Moment 50 - The Most Common Misconceptions About Sleep: Stephanie Romiszewski

00:02you're an expert in this field so you must as you kind of spoke to there you must get pretty i can feel it when you're speaking get pretty pissed off when you see unhelpful information being pushed on i don't know social media or online or through books these sort of simplified narratives what are some of the most um common misconceptions that you speak to your patients about you mentioned one there about this like eight hours of sleep being the optimal yeah and even when i put out on my instagram earlier what are the key questions you want to ask um i'm speaking to a sleep therapist expert today um i'd say the vast majority or at least the medium question was uh do i need to get exactly seven or eight hours sleep every single night yeah um yeah so that is definitely the biggest one we get um you do not that perfection is the enemy of the good have you ever heard that term because at the end of the day it's true yes your body loves consistency and regulation but that does not mean you have to get eight hours of sleep every night think about it differently think about it over a month for example we love this idea of the way the way we look at time is slightly different to the way your body looks at time

01:06and over a month you might actually be all right so maybe one night you get six and a half hours the next night you get seven and a half and then the next night you might get slightly different as long as it's fairly consistent and maybe 80 percent of the time you're doing fairly well and you're giving yourself the right opportunity to sleep, that's okay. Your body's going to do, you know, it will do what it needs to do. And with that, a caveat to that is this understanding of sleep debt. So we don't understand sleep debt properly. People think it's an eye for an eye.

01:34I lose four hours, I must gain four hours. Well, what happens when your body, being as efficient as it is, doesn't actually need you to gain an extra four hours of sleep to recover you. Your expectation is that it should. And when your expectation doesn't get met, you get upset about it and you change your behavior and that's when you start getting sleep problems when the reality is your brain is so smart that even in the certain amount of hours that you get normally at night it can recover you from that sleep deprivation by just improving or increasing the sleep stage that it thinks you miss the most for example but because we have a lack of education we believe we don't get some sleep we need to regain that sleep and when we don't regain that sleep that's when the anxieties and the stress is over not sleeping starts so that's a big one the sleep debt one the other one is this idea that fatigue and sleepiness are the same things so yes when we don't sleep well we get a lot of fatigue so fatigue is anything from feeling like your body needs to rest to needing to shut your eyes to pain to your brain buzzing because you've been working so hard for like 48 hours straight and you don't know what to do with

02:40yourself but the only definition of sleepiness is the ability to shut your eyes and within a few minutes you're falling asleep so if you were saying to me right now Steph I'm so so sleepy I'd probably say to you well you don't look it because right now you don't look tired in the way that I would expect you to be falling asleep I mean you wouldn't be able to sit still you you would be sort of probably your eyes would be shutting all the time dozing off having little micro sleeps that sleepiness and that's what we should really be understanding as a cue to sleep so in the evenings if you're not feeling that then don't be don't be worried give yourself permission to stay up later because you can't dictate what happens to you during the day and there are so many variables that affect your sleep you are never going to be able to control of them having good sleep hygiene how many good sleepers do you know have it so good sleep hygiene is all these things that we get told we should do.

03:32So the 10 top things that you should do, have a warm bath, never drink coffee ever again, never have alcohol, you know, all these things that you're supposed to do. But if you look at good sleepers, are they following all those things? No, they're not. And they're still sleeping really well. And that's to show that most of the time, sleeping poorly comes down to brain training and the patterns we get ourselves into. You start going to bed early, you might be able to get to sleep earlier, but you're probably not going to be able to have that sleep all the way through the night because at some point or another your body's going to be like well you've had enough now but your expectation is you should be able to sleep till seven and why didn't i sleep till seven or if you lie in you keep changing the goalposts of your wake-up time which is the most important thing that you should be looking at not your bedtime um if you keep changing that goalpost your body doesn't know when to feed you it doesn't know when to make you feel alert because you've changed everything and so of course you're not going to be sleepy at the right time in the evening the time you wake up is the the much more important time to be focused on yes the things your morning routine

04:36is going to be way more important than your evening routine when it comes to your sleep at night but because people see that as a far away time compared to when you go to sleep they don't really focus on it in fact haven't we been taught in this society that lying in is a luxury i can't believe that we have made it okay at the weekend to lie in so much but during the week one of the only things that gets us up is work it makes absolutely no sense to me i'm not saying it's the worst thing in the world i'm not saying i never lie in but i don't use it as a compensatory method for a bad night's sleep because that's when you're going to get into trouble because that's kind of throwing your your your schedule off is that what you're saying yeah yeah if you lie on the weekends and you're going to pay for it at some other point yeah why are we not looking you know if you have to lie in so significantly every single weekend why are we not looking at during the week and thinking why am i doing this to myself at the time when i need it the most i will choose to get less sleep and then at the weekend i'll just compensate and people and you much of the conversation around sleep in society talks about the amount of hours and it's almost

05:43like the amount of hours that i was in the bed um what's your sort of rebuttal to that because Quality over quantity every single time, every single time. And if you have good quality and you need longer, your body will tell you and you will get more sleep. But people are so obsessed with duration. And I think people don't understand what I mean by sleep opportunity. I mean every single night most of the time so about 80% of the time I will give myself a seven to eight hour sleep opportunity sleep window but I do not mean that if I'm not sleepy I take myself into a dark room and shut myself down I just know that it's there I've got a bedroom a place I really want to be to sleep that is available to me during those hours and I will not sleep outside those hours and that's the that is the big thing is you can dictate to your body when you don't sleep but you cannot dictate when you do and by doing that you will force your body to be in a nice regular cycle it's actually really really simple once you know how to do it and every time i fix someone of their insomnia there and honestly 50 60 years of insomnia they often turn around to me they're like i don't know why i wasn't taught this um when i was younger and i do believe if we taught

07:01everyone how to sleep properly give them a proper sleep education when they're little i wouldn't exist insomnia wouldn't exist a lot of people when they you know when they knew that i was speaking to you today um they want to know how they can sleep better in the short term tonight they're looking for some kind of quick fix to the to a problem they've had for a long time what would you say to those people okay so the first thing i'd say is that you're never going to find that reactive very quick method it's never going to happen and even if you find it i promise you it won't work in the long term it might control your condition in the short term but not in the long term i can teach you how to read to sleep but it's going to take you a few weeks not a night um but in the meantime don't worry it's okay like part of this is i just there is a solution so what i do is called cognitive behavioral therapy for insomnia it is not the same as cbt for depression or anxiety or anything else. And it is just about retraining yourself to sleep and building up that strong sleep drive. You have to do that over time. But in the short term, I usually tell people that they do not need to worry. Nothing bad is going to happen to you. And the reality is that it's

08:10more your mood that will affect your day when you wake up in the morning than the bad night's sleep you just had. So I know we've got evidence to show that when you have a bad night's sleep, your cognitive abilities etc are going to be reduced however if you think about how you generalize that you're not you're not going to lose your job you're not going to perform horrifically in that meeting because you didn't get a good night's sleep it would be far better for you to go to bed later and make sure you're lovely and sleepy and only get four hours than to go to bed eight hours before that meeting and toss and turn and be fidgety and stressed and anxious all night that's what I do I still get nervous when I have to do like a lecture in front of 500 people of course I get nervous but instead of you know focusing on my notes just before I go to bed I'll put everything aside I'll go and enjoy myself do something I really love to do I'll get ready for bed a bit earlier than usual just so that I do not have to think about anything when I get sleepy and when I am sleepy even if it's two three four hours later than usual I know that I'll go and have a really lovely three or four hours sleep. And then I'll wake up and I'll be like, great.

09:15I know I'm going to be a bit sleepy today, but that's only going to help me sleep tonight. And I'm going to have an epic day. I don't care that I'm a bit sleepy. Sleepiness is amazing. Sleepiness is such a good thing for you. Why are we teaching people that sleepiness is a bad thing? You need sleepiness to sleep.