Ep 32: Mastering Your Sleep with Irina Macare

In this episode of Reset Recharge, host Dr. Komal Patil-Sisodia, a triple board certified endocrinologist, discusses with special guest Irina Macare, a sleep coach. Irina shares her personal journey from an IT engineer to a sleep expert after battling severe insomnia, which ultimately led her to develop the DREAM Sleep Coaching Method. Throughout the conversation, they delve into sleep hygiene, quality versus quantity of sleep, and the critical importance of a consistent sleep schedule and light exposure. Irina also distinguishes between cognitive behavioral therapy for insomnia (CBTI) and acceptance and commitment therapy (ACT) in managing sleep issues. The episode provides actionable tips for better sleep and guidance on when to seek medical evaluation for sleep disorders.

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Audio Stamps:

00:00 Introduction to Reset Recharge

01:00 Meet Our Special Guest: Irina Macare

01:56 Irina's Journey to Sleep Coaching

04:26 The Birth of a Sleep Coach

08:15 Understanding CBTI and ACT for Insomnia

12:27 Defining Sleep Wellness and Quality

17:06 The DREAM Sleep Coaching Method

20:13 Understanding the Mind-Body Connection

20:30 The Importance of Sleep and Building a Foundation

21:00 Maintaining Sleep Habits for Long-Term Success

22:48 Creating a Consistent Sleep Schedule

25:59 The Role of Light Exposure in Sleep

28:40 Recognizing When Sleep Issues Need Medical Attention

32:26 Irina's Personal Journey with Sleep

37:01 Final Thoughts and How to Connect with Irina

Thanks for listening. Find more info about Reset Recharge on the website or Instagram.

Transcript

Dr. Komal Patil-Sisodia 0:02

Welcome to Reset Recharge, the podcast where women's health takes center stage. I'm your host, Dr. Komal Patil-Sisodia, a triple board certified endocrinologist and women's health expert. This show is all about empowering you with the knowledge to understand your metabolic health, navigate hormonal changes, and feel confident in the conversations you're having with your healthcare provider. Whether you're managing symptoms, exploring treatment options, or just want to feel more in tune with your body, you're in the right place. As a physician, my goal is to educate on this podcast. The content shared here is for informational purposes only and should not replace personalized medical advice. If something we discuss resonates with you, please talk to your healthcare provider at your next visit. Now let's dive in and help you reset, recharge, and take control of your health. Hi everyone. Welcome back to Reset Recharge. I'm your host, Dr. Komal Patil-Sisodia. Today I am very excited for our special guest Irina Macare is a sleep coach, and I met her through a local group of female entrepreneurs and we have a lot of. Overlap in what it is we're trying to do for women's health and just health in general. And sleep is a huge part of health and is hugely disrupted in midlife. So I wanted to invite her onto the podcast to talk about her background and then this and her sleep coaching business and a framework that she's come up with to help people feel like they can get to sleep in a better way. Welcome, Irina. Thank you so much for being here.

Irina Macare 1:40

Thank you so much, Dr. Komal, for inviting me and allowing me to have a voice on your platform.

Dr. Komal Patil-Sisodia 1:46

Oh, it's my pleasure. I think that all the good information that we can put out there for our listeners so that they have tools to be able to make their quality of life better is so important. Irina, can you tell us a bit about your background and what brought you to sleep Coaching?

Irina Macare 2:02

Yeah, that's a interesting story because my background is actually, I'm an IT engineer and I've been working in IT for 16 years, and the IT space, it's very competitive and very hardworking. So I burnout out multiple time and burnout came of course with insomnia. So I've struggled with insomnia for years and initially when it happened there was like a night here and there. But then as life went on, challenges got harder and harder, my stress level increased. So it got to, the point was it wasn't a matter if I wake up in the middle of the night. So I was waking up in the middle of the night and couldn't fall back asleep until morning. So at some point it wasn't about, if I wake up, it was about like at what time will I wake up and for how long will I be awake? And. Initially, I pushed through this being tired and the sleep deprivation and the effects of it through with coffee and willpower, but everything changed when I got into a car accident because I didn't have reactions fast enough to avoid a collision. So that was my wake up call, literally, and fig, figuratively. So that was the point when I realized that I have to do something otherwise, like I will literally die. But back then I was in Ireland and honestly like the medical system there is not great either. So I knew for sure that I didn't want to go to a sleep doctors or to even like to my gp first to go to the GP and then you go to a specialist. I knew that they're going to prescribe medications. I was always passionate about health, personal development, and personal improvement, so I start reading every book, every blog that I could put my hand on. So over the years, I experimented with a lot of things, some work, some didn't, and it took me some time until I was able to fix my sleep or to feel better. Because I was so passionate about what I was doing. I was always talking about this at work and a lot of people like was were listening to me and trying some of the things that I was sharing and they were like days or weeks after, it's oh, Irina, I tried your whatever you said, and it worked and I feel so better. And that fueled me so much.

Dr. Komal Patil-Sisodia 4:26

Yeah.

Irina Macare 4:26

And fast forward after I moved here in US and I burn out again.

Dr. Komal Patil-Sisodia 4:32

Yeah.

Irina Macare 4:33

I was like, so I got into a depression. I was starting to ask like existential question. I was like, what's life like? What? My work didn't bring any joy. So I wanted to go into coaching and to help people. And just at the same time, precision nutrition. I don't know if you're familiar with precision nutrition.

Dr. Komal Patil-Sisodia 4:53

I've heard the name, but I don't. Yeah,

Irina Macare 4:54

it's a very good and famous company that provides nutrition certification and they just launched their sleep stress management and recovery certification for the first time, and I felt like that was a sign and that was my entry into the sleep world. It was by accident and everything like. Conspired to get me there. And that was like the beginning of my sleep coaching education. After that, like I took more courses because there were so many gaps. I feel like right now there is not one single course that covers everything that a sleep coach should know. Initially I wanted to help people that I was seeing around me, especially in the IT world. Sleep was not seen as something that you should be proud of. Actually the opposite people were wearing as a badge of honor. The fact that they were sleep deprived is like, my code is the best when I'm writing it at 2:00 AM with a beer in hand. Or like, I slept only five hours. I'm so busy, I'm so, so important. You know, so it felt like. Sleep is a waste of time. And I was like so frustrated because like I knew what it means to be sleep deprived. Yeah. So my initial initiative as a coach, I wanted to, I had a motto, let's make sleep sexy again.

Dr. Komal Patil-Sisodia 6:12

Yeah.

Irina Macare 6:14

But. With time and that was trying to make people understand the benefits of sleep and how they actually can use sleep as a productivity tool and how they are better engineers when they are sleeping well. And while starting taking clients and working with people, I realized that. Those people, honestly they are not so open to hear the message, but they are the other people who are actually struggling with sleep. They're trying to do everything in their power to sleep, but they can't. And while trying to help those people, I realize I learned that the gold standard for treating insomnia is cognitive behavior therapy for insomnia. So I got myself educated in that field and. Start applying CBTI practices and start helping people and while working with people, I realize that there are some cases where CBTI, while it's evidence-based, there are so many studies, it's proven to work. There are situation with CBTI does not work because of its rigidity and. So I looked in acceptance and commitment therapy applied to insomnia, and that's how.

Dr. Komal Patil-Sisodia 7:30

Yeah,

Irina Macare 7:30

my evolution as a sleep coach and how I introduce gradually different knowledge and tools in my coaching practice. So yeah, that I'm,

Dr. Komal Patil-Sisodia 7:40

yeah, that's an incredible story. First and foremost, I'm so glad you're okay from that car accident. That sounds terrifying, right? Yeah. To be behind the wheel and not have control, I'm sure that was.

Irina Macare 7:51

Yeah. Yeah.

Dr. Komal Patil-Sisodia 7:52

I can understand how that was your wake up call. It

Irina Macare 7:55

took four years to have the courage to drive back on the highway, especially here in the us. Really? Oh

Dr. Komal Patil-Sisodia 8:00

my gosh, right? Yeah. That's just such a clear example of like how not getting enough sleep can be so detrimental, right? So I love that you are taking something from your personal experience and that's what's driving your. Passion for this type of work. So for our listeners, Irina, can you explain the difference between a CT and CBT? Like I, I've known what CBT is, but when we first started talking, that was the first time I heard about a CT and I really wanted to understand a little bit more. I'm sure that if, I don't know, there's probably. Some other people who may not know either.

Irina Macare 8:37

Absolutely. And I feel like though there are some practitioner who are using shortly, it's act, ACT and CBTI, so it's easier to pronounce. There are practitioner who are using ACT in their treatment for insomnia, but it's not as popular. And I would say it's relatively new because CBTI was such, had such good results that people were training only in CBTI and that was it. So the difference is that the CBTI focusing on changing the thoughts and the behavior that interfere with sleep while ACT focuses on changing the relationship with those thoughts and feelings, especially with the struggle around not sleeping. So with act, we change the relationship of towards wakefulness. And we are not challenging, like with CBTI, you are challenging the thoughts like, I'm not going to sleep tonight at this night, so tomorrow I'm going to be exhausted and it's going to be ruined. So with in CBTI, we are actually challenging those thoughts. Is it true? Have there been situation in the past where you haven't slept well and you actually perform well? So that's the CBTI approach on the act. Is it not? Necessary fighting against it. We are not looking at the thought. Is it true or not? More like is it helpful? Like what is the goal that I'm trying to have right now? Is it to sleep? Is the thought of or the worry of being awake, is it helping you to achieve the goal that you're having?

Dr. Komal Patil-Sisodia 10:05

Yeah, so

Irina Macare 10:06

we're not questioning the thoughts. We are creating like some psychological flexibility. And that allows you to do what matters, even when the mind is nosy, noisy, and even if your sleep is not perfect. So you don't let the thoughts control your action. You're actually diffusing away from your thoughts and taking, and not let your thoughts dictate your action.

Dr. Komal Patil-Sisodia 10:30

Interesting. Okay. Yeah. The whole premise of. CBT is that your thoughts drive your actions, right? So it's focused on the changing of your thoughts, but sometimes those are difficult for people to change and this is where a CT comes in and

Irina Macare 10:45

yeah, because that, I think act is used in many, many, many places, especially with addiction. But I feel like it's such a good fit for insomnia because

Dr. Komal Patil-Sisodia 10:57

yeah.

Irina Macare 10:59

You are feeling tired. You are. It is hard. It is hard. And we are not actually, we are not trying to invalidate your experience. And the thing with insomnia. It feels so lonely is being awake in the middle of the night, in the dark when everybody else sleeps and you feel like guilty. It's something wrong with me. Why am not sleeping?

Dr. Komal Patil-Sisodia 11:22

It's extremely isolating.

Irina Macare 11:24

So it feels sometimes that people who are trying who are telling us like, try harder. It's like they're invalidating us. Acceptance. It doesn't mean that you are denying what's happening. Yeah. It's just allowing to be and go through it with even when things are harder and there are techniques to help you to detach from those thoughts. To allow them to be Yeah. And to go forward with.

Dr. Komal Patil-Sisodia 11:51

That's a very powerful thing and I like how you have framed this. In the context of insomnia? Yeah. Specifically right with,

Irina Macare 11:59

and the biggest problem with sleep is that sleep does not reward effort. So the harder you try, the more anxious you become and the more anxious, the more hyper aroused and the harder it is to sleep. So trying more sleep is a situation when trying more actually backfires. I see.

Dr. Komal Patil-Sisodia 12:18

I see. That makes sense because I know the nights that I've tried to fall asleep, it's almost like your thoughts race more if I happen to wake up in the middle of the night. Now I, just so our listeners know, what is, how do you define sleep wellness versus just getting more hours of sleep? Because quality of sleep matters, right? And the hours can be a little different from person to person, but I'd love for people to hear what your take is on that. And then also like sleep hygiene in general.

Irina Macare 12:47

Yeah. What I like to say is that when it comes to sleep more doesn't mean better. Better is better.

Dr. Komal Patil-Sisodia 12:53

Yeah.

Irina Macare 12:54

And when it comes to better sleep, it means like better quality and all the stages of sleep because there's so some people who are focusing so much, I want to get more deep sleep, or I want to get more rem sleep. Each stage of sleep has its purpose and you should have like a balanced ratio of it. So when it comes to quality sleep, it means how not to be fragmented. So it should be like. In one bout. And of course we sleep in 90 minute cycles and we wake up every around 90 minutes. But we do not remember often. We do not remember those awakening, but one metric that we track quality of sleep is the sleep efficiency. And it measures the times in bed versus time asleep. Oh, okay. So a good efficiency is between 85 and 90. And again, sleep does not, you don't have to be perfect asleep. If you have a sleep efficiency of a hundred, that means you're sleep deprived. So it takes around like 15 to 30 minutes to fall asleep. Like it's totally normal. Yeah. And if you fall asleep as soon as your head hits the pillow, that's an indicator that you don't get enough quality sleep that your body needs. So

Dr. Komal Patil-Sisodia 14:13

That's so interesting. I never thought of it that way. Because all of us, like we have that type A, especially those of us who are type A are like, yeah, a hundred percent that means I'm better. That's such an interesting thing that a hundred percent actually means quite the opposite.

Irina Macare 14:27

And see, that's why a lot of the people who have a struggle with sleep, with insomnia. Yeah. They're like the perfectionist, the A typers. Yeah. Because like they try to do everything perfect, but as I was saying, sleep does not reward effort. So yeah it's about, and again, the sleep quantity differ from person to person, from stages of life, like. Across lifespan, the needs for sleep changes, and even for the same person. The sleep needs can vary from day to day. So for example, if you are sick, you might require more sleep. So to allow your body to, and your immune system to fight the. Disease. You should not be so fixated on the number of hours you're asleep. Of course, there is a range where it's not good.

Dr. Komal Patil-Sisodia 15:23

Yeah,

Irina Macare 15:24

less than six hours, let's say. It might be too little and it can be too much as well. If you sleep more than nine hours, that. I don't know if you've done that, but like when I was young and I had like summer vacation often I was sleeping 10, 12 hours and I remember those days I was like so groggy.

Dr. Komal Patil-Sisodia 15:44

Yeah.

Irina Macare 15:45

So if you sleep too much, you don't feel well. So sleep, wellness, I would measure it if, how do you feel during the day after asleep? Do you feel rested? And of course this can be impacted by so many other things. Food can be impacted by many other biological system in your body, but how do you feel if you had like a full night of sleep? Yeah. Do you feel rested? Do you feel emotionally balanced? So yeah that's how I would define quality of a sleep ness. Yeah.

Dr. Komal Patil-Sisodia 16:20

I think that is. Fantastic. And it gives people some tangible idea of what that would be. Yeah. With the wiggle room that it is different for each person. Exactly. And really you have to pay attention to it. It's interesting. My husband and I laugh because I think that I need much less sleep than he does. And I will get up early in the morning. I'm like a morning person. I have lived like a whole day before he, before like on the weekends before he gets up, he's just like, what have you been doing? I was like, I don't know. I've been up since six and you know, I did this and this and this and this and so it's interesting and I look at my sisters and their spouses and there's always one that. Goes, okay. A little bit of sleep and the other one who needs much more sleep. So there's a little bit of sleep disparity there. So let's shift gears and talk a little bit about your dream sleep coaching method, right? I'm interested in how you develop that and what each of the pillars means for your coaching style.

Irina Macare 17:19

Right? So working with people and over the years. I found myself saying the same things and trying to use different methods and to use different levers. And this made me realize that when people were coming to me, they were so overwhelmed they didn't know where to start improving their sleep. So I. Understanding the sleep, how sleep works, and what are affecting sleep. I created like this framework to explain the five pillars where we can see if you have to, you have any problem and if you have to do improvements and each pillar you have different levers that you can use. So the dream, it's an acronym actually, and the first pillar is sleep drive. And sleep drive is basically. Our body's desire for sleep. The moment you wake up, you start building the sleep drive and when you are asleep, you are actually removing that sleep drive. So think about is like when you're hungry, when you wake up, you're hungry, you eat, and then as you go through your day, you become more hungry. So it's similar with sleep stands for rhythm from the circadian rhythm, so sleep drive and circadian rhythm. There are two system that work together. Circadian rhythm is also responsible for. The timing of sleep, like telling you when to be asleep and when to be awake, and also is responsible with alertness, light. It's a huge factor to tell your rhythm when it's day and when it's night. And there are some other things like temperature and timing. B, it's environment, but basically it's a umbrella for all the sleep hygiene, like I put in there, all the sleep hygienes when it comes to your temperature or bedroom temperature. The noise, the light timing, like when to eat and when not to eat coffee. Yeah. And alcohol consumption. So I'm looking to see if you have any behavior that could disrupt your sleep that falls into this category. And a and m basically is the ACT and CBTI part of it. Yeah. So a is the automatic or the behavior and cognitive loops. First I'm looking at are there any behavior that are affecting your ability to sleep? And the thoughts as well as I was saying, is like, I have the thought that is I'm not, I'm a bad sleeper and this makes me more anxious. So looking at those and re restructuring the thought, the behavior, and the thoughts. And the M is the mind body connection where we are looking at your stress level and how can we work you with your body to help your mind Because like sometimes you can influence your mind by influence, by working on the body, and you can work on. Relaxing your body by working with your mind. Yeah. So it's a bidirectional connection. Some people, some books are saying there is no mind body connection, there is unity. It's just one thing. It's hard to, yeah. So when I'm working with people, I'm looking at. Each pillar to, and we assess. Dream sleep. Sleep is my method. So basically we study first what's happening in your life, in your body. So we are tracking things without. Trying to change anything. And that gives us insights and understanding what's going on. And then we start removing all the barriers and start building, supporting foundation for sleep. Yeah. And at the end we focus on sustaining the progress and improving resilience because life happens. Yeah. And sleep is like weight loss. Like you do all the work, you lose the weight. But then your work doesn't stop there. You have to continue to do all the things to keep the weight. It is the same with sleep. Once you have a better sleep, that doesn't mean like we stop there. You have to continue with all these patterns and when life happens, what can you do to bounce back? You know? Yeah. That's the resilience.

Dr. Komal Patil-Sisodia 21:25

I love that you used weight as an analogy because I know we've talked about this and I do a lot of weight management in my practice as well. It's so interesting that the habits are really the important thing, right? Even when people are going through weight loss plateaus, I will tell them it's. The consistency of the effort through the plateau. So you're saying the same thing. It's the consistency of the sleep habits. And I will tell you that on the nights that I do all the things that I'm supposed to do, I sleep like a rock. On the days that I am not great about it. My sleep is terrible and so I, you are a hundred percent spot on and I love. Part of your coaching is teaching people how to maintain those habits because it can be really hard. That is a whole other skillset in and of itself, is the maintenance arm of it.

Irina Macare 22:12

The brain and body likes to have routine. Yes. And anticipate, and that's like one of the things that I like to work with my clients is that to create routines, including weekends and a sleep schedule, including weekends, because your body will start reacting in anticipation of sleep.

Dr. Komal Patil-Sisodia 22:31

Yeah. So

Irina Macare 22:31

ideally, once you have started your routine, your mind and body knows that it's sleep time and. Start preparing the nervous system, all the hormones that are needed. Yeah, that when you go to bed, you're ready for sleep.

Dr. Komal Patil-Sisodia 22:48

For listeners who are ready to start working on their sleep, what are a few actionable mini steps that they can take tonight based on your framework?

Irina Macare 22:59

My number one recommendation is to create a consistent sleep schedule, because as I was saying, our body likes routines. And you can start with a wake up time because you have more control when you wake up than when you fall asleep. So you start with a wake up time to the po. Usually what I do is like I look at the schedule for the entire week and I find out like, where do you wake up the earliest?

Dr. Komal Patil-Sisodia 23:26

Yeah,

Irina Macare 23:27

and that's like the starting point. And you can vary plus minus 30, 30 minutes, and that's your wake up tab for the entire week, including days. Let's say you wake up at 6:00 AM. You'll wait. That's the hardest part. And sometimes I do make some adjustment depending on the people's schedule. And often, you know what, like I had clients who wanted to wake up at 6:00 AM but their chronotype was not an early bird. So

Dr. Komal Patil-Sisodia 23:56

Interesting.

Irina Macare 23:56

Yes. We haven't talked about chronotype, but chronotypes, no. Is a biological and genetically predisposition for a specific time of the day when you're asleep. And basically you have the late the night owl, the early bird, and in between. And the in between can be earlier or a little bit later in the morning. So sometimes people are trying to create a sleep schedule to fit that doesn't fit their chronotype, and that often can lead to sleep issues, including insomnia, because like if you're a night owl and you go to bed at nine. Pm your body is not ready to sleep.

Dr. Komal Patil-Sisodia 24:39

Yeah.

Irina Macare 24:39

And you toss and turn into bed and then your brain will start associating bed with wakeful wakefulness. And then that's, that's the equation for insomnia. And I had clients where I actually shifted their sleep schedule later and fit better to their lifestyle, but they were trying to wake up early because they were thinking. If I wake up early, I am like more productive or people appreciate more the early birds and they, there is a stigma with night owls. So there is some shame about like going to bed late or waking up late. So I'm trying to reframe that, that way of thinking. So then we look at, it's like, how many hours do you think you can sleep or do you want to sleep? And then we look at the, that's, that would be like the time to be asleep. And then we count 15, 30 minutes for you to fall asleep. And that's time in bed.

Dr. Komal Patil-Sisodia 25:36

Yeah. And

Irina Macare 25:36

then the previous hour would be a wind down. So that's how I would structure Okay. A sleep schedule. And if you can do that regularly over time, you will fall asleep easier and wake up easier. There are so many people who have like a consistent sleep schedule and they wake up without alarm. That's the best. Another thing that I recommend is getting light exposure. So we are bombarded with information about blue light and blue light blockers. Yeah. But there is not enough talk and discussion about how important light exposure throughout the day it is for our circadian rhythm. And the problem is that we are sleep deprived, a flight during the day, and we have like too much light at night. We live in indoor most of our time, and even if you have a window, the light that it's coming through the window, it's not enough. And then your brain doesn't have a strong signal that it was day and at night. When we turn on the lights, it's things that it's day. So by getting bright light exposure in the morning, the first 30 minutes after you wake up. It tell, gives your brain like a strong signal that it's day and that's like a countdown starter. And the brain knows that around 16 hours after that signal, it has to start producing melatonin.

Dr. Komal Patil-Sisodia 27:06

Yeah.

Irina Macare 27:07

And by also getting light exposure throughout the day in enhances that signal. And even if you get light exposure at night, it inoculates that signal saying it is like, we know that it was day. So even if you get light exposure at night, your circadian rhythm knows that it's nice. So getting light exposure early in the morning, the first 30 minutes, you can get a sad lamp, especially now that it's so dark outside. I was just going

Dr. Komal Patil-Sisodia 27:33

to ask that, right? Yeah. Like being in the Pacific Northwest, we don't get quite as much light. So the sad lamps help then?

Irina Macare 27:41

Yes. Especially in the morning. Okay. So they help with mood, but also with the circadian rhythm.

Dr. Komal Patil-Sisodia 27:46

Yeah.

Irina Macare 27:46

So get light exposure from that. If it's possible and you can go outside at lunch, during lunch break, movement and light exposure would help. And sometimes it's like 15 minutes. It's enough. Yeah.'cause if you measure the light outside, it is like. Thousands of locks while inside is just hundreds. Yeah. So it is a huge difference even on a cloudy day like today.

Dr. Komal Patil-Sisodia 28:13

Yeah, that's fantastic. And I know when we were chatting yesterday, I mentioned. One of my friends had written a book on circadian rhythms, so I'm gonna give her a quick shout out Lynne Peoples The Inner Clock, if you haven't read it. It's a great book. She spent well over a year researching and writing this book, but it talks all about the chronotypes and the things that you were saying. So I, I love when my worlds collide like this. When you said chronotype, I was like. I know where that registered. So from your perspective, Irina, how can someone know when their sleep issues are beyond just behavioral coaching and when they might need a medical evaluation?

Irina Macare 28:48

That's a good question. So the most underdiagnosed sleep disorder is obstructive sleep apnea. Yeah. Especially in women and especially in women at menopause.

Dr. Komal Patil-Sisodia 29:01

Yes.

Irina Macare 29:02

And that's because like when they. One of the criteria for diagnosing sleep apnea without the actual test in the lab is the stop bank questionnaire, and basically the stop bank is like the acronym and they're looking at the circum circumference of the neck, the body mass index and the weight, and

Dr. Komal Patil-Sisodia 29:23

correct.

Irina Macare 29:25

That captures a lot of people, especially men, but it excludes a lot of cases where the obstructive sleep apnea happens for other reasons. So when we entering menopause and our estrogen goes down and progesterone goes down, so estrogen. Impacts muscle elasticity. And with the estrogen being low, the muscles are not so elastic. So they collapse on our throats, on our airwaves and progesterone a huge role in sleep respiration. So the signal between brain and the lungs. So a lot of women that don't fit the stop bank criteria they struggle with obstructive sleep apnea. Some of the symptoms might be overlooked as other symptoms from menopause. Like we've talked yesterday about the fact that you can. Wake up during the night and too many times, and to go to bathroom, a frequent urination. It is a sign of obstructive sleep apnea. You wake up with headaches you feel you fall asleep as your head hits the pillow. Yeah. A lot of people look at like their spouses and things like why do I don't, I have like their sleep. But basically what's happening, they are like chronically sleep deprived. Yeah. Because they have epileptic sleep apnea and they not breathe during. And that's my number one recommendation is to get tested. So overall is like you've done everything.

Dr. Komal Patil-Sisodia 30:52

Yeah. You still, it's still not working. Yeah, not

Irina Macare 30:55

working. There are some sleep disorders that are so hard to diagnose. Yeah. And people get diagnosed very late. I've been recently, I've been at the Idiopathic Hypersomnia conference, which was here in Seattle this summer. And I've talked with so many people out there who were like patients and some took like 13 years to be diagnosed and basically there is like a. A need to sleep more and more and more. And they sleep so much. There is narcolepsy as well that it's, if it doesn't come with cataplexy, so there are two types of narcolepsy, narcolepsy type one and type two. And the type one covers cata, like you have cataplexy. So it's just some degree. Still hard to diagnose, but to some degree it's easier to pinpoint in that direction. But the ones who don't have cataplexy, yeah, like they're just having the sleep issues. So if you're struggling with your sleep, you're, you have a hard time to sleep or you are doing everything, you're sleeping a lot, but you're still feeling very tired, then.

Dr. Komal Patil-Sisodia 31:59

Yeah.

Irina Macare 32:00

Go to medical

Dr. Komal Patil-Sisodia 32:00

evaluation. Yeah. And

Irina Macare 32:02

I do a very deep assessment in my intake process because as a coach I have to be very careful with my scope of practice. Yeah. I do not diagnose, I do not treat. Yes. So if I'm seeing any red flags, I am trying to my best to refer them to the right specialist.

Dr. Komal Patil-Sisodia 32:20

That's really lovely to hear.

Irina Macare 32:22

Yeah.

Dr. Komal Patil-Sisodia 32:22

It's nice to hear that you are taking all of that into account. So Irina, how has your own relationship with rest and sleep kind of evolved since you started this framework?

Irina Macare 32:33

Honestly, when it comes to sleep problems, it's not like you are cured. I'm still having nights of bad sleep, especially when I'm having some stress happening in my life. That what change is my relation with sleep and how do I react?

Dr. Komal Patil-Sisodia 32:52

Yeah.

Irina Macare 32:53

When I'm having sleepless nights and. I remember like even in the past when I was still working as an IT engineer, I was like so busy that I didn't have time for anything. I love listening audio books, so sometimes when I was waking up in the middle of the night, I was actually excited because I was having some time to catch up. So it seems like it's a way of changing your relationship with anxiety.

Dr. Komal Patil-Sisodia 33:23

Okay.

Irina Macare 33:24

I knew that I'm going to, yeah, it's going to be hard, but I've done this many time and I know that I can handle things without, like less hours of sleep. So as soon as like the stressor is removed, then my sleep is back to normal. And that's the problem with insomnia because. That's how it starts. People start having some sleep problems because of an event or something happening in their life, and they start engaging in compensatory behaviors like going to bed too early or staying too late, or drinking alcohol or taking sleep meds and. Then even if the stressor is moved, their loop of insomnia continues and they get to be in a chronic insomnia. So this is very important on how do you think about it and

Dr. Komal Patil-Sisodia 34:14

yeah.

Irina Macare 34:15

How that affect you. And the other thing is like I am very careful with my light exposure.

Dr. Komal Patil-Sisodia 34:21

Yes. You know it's interesting, I was at the eye doctor yesterday and she was asking me if I wanted contacts with like blue light blocking, and I know. And I said yes. So now I'm gonna call back and say, no, put me back for the non blue light blocking ones. Because listening to you now, I'm thinking, oh my gosh, I put my contacts in when I go to walk in the morning. And if it's blocking all that blue light, well that's going to be bad.

Irina Macare 34:47

Yeah, because we need that blue light in the morning. And you know what's interesting to think about it? So with age, you know that our eye changes. Yes. You can

Dr. Komal Patil-Sisodia 34:59

develop It's the lens.

Irina Macare 35:01

So with age, that becomes more yellow. And that yellow actually blocks the blue light to enter your eyes. Really and older people beside the fact that their melatonin production reduces. Also their circadian rhythm is affected by the light that enters their eye. So I know people who got surgery for cataract. And dear Sleep got better after that because

Dr. Komal Patil-Sisodia 35:31

that is fascinating.

Irina Macare 35:32

Yeah, so it is fascinating. It's so interesting. That's why like I'm so stoked about the circadian rhythm.

Dr. Komal Patil-Sisodia 35:40

Yeah.

Irina Macare 35:40

You can improve your sleep just using some of the levers and it's a low hanging fruit. And I'm not saying that if you have insomnia, just fixing those.

Dr. Komal Patil-Sisodia 35:51

Yeah. Yeah. It

Irina Macare 35:52

will improve your sleep and. I would like to mention that a lot of people dismiss the sleep hygiene advices when they have insomnia, but you know, it is like when you have a cavity, you don't stop brushing your teeth because you have a cavity. If you have insomnia, you should not stop taking care of your, sleep hygiene practices. So don't underestimate if it doesn't fix your insomnia, it doesn't mean it doesn't matter.

Dr. Komal Patil-Sisodia 36:21

That's so good. I was just gonna ask you if you could leave our listeners with a takeaway, but I think it has to be that, yeah. So can you repeat that again?

Irina Macare 36:30

If you have insomnia and your sleep hygiene doesn't fix your insomnia, it doesn't mean those behavior doesn't matter.

Dr. Komal Patil-Sisodia 36:39

Ugh.

Irina Macare 36:39

They still matter.

Dr. Komal Patil-Sisodia 36:41

Yes.

Irina Macare 36:41

Just you have to do other things on top of that. In addition. Yes. In addition. Yeah,

Dr. Komal Patil-Sisodia 36:47

in addition. So I think that is. Fabulous advice because, and it goes back to what we were talking about before, which is like that maintenance, right? Those that the habits that you build around sleep hygiene are going to matter quite a bit. Yes. Irina, thank you so much for your time. How can our listeners who are tuning in, how can our listeners find you and where can they find you? Can you give us your. Social handles and your website and I will post them all in the show notes so that we can get that out to everyone.

Irina Macare 37:18

Definitely. And thanks for asking. They can find me on my website, irinamacare.com.

Dr. Komal Patil-Sisodia 37:24

Okay.

Irina Macare 37:25

That's where they can find more details of my coaching program, where I'm describing actually the dream sleep, the method and the framework and the method. Also, I am on Instagram at Irina Macare and on LinkedIn the same Irina Macare.

Dr. Komal Patil-Sisodia 37:42

Yeah. Perfect. So I will link all of that in the show notes and as a coach you have more of a reach, so you're not limited to just people in Washington state. No. So for any listener, even if you're not in the state of Washington, you can work with Irina and I. Again, I will post everything down in the show notes. Irina, thank you so much for the time you took today to share your framework and share how you look at sleep. It's, I think this is going to be a really valuable episode for people who are tuning in.

Irina Macare 38:11

Thank you so much for inviting me. It was my pleasure.

Dr. Komal Patil-Sisodia 38:14

My pleasure.