Episode 34: Optimizing Performance Through Sleep

In this episode of The Purposeful MD Podcast, I talk with Dr. Melissa Milanak, licensed clinical psychologist and founder of Mind Impact Consulting, about the critical importance of sleep for optimal performance and wellbeing.

Dr. Milanak shares how our society's perspective on sleep is shifting from viewing it as a luxury to recognizing it as essential for peak performance and health.

We cover: 

✔️ Why sleep deprivation is no longer a badge of honor 

✔️ The 15-minute pre-bedtime writing exercise for better sleep 

✔️ How to create effective "sleep triggers" for your brain 

✔️ Strategic napping (20-30 minutes max) for cognitive performance 

✔️ Why the second half of your night's sleep is crucial for cognitive function

Don’t miss this life-changing episode!

Connect with Dr. Melissa Milanak here:

https://mindimpactconsulting.com/

https://mindimpactconsulting.com/wp-content/uploads/2023/02/Sleep-Well-Guide.pdf

https://youtu.be/l2IP0HXtv1k?si=DmiNFDle1jODJHJD

https://www.linkedin.com/in/melissaemilanakphd/

https://www.instagram.com/drmelissamilanak/

Transcript

0:08

Welcome to the Purposeful MD Podcast. As a physician, you've sacrificed so much of your life for other people, your patients, your family, your friends, and your colleagues. What would it feel like to spend time doing what you enjoy and to live without guilt? I'm your host, Dr. Laura Suttin, a family physician, certified coach, and business owner. If you're a medical professional on a journey towards your most purposeful life, a life with more time and energy, and ultimately more joy, then this is the podcast for you. All right. Welcome to the Purposeful MD Podcast. If you're listening or watching on YouTube, I have an amazing guest today. Um, I'll introduce her and then we'll get to chatting. So, Dr. Melissa Malnik is a licensed clinical psychologist, executive consultant, and keynote speaker. Specializing in improving workplace effectiveness and quality of life by helping professionals develop a mindset focused specifically, successfully on overcoming various work and personal challenges. She founded Mind Impact Consulting, LLC., transforming her passion for helping others succeed, and her research and clinical expertise in anxiety, sleep disorders, stress, and workplace wellbeing into effective practical application for business executives and their organizations. Melissa, I'm so happy to have you. Thanks for being on. Thank you so much for having me. I'm really excited to have a chance to connect again. Yeah, me too. So we, we met almost two years ago now at an event here in San Antonio, and we were both asked to be co-presenters, um, for a, uh, on with a healthcare organization that I was with, um, before called The Health Cell here in town, talking about sleep. Um, we met briefly and then I got Covid and had to, we had to do the presentation virtually, unfortunately, um, or I was virtual. So, um, but just really enjoyed meeting you and getting to know you, and you've really transformed how I think about my own sleep and my own rest, and how I was taking care of patients, talking about sleep, how I coach on it. So, I just wanna say it's great to have you, and great to talk with you, and thank you for your work. Oh, thank you so much. I know I love that conversation and I know you've spoken for different organizations for me over the years as well. I always love hearing what you're talking about, being more purposeful and across all different domains, and so I was really excited to have the chance to talk and have this conversation, and hopefully help a lot of other people to sleep better, and stress less, and be much more purposeful about their 2025 and beyond. Yes, as we're recording this right around the new year, so I know you mentioned before we hit record that you're getting a lot of requests lately, um, that people must be creating intentions and resolutions around getting more sleep, which it's a, it's a good thing, right? I mean, I think we're kindly, we're, we're finally at a place where we realized that sleep is not a luxury. It's not something that we can save up. And what, you know, I saw somebody with a t-shirt the other day, like, I'll sleep when I'm dead, and I was like, ah, no, so. I hear that so often and it, it's really interesting, because, I think society used to tell us that whole idea of you snooze, you lose, and time is money, and it was always the who's the first person to show up, and the last person to leave, and if you were tired, that meant that you were dedicated. And for many careers, it was just assumed that that's how it was gonna be, you were gonna be tired, you're gonna work these long shifts, you're up all night and, but you know what, you're just gonna power through it and if you can get by on less sleep, then that means that, you know, you're stronger or things like that. And, I'm really happy to see that our mindset, set is shifting to realize that actually prioritizing our sleep instead of deprioritizing it, that, that's actually a sign of strength. And then it takes a, to really prioritize that piece, but then you can be much more efficient and effective. It's amazing how much more we can get done when we have a good night of sleep and how much more effective we are. People make many less errors, but you're right, it's such a shift, and I think we're slowly starting to, start to adopt that mindset. You're even seeing professional athletes. I loved when LeBron was asked, you know, what is your secret to performing and to hitting these milestones? He said, I sleep 10 hours a night. Yes. I, I, so much to unpack there and so much I wanna dig into. And I just, I wanna piggyback on that, that comment. I use, I use LeBron James a lot as an example, probably cause I'm a Spurs fan and he beats our Spurs, some, a lot of times and then we've beaten him. But anyway, um, but I, I always say if, if LeBron James has a coach, and, he's got multiple coaches, I'm sure, shooting coach, dribbling, I mean, sports psychologists nutrition, if he has access to all of these resources, then physicians need coaches too, and physicians need the support. So I I, I love that example. And yeah, I mean, we're seeing this in, in our professional athletes, um, Olympians who are really coming out and saying, this is how much sleep I get every night. Um, as a runner, I've read several books by professional runners and they all talk about how much sleep they get, and they have to take naps during the day. I mean, it's, it's part of their job is to sleep. And so, um, I, I really appreciate the emphasis on that too. Um, so much I wanna get into about what you said. I, there's a story that comes up for me about one time when I was in medical school and I was post-call. And so this meant, I mean, I'll think a lot of our physicians, our listeners are physicians, but I would been awake all day, awake all night, and then this is at like 3:00 PM the next day. So I've been awake for however many hours that is. A lot more than, than I should have been. More than as normal. And I was in a lecture hall and he had turned down the lights, because he was using overhead projector. I know I'm dating myself there, but we had to show the screen and with the lights off and being post-call, I fell asleep. And I remember getting yelled at by this professor and, it was just so traumatic for me, and just such a, really a, um, just so incredible how sleep is, or lack of sleep is glorified, at least in my profession. Um, I know a lot of other professions as well, and like you said, we're, we're rewarded for being the first one to show up in the morning. And I mean like, 3:30 in the morning, right, like in the morning, um, being glorified and rewarded for being the last one to leave, we would brag about how little sleep we got, because it meant that we were working harder. Um, and now, again I'm curious to, to hear, um, your take on some of the, some of the challenges that the medical training community, medical education community is having now around work hour restrictions and, and all of that. Um, but yeah, just this understanding that, that we're seeing now that sleep is not something that, we do because we're falling over from exhaustion, but it's something that's necessary, so, um, yeah, just that, that story just came up for me when, when you were talking about how, just how we see this in a lot of different professions, so, um, I'm hoping that's changing. I don't have a lot of connection to the medical training community these days. Um, so I don't know if it's changing that much, but, um, I've, I read articles about, from, there wasn't kind of a widely circulated article a few weeks ago from a, um, a physician who's trained in the maybe later or, uh, previous generations trained in the nineties, and saying how physicians today have it too easy, and they were working 120 hours a week, and so I know there's still that debate. I'm, I'm curious what, what your, what your take on that is, and then just your, you know, your connection to the medical community, or medical training community, and your influence there. So much there to unpack as well, right? So what I think is, is really interesting is, you know, for most physicians, and if you're working, especially if you're part of an academic medical center and such, you have to do these yearly trainings, and people know the OSHA trainings and all these different training, you know, the in the city trainings, all these things you have to do each year. And over the last few years, what really struck me is that, either its own module or as part of a module, sleep started to come up. And some of the questions were, what are the requirements in terms of, for residents and for training? How many hours are they required to get sleep? Or how many hours are they allowed to work, and then they have to quit working. And so it was really interesting how, as we're seeing more and more research coming out, and also, as more exploration into potential errors, for patient care and for many of these other pieces, and so it's been, it seems to be, and, and sometimes it's what, what is the impetus and what, what is the, the catalyst for it to happen? Right? But when they started to dive deeper into potential errors or risk factors, and realize that sleep deprivation was playing such a huge role, then that seemed to be what got people's attention. And there's lots a, of different opinions on whether that should have been the catalyst or not? For me personally, I'm just glad that it's starting to get the attention. Yeah. We can go in that direction with many different domains. You know, you talked about with athletes, we know that they can do two, three workouts a day, but if they're not sleeping at night, their workouts don't work for them. Right. And the research is showing us that your body can actually break down muscle before fat, cause it's gonna hold onto the fat to use as a potential energy source to fuel the workout that you're waking up early to do. I'm not saying we shouldn't exercise, but, and so the same thing with the way our brains work. If we look at the neurobiology, even if things like glia cells and such, that play a role in memory and learning, that, that's why we see the med students pulling all-nighters, and you can remember it really briefly for the test, but you don't end up encoding it for longer term, cause we need that REM sleep, that memory consolidation. And so it's been really interesting to see as more and more research is coming out on the impacts of sleep, even just our ability to be productive. So take aside work whether you know, whatever your setting is. We have a lot of individuals that are now more in administration, and they may not be just doing direct patient care. But, we see that when we're not getting enough sleep, we actually end up multitasking more frequently, and we can see that it can reduce our productive time, but up to 40%. So now, yeah, we're getting, we're busy, the busy versus productive, because it's taking us 2, 3, 4 times longer to do something. And you're trying to then, okay, you're getting in the hours to see your patients, but now you gotta get that grant proposal in, or you have to do this other reporting, and everything else, and notes. So it's really intriguing to see how some of the higher ed institutions are starting to, say that sleep is important, but, policy and what's being said, and what we are also practically seeing, and different mindsets across different generations, so it's definitely a conversation that needs to continue to happen. Yeah, yeah. Yeah, the, the medical errors piece, that was a, a large part of my work in my, um, in my previous role was looking at patient safety and reducing errors. And we know how much a lack of sleep can have an impact and, and increase the risk of medical errors, and there are a lot of unfortunate cases where patients have been harmed and, um, and in very serious and sometimes fatal ways by, by errors that are caused and, or maybe not directly caused, but are attributed to lack of sleep, and lack of sleep plays a role in that. And of course we know that, that being, going without sleep for a certain number of time, can have the same impact on the brain as being intoxicated. And so, yeah, just so happy to hear that there's so much conversation about it nowadays. Um, I think as physicians, again, we, and again, I know I'm dating myself, but when we, when I was training, there was so much that was required of us, and I know there's so much required of trainees today too, but we kind of had this mentality that we don't need the sleep, and we'll catch up on it when we're off work or whatever that looks like. And that mentality is hard to break free from, especially as trainees start primary care jobs, or attending roles, or specialty fellowships, um, or go out and into private practice and start families, and things get busier. And those, that mentality that, I talk about this a lot on other podcasts and in my book, that, that mentality that kinda gets us to where we are at that stage in our life, it's, it rewards us, and rewarded in with grades, and promotions, and that type of thing. And so it's hard to break free from that, because we've got that dopamine going, and so, how, how do you work with individuals, groups who have this sort of outdated mentality that sleep is, is a luxury and is not something that we really need to prioritize? It's an interesting question, because you touched on a, a few things there. I think that there's, I can go through, and I can tell people the core strategies of, we need to have consistent schedules, and how do we determine how much sleep we need? And, those are our, our all core things. And I definitely wanna touch on that. But I think what, has really resonated the most, is I'm working, whether it is with physicians, but I mean, I see the same thing with founders and entrepreneurs or you know, parents and everything else too, where there are so many, there are only so many hours in the day, and we have so many things that we want to put in there. And what I think is so interesting, is that it is truly sleep that ends up being the thing that gets depleted. Yeah. Because we care about our families. We wanna have that quality time in our work, and our jobs. And, when there aren't enough hours in the day, we typically put everything else first. And so there comes to what's the practicality? And so I think that, that's the biggest thing that tends to resonate when I'm having these conversations, when I'm working with all different clients and, and doing this work, is okay sure, it'd be great, I would love to get this much sleep, but, I can't get everything into my day. And so I tend to take a step back at that point. And one, the first thing is reminding people why we need sleep in the first place. And I know, you know, there's a difference between simple and easy. And, I think for people to realize, okay, well I can fit everything else in that I wanna do, and we're in such a hustle and bustle society, so, if I'm cutting into my sleep, then everything else gets done. So, like the conversation we've already had on how we are less productive, it makes us less efficient. How, yes, you wanna get your workout in and you wanna prep your meals, but, if you're doing all that, and you're not getting the sleep, it's not, gonna help you. So I do typically have to first explain that. I also find that helping people to remember how sleep works, tends to be really useful, because I can just tell somebody to do something. But when we really have a, a general handle on it, and I find it's really interesting, especially when I'm working with physicians, where we've had to learn sleep, but that was so far back, to just remembering the way that we do go through stages of sleep, and cycles of sleep, and the beginning of the night, our physical body is gonna repair first, cause it's survival mode. We need to be able to protect ourselves, and it's all the cognitive, and the emotional regulation, that happens the second half of the night, that many of us are cheating ourselves out of. And so, we may wake up and feel somewhat rested, but we may not be able to have the reaction time or the way that we want. And so helping to reframe that, I think also helping people to understand that, that eight hour number is an average. Mm-hmm. There are some that need more, and there are also some that need less. The key is to figure out what is your ideal number, and then stick to that specific number. And if it is seven, and you can get your seven hours, that may seem like a luxury, but when you get your seven, everything else for the rest of the day is gonna be useful, but how can we be more efficient? So instead of it being, I'm spending 10 hours in bed, to get those six or seven hours of sleep, helping them to get, be in bed and have 90 to 95% of the time be asleep, so there's no time wasted, but they have all this extra time to do everything else that they want to do, and also then not be reliant on the caffeine to keep them awake. Maybe a drink or something to relax yourself at night. How do we get ourselves rebalanced? So, a lot of those things that may seem rudimentary, but it's much more than just sleep hygiene. Yeah. I, I wanna dive into that so much, cause like I said, I remember from hearing you a couple years ago, and just how much I learned about, how we can improve our sleep. It's so, so I wanna touch on something that you said before about physician, when you're working with physicians, that, we have, we kind of remember what we learned about sleep, but we don't learn that much about sleep. We really don't. At least, I'm a family physician. I might have had a couple lectures on sleep, and it was really about the stages of sleep. Um, of course there are sleep specialists, and obviously they're gonna get a ton more training on this, and depending on what specialty they go into, neurology, pulmonology, um, if there's a focus on sleep disorders or ENT, but, a lot of us in, uh, outside of those specialties, just really don't get a lot of education on sleep. And it's frustrating, because when patients come to us, they might have a list of all these symptoms that are going on. And my clients too have a list of, of behavioral, emotional, cognitive symptoms. And one of the first things I've started asking now is about sleep. When I was, I'm not practicing right now, but with patients, I was asking about their sleep practices and sleep hygiene. I do that a lot with my clients now, um, because I've, I've seen that so much in my clients where, we're having a, a family, and having a full-time job, and running a household, and all these things that can interfere with sleep, and I, I love what you said about, yeah, we can't do it all. We can't, we don't have enough hours in the day. And that's something that I talk about in the book as well, is something's gotta give. And so, if we're trying to please everybody else, and sacrificing for everybody else, but it's causing us to not sleep as much, then, is there something that we can do to give and take? Can we, does, does it really matter to us that our house is spotless every night, or can we maybe delegate some housework, or hire that out, or can we do something else for meal prep or, what are the areas where we can have some, um, you know, do some B plus work? You and I talked about, I know I used the term planned neglect. Yeah. Where I say, you know, how do you take back control over that? So, okay, I'm going to plan that I'm going to neglect this thing. Maybe instead of cooking the meal, you know what, I'm gonna order salads, or I'm gonna order a pizza, but I'm gonna get those 30 minutes back Yes. To spend with my kids. Or, yes, I wanna get this workout in or do this other thing. And that's important to do. I think it is really coming up with what are the things where we feel like we have to do all of it? What can we choose to neglect? But when we're making that choice, then it's still in our control. Yes. It doesn't feel outside of our control. And, also being realistic, that with some of our schedules, it may, it's not gonna be a typical nine to five. Right. And a lot of what is out there that you can Google and search, is for the typical nine to five individual, and we take it home with us, or we're thinking about it, or we are on call, and we're getting all this, everything else. And so it's how do we work specifically? Instead of just feeling like, well that doesn't apply to me and it's hopeless, and I'm just never gonna get good sleep. Right. Yeah. And there are certain stages in our life, I mean, when we have newborns, or maybe we have a new puppy. Survival or something. Yeah. Survival. Um, and so, but those, those phases, I mean, unless we're caring for a, a, a family member, who has around the clock needs, something of that nature, um, those stages typically don't, you know, they're, they're temporary, and so, we just kinda, we have to make adjustments. Um, I think about this, a stage in my life where I had major surgery a couple years ago, and I, for weeks afterwards, I couldn't believe how much sleep I felt like I needed. I, I felt like I needed 10 hours of sleep every night for probably two months, consistently after. And you probably did for your body to heal. Yeah. Yeah. And it was so, I mean, again, as a physician, it's one of these like, oh, I, you think I would know, I would know this, but I'd never been, I'd never had general anesthesia before. It was a major abdominal surgery, I had my gallbladder taken out. And, you know, I'd be feeling physically pretty good. Wasn't under any pain, or anything like that, several weeks out, but I was, was needing so much more sleep, and it was just, uh, it was, it was a really interesting experience, and I, I had to, allow my body to do that, and let myself go to bed early, and not wake up as early as I had before. So, um, yeah, I'm glad I, I'm glad I did. Oh, it's interesting that you hit that, cause that's something else that I'm seeing more conversations happen on the patient care side as well, because we know how important sleep is for that health and for healing. But then you have patients that are in the hospital and they, you have to take vitals every so many hours, and you have to give them medication, there's so much of that disruption. And so, it's really interesting to see how more of us are being consulted, to help set the, the patients up on sleep plans for when they go home, so that they can get that heal and rest, because now it's been so disrupted, and you're seeing the physicians that are caring about their patient's sleep, but not practicing it for themselves. Yeah, that is really interesting too about the 4:00 AM lab draws and vitals Q4, even if it's during the night, and the noise, um, that's in the hospitals at nighttime, and lights, and all of that. Yeah, that's, that's a definitely interesting field too. I have a lot of physicians that I work with, that actually can't sleep when it's quiet, because they were used to sleeping on call, and being around all the noises and everything. So, we, I have a really interesting conversation with them, but, so now they're like, oh, well I have the TV on or the radio, and so then we end up talking through, noise is okay, but we need it to be static. It needs to be a white noise machine or a fan. We don't want the television, where the commercials are louder, or something with voices, because then our brain is gonna be checking, is there a threat, or we're used to being woken up, because we're on call, and so our bodies won't let us completely get into those restorative stages of sleep. So if you need the noise, that's fine, but have it be something static. And so just those small little tweaks that can help you to be able to get better quality sleep. Yeah. A lot of what I also do with, when I'm working with individuals that are coming even out of residency, and kind of early stage and such, is helping physicians to be able to create what I call sleep triggers. So if you think about for kids, you have a bedtime routine for them, and they're gonna, you know, wash their face, and brush their teeth, or take their bath, read their books, whatever, you know, say their prayers, whatever your family's process is, that they do it every night, and it tells them that it is time to sleep. But as adults, we don't have those triggers, other than doom scrolling on our phones. Right. So what are little things that we can do, that if we need to fall asleep quickly, cause we maybe only have two hours left, because we were woken up on call in the middle of the night, or whatever we're trying to get in there, how is it that we can have two or three things that we can do relatively quickly, but it sets that routine that triggers our body and brain to know now it's time to sleep. Yes. Or, what are those habits that we're doing, and I, I mean, I've been guilty of this too. I think we all have of, well, right before bedtime especially, maybe it's parents of small kids, is the only time they have to themselves and, so that revenge, procrastination, they're, they're online, or watching Netflix, or whatever that looks like, and that's kind of their only downtime. Yeah. Um, and trying to get everything in, rather than preparing the body for sleep. I, that's one of the things that I always will talk to folks about, and reminding them that light is really the biggest culprit, that we see in terms of disrupting our sleep. Our optic nerve perceives light, it sends messages to the suprachiasmatic nucleus, our sleep switch, saying it's light, be awake, it's dark, be asleep. So if you're gonna have to be on your devices, and your technology, put it in night mode. Black background with white lettering is gonna emit significantly less light, turn off all the overhead lights, and have the side lamps on. Some of these things are typical. We think about sleep hygiene, but that's why we're seeing so many people with melatonin deficiencies. Mm-hmm. Because when the sun starts to set, that's what triggers the body to produce the melatonin. And it's really interesting, and I always tell people, I'm not a prescribing provider, I'm very cautious about those pieces, but I can tell you 95% of the people that come into my office, are using melatonin incorrectly, cause they think it's a sedative or a hypnotic, and they take it 20-30 minutes before bed, and don't realize it should be taken hours before bed, and they're taking too much, because they're trying to force themselves to fall asleep, and then it disrupts the body's ability to produce it. Or even the fact that they're not third party tested, because of FDA regulations. Right. So there's so many people that are using these things incorrectly or what can they use, what can't they use? So it's really been interesting to see how behaviors like our light, and sound, and those types of things, can disrupt it, and then that makes it harder to have the consistent bed schedule. Now we get in bed, we wanna fall asleep, and we can't shut our brain off. We're exhausted and we're looking at the clock. By the way, just the reminder for your listeners, if you wake up in the middle of the night, don't check the clock. Doesn't matter what time it is, your brain's gonna start calculating. You're gonna wake it up, you're gonna be frustrated. Why is it 3:00 AM every morning? Don't do it. Yeah, oh my gosh, I, I have definitely been guilty of that and I, and I do it, and then the next day I think about you, and I'm like, oh, I shouldn't have done that. But it's, yeah, it's, um, gosh, the 4:00 AM brain is, so much more, um, so much more, just hyper-focused, and anxious, and worried about things that would never worry us at 4:00 PM. You know why that is though, right. So tell us, tell us why that is. So there, well, there are a few reasons. So, one, what most people don't realize, is that our bodies actually start the wake up process about two to three hours, hours, before we wake up. So when we're falling asleep, our temperature is dropping a few degrees, or in terms of the chemicals, and the cortisol, melatonin, and how things are adjusting. So about two to three hours before we wake up, our body starts to raise our temperature, and we start to see cortisol production again. So, for those people that are waking up around six, seven in the morning, no wonder around three or four, they're waking up. And what happens is we wake up, cause we're sensitive to that adjustment. We immediately look at the clock, we get frustrated and such, but that's also where, because of those changes, and the chemicals being produced, so one, we were so exhausted, we fell asleep. Well now our brain has enough of that little boost, where now it's starting to think and process. And if we afforded that time to do it when we're in bed, then our brain's gonna learn, okay, I need to process, you don't give me time during the day. If I wake you up at night, you do it, it's gonna keep waking us up. Yeah. So, some of it is the chemical processes, and how our body's naturally doing wake up. That's also why snooze, is a really bad thing for us. Yeah. Because when we hit that snooze button, we negate that entire process. It can take up to 60 minutes for our brain and body to fully go through and get to the full wake up process again, once we start hitting snooze, and people will schedule it in now. Yeah. Okay, I'm gonna set my alarm, we're gonna hit snooze three or four times. Yeah. And that's new sleep. It's like eating empty calories. It's not going to give you the restful sleep. It's better to set the alarm 15, 20 minutes later and get more restorative sleep. Mm-hmm. But it's really interesting how that wake up process happens. How our brain goes. That's why I usually have people do the writing exercise for their brain. Did you want me to share? Yeah, let's go through that, for sure. So our brains are typically designed as we know to process information, and we have so much that we're carrying, and so much that we have to do. And usually we're so busy throughout the day, that when we get in bed, it's the first time we're alone with our thoughts. And so I always will ask folks, I'll say, all right, if you've ever cooked, would you take a casserole out of the oven and put it right into the fridge? No, you usually let it cool down. But we run all day, our brain's going hot, and then we immediately want it to shut off. Yeah. So, if you can take about 15-20 minutes before bed, it's gonna be one of those sleep triggers. Take a notepad and a pen, no technology, and on the right hand side, write your To Do List for the next day, cause you're naturally gonna get in bed and plan of what else you have to do. And then on the left hand side, you wanna write down and do a brain dump. Everything that's running through your brain. I usually will make people set a timer for five minutes, cause they'll do about a minute, it's high level, worried about kids, finances, health, and then they say they're done. But if you keep writing, more and more pours out of your brain, and you will feel exhausted. So you put it on the nightstand, you get in bed, and you go to sleep. If your brain's still running and racing, you get out of bed, and write more. So just like you take a puppy, and you put it outside to potty, you're teaching your brain that it doesn't get to go in bed. So it processes right before bed. It gets it all out. So it's easier to fall asleep, and you don't have to wake up in the middle of the night to do the processing, cause you already did it. But if you wake up in the middle of the night, and your brain is running, you, cause it now has the energy to do it, when you get out of bed and write it down, and get back in bed, it again is saying, oh, I'm not gonna get the rest I need. And so that's why we do it before bed, so that we don't have to wake up to fit it in later. Yeah. I love that. I, I just love the, the way you're describing the conditioning of the brain, you know, we're teaching our brain that it doesn't get to those worries and thoughts don't get to come with us. Right? Yes. You can't take your troubles to sleep with you anymore. Yes. And it's, I tell you, this is the same reason why our bed truly should be reserved for sleep, and romantic activity, but that's it. Yeah. Because otherwise our brains are confused. And think about it, when we were going through, and you were on call and you, okay, check the pager, and check the phone, and you know, you're so used to waking up and then you're, but now your brain doesn't know, should it associate the bed with sleep? Should I be awake when I'm watching on tv? Should I be awake and processing what I'm reading? So the best thing we can do is get out of bed. Mm-hmm. Now, if you can't, maybe you are in an on-call room, at least get on top of the covers. Or if you have downtime, read at the foot of the bed. And then when it's time to sleep, go to the top of the bed, get under the covers, have something, again, I keep using the word trigger. Yeah. But let the brain know this is when I expect you to be awake. This is when I expect you to sleep. I do the same thing with college students. Mm-hmm. But their bed's the only place to sit in a dorm room. Right. Because again, those little separations make it easier to fall asleep when we want to. Yeah. And stay awake when we need to. Yeah. As a, as a parent of a senior in high school who is about to go off to college, that's a really good, that's a really good thing to keep in mind. And I, I think about that too when I travel, I know you do a lot of travel as well. If we're in a hotel room, the bed is the only place, that, we might not have another chair or somewhere else we could, we could sit. So I think that's really helpful, just those little things that we can do to help prime the brain and, and help it to associate sleep with being in bed, all tucked in and under the covers. Don't get me wrong, I get it. It's cold outside. You've had a long day. It's comfy. You wanna be there, but it, and again, if it's not broken, we don't need to fix it. And there's a difference between being so exhausted that you lay down and fall asleep, but then you can't sleep when you want to. Yeah. And so that's why if we can take back a bit of control over that, I know we can't always have a consistent schedule, but again, when I'm working with my healthcare providers, if we can have a somewhat, consistent schedule of a general bedtime. Your body, just like if we eat around six most nights, we get hungry around that time. If we're able to find a time where we're typically going to bed, and if we can have a consistent wake time most mornings, then our body can prepare us to wake up at the right time. When it knows what it has to work with, we can have more efficient restorative sleep. Again, we may get paged, we may have a call. We can't do it every night, but that's where strategic napping comes in. And if we're talking about this, if you wouldn't mind, I'd love to talk about naps first. I would love, yes. Yes.'cause I love naps, but I know there's a way to do it. That's helpful. Don't we all love our naps, right? Yes. And it's interesting, cause when I first explain this to people, they, and they'll say, oh, you're mean you're taking my naps away? And I said, no, here, here's the thing behind it. If your mom ever told you don't eat a snack, you'll ruin your dinner. We say, don't take a nap, you'll ruin your sleep. And what we mean by that, is if you are gonna be able to sleep, and have a full night of rest, we don't wanna be napping during the day, because that's gonna deplete our sleepiness. And we need to have enough sleep to get all the way through the night, because the way that our sleep works, is we're going through these stages, and cycles of sleep, we not only want the physical body repair that happens earlier in the night, but we want the full mind repair, and cognitive, and emotion regulation, so we don't wanna deplete it and not be able to get all the way through the night. When you aren't getting the full amount, then how we work naps in is very strategic. If you find that you take a nap typically at the same time every day, you are going to feel like you need that nap. And that's what ends up happening, is that people say, well, I, I get tired at two every day. Right, because your body and brain have now learned that, that's when they get sleep, and it's going to make you feel tired. Same as be careful when you wake up in the middle of the night. If you're always drinking a lot of water, and you don't get enough during the day, your body will actually wake you up for that water. Mm-hmm. But, what happens is with napping, we actually, ideally should be doing power naps 20-30 minutes max. It's enough to give a little bit of that boost in that jolt to the system, without it depleting too much for you to sleep at night. Ideally, we'd like to see it before 10:00 AM or before 2:00 PM if possible, if you have a typical around 10 o'clock bedtime, just like if you have that little snack earlier in the day, but you build up enough hunger to still eat your dinner. Mm-hmm. So ideally it's not the same time every day, and if we can, we'd be taking that nap in a bed, instead of a chair, or on the couch, because then our brain learns, ooh, I might be able to get some sleep when I'm on that couch or in that chair. And then now we're conditioned to fall asleep and feel sleepy, cause it's gonna try to grasp at sleep if we don't get enough. So naps can be really helpful and really useful. It's just we wanna be a little more deliberate about how and when. Yeah. Yeah. That's super helpful, um, cause I think, like I said, I love my naps and I think a lot of us, a lot of us do. And so just knowing that there's a way to do it, that's helpful. Um, I think that's gonna be really beneficial. I feel like I could talk to you all day, but I know, uh, your time is valuable and so I, we will have to have you back, cause this is amazing. I have so many more questions for you. Thank you so much for being on. Um, so how can our listeners reach out to you if they wanna find you? Sure, of course I have my website Mind, MIND, Mind Impact Consulting, and on there I have a video library over 200, close to 200 videos that are about three minutes long, tips and practical strategies. Sleep Well Guides. They can also get access to my TEDx Talk about sleep, and then on social media I am on LinkedIn, Instagram, Facebook, all the different platforms where they can connect. And if anybody has specific questions, I'd be more than willing to answer them. Or if they wanna connect with me through you, I would be more than willing to help any of your listeners or they wanna do a quick consultation. So. Thank you so much. Thank, thank you so much. Yes, thank you. It's so wonderful to have you. And um, I, Happy New Year and just, uh, really excited to talk to you. Thank you. Yes, you as well. Sweet dreams to everyone. Thank you. While I am a physician, the information presented in this podcast is for educational purposes only and should not be considered medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Please consult with your own healthcare provider before making any significant changes to your lifestyle or routine. By listening to this podcast, you are not creating a physician patient relationship. Thank you for listening to the Purposeful MD Podcast. If you like what you hear, please rate and review the show. Please also visit my website, www.thepurposefulmd.com for free downloads or to discuss working with me as your coach.