in that sleep hygiene, I can’t do all of that. Where if they, we wanna start maybe getting them to do maybe one thing at a time, how would you suggest people ease into something like that?

[00:35:30] Dr. Angela Holliday-Bell: Yeah, and I think, I always try to tell people to take it slow. You don’t have to revamp your entire routine in one night because it’s gonna be hard to do. I think it’s similar if you’re doing any type of diet or exercise, you should build up, like you can start slow and then build up. So I even on my website, I have a seven day A seven day kind of sleep makeover where every day we just add a new habit so that it’s something that you’re doing slowly.

But I always start with the first thing, and this is more mindset, is prioritizing sleep. If you just wake up and say, okay what are, what’s a way that I can help myself to sleep better at night? And in saying, okay, I require eight hours of sleep for these eight hours of sleeping, and then I’m going to schedule everything else around that time.

That honestly makes difference in people. And then the second thing is waking up at the same time every day. If you can stick to those two things for the first one to two weeks, I think you’ll actually see significant changes and then build on that with all of the other habits. And over time you’ll have a revamped routine that is a lot more conducive to.

[00:36:30] The link between energy and sleep

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[00:36:30] Tony Winyard: You know, One, one thing I find interesting, I guess I could say is a word I could use in some of the clients that I help and often I ask ’em about how their energy is during the day and how many people don’t link the, they’re having drops in energy through the day and they don’t connect that with their poor sleep.

[00:36:50] Dr. Angela Holliday-Bell: Yeah, because I think for so long, it’s just been something that’s been in the back of our minds. It’s not important that people don’t realize I’ve had pe patients come to me like, oh, I’m so fatigued. I’m so tired of that. I don’t know why. Can you give me something for this? Is there a supplement I can take?

And I’ll say how are you sleeping night? Oh, I sleep five hours. I don’t take, I wake up multiple times and I’m like, yeah let’s start there. Let’s figure that out. But like you said, most people have not. Even connected it ’cause there’s such this disconnect between sleep and all these other things because sleeping, like I said, makes you lazy and I’ll sleep.

Diet, I have too much to do. Sleep. Sleep, not that important that they don’t realize just how much it’s affecting them.

[00:37:26] Dr Holliday-Bells favourite book

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[00:37:26] Tony Winyard: Yeah, changing the subject slightly, but it’s not really, ’cause I know your answer to this already, but is there a book that’s really moved you for any reason?

[00:37:37] Dr. Angela Holliday-Bell: Yes. And not surprisingly, I know it may sound boring to some, but why We Sleep by Matthew Walker? It was a life changing book for me. That was the first book that I read when I. What is going on? I need to fix my sleep like I have. I can’t live like this. I read his book and it opened up a new world of sleep to me.

And the importance of sleep and the effects of sleep. And so it was really something that was just so enlightening and things that. Even as a physician, even as a doctor, things that I was not aware of or was not taught, that it really just changed my outlook on life and that I was like, oh no, we need to start with sleep and then everything else will fall into place.

And I’ve lived my life that way for many years since then. So absolutely, that’s by far one of my favorite books. I recommend anyone grabbing a copy because it is very enlightening.

[00:38:28] What have you changed your mind on?

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[00:38:28] Tony Winyard: Is there anything around sleep and the science around sleep that you’ve changed your mind on or had different thoughts on in the last few years?

[00:38:37] Dr. Angela Holliday-Bell: Oh, that’s a good question. Anything that I have changed my mind on so I would say I, I was not, so when I first started my sleep journey and started helping people with sleep, Sleep was more about what happened that night, right? It was like, okay, you need to have this bedtime routine. You need to do all these things and this is how you sleep.

And over the past, I would say couple years, I’ve really shifted a lot of my own sleep habits and my sleep recommendations to the day. Because so much of what happens during your day is what impacts your sleep at night. You sleep for, eight hours on average, but then there’s other 16 hours of the day that impact how you sleep at night.

So when I. Work with individuals. We talk about stress management, anxiety management, setting up your workday in a way that’s more that’s less stressful and that’s more pleasant because all of those things factor into how you sleep at night. And so instead of looking at it as this like segmented time of day, it’s this whole person, whole day picture that I think has been a lot more helpful in addressing the full picture as opposed to this one kind of aspect of.

[00:39:44] How does exercise and movement effect sleep?

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[00:39:44] Tony Winyard: And what would you say about people who maybe don’t move enough, don’t get enough movement exercise in, in relation to sleep?

[00:39:53] Dr. Angela Holliday-Bell: Yeah, that can definitely impact sleep. So research has shown that physical activity leads to deeper sleep. So you do get more of that deep, better quality sleep when you’re being physically active. So trying to engage in some sort of physical activity every day is very important. I like to get people to do, things that incorporate multiple healthy sleep habits at once.

So getting natural sunlight by going on a walk outside for.

Are. There are some studies that suggest not sleep, not exercising too close to bedtime because exercise can increase your body temperature and it can take longer for it. Drop. As mentioned, your temperature has.

But by and large, research has shown that being active, no matter what time of the day, is gonna be better for sleep than not being active at all. So if you have a tight schedule, if it’s hard to get it, just trying to get it in as much as you can. Again, small habits, but build on themselves. But for many aspects of your health, including your sleep, physical activity is gonna be a very important part.

[00:40:58] Angela’s contact details

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[00:40:58] Tony Winyard: If people want to find out more about you and maybe to work with you where would they go?

[00:41:04] Dr. Angela Holliday-Bell: So you can go to my website at www. The solution is sleep com. I work with individuals who have chronic insomnia through the delivery of cognitive behavioral therapy for insomnia. So we have one-on-one consultations with me as well as an online course to do it at a self-guided pace. I also have been working with corporations.

At large to help their workforce sleep better because we know that sleep is linked to productivity and mood and retention and workplace relationships that are all important for the workplace experience. So really coming in and changing the culture of sleep and rest in the workplace and giving people actionable tips on how to improve their sleep.

In addition, I do have a, my first book coming out, sleeping on the Job, proven Strategies to optimize workplace performance and personal wellbeing through Better Sleep, where I really break down. How interrelated the sleep and work relationship relationship is. So work affects your sleep and how you sleep affects your work.

But then specifically how to build your workday, e evening and night in a way that’s gonna be best for sleep. And I do that via very specific actionable things that you can start to implement right away to help you get the sleep you deserve and be the worker that you.

Do you work

[00:42:15] Tony Winyard: locally, globally…

and what you were just talking about, are you mostly working with people in a Chicago area or is it nationally or globally, or?

[00:42:23] Dr. Angela Holliday-Bell: Yeah, globally. So I do deliver most of my services via my online platform. So I work with individuals all over the world. I’ve done in Africa and Australia. And then as well as in person, like the conferences and companies I’ve worked with, I’ve done never virtually as well as in person. So I do it wherever it is necessary.

[00:42:45] Favourite quotation

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[00:42:45] Tony Winyard: Well Finally, do you have a quotation that you particularly like?

[00:42:50] Dr. Angela Holliday-Bell: I do, I’m gonna read it so I can make sure that I do not mess this up. But my favorite quote is, instead of asking, have I worked hard enough to deserve rest, I started asking, have I rested enough to do my most loving meaningful work? And the that’s by Nicola Jane Hobbes. And I love that quote because I think that.

A lot of people view rest and sleep as this reward they get once they work hard enough. Or if they’ve done enough of the other things, then they can reward themselves with sleep. But understanding that it should start with sleep. And once you’re rested, you can be your best self, your most motivated, productive, efficient, happy self, that will then produce your best work.

So you deserve to sleep. You don’t have to earn it. Sleep is not a luxury that only a few should be able to afford. It should be afforded to everyone. And then from that can come your most meaningful.

[00:43:39] Dr Holliday-Bell’s final thoughts on sleep

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[00:43:39] Tony Winyard: Is there anything about sleep I haven’t asked you about that you think people should know?

[00:43:47] Dr. Angela Holliday-Bell: Let’s see. Is there anything, yeah, so I think one thing I wanna address, and it’s one of my favorite things to talk about, is because a lot of people will say, is it okay to nap? How do I do that? Does that interfere with my sleep? And I like to give people permission in a way that I love nap.

So whenever I don’t have. Clinical duties I nap every single day. I think napping is great if done responsibly just like anything else. And napping helps to provide a boosting your mood and productivity and creativity and problem solving throughout the day. So it can be a great addition to your day.

The key is to keep it short, so no more than 20 to 30 minutes because if you’re nap longer than that, You run the risk of getting into deeper stages of sleep that can make you wake up feeling groggy and disoriented. We call that sleep inertia. Which can be more problematic than how tired you felt before the nap.

You also wanna do it earlier in the day, sometime before 3:00 PM so that it doesn’t steal from your sleep drive and make it more difficult to fall asleep. And then if you’re someone who suffers from chronic insomnia and you’re like, I’ve tried to sleep hygiene things I just cannot get my sleep on track, I would actually avoid napping altogether.

Until your sleep is on track and then adding in healthy naps once you’re

[00:44:56] Tony Winyard: Dr. Holiday, it’s been great information. I’m sure it’s gonna be really helpful to many people, so thank you for your time.

[00:45:07] Dr. Angela Holliday-Bell: Absolutely. Thank you so much for having me. Anytime I can talk about sleep.

[00:45:14] Next weeks episode, 237

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Next week. Is episode 237 with Jeff. Second off. Jeff is a 68 year old competitive cyclist. Who is training to break the U S our record for the 70 to 74 age group by the year 2025. And we discussed Jeff’s Jeff’s passion for cycling, how we use his coaching to train efficiently and avoid injury. And he also talks about how he applies a coaching model to. His scuba dive in certification business. So help students improve, not just their diving skills, but their overall wellbeing. I throughout the episode. We talk about living proactively by seeking out new challenges, helping others find purpose. I’m knowing when to quit and when to persist. So that’s next week’s episode 237 with Jeff. Second off. If you’ve enjoyed this episode with dr angela holiday bell please do subscribe so you can find out and you can automatically get new episodes downloaded onto your phone Please leave us a review and i hope you have a great week