Alexa: [00:00:00] What are the topics that us singing teachers find ourselves banging on about daily? I can imagine that one of those things is vocal health. And in the conversations about vocal health, we often talk about nutrition, lifestyle, hydration, but maybe not so often about sleep. 

So you've got a client who's about to go off on tour, spending weeks, maybe months living out of a tour bus, or maybe they're jet setting between time zones and will be experiencing jet lag. Or maybe you're a singing teacher with a rapidly changing routine, often finding yourself waking up exhausted. 

Well it's our pleasure to be welcoming Dr Jill McGarry from Sleep Better Doctor to this week's episode of the podcast to help us understand what sleep actually is and the stages of it and how we can all make sure that we are getting better quality sleep. 

Dr Jill McGarry, what was the last dream that you remember having?  

Jill: [00:01:00] Oh wow, that is a really interesting question. I dream quite regularly, but that bit about remembering it is so relevant because I don't remember them. I kind of remember sometimes a few seconds beforehand, but my sleep is so not regular at the moment. 

It varies quite a bit because lots of demands on family life at the moment means I'm not going to bed at exactly the same time and getting up at the same time. So I'm not able to. have those moments as often as I used to. I know that's a really complicated answer, but maybe, I could explain a little bit more about why sometimes we remember dreams and why we don't other times. 

But my favourite one, it's a favourite one, but a favourite one because It helps people understand trauma a little bit and about how nightmares can be healthy if you work through them. So as a child, I had a nightmare regularly [00:02:00] about our house burning down. And my Nana was Spanish and she believed in dreams and the importance of them. 

I think there's a part of culture in some of that as well. And we created a plan for me to get out of the fire. in my dreams, and we actually created a superhero that meant I could fly out of my window if I needed to, or if the kitchen below my bedroom window, I went through it, I was so strong it didn't damage me. 

So those things are quite interesting, aren't they? So that's the dream that I remember the most from my life, but it's not the most recent dream that I had.  

Alexa: I remember having a dream when I was a kid about a pig that was dressed in a dressing gown and had green fluffy ears. And it was trying to go from the room opposite my bedroom to get to me, but my nan was on the landing ironing, but she left to go and get water for the iron. 

This pig ran into my room, but before it could kill me, it ran into my [00:03:00] wardrobe. And so for the rest of my childhood, I remember even in the blistering heat of summer, being underneath my duvet with the duvet over my face because I was so worried this pig was going to come out of the wardrobe and get me. 

Jill: Yeah, and aren't they fascinating that it creates such anxiety in us, but they're so bizarre as well. Why would it be wearing those clothes, pieces of clothing? And why would you nab me on the landing? So yeah, there's always an element in our dream. about something we're anxious about, something that we're preparing for that universally we know that those things are what we dream about. 

It's our subconscious trying to fathom things out or our REM sleep is what we would say is a sleep specialist is trying to help you work things out.  

Alexa: So what about the times that I wake up with a major crush on someone? There's been a few times that I have woken up with a real crush on, say, Steven Bartlett. 

That was the most recent one. And, I've respected him before, but [00:04:00] why would I wake up suddenly having a crush on him?  

Jill: Our dreams are really good at trying to help us work through stuff, work through our emotions for the day. So you might just actually have a crush for that type of person. 

And that's quite good to be aware of that type of uh, A man is what you're interested in and you're, I don't know if you're trying to emotionally work out who your partner would be or some people worry that when they've got their partner, they're married or in a long term relationship, that why would they dream about somebody else? 

And it is quite healthy. We're still sexual beings. And although, you know, we're quite a monogamous, if that's the word Being, it doesn't mean our fantasies don't have to include other people. So, um, Our dreams, our REM sleep is made to do exactly that. It's to help us work through things emotionally to work out what is it about the partner we're living with long term that we find attractive, [00:05:00] that, that might be useful. 

Or if it's a new partner, what is it that fits with that dream that you've just had? Some people try to read too much into it and just trying to see the general theme is often a more important way to review those types of things particularly.  

Alexa: Considering the singer's vocal health, we know that it's much more holistic than just what's happening in the throat at the vocal fold level. 

The scope of vocal health conversations usually cover things like nutrition and mental health, allergies. and medications and therefore sleep really does need to be part of that conversation as well. And you've mentioned terms there like REM sleep. So I'd really love to understand what actually is sleep and what are the stages of it that we experience? 

Jill: Gosh, yeah probably a long answer if that's all right with you, Alexa. Um, And it won't include Steven Bartlett.  

Alexa: Oh, no.  

Jill: Sorry. But yeah, in the [00:06:00] past we used to just think that when you're asleep, You're just unconscious. It's a bit like having an anesthetic. But it's not at all. We now have clever kits that we put on people's heads and we can measure what's happening at night. 

And what's happening is we're going through four stages when we go to sleep. Um, But Michael Mosley, the GP that recently died in the summer actually described it a bit like being a seal. So at the beginning of the night, we're sort of on the surface of the water, like a seal. And then we do a little dive down and we go through what. 

It's a horrible term called N1, it's very scientific. And that means like just dropping off to sleep. Do you ever have that feeling, Alexa, like you're falling off a cliff or you've just stepped off the curb? So that N1 is that that jerky feeling, yeah? And then we go into N2, which we often call light sleep. 

And we call it that because you might be woken up by sounds in the house, maybe a radiator gurgling or the wind brushing branches against the window. But later on in the night, you [00:07:00] wouldn't. Wake up from it. So that's called light sleep. So that's the second stage. And then the third sleep is called deep sleep, and that's like the seal's deep dive. 

So it's gone past the N one and then two and deep sleep is right almost at the seabed. So you are right at the bottom. And then you come up quite close to the surface to do REM sleep. So REM sleep stands for rapid eye movement. And that's called rapid eye movement because at that point, all that's happening is your eyes are moving and your diaphragm is moving because you still have to breathe when you're asleep. 

We wouldn't want it any other way, but the rest of your body is paralyzed. So I don't know if you've ever picked up a child and they're a complete dead weight. Their arms are so floppy. They look like they are dead. That's why it's called a dead weight. And that's because all their body muscles have gone into paralysis call it. So they don't work . There's no muscle tone at all. It's just our eyes are moving and our diaphragm is helping us breathe. So that's called REM sleep. And that's when [00:08:00] we do most of our dreaming. Science is getting even cleverer now to work out, but actually do a little bit of dreaming in the deep dive bit when we're at the bottom of the bed, but REM sleep is quite close to the surface. 

So we don't just do one movement like that in the night. We do it four times. And it's really interesting. The first deep dive goes through N1 but you don't normally experience N1 again. The next time you do a dive, there's no N1. You don't get that jerk again. You just get it once at the beginning of the night. 

So sleep onset is quite a specific problem that you can't do the N1. Um, For other people for everybody, that dive is not the same every time that you do it. Um, the first, The first, dive that you do, the deep sleep is quite long and the REM sleep near the surface is quite short. And then the next one, the long bit gets shorter, that deep dive gets shorter and the REM gets a bit longer. 

And then by the time you get to the fourth one, just before morning or the fifth one, your REM sleep is really long and there's [00:09:00] sometimes no deep sleep at all. we do that on purpose because what's happening In some of light sleep, but lots of deep sleep, is our bodies are rejuvenating themselves. 

So like you were saying for vocalists, you'd want good nutrition, you'd want good physical health to make sure your vocal cords are working well. When you are asleep in that deep sleep state, all our muscles are being repaired. All our toxins are being washed out. All our neurotransmitters are being rebalanced. 

So there's a hell of a lot that's really beneficial to our voices. It's not just our vocal boxes, is it? It's our lungs, it's our heart. All of those things working together. Knowing that all those things have been refreshed and replenished is a fantastic thing. But the other thing that's happening also in that deep dive bit, when you're right near the bottom of the seabed, is actually our memory is being refreshed. 

So I like to think of it a bit like a filing cabinet. Throughout the day, so say like today, [00:10:00] I parked my car near the business centre, I had some breakfast, I wore some different clothes earlier on today because I thought it was quite warm. I phoned my sister, I've done quite a few business calls, tons of information. 

So my in tray is quite big and quite full. And when I sleep tonight, my brain will look at all that information and go, yeah, Jill, you do not need to remember where you parked your car. You really do not need to remember what you wore this morning. You might need to remember a bit about what you said to your sister. 

So I'll go through all that information, get rid of a load of stuff and move the rest of it into long term memory. So that you keep it for longer, so that when you wake up in the morning, you're in tray smaller so that you can fit more information in. So if you didn't get enough deep sleep, your in tray would be really full and you wouldn't be able to put much more in it. 

It'd just spill out, wouldn't it? And fall on the floor. So For singers that are trying to learn new songs and work out locations of places and people to [00:11:00] contact and all those bits of information. If you don't get enough sleep, not only will your body not be recovered for the next day of singing, but all that information that you need to be able to organize your business, your career, your profession will start to fall off as well. 

And then it has a big impact on our health. long term as well. We know that if we don't do that replenishing deep sleep, then we won't, then we're more at risk of having different forms of cancers, different forms of heart conditions our metabolic rate reduces. Diabetes is more likely. So all sorts of things start to come into play. 

So you do a deep dive and you do a lot of that deep sleep in the first cycle in the night, because if you think about it, evolutionary, when we were cavemen and cavewomen, if a lion and tiger was going to come along and we were inside the cave with our fire protecting us, the next day we'd want to be physically recovered more than emotionally recovered. 

So the [00:12:00] beginning of the night, You use up more of your sleep time to physically recover. And then if you've got time and the fire's still lit and the tigers and lions haven't got in, then you have time to emotionally recover from the trauma of it. So that's why quite often we remember our dreams, because they happen in the more, they've got more chance of remembering them because it's longer in the morning than it is at night. 

But that's why we do more of it in the morning is because we've got the chance to do it, I suppose is the best way to describe it. And we do, we, we use that REM sleep to work through things emotionally. Actually thinking about singing and songwriting, I don't know who it is, but I think it's either Paul McCartney. 

or Mick Jagger, somebody from that era would, I can't remember which one of the two, I think it's one of those two, said that they wrote quite a lot of their songs and their lyrics in their dreams and they would have a pad by the side of the bed and they would write them down ready to use the next day because that's when we're really creative. 

That's why we have, you're like, your strange one [00:13:00] about the pig dressed up or me flying through the floors the kitchen. Those things are possible because what happens in our REM sleep and all night actually is our brain parts are no longer working separately. There's a lot more integration. So like I'm using my hands loads now. 

So as I'm talking during the daytime, my motor cortex , which is at the top of my brain, is working tons because I'm using my hands, I'm using my voice. My Broca area and my Wernicke area, which are my language and understanding speech, are working quite hard at the moment. But when we're asleep, they don't work. 

They actually integrate a lot more than they do during the day. So that's why we can do far more creative things. And the other thing that happens when we're asleep is the only bit of our brain that's not working is this frontal lobe. The bit that makes us humans rather than apes. That bit that makes us be able to plan and [00:14:00] strategise and think logically is switched off. 

That's why we never dream about maths. Because that's all done from the frontal lobe, so it's switched off, which means our imagination can go wild. If logic isn't there, yeah, you can do anything, can't you, if logic doesn't need to sit in there. So that's why we can, in REM sleep, come up with some great solutions to problems that might be needed. 

Alexa: That is so interesting, and I consider myself to be quite a boss at sleeping. I can pretty much fall asleep anywhere, even when I went to see Infinity War, one of the best Marvel films that you will come across, in my opinion, at the cinema with my husband, who won't let me forget that I did it. I fell asleep in the middle of the big battle. 

So I consider myself to be quite good at it, no matter where I am. But that doesn't necessarily mean that I'm getting good sleep or enough sleep. [00:15:00] So how do we know as singers and as singing teachers? And as human beings in this world, really, that we're getting the best quality  

sleep.  

Jill: So I think what you just said there is a perfect example of somebody that perhaps isn't getting enough quality sleep. 

So we have this stupid myth, I was going to say in England, but I think it's international, that everybody needs eight hours sleep. That's not true. We're all different heights, weights, sizes, colour hair. We're the same when it comes to sleep. We all need a different amount of sleep, but we think scientifically we need to be somewhere between six and nine. 

If we're getting less than six and nine, then we're really sleep deprived. And either doing it on purpose because you're trying to do other things instead of prioritising sleep, or there's a sleep problem going on. So you really need to think that if you're beyond those parameters, you need some help. 

But within that, it is just working out what makes you feel refreshed and not tired. [00:16:00] So for you falling asleep in a cinema or a film you wanted to watch, if you're bored of it, you might decide that you wanted to sleep through it. But if you wanted to watch it and you fell asleep, then it's a sign that your sleepiness score would be really high. 

So we in the sleep world use a a scale called the Epworth Sleeping Scale, and it's only five things on it. And if you score three out of the five, then we think you've got a real sleep problem. And one of the questions is, do you fall asleep in the theatre or cinema?  

Alexa: Oh there we go.  

Jill: So you must have been sleep deprived that week when that happened, or that you were struggling. 

But you might just be able to fall asleep anywhere and you made that choice that you just didn't want to watch the film or whatever. It's being careful about making a judgment. I don't want to make a judgment about whether you wanted to watch it or whether you found it boring, but you would have to make a judgment about, yeah, maybe I wanted to catch my sleep then. 

Maybe it was an ideal time.  

Alexa: For me, it's being cozy. If I have got a warm blanket, if it's dark, And to [00:17:00] be honest, I hadn't watched the other Marvel films, so I couldn't really follow it at the time. Since then, I've watched the others and now understand what's going on in the film. So I do think there may be something there, but it's really interesting about you saying that there's five things that you would ask. 

So what are the five?  

Jill: Oh my gosh, you're testing it. So one is, do you fall asleep at home watching the telly or listening to the radio? And one is, do you feel like you're going to fall asleep at the traffic lights while you're waiting for the lights to change? One is, do you fall asleep in the car as the passenger quite regularly? 

And do you fall asleep reading or, no  

Alexa: never - reading is my jam.  

Jill: Yeah. Knowing those things as well, and you didn't fall asleep when you're a passenger in a car. That's quite a common one as well that people would be worried about.  

Yeah. Falling asleep in a meeting, I think it's the other one, yeah. 

Alexa: Oh, okay. Interesting. 

Jill: Or feeling your eyes are going and you're wanting to drop off. I think we've all had those moments, haven't we? And that's okay if [00:18:00] it's just for a week because you've really squished in a project. We're quite lucky as humans. Our sleep can be quite flexible. 

We can borrow a little bit of time or we can borrow a lot if we don't mind the long term effects on our sleep. We can't do without it though. There have been tons of experiments and Silly games where people have tried to stay awake as long as possible. And it's not. 

You, you end up thinking you're awake, but actually your power napping is what the electrodes on our head show us. That actually, even when we try and keep somebody awake for months on time, they are actually getting naps of sleep. And that are possible. We're not like dolphins though, or birds, that we can switch off half our brain. 

So it sleeps while the other half of the brain is doing the work. You know, That's why birds can fly forever. That's why dolphins can swim forever because they switch off half their brain. We haven't evolved to be able to do that. We need our sleep. In fact, there is um, a condition called fatal familial insomnia. 

 And it's , a [00:19:00] very, very uh, extremely rare condition um, I can't remember, it's something like 0. 0005 percent of the population has it. And that gene means when you turn to about the age of mid 30s you can't sleep anymore. Sleep onset doesn't ever happen and then you die within two years. 

Because your body needs sleep that much, all that stuff I talked about replenishing your muscles and your neurotransmitters and the toxins, they just, the toxins particularly just build up in your body and your body can't survive without the sleep. So we, yeah. We definitely need it.  

Alexa: Many artists might find that they are struggling with their sleep because they're in and out of time zones, maybe touring the country or getting back late from a function gig. 

So how can we help the singers that we work with in those capacities to get as good sleep as possible when they might be on things like planes or tour buses or in the car, [00:20:00] obviously, hopefully not being the driver?  

Jill: I would wanna assess each individual because some people might be doing gigs all the time, and then we would have a different intervention to somebody that would just do some gigs. 

And I would perhaps do a different intervention for somebody that's experiencing jet lag regularly compared to somebody being on a tour bus. So one of my favorite pieces of advice for athletes as well as performers is that you choose the hotel really carefully and you choose your room in the hotel really carefully because if you're going to have an odd sleep, you want it to be as best, good quality as possible. 

So you would want to choose a hotel. a bedroom that's on a high floor because you're not naked. So families usually choose the lower level floors. So you're not going to have noises from kids waking in the night or babies screaming. So higher floors and a bedroom that's away from the lift because people make a lot more noise as they're getting in and out of lifts. 

So [00:21:00] just having that little bit of basic advice that means when you actually do get in your bed, you're going to get the best quality sleep possible is really important. But you might also want to think about taking like a pillow with you so that you have some things that make you still feel comfortable. 

So anything that you think would make yourself feel like you were safe, that feeling of comfort that you talked about before and feeling cozy in the cinema, if you can replicate that wherever you go. The cyclists in the Tour de France and the Olympics, the British cyclists, are doing really well, aren't they? 

We're, we're now known to be excellent at it. We weren't excellent at it, but we have had some sleep experts work with them and they actually take their own sleep pods with them, right? on those events. So now footballers are copying the same thing. They're taking sleep pods with them. They're not sleeping in the hotel beds. 

They're taking their own bedding. In some cases, when they're like Liverpool [00:22:00] football club, they're taking their own mattresses because all the time. Comfort is really important and your mattress is different to the next person mattress that works for you. So taking it with you to enable you to get the best sleep is fantastic. 

If I'm working with somebody that's I don't know, some famous person, I'm trying to think of all sorts of names , and they could take huge amounts of kit with them. I would definitely be saying, put in your tour bus at the bottom a load of mattresses, especially for your main singers and band players. 

They need to take their own mattresses and sheets as well. That would be useful for them. Thinking about what smells lots of performers and like Olympians that you know that they don't get much money though. And they have to do things on a shoestring because they, the industry doesn't pay them well, they've got to have a second job. 

Often we'll talk about setting a routine because our sleep's a little bit unconscious. We don't want to think about it too much. We want it to just happen. The more we think about it, the worse it gets. So [00:23:00] having a nice, healthy routine can be good. So if somebody's doing a night gig, no matter what time they finish at, you'd want them to do the same, maybe 10 stages so that their body gets that same kind of rhythm. 

Oh, okay. no matter whether it's 11 o'clock at night or four o'clock in the morning. These are the 10 things I do. And therefore the sleep is more likely to happen because it's got into that rhythm of going to bed. But it's the same things for, for the times that you want to make it as dark as possible. 

So some people might be coming in from doing a gig. at the same time as night shift workers will be coming in like four or five o'clock in the morning and the sun might be rising. So what I would say then is you'd want to wear a cap and sunglasses because you don't want the bright light of the day hitting your eyes, giving your brain a signal that the day's starting because you want to go home and go to sleep, don't you? 

often we talk about what you do during the day. more important than what you do at night, but making sure that the bright daylight is only getting to your [00:24:00] eyes when you want it to get to your eyes is really useful.  

Alexa: You spoke a bit earlier about picking your room in a hotel. And that might maybe work for the people who are got a big budget, who can talk to the hotels. 

But for example, when I was on a contract for a cruise ship, we were up in a hostel on the strip in the Reaper barn in Hamburg. where loads of people would go for like lads holidays and hen do's and stag do's and I was on the second floor, which is just above the bar. And I remember going downstairs, I would meet my friend, she was on the opposite side of the hostel and we'd meet in the kitchen to get a cup of tea, we could talk about tea and what we drink in a second before bed. 

And I didn't get the memo because when I came down to the kitchen, a hen do was there and I walked in on a stripper, which was not what I was expecting to have with my PG tips, to be honest with [00:25:00] you. I didn't get the memo at that time, but it was buzzing with excitement. How can we get better sleep when we are in a scenario where it's loud and there's music and there's cars and there's drunkards? 

Jill: Yeah, it's tough, isn't it? It's nice for them, but for being on the periphery of it and just, Stumbling upon it when you want your cup of tea is not easy at all, is it? But we are lucky today that we do have some gadgets that are really helpful. So have noise cancelling headphones can be useful. 

Although some people talk about them not fitting well when they're in bed. And what we always want people to do, the best position for sleeping is on your side. So trying to find some that or a way of keeping them on your head. So some people wear a headband as well, so they stay in position. Some people don't like wearing them and, and don't move much, so they might just put an ear-pod not an ear-pod, an earplug in one ear. 

Some people will actually play their own music in their ear [00:26:00] because often the noise from elsewhere changes quite often, doesn't it? And there's lots of squealing and giggling that is coming and going. Whereas if you play your own music in your AirPod or your, some music in your ear, then the chances are you can make it more constant rather than it being erratic, which will help because it's the eraticness when you're in that light sleep that you makes you alert to what's going on again. 

So if we can get you past that light sleep stage and into deep sleep by having some other noises in your ear, it can be helpful. It might mean that you need a blackout mask, wearing an eye mask can be really useful. Some people like the eye mask that actually slightly presses on the eyelid because it helps them stop their eyes moving as much. 

They're quite like it. Other people hate that and they want the ones where they're quite like a they don't touch even their eyelashes. So playing around with. an eye mask if it's useful [00:27:00] because some hotel rooms have the most, if it's a cheapo budget hotel, it might as well be just like a piece of lace against the window because it's just not doing anything at all. 

Some of the posh hotels, it's like a proper black room, isn't it, at night time. But the most important thing thinking about an eye mask is that you take one with you that's got an adjustable strap at the back, cheap ones that you'd get on a flight or I don't know from a supermarket. They don't have an adjustable strap and they're not going to stay on your head well overnight. 

So they're not going to do the job. It would be better if you could put up a blackout blind and it is useful that on Amazon now and other places you can get some travel blackout blinds. So they're like a piece of material that kind of not sticks like glue, but can be peeled off and put on the next one. 

And taken places for people that are really struggling. And that's because lots of people have different thicknesses of eyelids. Some people go, it doesn't bother me. And other people go, Oh my God, I'm super [00:28:00] sensitive to it. The light. So just knowing yourself well, and which bits need to be adjusted and which bits you can't put up with is really relevant. 

But yeah, having a nice routine. I love the idea. You went down for your PG tip and you always chatted to your friend in the kitchen that will have been a little bit for you to help you have part of your routine to get off to sleep, no matter what the chaos is around you. Did it work? If even it was disturbed by a stripper. 

Maybe they entered your dreams later on.  

Alexa: So we've mentioned mattresses, smells, pillows, eye masks, taking your own blackout blinds, and you also mentioned gadgets like the earbuds and the AirPods. We also have these very clever watches now which tell us How good sleep is if you wear one at night. My husband's got a Garmin watch and he is very interested. 

I like to see what his little spikes have been. How [00:29:00] accurate are they?  

Jill: A Garmin's quite an accurate one. It's not as good as a kit that a sleep team would give you to wear. There's a watch pro and a Knox piece of kit and they wouldn't just be on your wrist then. They'd measure via a microphone you're snoring, they'd have, you'd have electrodes on your legs to see how much your legs are moving, just so a sleep team could assess you more thoroughly. 

So it's quite basic information, but a Garmin's better than an Apple Watch, it says more accurate and more detailed information but they're not as good as a proper sleep study, so if you're really having a sleep problem, it's It's nice, interesting information that you can take to your GP to say, look, I'm not just complaining about sleep. 

It's not just a feeling I've got. My scores are showing that I'm not doing very well. However, if you don't have a sleep problem, it is not the best thing to be looking at those scores, trying to get them better. The best thing is you just feel rested and to [00:30:00] focus on whether you feel rested or not and what's happening in your life to, and to try and change things slightly so that you can get more restful sleep is the most important thing, rather than looking at a watch and hoping that it will get better some nights rather than other nights is a better way of using those watches. 

So yeah, don't wear them all the time, take them off after you've done a measurement. And you think, yeah, I thought it was a sleep problem. It's not a sleep problem. Take it off, charge it at night, because it'll be measuring some of the great things that you might want to do during the day. But the worst thing for most people is they begin to become quite obsessed with getting their scores to be higher. 

And you can do that during the day, you can drink more water, you can take more steps upstairs, you can stand more often, you can do some more exercise, but you can't just make yourself have more REM sleep or make yourself have more deep sleep. It doesn't work like that. Our brains are really clever and it will give you what it wants. 

So there's [00:31:00] been quite a few experiments done whereby. They've measured how much an individual has of deep sleep at the start of the night and how much REM sleep. And then they've got them to do more physical exercise or do some more emotional work. And for those that do more physical exercise, they have more deep sleep because your muscles need to repair more. 

So your brain makes the choices about what it needs. You can't make your brain choose what to do. What it needs. It will make those choices for you, if that makes sense.  

And on that then, what are the things that we can make sure that we have in our day that will help us get more of that quality deep REM sleep? 

The things that we can do during the day that can help us get not just the REM sleep but all the stages that are really important like the deep sleep as well is making sure, the first and most important thing that any sleep specialist if they're good would tell you is to make sure you get enough daylight in the morning and [00:32:00] so and to have a good routine. 

So when we say a good routine people automatically go, I'll always go to bed, 11 o'clock or whatever we say, it's not what time you go to bed. It's what time you get up first thing you want to say is to try and get a good routine of getting up at exactly the same time. That's why I said right at the beginning of this, that my routines a little bit out at the moment. 

So I'm not dreaming or remembering that I've dreamt as readily as I would, because I'm not waking up at the end of a REM. But if you can become more regular and keep to a set time that suits you individually. So lots of people get better. quite hooked up once they've got a partner to try and sink in with them. 

But that's, we shouldn't do that. We should live with what works for us. So I'm a real owl. I like staying up and my energy and my creativity quite often happens at night. And I'm really sluggish in the morning. My husband is quite the opposite. He likes to go to sleep early. Might fall asleep downstairs and then go upstairs and then get up early in the morning and is wide [00:33:00] awake in the morning and quite active and lively and we're completely the opposite. 

And that is really healthy. In fact, when we've looked globally and internationally, we often married the opposite to ourselves. And that's, that makes sense evolutionary wise, because if we're going to have a brood of kids, You'd want one to be awake while the other's asleep watching over them. So it gives us less of a risky time when we're both asleep. 

So it completely makes sense. So you need to think about what time works for you so that you set your get up time that works for you. So my get up time, my preferred get up time is eight o'clock in the morning. Of course, I've had kids and I've had to get up earlier, but I've always Manage to get ready in 10 minutes because I love my sleep in the morning that much. 

So I do lots of prep at night to make sure I get up later and I can still get up later in the morning. Whereas other people would do it the other way around. They do all the making of sandwiches and in the clothes in the morning because they like to get up early. So setting your time that suits you in the [00:34:00] morning is the most important thing. 

And then the next thing to do during the day is to get 20 minutes of daylight. I know that sounds crazy, but we need that daylight to reset our clocks in our heads. So we've got, I don't want to get too sciencey, but we've got a part of our brain called the super charismatic nuclei. Sounds like supercalifragilisticexpialidocious, but it's not. 

And so we shorten it to the SCN and that's like the grandfather clock. So that sets all our internal clocks. And the only way that can stay tuned is by resetting every day by the sun, because as you can imagine, the time we wake up and the time we go to sleep changes slightly. That's why every four years we have an extra day. 

So it needs the sunlight to recalibrate every day. And that will help us get off to sleep because that sunlight in the morning gives us a chemical [00:35:00] called melatonin. That goes into our eyes, you might, you have melatonin receptors on your skin, but to actually to help your sleep, that melatonin or lux needs to get through your optic nerves into that SCN. 

And then that helps you get off to sleep. And without enough of that, you can't get off to sleep. That N1, that jerky feeling, you don't, you can't do that without the melatonin.  

Alexa: That's so interesting because I think about how society has built its kind of work structure where we're there at nine and we finish at five or whatever and in the winter when people are going to work in the dark and coming home in the dark. 

And then for the singer who might have a really late gig so gets home at three in the morning and then really doesn't really feel like getting up until 12 I mean I guess they still get a bit of daylight but it's not morning daylight. How can we work around that?  

Jill: So if you think about it, there's a whole. 

load of [00:36:00] countries and the Nordic countries like Scandinavia, Norway that have that happen to them naturally, that they don't get enough daylight. And they've done a beautiful job of using what we would call sad lamps. But they're not sad lamps. They are the same kit, but they don't have to be called sad lamps. 

They're called luxe lamps. And that luxe lamp gives off the lux that gets converted by the eye into melatonin. So in Scandinavia I find it fascinating that they have these lights as lights in the conservatory. So they all sit underneath them and bathe in 20 minutes of lux from that. to give them the recalibration and the enough melatonin to get off to sleep the next day. 

And they often eat their breakfast, it takes about 20 minutes to have a chat and have your breakfast if you're a social family. So yeah, that, that, and so for some people that I work with that can't synthesise that melatonin and there are, there is quite a few people that can't especially people with autism. 

So we [00:37:00] would. We would give them these lux lamps to try and help them and they just need to leave them on the desk, a bit like a desk lamp that I've got here. It just looks like an ordinary lamp but we give them to night shift workers. So I did a project on a mental health ward near me, and we had it on the night station for all the nurses. 

So when they were inputting the computer information on the patient, the lamp was on there for every single member of staff to, to bathe themselves in 20 minutes of good lux that they would have got if they were outside at the right time of the day.  

Alexa: Yeah, so our singers could take one of those in their bags if they need that 

Jill: Yeah. And it's not big. It's not like a lamp with a stand. I'm trying to think I've got one to hand. I haven't actually, but the one I often take to training is about, and it was not even an A4 size and about that thick. So easily can fit in a bag. The biggest thing, probably the most clumsy bit is the plug and the wire. So yeah, you could definitely, and they cost about 25, but you have to have one that's got 10, 000 lux. So there are some [00:38:00] companies, that are trying to jump on the bandwagon and they're not strong enough. So they wouldn't do the job. So you just have to make sure it's got 10, 000 lux for it to be able to do the job. 

Yeah. So they could definitely take that. It's definitely a recommendation I would give to anybody that's a gig worker, a night shift worker.  

Alexa: There was a sleep scientist and a professor at the Stanford Sleep Medicine Center, I think her name's Dr. Ma. She was a recent guest on, seemingly my favourite person at the moment, Stephen Bartlett's Diary of a CEO podcast. 

There's a pattern here, it's emerging.  

Jill: Oh, was she the one that did the Nappuccino? 

Alexa: I think she was the Nappuccino, potentially, I can't remember. But she was talking about the sleep environment, and you've mentioned about making it dark. She also talks about it being quiet, cool, and comfortable. 

And how big a meal an hour before bed, which is fried, fatty, or sugary, maybe washed down with some alcohol or caffeine, can be quite detrimental to sleep. For the singers who might be finishing their day at [00:39:00] college quite late, getting home at half eight, nine o'clock, they've got an early start the next morning, or the gigger who has the hunger pangs at 2am when they're getting home from their gig, what's one of the best tips foods or meals or drinks that we can have before sleep so we don't get disturbed.  

Jill: Yeah, so she's spot on, we would prefer people not to eat two or three hours before they go to sleep. Our bowel will, if it's working on food, it'll be sending messages to your brain saying, It's not time to sleep yet. 

I've still got work to do. And so it will be really hard to sleep with those two different functionings going on at the same time. So if you could eat before then, so I would often say to people, if you can take a packed lunch wherever you're going, so on your journey home, you could be munching on something. 

Nice things like that. cooked chicken drumsticks, some nice cheese, those types of food rather than chocolate bars that are full of sugar that will give you a [00:40:00] sugar rush that will keep you awake because it's sending your glucose levels into spiking and therefore your body not knowing whether it's awake time or and slowing down time. 

So yeah, I'm trying to eat protein food, but trying to keep it away from the last two hours. And the same for caffeine, caffeine, whether it be in a coffee substance or Coca Cola or energy drinks, they all have quite a lot of caffeine in and caffeine stays in our body for quite a long time. 

And caffeine, binds to another chemical called adenosine that we need to help us stay asleep. And so if adenosine , is bound to caffeine, then it doesn't help us stay asleep. So we want to make sure that the caffeine's out of our body quite a long time before. So that's even more than two or three hours. 

The hardest bit around caffeine is that everybody's Sensitivity to caffeine and how long it stays in our body is different. So [00:41:00] just using me and my husband as an example, again, I'm not sensitive to coffee at all. I could have one like an hour before bedtime and it wouldn't affect me. My husband is super sensitive to it. 

He doesn't drink a coffee after 11 o'clock in the morning. But everybody's different. And I think people intuitively know, I don't know what you're like, Alexa. Do you know what you might be like?  

Alexa: I'm fine with it. In fact, I sometimes have it too. I find it a comfort. So that cozy comfort, I don't feel it keeps me awake. 

Jill: So don't worry about it. It won't be the case for you. But I think people know when they know. But when they know, they don't always cut it out because they still like it. And it is about knowing your own body really well to be able to cut it out. There might be something in that, that cozy comfort drink. 

There might be about a hot milk because what we do need is the lady you spoke about is for our body temperature to be cool when we go to sleep. So we can do that by the room being cool. But one of the other things [00:42:00] which sounds counterintuitive, is to have a hot drink. Because what's happening, it's a bit like when you have a curry in India. 

Why would they have hot curries that make you sweat? It's good to make us sweat because it lowers our body temperature. So that's why curries and hot food is popular over there. So it's the same thing for us. If we have a hot drink, our body temperatures will begin to cool down a lot. But it does take two or three hours to have an effect. 

So having a hot drink just before bed's not the best thing if you can bring it further. So you might make a hot flask of tea or a hot flask of cordial or hot milk just before you set off from the gig to go home. And if it takes you an hour to get home and another hour to get through your routine of getting in the house and getting into bed. 

And then you've done two hours, haven't you? If you've had the drink on the start of the journey on the way home. So it's about a little bit of preparation that might be useful.  

Alexa: Yeah. Yeah, for sure. And I'm talking about [00:43:00] being cool and what we wear and who we share the bed with. So I sleep with my husband. 

He sleeps with me. is as naked as the day he was born. I hope that's all right for me to say. And I am like a Victorian, I'm dressed head to toe. So what is What's the best thing for us to be wearing when we're asleep? Or should we be wearing  

anything?  

Jill: I think that's, again, just a real personal thing. I think some people are really cold. 

So one lady I worked with, her ability to regulate her temperature was really low. And she was really cold at night. So we were, she was wearing gloves, she was wearing socks as well. Her extremities were the worst. But actually, we began to realise the one place you lose the most heat from is your head. 

And the way we managed to keep her warm in bed and warm enough to be able to sleep, not too warm that she was overheating was to put a hat on her. So she was able to tolerate things with a woolly hat on. [00:44:00] So she actually wore a hot woolly hat in bed. Whereas, whatever your needs are is important. 

So for women going through the menopause, it might be layers that are important because somewhere in the night, they might have a night's sweat or the body will get hotter. And so they'll need to take layers off. When I go away and stay in a hotel, I always get really annoyed with hotel beds because they tuck the bedding in loads, don't they? 

And I like to stick my legs out sometimes in the middle of the night because I use my cold feet as a, like a recalibration, making myself a little bit cooler and being too wrapped up means I can't get my legs out. Whereas other people quite like that cozy type feeling, don't they? So yeah, whatever suits you and is your needs is important to be aware of and to try and stick with. 

But yeah, not wearing things that make you feel constricted and might make you wake up. That would be important. That's why being as naked as the day you were born is a good strategy. You're not going to get caught up in things. Some [00:45:00] people like duvets, some people like covers and blankets. 

And I think when we're going through, different temperature needs, then you might want to even think about. Whether one of you would want a different duvet number compared to the other person. So thinking about having two separate mattresses I've worked with a young lady recently that she realized whenever she went through menstruation, she was really super hot. 

And therefore being next to her new partner and he was super hot meant it became intolerable. So what they've now decided to do is to have a super king size bed. And to have two mattresses. So his body, he isn't being transferred through the mattress, but it also means they can have different, he can have a different quilt to her depending on what they need. 

But yeah, in some countries it's not common in some countries to have double mattresses and super king size mattresses. They believe in sleeping separately. And if you look at us as primates, [00:46:00] we don't sleep with our partners. And maybe. quite a modern thing to live in houses and for parents to sleep on their own in a bedroom. 

In some cultures you sleep with your kids and you're all together, aren't you? And no two people are in one mattress, just the two of you together. It might be a whole bunch of people sleeping on all separate little beds of their own. So yeah, it's whatever floats your boat. And I often talk to people about the fact that if your partner snores and it's something they need to work through and it could be a real health problem. 

They may need to think about why they're snoring, but to help the other person, sleeping in a separate bedroom doesn't mean it's the end of the relationship. It can be really good for the relationship.  

Alexa: Yeah. Oh, snoring is one of the worst things. in the world. It's such an annoying noise. Why do we end up snoring? 

Jill: Oh, it's such a good question. I think I have got a book on my desk that can help describe it best or give you a picture of it. Why can I not find it? But I'm still [00:47:00] into something. So here it is. So this is a picture of our throat and our tongue. So when we're stood upright, it looks like this, but oops let me just go like that. 

So when we go to sleep and we're lying down, our tongue slips into this throat here and it's the blocking of the throat that makes the noise. So if we can, rather than just go like that, but to go like that and sleep on our side, rather than on our back, which will be there, then our tongue won't fall quite so into that gap. 

It is more likely to slip to the side and therefore still be forward and not too much in the throat. But quite often I'll help people, and I can imagine this is for singers, is you probably got good breathing skills, that ability to use our, and our noses and our throats and our tongs very effectively is not the case for everybody. 

And some people's tongue muscles have had very little practice at all. And so sometimes I will [00:48:00] give them things to think about chewing just so that they can build up their tongue muscle so it's not as likely to slip into their throat. And also, the more you can breathe through your nose and use that pathway into your throat, rather than your mouth breathing, the less likely snoring is going to be as well. 

Alexa: Yeah, we had Patrick McCohen on our Focus on Event on Breathing a couple of years ago, and he's really an advocate for nasal breathing and the need for deep sleep. And he said, if you're, if you have a stuffy nose, you're two to three times more likely to have a sleep disorder. And for sure for singers, we like to, we want to make sure the airway isn't dry and snoring can, and sleeping with the mouth open, catching flies definitely is an environment for dryness. 

So I tend to use the little breathe right strips or nasal strips across my nose just to keep the mouth closed.  

Jill: Yeah. Some people are quite into taping. I don't know whether Patrick McKeown talked about that. Just a little tape here and [00:49:00] here. And it's not that it's to close the mouth, but it's just to remind yourself subconsciously as well as consciously to keep the mouth shut. 

We're not asking you to tape the mouth up. In fact, we think that would be really unhealthy. the if somebody needs to breathe through the mouth because their nose is not doing its job, then we wouldn't want to block it up. It's just a reminder like the strip does on the nose. And I think the more you can do to during the day to help those systems, the whole facial system work better, the more likely it will happen subconsciously or without effort. 

At night as well. So yeah, totally agree. There's so many benefits through breathing through our nose. This thing is really clever with all the structures that are in there and all the muscles and tissues that filter out everything. It is a bit like being a whale with your mouth open, isn't it? 

Anything goes in there, we're just not meant to get anything in there. And it does, it makes those really dry, doesn't it?  

Alexa: Yeah. It does. Sleep's not the most attractive thing, is it? I'm just thinking about myself in my Victorian outfit, my wee [00:50:00] willy winkle hat on, and my my Breathe Right strips on, my eye masks. 

If there was any deterrent for a husband to want to rethink a relationship, I think it's that.  

Jill: Do you know what, though? We say that. So the other day I was speaking to a gentleman who's got sleep apnea, so he can't breathe well at night, so his tongue does sit low, and he has a kit called a CPAP kit, so it helps him breathe, and he thinks it's magical. 

So it doesn't look great. He's wearing a mask at night. He looks like a monster. He's got this machine on the side of his bed, but he loves it, and his wife loves it, because he doesn't snore. And he's not knackered the next day, if I'm allowed to swear, maybe I should just say tired. No, you're good. And that he even takes it on holiday. 

So he has a letter from our sleep service that says he's allowed to take that kit like a medical device, like you would have for a heart condition, for diabetes. So he's allowed to take it on the flight as an extra piece of kit and so it's always with him. And that's how important it is. We [00:51:00] are our most attractive when we've slept well. 

How much better is our skin? So we might not look great at night, but if we do the things that make us sleep well, then we will look really attractive during the day.  

Alexa: And we look good in our dreams.  

Jill: Oh yeah,  

definitely.  

Alexa: Can you tell us about the work that you do at Sleep Better Doctor and what resources would you really encourage us to check out at the back of this chat? 

Jill: Oh, that's a really good question. I do two pieces of work. I run clinics. So people that have got sleep problems, that could be nightmares or sleepwalking, sleep talking, or insomnia, just really finding it hard to stay asleep or getting off to sleep. And for the odd person, it might be narcolepsy, like falling asleep all over the place that they just can't stop. 

So I run those clinics two days a week, and then I work for companies and organizations and groups. running wellbeing sessions. So sometimes they're an hour, sometimes they're a whole day with some team building in [00:52:00] there to help them sleep. So some companies realize they've got a huge responsibility for their staff around fatigue. 

Whether that be a logistic company with lorry drivers, you don't want a big articulated lorry causing fatalities on the motorways. I think companies are getting better at being aware. So I will run them as well. For people, but there are quite a few good YouTube clips out there. 

So Matt Walker is a really good person to have a listen to his YouTube clips. And I'm trying to think which books. So Michael Mosley, the guy, the GP that I was talking about before. His book called Fast Asleep is quite good. It's one of my little bibles. Like I said, it's about the side of my desk and I can't find the little otter picture or beaver picture seal picture should I say. 

And then, yeah, I think those would be the main things. I think you can get a bit obsessed with different things. And I think, There are some books that like one of them talks about 110 sleep tips, and I think we make it far [00:53:00] too complicated. I think sleep and getting good general sleep is like a bit like sleep hygiene is like dental hygiene and stomach hygiene. 

If you brush your teeth well during the day and you wash your hands well, you're less likely to need a filling or have a stomach bug. However, if you get a stomach bug or you need root canal treatment, you shouldn't stop doing. the brushing of the teeth and washing the hands. And it's the same with sleep hygiene, do the basics. 

And I would say there are four basics, get the heat get the light get some routines in place and get some good nutrients in your body. And if you can keep them going, even during the bad times, then it will get back online. I think it's when you throw them out the window thinking, Oh, it's not working now. 

So I'll do something different that actually you. make it worse.  

Alexa: Yeah. Oh, Jill, I could talk to you for ages on this. It's such an interesting topic, but we're so glad that you could join us and keep us company today. Where can people find out more about you and about Sleep Better Doctor? [00:54:00]  

Jill: So I have a website called sleepbetterdoctor. 

co. uk. So there's some information on there. I'm on LinkedIn. I probably post once a week, once every two weeks. Some of it's some specific facts that might be useful. Some of it, might be some techniques that might be useful. Some of it's pointing you in different directions for advice and support. 

But yeah, you can find me on both of those places or you can just call me. So people often phone me up and I offer a 15 minute free consultation because I might not be the right person to offer support. You might need some CPAP kit like I was talking about before, but I can point you in the right direction. 

So they're 15 minutes free and I do them on a Thursday morning. So they just need a phone up, book in, so my number's 07768 068 070. And we can find a time slot that, that suits you.  

Alexa: Well, Dr. Jill McGarry, thank you so much. I hope we all sleep soundly tonight and get our restorative sleep in. Thank you so much for your time.[00:55:00]  

Jill: It's a pleasure. Thank you.