The Secret To A Good Nights Sleep with Stephanie Romiszewski | E64

1. 0:00 – 1:04

   Intro

   1. SRStephanie Romiszewski0:00

      They just don't have the education. So our own doctors do not have enough education in something that we do a third of our lives. If you are waking up in the middle of the night and it's been happening to you over and over again, to resolve the habit you're going to have to-

   2. NANarrator0:14

      (Instrumental music)

   3. SBSteven Bartlett0:19

      Sleep, it's a thing that we all do every day. But for some reason in our society, it's still a little bit of a mystery. How many hours should we be sleeping? What is sleep debt? Is there a perfect sleep routine? Should I wake up at a certain time? Why do I get sleep paralysis, insomnia? Why do I have these dreams? My next guest, Stephanie Romiszewski, worked with NASA and Harvard Medical School to understand these questions. Stephanie currently works as a sleep physiologist helping people cure and understand their insomnia and sleep disorders. So without further ado, my name is Stephen Bartlett, and this is The Diary of a CEO. I hope nobody is listening, but if you are, then please keep this to yourself.

   4. NANarrator1:01

      (Instrumental music)

2. 1:04 – 4:00

   What the result of not sleeping properly?

   1. NANarrator1:07

   2. SBSteven Bartlett1:07

      Stephanie, the first question I wanted to ask you, and I've got millions and millions of questions to ask you, because this is a- a topic which I- I- as I said before we started chatting on air, um, has really piqued an interest over the last three years. I've never had so many of my friends in my sort of close circle ask me questions about sleep, send me articles about sleep. And I don't know what's happened, but as a nation and as a- as a species, I think we've got really, really curious about this idea of sleep and also its importance. The first question I wanted to ask you was- was how important sleep is. But I think a better way to understand that and the answer is to actually look at the consequences you've seen in your line of work, um, for people that have bad sleep or that have insomnia. Um, so could you speak to that a little bit?

   3. SRStephanie Romiszewski1:57

      I can. That's a big, big question.

   4. SBSteven Bartlett2:00

      Yeah.

   5. SRStephanie Romiszewski2:00

      Um, what I have seen over the last 16 years of my career is not people coming in dying because they aren't sleeping or, uh, with really, really significant illnesses. I've seen people very anxious, very stressed, very low because their sleep is poor and they are extremely worried about it. And I've seen people who are, you know, at the top of their game and doing really well in life, but are completely crippled by these sleep problems. But it is the fear of bad things, worse things happening to them that is keeping them as stressed and upset as they are.

   6. SBSteven Bartlett2:37

      Mm.

   7. SRStephanie Romiszewski2:37

      So it's quite interesting because I think the f- the things that bring people to me to get their sleep treated are exactly that- that fear is actually what I'm trying to alleviate rather than, um, fixing their sleep because I think they're going to get so sick that something terrible is going to happen to them.

   8. SBSteven Bartlett2:55

      Mm.

   9. SRStephanie Romiszewski2:55

      Um, so it's a really interesting question to ask, how does sleep affect us? The reality is we actually- we- we- or why do we sleep? We don't know actually why we sleep. We know what happens when we don't sleep, but I think we're getting very, very confused between those of us that struggle with sleep and those that are actively depriving themselves of sleep like the CEO who says, "I'll sleep when I'm dead," for example.

   10. SBSteven Bartlett3:20

       Sure.

   11. SRStephanie Romiszewski3:21

       Um, but, you know, those of us who are actively trying to sleep when we can't and we will do anything and we- we- we make our sleep opportunities larger and we still can't get sleep. We're not depriving ourselves of sleep. We're doing anything we can to get sleep.

   12. SBSteven Bartlett3:37

       Mm.

   13. SRStephanie Romiszewski3:37

       So I- I worry about the amounts out there about sleep at the moment and the way that it's- the information is being disseminated-

   14. SBSteven Bartlett3:45

       Mm.

   15. SRStephanie Romiszewski3:45

       ... because I think that's where we're going a bit wrong and all the tracking of sleep and all the tech that comes out, I'm not saying it's- it's a bad thing, I'm just saying that it's almost like we haven't quite caught up with all the information that we have and we can't cope with

3. 4:00 – 10:00

   Where is the bullshit?

   1. SRStephanie Romiszewski4:00

      it quite the way we need to.

   2. SBSteven Bartlett4:02

      So you- you speak about the tech that we have now, Apple Watches-

   3. SRStephanie Romiszewski4:06

      Mm-hmm.

   4. SBSteven Bartlett4:06

      ... all these little, you know, smart devices-

   5. SRStephanie Romiszewski4:08

      Mm-hmm.

   6. SBSteven Bartlett4:08

      ... that are telling us how many hours a- a day we're sleeping. And also there's, you know, books- there's probably a couple of books on the shelf behind me about the perfect night sleep or the perfect morning routine or the perfect time to wake up. Where is the bullshit?

   7. SRStephanie Romiszewski4:19

      (laughs) Oh my God. Again, another massive question. Um, there is so much of it. It's- it's all- it's so nuanced, you're gonna have to ask me some specifics-

   8. SBSteven Bartlett4:29

      All right.

   9. SRStephanie Romiszewski4:29

      ... because there is so much there that actually is- I mean, well, the first thing- the biggest thing I would say is, you know, going to bed at exactly the same time every night, dictating your bedtime is probably the worst piece of advice I've ever heard and sends people off on all sorts of different tangents which does not help. If anything, it makes their insomnia worse because they go to bed in the dark, not able to sleep, getting more anxious, heart rate going up.

   10. SBSteven Bartlett4:56

       What should they do instead?

   11. SRStephanie Romiszewski4:57

       Stay up until they're sleepy. Don't worry about it. Enjoy yourself, relax, do the things that you probably don't get time to do because you're busy doing all the other things during the day.

   12. SBSteven Bartlett5:07

       Here's the problem I have with that approach-

   13. SRStephanie Romiszewski5:09

       (laughs)

   14. SBSteven Bartlett5:09

       ... which is the- the approach that I think I've adopted maybe a little bit too much or incorrectly, is if I stayed up doing the things that I want to do, what happens is, I'll stay up till 7:00 AM just looking-

   15. SRStephanie Romiszewski5:19

       Mm.

   16. SBSteven Bartlett5:19

       ... at YouTube videos and learning-

   17. SRStephanie Romiszewski5:20

       Mm.

   18. SBSteven Bartlett5:20

       ... about rockets and looking at like stocks to invest in and stuff.

   19. SRStephanie Romiszewski5:23

       (laughs)

   20. SBSteven Bartlett5:24

       That's- that's me to a T.

   21. SRStephanie Romiszewski5:25

       Yeah.

   22. SBSteven Bartlett5:25

       I- I- at some point I have to put my laptop down and be like, "Steve, just- you're going to feel awful tomorrow if you carry on looking at-"

   23. SRStephanie Romiszewski5:30

       Yeah.

   24. SBSteven Bartlett5:30

       "... this investment fund that you think is interesting."

   25. SRStephanie Romiszewski5:32

       Yeah, absolutely. To- to a degree you can. I mean, we can manipulate our bodies to do anything. In a lab, I could manipulate your body to sleep when I wanted it to sleep, um, but that's taking away all the environmental factors, all the behavioral factors of your life.

   26. SBSteven Bartlett5:46

       Mm-hmm.

   27. SRStephanie Romiszewski5:46

       Um, and what you're doing now, you know what? It's not the end of the world. You know, you're obviously coping with it and you're healthy.

   28. SBSteven Bartlett5:52

       Mm.

   29. SRStephanie Romiszewski5:52

       Um, the problem is you probably won't be able to sustain that. And unfortunately, we are built in such a way that kind of goes with the- the light-dark cycles on this planet. Um, and so to a degree you are sort of going against that. And unfortunately we've got lots of other- we've got lots of research showing that after a while you just can't do that forever without implication.

   30. SBSteven Bartlett6:10

       Mm-hmm.
4. 10:00 – 16:51

   What are the common misconceptions

   1. SBSteven Bartlett10:00

      these sort of simplified narratives. What are some of the most, um, common misconceptions that you speak to your patients about? You've mentioned one there about this, like eight hours of sleep-

   2. SRStephanie Romiszewski10:09

      Mm-hmm.

   3. SBSteven Bartlett10:09

      ... being the optimal.

   4. SRStephanie Romiszewski10:11

      Yeah.

   5. SBSteven Bartlett10:11

      And even when I put out on my Instagram earlier, what are the key questions you want to ask? Um, I'm speaking to a sleep therapist, uh, expert today. Um, I'd say the vast majority, or at least the medium question was, uh, "Do I need to get exactly seven or eight hours sleep?"

   6. SRStephanie Romiszewski10:26

      Every single night.

   7. SBSteven Bartlett10:26

      Yeah.

   8. SRStephanie Romiszewski10:27

      Um, yeah. So that is definitely the biggest one we get. Um, you do not... p- perfection is the enemy of the good. Have you ever heard that term?

   9. SBSteven Bartlett10:34

      Yeah, I have. Yeah.

   10. SRStephanie Romiszewski10:34

       Because at the end of the day, it's true. Yes, your body loves consistency and regulation, but that does not mean you have to get eight hours of sleep every night. Think about it differently. Think about it over a month, for example. We love this idea of the way ... the way we look at time is slightly different to the way your body looks at time, and over a month you might actually be all right. So maybe one night you get six and a half hours, the next night you get seven and a half, and then the next night you might get slightly different. As long as it's fairly consistent and maybe 80% of the time you're doing fairly well and you're, you're giving yourself the right opportunity to sleep, that's okay. Your body's going to do, uh, you know, it will do what it needs to do. And, and with that, a caveat to that is this understanding of sleep debt. So we don't understand sleep debt properly. People think it's an eye for an eye, I lose four hours, I must gain four hours. Well, what happens when your body being as efficient as it is, doesn't actually need you to gain an extra four hours of sleep to recover you? Your expectation is that it should, and when your expectation doesn't get met, you get upset about it and you change your behavior, and that's when you start getting sleep problems, when the reality is your brain is so smart that even in the certain amount of hours that you get normally at night, it can recover you from that sleep deprivation by just improving or increasing the sleep stage that it thinks you miss the most, for example.

   11. SBSteven Bartlett11:52

       Mm-hmm.

   12. SRStephanie Romiszewski11:52

       But because we have a lack of education, we believe we don't get some sleep, we need to regain that sleep. And when we don't regain that sleep, that's when the anxieties and the stress is over, not sleeping starts. So that's a big one, the sleep debt one. The other one is this idea that fatigue and sleepiness are the same things. So yes, when we don't sleep well, we get a lot of fatigue. So fatigue is anything from feeling like your body needs to rest, to needing to shut your eyes, to pain, to your brain buzzing because you've been working so hard for like 48 hours straight and you don't know what to do with yourself. But the only definition of sleepiness is the ability to shut your eyes and within a few minutes you're falling asleep. So if you were saying to me right now, "Steph, I am so, so sleepy." I'd probably say to you, "Well, you don't look it."

   13. SBSteven Bartlett12:37

       Mm-hmm.

   14. SRStephanie Romiszewski12:37

       Because right now you don't look tired in the way that I would expect you to be falling asleep. I mean, you wouldn't be able to sit still. You, you would be sort of probably your eyes would be shutting-

   15. SBSteven Bartlett12:46

       Dozing off.

   16. SRStephanie Romiszewski12:46

       ... all the time dozing off, having little micro sleeps. That's sleepiness and that's what we should really be understanding as a cue to sleep. So in the evenings, if you're not feeling that, then don't be, don't be worried. Give yourself permission to stay up later, because you can't dictate what happens to you during the day and there are so many variables that affect your sleep, you are never going to be able to control all of them. Having good sleep hygiene, how many good sleepers do you know who have it? So good sleep hygiene is all these things that-... we get told we should do. So the 10 top things that you should do. Have a warm bath, never drink coffee ever again, um, never have alcohol. You know, all these things that you're supposed to do. But if you look at good sleepers, are they following all those things? Mm, no, they're not and they're still sleeping really well. And that's to show that most of the time, sleeping poorly comes down to brain training and the patterns we get ourselves into.

   17. SBSteven Bartlett13:40

       Mm-hmm.

   18. SRStephanie Romiszewski13:40

       You start going to bed early, you might be able to get to sleep earlier, but you're probably not gonna be able to, uh, y- have that sleep all the way through the night because at some point or another, your body's gonna be like, "Well, you've had enough now." But your expectation is you should be able to sleep till 7:00. "And why didn't I sleep till 7:00?" Or if you lie in, you keep changing the goalpost of your wake-up time, which is the most important thing that you should be looking at, not your bedtime. Um, if you keep changing that goalpost, your body doesn't know when to feed you, it doesn't know when to make you feel alert 'cause you, you've changed everything.

   19. SBSteven Bartlett14:10

       Mm-hmm.

   20. SRStephanie Romiszewski14:11

       And so, of course, you're not gonna be sleepy at the right time in the evening.

   21. SBSteven Bartlett14:14

       So you're saying th- the time you wake up is the, the, a much more important time to be focused on?

   22. SRStephanie Romiszewski14:19

       Yes. Yes. The things... Your morning routine is gonna be way more important than your evening routine when it comes to your sleep at night. But b- be- because people see that as a faraway time compared to when you go to sleep, they don't really focus on it. In fact, haven't we been taught in this society that lying in is a luxury? I can't believe that we have made it okay at the weekend to lie in so much, but during the week, one of the only things that gets us up is work. It makes absolutely no sense to me. I'm not saying it's the worst thing in the world. I'm not saying I never lie in, but I don't use it as a compensatory method for a bad night's sleep because that's when you're gonna get into trouble.

   23. SBSteven Bartlett14:57

       Mm-hmm. 'Cause that's kinda throwing your s- your, your schedule off. Is that what you're saying?

   24. SRStephanie Romiszewski15:02

       Yeah. Yeah.

   25. SBSteven Bartlett15:02

       Yeah. So if you lie in on the weekends, then you're gonna pay for it at some other point, right?

   26. SRStephanie Romiszewski15:06

       Oh, yeah. Yeah. Why are we not looking... You know, if you have to lie in so significantly every single weekend, why are we not looking at during the week and thinking, "Why am I doing this to myself? At the time when I need it the most, I would choose to get less sleep, and then at the weekend, I'll just compensate"?

   27. SBSteven Bartlett15:21

       Mm-hmm. And people... And you... Much of the conversation around sleep in society talks about the amount of hours, and it's almost like the amount of hours that I was in the bed.

   28. SRStephanie Romiszewski15:31

       Mm-hmm.

   29. SBSteven Bartlett15:31

       Um, what, what's your sort of rebuttal to that? 'Cause-

   30. SRStephanie Romiszewski15:35

       Quality over quantity every single time. Every single time. And i- if you have good quality and you need longer, your body will tell you and you will get more sleep. But people are so obsessed with duration and I, I think, uh, people don't understand what I mean by sleep opportunity. I mean, every single night most of the time, so about 80% of the time, I will give myself a seven to eight hour sleep opportunity, sleep window. But I do not mean that if I'm not sleepy, I take myself into a dark room and shut myself down. I just know that it's there. I've got a bedroom, a place I really wanna be to sleep that is available to me during those hours, and I will not sleep outside those hours. And that's the, that is the big thing, is you can dictate to your body when you don't sleep, but you cannot dictate when you do. And by doing that, you will force your body to be in a nice regular cycle. It's actually really, really simple once you know how to do it. And every time I fix someone of their insomnia, their... And honestly, 50, 60 years of insomnia, they often turn around to me, they're like, "I don't know why I wasn't taught this, um, when I was younger." And I do believe if we taught everyone how to sleep properly, give them a proper sleep education-
5. 16:51 – 18:25

   How should I be designing my environment

   1. SRStephanie Romiszewski16:51

      wouldn't exist.

   2. SBSteven Bartlett16:51

      Mm-hmm.

   3. SRStephanie Romiszewski16:52

      Insomnia wouldn't exist.

   4. SBSteven Bartlett16:53

      You talked, uh, when you referenced your own bedroom, I think you, you s- spoke about it quite lovingly.

   5. SRStephanie Romiszewski16:58

      (laughs)

   6. SBSteven Bartlett16:58

      Said, "I have this place I like to sleep." How important is that? How important is it to sleep in the same place and for that space to be... Is there a certain way I should be designing my bedroom? Is there, like, a bed that's good or, like, a pillow?

   7. SRStephanie Romiszewski17:10

      Um...

   8. SBSteven Bartlett17:10

      You know, 'cause there's lots of fads around.

   9. SRStephanie Romiszewski17:11

      Yeah, yeah, yeah. There's a lot of fads around. I think your environment is important, but I can't dictate to you what that is because we're all so different. Um, yes, it's true, you don't need loads of technology in your bedroom to sleep, but I'm not saying technology can't aid our sleep because I think in the future, we're gonna come up with some crazy cool things that are gonna really help us. I just think right now, we're not quite there.

   10. SBSteven Bartlett17:33

       Mm-hmm.

   11. SRStephanie Romiszewski17:33

       I think the least you have in your bedroom that reminds you of the day is really important. So obviously, screens and light, uh, is very important when it comes to sleep, but I think people mis- are missing a trick. When, when we say, "Don't look at your phones," we're not just saying, "Don't look at your phones because of the light exposure." We're saying it because it's reminding your brain of something that you did during the day. And so your brain, being the smart thing that it is, is thinking, "Okay. Well, I'll, um, I'll, I'll, I'll increase your cortisol and I'll reduce your melatonin, which is your stress and your sleepy hormone, uh, hormones, um, and I'm gonna help you be more alert because you clearly want to be alert right now." And so your brain thinks it's helping you. And then you're thinking, "Hang on a minute. I just looked at my phone for, like, three seconds and now I'm buzzing. Why?" And it's just because your brain is, uh... Your, your behavior is so much more influential on your physio-

6. 18:25 – 19:08

   What do you thunk about the snooze button?

   1. SRStephanie Romiszewski18:25

      physiology than you realize.

   2. SBSteven Bartlett18:27

      What do you think about the snooze button?

   3. SRStephanie Romiszewski18:29

      (laughs) Um, I think if you have to use it on a regular basis, you need to start questioning why you always need to snooze. Unfortunately, the research shows that snoozing does not benefit us at all.

   4. SBSteven Bartlett18:40

      At all. Yeah.

   5. SRStephanie Romiszewski18:40

      And actually, if you think about it, if, if, if you are a snoozer, you know, how many times does that actually make us feel better?

   6. SBSteven Bartlett18:47

      Doesn't.

   7. SRStephanie Romiszewski18:47

      Exactly.

   8. SBSteven Bartlett18:48

      Delays.

   9. SRStephanie Romiszewski18:48

      Sorry.

   10. SBSteven Bartlett18:49

       (laughs)

   11. SRStephanie Romiszewski18:50

       (laughs)

   12. SBSteven Bartlett18:50

       No. I, I think it's nonsense as well. I did a... I... One of my modules when I was doing s- psychology in school was about sleep.

   13. SRStephanie Romiszewski18:56

       Mm-hmm.

   14. SBSteven Bartlett18:56

       And, um, understanding the different phases of sleep-

   15. SRStephanie Romiszewski18:58

       Mm-hmm.

   16. SBSteven Bartlett18:58

       ... made me realize that the snooze button is, I think, totally pointless because-

   17. SRStephanie Romiszewski19:02

       Yeah.

   18. SBSteven Bartlett19:02

       ... it's you have to be, uh, in a certain phase of sleep for you to get-

   19. SRStephanie Romiszewski19:05

       Yeah.

   20. SBSteven Bartlett19:05

       ... real benefits. And-

   21. SRStephanie Romiszewski19:06

       Yeah.

   22. SBSteven Bartlett19:06

       ... within 15 minutes, it's impossible to get to that phase.

   23. SRStephanie Romiszewski19:07

       You're not

7. 19:08 – 21:39

   How to sort your sleep tonight

   1. SRStephanie Romiszewski19:08

      gonna get there.

   2. SBSteven Bartlett19:09

      Right?

   3. SRStephanie Romiszewski19:09

      Absolutely.

   4. SBSteven Bartlett19:10

      Um, a lot of people, when they, you know, uh, when they knew that I was speaking to you today, um, they wanna know how they can sleep better.... in the short term, tonight. They're looking for some kind of quick-

   5. SRStephanie Romiszewski19:21

      Yeah.

   6. SBSteven Bartlett19:21

      ... fix to the, to a problem they've had for a long time.

   7. SRStephanie Romiszewski19:23

      Mm.

   8. SBSteven Bartlett19:24

      What would you say to those people?

   9. SRStephanie Romiszewski19:25

      Okay. So the first thing I'd say is that you're never gonna find that reactive, very quick method. It's never gonna happen. And even if you find it, I promise you, it won't work in the long term. It might control your condition in the short term, but not in the long term. I can teach you how to re- to sleep, but it's gonna take you, uh, uh, a few weeks, not a night. Um, but in the meantime, don't worry. It's okay. Like, part, part of this is I just... There is a solution. So what I do is called cognitive behavioral therapy for insomnia. It is not the same as CBT for depression, or anxiety, or anything else. Um, and it is just about retraining yourself to sleep and building up that strong sleep drive. You have to do that over time. Um, but in the short term, I usually tell people that they do not need to worry. Nothing bad is gonna happen to you. And the reality is, that it's more your mood that will affect your day when you wake up in the morning than the bad night's sleep you just had.

   10. SBSteven Bartlett20:19

       Mm-hmm.

   11. SRStephanie Romiszewski20:19

       So I know we've got evidence to show that when you have a bad night's sleep, your cognitive abilities, et cetera, are going to be, um, reduced.

   12. SBSteven Bartlett20:26

       Mm-hmm.

   13. SRStephanie Romiszewski20:26

       However, if you think about how you generalize that, you're not, you're not gonna lose your job.

   14. SBSteven Bartlett20:31

       Mm-hmm.

   15. SRStephanie Romiszewski20:31

       You're not gonna perform horrifically in that meeting because you didn't get a good night's sleep. It would be far better for you to go to bed later and make sure you're lovely and sleepy and only get four hours, than to go to bed eight hours before that meeting and toss and turn and be fidgety and stressed and anxious all night. That's what I do. I still get nervous when I have to do, like, a lecture in front of 500 people. Of course I get nervous. But instead of, you know, focusing on my notes just before I go to bed, I'll put everything aside, I'll go and enjoy myself, do something I really love to do. I'll get ready for bed a bit earlier than usual just so that I do not have to think about anything when I get sleepy. And when I am sleepy, even if it's two, three, four hours later than usual, I know that I'll go and have a really lovely three or four-hour sleep. And then I'll wake up and I'll be like, "Great. I know I'm gonna be a bit sleepy today, but that's only gonna help me sleep tonight."

   16. SBSteven Bartlett21:21

       Mm-hmm.

   17. SRStephanie Romiszewski21:22

       "And I'm gonna have an epic day. I don't care that I'm a bit sleepy." Sleepiness is amazing. Sleepiness is such a good thing for you. Why are we teaching people that sleepiness is a bad thing? You need sleepiness to sleep.

   18. SBSteven Bartlett21:33

       I've got two questions there. The first, I'm sure, is it feels like a very, um, related sort of,

8. 21:39 – 24:19

   Do you sleep well?

   1. SBSteven Bartlett21:39

      uh, question to what you've just been talking about there, which is, do you sleep well? I'm sure you get asked this all the time at every party, every time you in a... It's like asking a comedian-

   2. SRStephanie Romiszewski21:47

      (laughs)

   3. SBSteven Bartlett21:47

      ... to tell a joke, right?

   4. SRStephanie Romiszewski21:48

      Yeah, yeah, yeah.

   5. SBSteven Bartlett21:48

      It's like (laughs) -

   6. SRStephanie Romiszewski21:49

      (laughs)

   7. SBSteven Bartlett21:49

      "... How was your sleep?"

   8. SRStephanie Romiszewski21:50

      Okay. So most of the time, my sleep is fairly good because I've been lucky enough to be educating myself through this for the last 16 years.

   9. SBSteven Bartlett21:58

      Mm.

   10. SRStephanie Romiszewski21:58

       But it's not good all the time because it's totally normal after some kind of life stressor, new illness, some dramatic change in our society-

   11. SBSteven Bartlett22:09

       Mm-hmm.

   12. SRStephanie Romiszewski22:09

       ... like we're seeing right now-

   13. SBSteven Bartlett22:11

       Pandemics. Yeah.

   14. SRStephanie Romiszewski22:11

       ... for your sleep to change and for it to be poor, okay?

   15. SBSteven Bartlett22:14

       Mm-hmm.

   16. SRStephanie Romiszewski22:15

       It is totally normal to have sleep problems. We will all get them. You will never find someone who does not have a sleep problem at some point in their lives. But there is a difference between somebody who has a short-term sleep problem and when the initial issue resolves itself, the sleep problem goes away, and the person who has now unfortunately got a long-term sleep problem.

   17. SBSteven Bartlett22:35

       Mm.

   18. SRStephanie Romiszewski22:36

       The difference is the behavior. It is not the person. It is not some trait that you have over someone. It's not something genetic. There are, there are all of those things that do feed into, for example, insomnia, but the reality is, the thing that seems to perpetuate sleep problems is not usually the original trigger. So we cannot blame the divorce, for example, 20 years ago... I'm not divorced, but I'm just making-

   19. SBSteven Bartlett22:59

       (laughs)

   20. SRStephanie Romiszewski22:59

       ... an example. So 20 years ago, we get divorced and it's a really stressful situation and it stops you sleeping for a month, okay? But now you're remarried and you're perfectly happy, but you've got a 20-year insomnia problem. We cannot blame the divorce for that anymore. And also, somebody else who's gone through the same situation, same illness, or divorce, or new medication would not have had that sleep problem 20 years later. So what is it? And I believe, and we know, that most of it is your behavior. After a few weeks of a sleep problem, most people will freak out and they'll start changing their behavior. So they might start lying in, they might start going to bed early. They're trying desperately to improve their sleep opportunity because they believe the mere act of lying in a bed for longer is gonna miraculously give them a stronger sleep drive and make them get through whatever it is they need to get through. When the reality is, and this is usually how we treat insomnia, or one of the ways, we actually deprive you of your sleep opportunity. So we don't deprive you of sleep, but we do deprive you of your sleep opportunity, so we only allow you to be in bed for a certain amount of time and that fixes it. But that's frightening because with teaching people that sleep is so bad... Or not, sorry, not sleep is so bad, but sleepiness is so bad that they don't feel that they can build up that strong sleep drive without something terrible happening to them.

   21. SBSteven Bartlett24:14

       Mm-hmm.

   22. SRStephanie Romiszewski24:15

       So the way we are disseminating knowledge right now is not working and

9. 24:19 – 28:20

   The Therapy you offer

   1. SRStephanie Romiszewski24:19

      we have got to find a way to change that.

   2. SBSteven Bartlett24:22

      You talked about the, the type of therapy you offer, cognitive behavioral therapy for insomnia. One of the elements you've described is this sleep deprivation-

   3. SRStephanie Romiszewski24:30

      Mm.

   4. SBSteven Bartlett24:30

      ... which is in essence you're d- stopping people sleeping, I- I'm guessing throughout the day, to focus them on their sleep opportunity?

   5. SRStephanie Romiszewski24:38

      Um, yeah. So it's less about restricting their sleep and more about restricting their bedtime. So often when you come across somebody who's had a sleep problem for a fair while, enough to come to see me-

   6. SBSteven Bartlett24:47

      Mm-hmm.

   7. SRStephanie Romiszewski24:48

      ... they're usually spending more time in bed than they are sleeping. So for example, they might be in bed for around 10 hours, but they're only sleeping for say six hours. And so what I would do is I would restrict them in the first instance only, so it's only mildly, to six hours in bed because... or five hours in bed, whatever they're sleeping for. I would, we would, we would never really go lower than five hours because at the end of the day, we're only, um, uh, sort of guess, it's all a bit of guesswork here. Um, and that's important that it's like that and we're not over-tracking sleep because that's has its own issues.

   8. SBSteven Bartlett25:19

      Mm-hmm.

   9. SRStephanie Romiszewski25:19

      Um, and then for a week or so, I'll keep them on that schedule and try and get them to strictly stick to it, which is quite scary for somebody who thinks the total opposite way is gonna fix them, even though they've got no evidence that it works. It doesn't matter. They've been doing it for a long time. So it's quite hard to get someone to do this. And then once we can get them to sleep for around 90% of that five or six hours, whatever they spend in bed, then we can start increasing their sleep time out very, very slowly-... but people sort of get very overeager about this. It's called sleep restriction therapy, um, uh, or, uh, there's lots of different ways of calling it. Um, people get overexcited about it and they're obsessed with reaching that 90% efficiency so they can move on and add time, but I try to always explain to people, and indeed I do online courses in sleep that they can do themselves, and I'm always trying to explain to them, "It's not about adding more time. Imagine if you are getting to five or six hours sleep efficient every, every night for seven days as an average, that's really good. That's so much better than the broken sleep you were getting before. Think about the new quality that you have built. How amazing is that? When's the last time you went for a week and you had that consistent sleep?" And when they start thinking about it that way, they're like, "Oh my God, yes."

   10. SBSteven Bartlett26:33

       Mm.

   11. SRStephanie Romiszewski26:33

       "This is so much better. And I'm even able to add more time now." And we slowly, incrementally start adding sleep out, and that's how you fix it. I mean, it's not everything because you've got to work on the mindset, you've got to work on the reeducating people.

   12. SBSteven Bartlett26:45

       What are those other pieces of the therapy?

   13. SRStephanie Romiszewski26:48

       So-

   14. SBSteven Bartlett26:48

       Some mindset and then-

   15. SRStephanie Romiszewski26:48

       Yeah, you gotta... So first of all-

   16. SBSteven Bartlett26:50

       ... so we've got, one is the, the sort of sleep restriction, as you called it.

   17. SRStephanie Romiszewski26:53

       Yeah. One area is y- we need to r- you've got to be reeducated on sleep. J- much like we've been chitchatting away today-

   18. SBSteven Bartlett27:00

       Mm-hmm.

   19. SRStephanie Romiszewski27:00

       ... that's how I will talk to someone, and I will try to help them understand. Um, I'll try and pick out a lot of the things that they talked to me about, um, but it's trying to help them understand where the myths are and where the facts are with sleep, because a lot of their ideologies around sleep will be directly influencing their behavior. And so as soon as you can change that, and i- it's not as simple as just saying, "That's right and that's wrong." You gotta keep doing it, and they need to trust you and, and you've got to find a way and the right language to speak to that person. Once you've done that, you can start with the s- sleep restriction. And then, of course, whilst there is no evidence that relaxation or anxiety reduction is going to directly and reactively fix a long-term sleep disorder, after you started improving your sleep drive and using the sleep restriction therapy to do that, then yes, we do need to start looking at how do you bring yourself back to balance during the day? Is it stress and anxiety that got you here in the first place because you're working too much and you got yourself into the wrong patterns? How are you going to process more during the day? How are you gonna balance more during the day? We need to look at those things, but we need to look at them with the right expectations, which is that they are not gonna make you sleep-

   20. SBSteven Bartlett28:08

       Mm-hmm.

   21. SRStephanie Romiszewski28:08

       ... because once that expectation is not met, you feel really inadequate, and then you feel like nothing can help you, and then you get hopeless and out of control and lonely about your problem. So all this, lots of different sort of elements, uh, like a pyramid,

10. 28:20 – 31:45

    Caffeine and sleeping pills

    1. SRStephanie Romiszewski28:20

       to try and help someone with their sleep.

    2. SBSteven Bartlett28:22

       And, you know, people, um, c- caffeine has become a huge part of our-

    3. SRStephanie Romiszewski28:26

       Mm-hmm.

    4. SBSteven Bartlett28:26

       You know, we live in a society where people take caffeine to wake them up, and then quite often they'll take certain supplements to shut them down again, like sleep supplements or, um, various ... Nitol I think is one of them, right? I don't know.

    5. SRStephanie Romiszewski28:37

       Mm-hmm. Yeah. Yeah. Yeah.

    6. SBSteven Bartlett28:38

       Um, what, what's your take on all of, all of these chemicals we're using to kind of regulate our alertness and then our tiredness?

    7. SRStephanie Romiszewski28:45

       They just, they can't work over time, so all the research shows that eventually you either get used to them, they stop working, they make you feel really uncomfortable. I don't think there's anything wrong with, for example, sleeping pills or using caffeine in the short term, things like that. Um, but starting to use them long term, they have their own, all of them have their own side effects, and over a long time of use, um, aren't very good for the body. Um, but in general, they're just not going to, they're not gonna suddenly miraculously reset your sleep button or anything that s- people seem to think they're gonna do. So I don't think relying on these things in the short term is a bad thing every now and again, but if you're relying on them every single time you have a sleep problem, you're effectively making it worse because your brain isn't learning anything. It is literally just being given a cheat method, uh, uh, like a fake sleep almost, and that is what you get from a lot of sedatives. It's sedative sleep, which is not the same as the cycles that you go through usually to sleep well. So you're not getting ... But psychologically, we believe that sleep is better than no sleep. And actually, I don't necessarily agree with that. In a way, I'd rather get no sleep than a really rubbish sleep knowing that my body will, like, build up a really strong sleep drive and help me later. But people are so terrified of that that they w- that psychologically they just need to feel like they've slept. But if they had a bit of better education around sleep and they understood how it worked more-

    8. SBSteven Bartlett30:07

       Mm.

    9. SRStephanie Romiszewski30:07

       ... then I don't think people would be trying to grab all these things all the time. But we live in a reactive society. We're not very proactive as creatures. We want, we want it now, and we want it done yesterday.

    10. SBSteven Bartlett30:19

        What about caffeine? That's such a huge part of everybody's-

    11. SRStephanie Romiszewski30:21

        Mm.

    12. SBSteven Bartlett30:21

        Well, pretty much everybody's-

    13. SRStephanie Romiszewski30:22

        Mm.

    14. SBSteven Bartlett30:23

        ... daily routine. People, they, they, you know, they'll say, "I have to have this coffee-"

    15. SRStephanie Romiszewski30:27

        Yeah.

    16. SBSteven Bartlett30:27

        "... to wake my- myself up."

    17. SRStephanie Romiszewski30:28

        Yeah. Yeah. Yeah.

    18. SBSteven Bartlett30:29

        And they'll have three or four of them a day. And then h- what impact does that end up having on sleep?

    19. SRStephanie Romiszewski30:33

        So caffeine is very interesting because genetically we are all either sensitive or not sensitive or somewhere in between with caffeine, so it's very hard to say nobody should be drinking caffeine after this time. Yes, it does have a very sort of, it's a, it has a big afterlife, so it, it definitely ... Or half-life, so what we mean by that is that, um, you know, it's gonna have an effect on you hours and hours after you've had it, but depending on how sensitive you- to, uh, to it you are, you know. But at the same time there's so much more you can do. If you started waking up at the same time every day, you would start to feel refreshed. You would be one of those people who wakes up and is like, "Yeah, I'm ready to start the day." Imagine if you just used your body the way it was designed to be used. I'm not saying caffeine is bad. I definitely wouldn't say you can't drink caffeine, but if you're starting to use it, anything in life, an- anything chemical in a, in a compensatory method because something is wrong, that's when you need to start questioning it. But in general, having caffeine in the morning, I don't think there's anything wrong with that. If you enjoy it, great. But then there's lots of research that shows that even your performance isn't significantly improved by having caffeine. You might feel like you're able to buzz around everything more, but your actual efficiency

11. 31:45 – 36:38

    Whats causing all these sleeping problems?

    1. SRStephanie Romiszewski31:45

       isn't necessarily improved.

    2. SBSteven Bartlett31:47

       I, I, I wonder, you know, 'cause I think I was looking at some stats around insomnia and sleep dis- so sleep disorders, and the stats are pretty staggering.

    3. SRStephanie Romiszewski31:55

       Mm-hmm.

    4. SBSteven Bartlett31:56

       ... I don't know how to say this, but I just don't tend to believe that humans, after all these thousands of years of evolution, have been born with quite an apparent, or seemingly apparent, um, s- problem with sleep.

    5. SRStephanie Romiszewski32:13

       Mm-hmm.

    6. SBSteven Bartlett32:14

       So it makes me think, okay, so what is it in our social, um, environment and society that's making us struggle with sleep? Is it our over-obsession with the perfect sleep? That might be one element-

    7. SRStephanie Romiszewski32:27

       Oh.

    8. SBSteven Bartlett32:27

       ... and this, you know, and all the fear and anxiety around not sleeping perfectly-

    9. SRStephanie Romiszewski32:31

       Mm-hmm.

    10. SBSteven Bartlett32:31

        ... as you've described, and we're actually doing pretty good.

    11. SRStephanie Romiszewski32:33

        Yeah.

    12. SBSteven Bartlett32:34

        Right? And labeling ourselves as insomnia, you know, because that word, I'm an insomniac or-

    13. SRStephanie Romiszewski32:38

        Mm-hmm.

    14. SBSteven Bartlett32:38

        ... I've got insomnia is thrown around pretty loosely.

    15. SRStephanie Romiszewski32:40

        Yeah, absolutely.

    16. SBSteven Bartlett32:41

        Or is it the, you know, the tech in our lives? Is it the- the- the over-stimulation of the, you know, the technology we have? Is it overworking? What's your take on that? Because I- I feel the same about depression and anxiety as well.

    17. SRStephanie Romiszewski32:53

        Yeah.

    18. SBSteven Bartlett32:53

        I look at the stats growing over time, um, in var- with various sort of mental, um, illnesses, and I think surely we weren't born, um, with chemical imbalances as is, um, said in, um, yeah.

    19. SRStephanie Romiszewski33:09

        Hm. I-

    20. SBSteven Bartlett33:10

        All of them.

    21. SRStephanie Romiszewski33:11

        Yeah, I- So it's a hard question to answer. I think that there is element, there's lots of different elements. I don't believe that the stats are as accurate as they probably seem. For example, I believe that before, you know, the Industrial Revolution, for example, we had, um, sleep problems. I- I mean, I- I, no, I do, I believe we did. It's just that I believe we're recording things now more, so there's that aspect of it. There is this aspect of we over-worry about things, and you know, at the end of the day, while someone keep, you know, lots of people out there keep telling us that actually, um, you know, if you sleep less than six hours, you will die early, but actually we're not actually seeing that.

    22. SBSteven Bartlett33:51

        Someone asked me that today.

    23. SRStephanie Romiszewski33:52

        Um, yeah.

    24. SBSteven Bartlett33:53

        They said, "How- how much am I reducing my life ex- expectancy with my poor sleep?"

    25. SRStephanie Romiszewski33:56

        The thing is, okay, so if you know you've got poor sleep, you need to improve it, but hopefully it's not going to be long term. You can actually get some support for that and get it sorted. If you're actively keeping yourself at five hours when you know you're a seven-hour sleeper, then yeah, you're going to reduce your life expectancy. But if you're naturally a five-hour sleeper, and they do exist, then that does not mean the same thing, that you're going to be reducing your life expectancy when genetically you can't, you know, that's for you. Um, it's really difficult to understand. I think, um, you know, electricity has a big part to play. So again, I talked a little bit briefly at the beginning about the light-dark cycles of this planet and the way that we are designed, or not designed, but you know, we're built f- on this planet. We- we-

    26. SBSteven Bartlett34:39

        Mm-hmm.

    27. SRStephanie Romiszewski34:39

        ... seem to have evolved that way, um, and so we- we- we definitely do need to be, in general, not, uh, working and resting more at night, and we- we work better our metabolisms, our brains function, we're more rational during the day. Um, and so with electricity has become many problems. I definitely think the scaremongering and the fear and the tracking of sleep has definitely caused, in the last few years, a boom in sleep problems, or at least how many people are coming to us for help.

    28. SBSteven Bartlett35:11

        And with the- the- the pandemic, what impact has that had on people's sleep? (page turns) Huel. Let's talk about Huel for a second. I've spent a lot of time on this podcast talking about the ready-to-drink Huel bottles, which are my favorite for convenience reasons. It means I don't have to mix anything. But this week, as my goals in gym and in my health and in my physique have started to evolve, I've started using a new product that I wanted to tell you about. And the reason why I've started using this product, which is called Huel the Black Edition, is because there's 50% less carbs, 33% more protein, um, zero artificial sweeteners, and it's, of course, gluten-free. I wish I had something like this, to be honest, when I was a student, because it's literally 1.47 pound per meal. I think you get about 17 or 18 meals out of one bag, and if you're someone like me that's in this phase of my life that's trying to build a bit of m- muscle, get a little bit more lean, whilst also, you know, reducing the carbs a little bit, then give Black Edition Huel a try, and try the vanilla flavor if you do get a chance, because that's, um, for me, is the- the tastiest flavor of them all. And do you know what I'm going to do next week in the podcast? I'm gonna take my top off, okay? So I'm gonna, um, show you the impact that, uh, all of this, being a Huelogin has had for me. You're gonna have to tune in next week, and you're gonna have to watch it on YouTube to see that, but, um, I'm gonna show you the before and after of using Huel and, uh, uh, and before I used Huel, okay? So that's something to

12. 36:38 – 38:48

    What impact has the pandemic had on peoples sleep

    1. SBSteven Bartlett36:38

       (laughs) look forward to, or maybe not. (page turns) With the- the- the pandemic, what impact has that had on people's sleep?

    2. SRStephanie Romiszewski36:44

       It's had a huge impact, so, um, in various different ways. So the first way is that everybody's routine changed, um, because we couldn't go outside and move as much as we once did. We couldn't get as much light exposure as we once did. We didn't get as much stimulation, social stimulation, so our brains weren't being used in the same way. Plus, we all had this sort of, uh, thing to look at on the news all the time. So we're actively sort of looking at something that is stressing us out and making us anxious, so various different components. No wonder sleep changed, but it would have been totally normal for that to happen. Your sleep is adapting to your new environment. And so when people start worrying about this, I try to get them to calm down about it, because actually, if your sleep wasn't working properly, you just wouldn't be here, okay? So to a degree, our sleep is doing a bloody good job for us, um, and we need to be better about it. We blame sleep for everything, um, and actually there's so many other variables that we can control in our lives that will have an effect on us. But yes, during the pandemic, we saw, um, or we still see there's plenty more problems with people struggling to get to sleep. Maybe they're feeling really buzzy, and they can't get to sleep. Maintaining that sleep, so people waking up in the middle of the night, and they're just like, "Ugh, what, why am I waking up?" Sometimes they- they've got million thoughts in a minute, or, um, sometimes they're just thinking of nothing, and they don't know why that's happening. We've seen more dream recall, very graphic dreams.Um, and we believe that's because obviously when your routine changes and you don't have to work, and ironically I always say to insomniacs that actually when they're working and when they've got busy lives, it's a lot easier to treat them-

    3. SBSteven Bartlett38:18

       Mm-hmm.

    4. SRStephanie Romiszewski38:19

       ... than when they don't have a routine, because routine is everything to our bodies. I wish we understood more how much our bodies love to be regulated, and going to work and doing exercise and going to see our friends and going to the gym and eating at regular intervals is telling your brain so many signals. The light exposure you get is telling your brain about how much melatonin to r- r- release for you. It's fascinating, but we do need regulation, and the biggest thing that changed

13. 38:48 – 42:02

    What control do we have on our dreams?

    1. SRStephanie Romiszewski38:48

       during this pandemic was our routines.

    2. SBSteven Bartlett38:50

       Mm-hmm. People, people have a, a real desire as well, you mentioned the, the, the fact that the pandemic had caused very, like, vivid dreams. People have asked me so many times if they can control their dreams or how do they stop themselves-

    3. SRStephanie Romiszewski39:03

       (laughs)

    4. SBSteven Bartlett39:03

       ... dreaming so vividly or, um, and some people having, you know, recurring nightmares and things like that. What, what is your answer to that? What control do we have on our dreams?

    5. SRStephanie Romiszewski39:11

       So you can, you can learn to, that's what we call lucid dreaming. So you can learn to lucid dream. The problem is it's probably not very good for your sleep in general, um, so effectively when we remember our dreams it's because we have been woken out of REM sleep. So REM is actually a very active stage of sleep, it's not your deep sleep, it's actually quite a light stage of sleep. Some might argue that it's even a different state of consciousness and not sleep at all. So REM is a really strange, uh, time. It's when we believe that more of our memory and our psychological restoration is happening and consolidation and things like that, and part of REM we tend to have more, uh, graphic dreams, but it's, it's you being interrupted from that state which you may not remember in the night, it could just be a van driving past in your REM sleep and it wakes you into a lighter stage of sleep, like stage one or two sleep. And so in the morning you think, "Oh my God, I really remember my dreams." Or maybe your alarm wake you up in the middle of REM sleep and you're like, "Oh my God, I can really remember my dreams," as opposed to the times when you're like, "I didn't dream at all last night." Well, of course you did dream, it's just that your REM wasn't interrupted. So that's why you're remembering your dreams. When we try to control our dreams, usually you have to kind of control that interruption a bit, and so, um, I haven't looked into it properly in terms of lucid dreaming because it doesn't really help me do my job, I don't really want people to learn to lucid dream because then, one, they're gonna be remembering their dreams more, um, and if they're remembering their dreams more than their sleep is more interrupted and that's not good for your sleep. We want you to go through the cycles of sleep as, as, uh, you know, as comfortably as we can and so that you get all the right percentages and all the right restoration and, and healing and everything that you need from your sleep. Um, so yeah, uh, it's an interesting concept. I don't think it's very helpful to healthy sleep.

    6. SBSteven Bartlett40:52

       Mm-hmm.

    7. SRStephanie Romiszewski40:53

       Um, but every now and again, especially kids I find when I'm talking to children, they seem to be able to control their dreams a little bit better, like flying, for example. They concentrate more on it, and that's why, so they have more time and they concentrate on it. Uh, which is quite a fun thing. Maybe we should all be doing more of that daydreaming and stuff. It's actually really good for problem solving. Um, so yeah, it's fascinating and, and, and there's a lot of famous people, I think Einstein though, don't... oh, I mean, I don't know if I'm right about this, but Einstein and various other geniuses would do things like hold a, um, egg or, or a spoon or something, um, uh, so that if, um, when they fell asleep that spoon would drop, and then they would wake up because they felt they had all their best ideas. I can see you looking at me f- and thinking about doing this-

    8. SBSteven Bartlett41:40

       (laughs)

    9. SRStephanie Romiszewski41:40

       ... to get better at sleeping (laughs) .

    10. SBSteven Bartlett41:41

        I was holding a spoon tonight and dropping it off my bed.

    11. SRStephanie Romiszewski41:42

        Um, but it's not very good for sleep to keep interrupting it like that. Um, so you can, yes, you've got the power to manipulate sleep however you want, but at the end of the day, if the goal here is to keep you alive for longer and to feel refreshed in the day and to have your best ideas consistently and to be healthy consistently, then you probably want to do sleep right

14. 42:02 – 43:56

    How does what I eat effect my sleep?

    1. SRStephanie Romiszewski42:02

       the way it was designed.

    2. SBSteven Bartlett42:03

       And what about what I eat before I go to bed? A lot of people talk about that. That's another, uh, thing, you know, if I, uh, order food really late someone will turn to me in the room and go, "Oh, you shouldn't be eating anything at this time."

    3. SRStephanie Romiszewski42:13

       (laughs)

    4. SBSteven Bartlett42:13

       You know what I mean? What, what do I say to them?

    5. SRStephanie Romiszewski42:15

       You know what... Okay, y- I, I've said it before, a good sleeper does all the wrong things and they seem to be okay, but they're probably not doing all the wrong things all the time. So yes, the, the later you eat you're basically asking your body to metabolize and asking it to sleep and it does not like doing both, and so one of them will be, um, compromised. Um, in terms of, um, anything that you can eat that will have a significant effect on your sleep, there's no real research. Um, there is research to show things like, you know, if you, if you eat enough cherries or you have enough milk or enough turkey it's gonna give you some kind of sedatory effect, but at the end of the day, i- i- it's... you'd have to have a stupid amount of those kind of foods to have any kind of effect. It's not gonna help you sleep healthily from day to day. That's not gonna suddenly boost the quality of your sleep, um, significantly, um, so I would argue that unless you have some kind of deficiency in a vitamin or mineral that is affecting your sleep-

    6. SBSteven Bartlett43:13

       Mm-hmm.

    7. SRStephanie Romiszewski43:13

       ... then you probably don't need to be looking at the food you eat. In general, as I'm sure a lot of people will say, but in general, eating a healthy balanced diet where you have what you would call naughty foods and good foods in, in balance, all that stuff is really good for you, and probably the only piece of advice I'd give around eating is, again, regulating how you eat, so if it's breakfast, lunch and dinner you like to do, trying to do that at consistent times every single day is gonna help your body understand when you want to be awake and metabolizing and when you want to be sleeping, and then not sleeping too late at night just so that you can make sure that your body metabolizes well and sleeps well.

    8. SBSteven Bartlett43:52

       Mm-hmm. And can I sleep too much? Is that such a... People, people, there's this myth, again, in society

15. 43:56 – 45:17

    Can I sleep too much?

    1. SBSteven Bartlett43:56

       where people think that they overslept and now they're knackered.Right. So-

    2. SRStephanie Romiszewski44:00

       So, yeah. So you can... It usually... When people say they've overslept, if we actually looked at them in a sleep study and they've overslept for the amount that they usually sleep and they didn't need it, probably the quality of their entire sleep wouldn't be amazing, um, and that's why they were able to have this dribble-drabblely longer sleep. And, and, and it's not, it's not gonna be very helpful. But usually when we're talking about that research that shows that longer sleepers actually can get sicker, um, is because the quality of their sleep is impaired by something like sleep apnea or another sleep disorder-

    3. SBSteven Bartlett44:32

       Uh-huh.

    4. SRStephanie Romiszewski44:32

       ... which is impairing the quality of their sleep. So-

    5. SBSteven Bartlett44:34

       Actually poor quality.

    6. SRStephanie Romiszewski44:35

       We... Yeah, so-

    7. SBSteven Bartlett44:36

       Yeah.

    8. SRStephanie Romiszewski44:36

       ... poor quality sleep, you're gonna sleep longer. It's kind of the same as having insomnia, because you're not really sleeping and so therefore you feel you need to sleep longer and you wake up and you still don't feel like you've slept as much as you needed to. If you're sleeping really well from night to night, you don't need to sleep more, so your body won't really let you. So if the quality is good and you've reached that optimal time, you'll notice that if you do try to sleep longer, it's quite... If I looked at that sleep for you in a polysomnography study, so I looked at your brain activity, the quality of it is just like a snooze. It's probably not gonna-

    9. SBSteven Bartlett45:10

       Right.

    10. SRStephanie Romiszewski45:10

        ... be the same. It's not gonna be... But it's very rare you find someone like that. Usually they're deprived of something or other, or they haven't been sleeping properly

16. 45:17 – 47:53

    These top tips about sleep

    1. SRStephanie Romiszewski45:17

       and then they sleep a bit longer.

    2. SBSteven Bartlett45:19

       You, you hear a lot of, um, a lot of successful people, I think it's, it's part of bragging, you know, l- bragging about how little they sleep. They'll say-

    3. SRStephanie Romiszewski45:26

       Mm-hmm.

    4. SBSteven Bartlett45:27

       ... "Oh, I only sleep three or four hours a day." And, and I think it's pushed this idea into society that in order to be successful, you've gotta sleep for a l- you know, just two or three hours or four hours, whatever.

    5. SRStephanie Romiszewski45:36

       Mm-hmm.

    6. SBSteven Bartlett45:36

       But then on the other side, you have this total contradiction, which is in order to be successful, you need to wake up at 6:00 AM and drink green juice and do yoga and, like, sleep for exactly seven hours, um, and it, and it... I guess this kinda speaks to the original point, which was, um, that there's so much over-generalization and, uh, through an attempt to sell you something, whether it's a book or, um, my authority or to get you to follow me-

    7. SRStephanie Romiszewski46:04

       Mm-hmm. Yeah, yeah, yeah.

    8. SBSteven Bartlett46:04

       I kind of preach this secret-

    9. SRStephanie Romiszewski46:06

       Yeah, yeah.

    10. SBSteven Bartlett46:06

        ... which can be quite easily r- replicated for all of you, right?

    11. SRStephanie Romiszewski46:10

        Mm-hmm. Yeah.

    12. SBSteven Bartlett46:10

        That's causing us to, to be, uh, like, uh, be sma- like, smacked with these contradicting narratives around sleep, um, which is making everyone a little bit confused.

    13. SRStephanie Romiszewski46:21

        Mm-hmm.

    14. SBSteven Bartlett46:22

        Um, what's your sort of take on all of that? 'Cause, you know, as... when I was growing up I thought, you know, if I wanna be successful, I've got to just sleep less. And I, I, I think I... if I'm being completely honest with myself, I think I used to be proud of how little I slept.

    15. SRStephanie Romiszewski46:35

        Yeah, yeah.

    16. SBSteven Bartlett46:35

        I thought it was like a... more like a badge of honor, you know?

    17. SRStephanie Romiszewski46:37

        Yeah, yeah, yeah. Absolutely.

    18. SBSteven Bartlett46:39

        Um, yeah. But now I think I'm getting a little bit older and I'm... I don't really give a fuck what people think anymore, like-

    19. SRStephanie Romiszewski46:43

        (laughs) Yeah. Good. Good for you.

    20. SBSteven Bartlett46:45

        (laughs)

    21. SRStephanie Romiszewski46:45

        Um, uh, so yeah, I, I definitely have seen a change around in this recently. But yeah, there has just been this thing about, like, clean sleeping. It's a bit like the whole clean eating thing. It's a con- sen- co- it's a, it's everything that you've ef- effectively just said, um, but people trying to say you need to do this, that, and that to have the perfect night's sleep. Actually, that doesn't really exist. Once you know how much sleep you need around, make sure you have that opportunity most nights that you're doing this.

    22. SBSteven Bartlett47:11

        But how do I know, though?

    23. SRStephanie Romiszewski47:12

        Um, so I guess-

    24. SBSteven Bartlett47:13

        You, you referenced genetics. Uh, you said there are five-hour genetic sleepers.

    25. SRStephanie Romiszewski47:15

        Yeah, yeah, yeah, yeah, yeah. So I guess, um, I guess, uh, a more relaxed way of looking at it is when you go on holiday, after the three, four days of recovery from, you know-

    26. SBSteven Bartlett47:25

        Mm-hmm.

    27. SRStephanie Romiszewski47:25

        ... work life, um, what happens? You know, left to your own devices, what happens? Um, that's a pretty good way of looking at it. If you're looking at it a really scientific way, then sleep restriction therapy, so what we would put a insomniac through also will show you how much of a duration that you need right now. Because there'll be a point where you can't keep adding time. Your body won't get you to 90% efficient, and that's where you know, "Okay, maybe this is around the right time for me."

    28. SBSteven Bartlett47:51

        And sleep

17. 47:53 – 49:32

    The correlation between poor mental health and poor sleep

    1. SBSteven Bartlett47:53

       and mental health, I feel like it's... I don't know. My guess would be that it's someq- a kind of a, uh, a cycle, right? I think poor sleep might lead to poor mental health and then poor mental health might lead to poor sleep. Uh, is that accurate?

    2. SRStephanie Romiszewski48:04

       You're absolutely right, but it doesn't matter what came first, the chicken or the egg. The main issue is, especially in medicine, and I've just done a piece of research, um, that shows that undergraduate, um, medical degrees only teach a median of an hour and a half of sleep. So this is why this next thing happens a lot, because they just don't have the education. So our own doctors do not have enough education. It's something that we do a third of our lives. So historically, or traditionally, when you go to your GP and you say, "I've got a sleep problem," they'll tell you you've got depression. And insomniacs will be able to relate to this. And it is because, uh, in general, we look at sleep or poor sleep as a symptom of another condition. Now even if it is, even if you do have a significant mental health problem and it is causing you to have sleep issues, if it's been longer than three months, you now have a entrenched sleep disorder and you need to be treating the sleep problem as a primary condition on- in itself. And the one that I would treat first is whichever one is most prevalent. So whichever symptoms seem to be more distressing for you at the time is where I would start, but I would be fixing, for example, the depression and the insomnia separately. And the results show that when you treat insomnia you have less relapse of depression-

    3. SBSteven Bartlett49:17

       Hmm.

    4. SRStephanie Romiszewski49:17

       ... because you have actually resolved one of these things that unfortunately was perpetuating everything. So it doesn't really matter where sleep comes into it, but you've got to give it its own podium. It needs to be... It is a pillar of health, and you need to treat

18. 49:32 – 57:14

    characteristics of a good sleeper and bad sleeper

    1. SRStephanie Romiszewski49:32

       it that way.

    2. SBSteven Bartlett49:33

       Mm-hmm. You reference, like, good sleeper and bad sleeper. What's the, uh, what are the characteristics of each?

    3. SRStephanie Romiszewski49:38

       So, uh, everyone always thinks I'm gonna say, "Well, a good sleeper does this and a good sleeper does that," but actually, the only difference I have seen over however long doing this is that a good sleeper is somebody who just doesn't worry that much about their sleep. They are very grateful for their sleep and they're very, you know... you know, they, they give themselves the fair opportunity. They don't always sleep well. They don't... You know, sometimes they have sleep problems, but they don't get overly bothered by it, and they notice that their sleep, when left to its own devices, will go back to whatever it needs to be. About 10% of insomniacs we never see, because they don't perceive themselves to be having a problem. And they're not sick and dying.

    4. SBSteven Bartlett50:16

       Isn't this somewhat, uh-... I guess, a metaphor for the, for the rest of our lives as well, where typically, much of the problem is people thinking that they have a problem, or their own perception of their reality. Because I'll be honest, um, everyone around me doesn't think I sleep very well, but I've always thought that I slept really, really well. And I've just, I think, refused to buy into the idea that I'm a bad sleeper. They think that because I'm up at strange times-

    5. SRStephanie Romiszewski50:41

       Mm-hmm. Mm-hmm.

    6. SBSteven Bartlett50:41

       ... sometimes I'm traveling at strange times, but I- I- I've never worried about my sleep. When I go into my room, eventually I'll fall asleep-

    7. SRStephanie Romiszewski50:46

       Mm-hmm.

    8. SBSteven Bartlett50:47

       ... and at some point I'll wake up. But I guess the point I'm trying to make there is as well, if you look at what's happening in the world, um, with the pandemic and, uh, you know, people feeling certain, um, feeling like they should be a, a certain way-

    9. SRStephanie Romiszewski51:00

       Yeah.

    10. SBSteven Bartlett51:00

        ... is actually making them that way.

    11. SRStephanie Romiszewski51:01

        Yeah.

    12. SBSteven Bartlett51:01

        People feeling like they should feel self-pity-

    13. SRStephanie Romiszewski51:04

        Yes. Yes.

    14. SBSteven Bartlett51:04

        ... is making them feel self-pity. And, um, for, uh, as, as someone that's been to Rio de Janeiro and seen the, um, the favelas there, and spent time in the favelas, but also I've been to India and, and spent some time in the dharavi, I think they call it, which is, you know, known as the slums, which I think is a derogatory term.

    15. SRStephanie Romiszewski51:22

        Mm-hmm.

    16. SBSteven Bartlett51:22

        Um, I've seen people in the s- in the slums in India who were significantly happier, um, than people that I know that are very, you know, relatively kushy, and I know it's all subjective-

    17. SRStephanie Romiszewski51:36

        Yeah.

    18. SBSteven Bartlett51:36

        ... living in the UK, and it just, uh, but people hate when we talk about these, th- these, these things because it gets the mirror of blame and responsibility and it just-

    19. SRStephanie Romiszewski51:45

        Yeah. Yeah. Yeah. Yeah. Yeah.

    20. SBSteven Bartlett51:45

        ... turns it back on themselves and says, "Maybe you're the problem."

    21. SRStephanie Romiszewski51:48

        Yeah.

    22. SBSteven Bartlett51:49

        "Maybe the way you're thinking is the problem, and maybe you can do something about it."

    23. SRStephanie Romiszewski51:53

        Yeah. Absolutely. You've hit the nail on the head. Um, I, like I said, about 10% of insomniacs, we, we never see. And actually, if you think about it, insomnia is just another pattern of sleep, and you have a certain pat- of sleep right now, and if it's not broken, do not fix it. I firmly believe that. And if you ever have a problem, well, you know where I am.

    24. SBSteven Bartlett52:14

        (laughs)

    25. SRStephanie Romiszewski52:14

        Um, but hopefully you never will because you'll follow your gut, follow what you feel is right. Um, if that turns with you awry, then fair enough, um, get some support. But actually, you, you really have hit the nail on the head, and I really do believe with a bit more of understanding and education around sleep and that it's not night-to-night-

    26. SBSteven Bartlett52:32

        Mm-hmm.

    27. SRStephanie Romiszewski52:33

        ... your, your sleep doesn't work like that. I get, yes, we do need to, uh, most of the time sleep night-to-night, but it can survive without doing that. Um, it is in- it's in- incredible, if we spent more time understanding how amazing sleep was rather than fearing when it doesn't happen and then blaming it for absolutely everything-

    28. SBSteven Bartlett52:52

        Mm-hmm.

    29. SRStephanie Romiszewski52:52

        ... we would be in a much better position. We would cherish it more and we would, um, you know, love it more, but not overly put pressure on it, which is ridiculous. Sleep cannot force you to lose your job. Sleep can't do tha- or lack of it. Th- it just can't. Um, but our belief that it does is making this problem worse. So yes, it is 100% a mindset. I spend most of my time not training people to sleep again, but actually trying to help resolve that mindset. One of the last things I do when I've finished with a client is I have to go through and help them understand that sleep is not the be all and end all, because actually even to treat their sleep, I have to get them to focus on it.

    30. SBSteven Bartlett53:31

        Mm-hmm.
19. 57:14 – 1:02:32

    What do you want people to get from this podcast?

    1. SBSteven Bartlett57:14

       sleep overall.

    2. SRStephanie Romiszewski57:15

       Yeah.

    3. SBSteven Bartlett57:15

       What have we missed? I'm asking you this question because there's so many unknown unknowns. I don't, I don't know a ton about sleep, again, because I've never really cared that much about it.

    4. SRStephanie Romiszewski57:24

       Mm-hmm.

    5. SBSteven Bartlett57:24

       Right? So is there anything that you think we've missed, any s- specific topics or...

    6. SRStephanie Romiszewski57:28

       I think... I would love it if people came away from this podcast and gave their sleep a little bit of a break. And in the same sort of, uh, with the same idea, uh, I'm sure there'll be people out there thinking, "Yes, but when I wake up tonight in the middle of the night, what do I do about it?" So I guess this is one thing we haven't covered. To understand that if you are waking up in the middle of the night and it's been happening to you over and over again, this has become a habit. And therefore, to resolve the habit, you're going to have to do something consistently. You're not gonna be able to solve it in one night. It's just not gonna happen. However, if you're waking up and you're getting stressed and anxious, do not lie in bed. It's not going to help you. You've got a different problem now. You've made yourself anxious and stressed and you need to alleviate it. Leave the bedroom, go and enjoy yourself. It is not going to wake you up. You are already awake. Your sleep drive clearly isn't there to take you back to sleep. So go do something else. Make sure you get up in the morning. Do not lie in. Go and have the epic day. Enjoy yourself. Go and see your friends or talk to them over Zoom, or go and do some-

    7. SBSteven Bartlett58:29

       Hmm.

    8. SRStephanie Romiszewski58:29

       ... exercise, get outside, get some light exposure. Be happy and content in your life, focus on other things, and go to bed when you're really, really sleepy. And when it happens again the next night, do the same thing. And I promise you, eventually you will be able to get out of it. But if you lie there and you get anxious and stressed and you try and force yourself to sleep, you already know this doesn't work. You're trying it over and over again. So don't do it. So that's the thing that I would say. I, I hope that when people listen to this, they come away and they're like, "Do you know what? I'm not as worried as I was about my sleep. I'm actually gonna chill out and I'm go- I'm gonna be all right about it."

    9. SBSteven Bartlett59:03

       Mm-hmm.

    10. SRStephanie Romiszewski59:04

        "But if I do wanna improve the quality, I've listened to what she said, there's some key things there, I'm gonna, I'm gonna try do those few things." But it's about the little things. So it's not about doing 20 different things. It is just about literally get up at the same time every morning, stop overcompensating, stop diluting your sleep opportunity when you don't get good sleep. Make it smaller. Build that sleepiness. It's actually good for you. Don't freak out. Nothing bad is gonna happen.

    11. SBSteven Bartlett59:27

        And, uh, y- you talked, uh, one particular point I wanted to come back on there because I, I r- when I asked my audience about the questions they had for you-

    12. SRStephanie Romiszewski59:33

        Mm-hmm.

    13. SBSteven Bartlett59:34

        ... again, about, I'd say, uh, 15 to 20% of them were all about, "I keep waking up in the middle of the night-"

    14. SRStephanie Romiszewski59:38

        Yeah, yeah, yeah.

    15. SBSteven Bartlett59:39

        "... what to do." So you're saying get out of bed?

    16. SRStephanie Romiszewski59:40

        Get out of bed and go and do something that you love.

    17. SBSteven Bartlett59:43

        At 4:00 AM?

    18. SRStephanie Romiszewski59:43

        Do not... Yeah. Do not go and do something like clean the bathroom or do something boring. Go and do something that is gonna be distracting. For God's sake, we're always going on about how little time we have. You've got more time now, so go and use it. Go and do something fun. I'm not saying get up and go to work. I'm not saying that. Because I still think this is your sleep opportunity, and if you wanna retrain your brain to sleep during this time, then you've got to sort of, uh, y- do things that are... I'm not saying you need to relax, relax, relax, 'cause I think people get stressed at that term and they're like, "I can't relax. I don't know how to relax. Don't make me do this."

    19. SBSteven Bartlett1:00:15

        Watch yourself through life.

    20. SRStephanie Romiszewski1:00:15

        So I think, what makes you happy? Do some things that just make you happy. Whether that's looking at old photos or just doing something that you love, it is okay. Okay? It's not gonna be forever. Like I said, you cannot force yourself to sleep, but you can dictate when you don't sleep. So as long as you're not overcompensating by lying in or going to bed early because you're so worried about the sleep that you've lost, forget it. It's gone. There's nothing you can do about it. So just move on and do the right things, and I promise you, you will start sleeping better. But the more you freak out and you're worried about what is gonna happen to you if you don't sleep another night in a row, the more you won't be able to fix the problem.

    21. SBSteven Bartlett1:00:52

        Got you. Where can people find you?

    22. SRStephanie Romiszewski1:00:55

        Uh, so I'm at sleepyheadclinic.co.uk. It's gone pretty international now because of the, COVID is literally, I'm online now.

    23. SBSteven Bartlett1:01:03

        Mm-hmm.

    24. SRStephanie Romiszewski1:01:03

        Um, and sleepyheadprogram.com. If you have no time to speak to me or you just wanna do it yourself, um, I have set up this online course that you can do, uh, which I'm very excited about, with two awesome business partners who are just as crazy and passionate about sleep-

    25. SBSteven Bartlett1:01:19

        Mm-hmm.

    26. SRStephanie Romiszewski1:01:19

        ... as I am. And hopefully we can start seeing more people, um, and, and, and build on it and make it an even better experience. So, yeah.

    27. SBSteven Bartlett1:01:28

        Listen, thank you so much for your time today. Um, sleep is, uh, a thing that I think has be- as I said at the start of the podcast, has been, uh, in- i- inc- increased in relevance, um, in our society and in, in my personal conversations online, through Instagram, through books that aren't, as you say, necessarily very helpful. So it's been, um, very refreshing to, to hear a, almost a counter-narrative to the kind of very binary, specific, um, uh, quick, um, secret-orientated like hacks that people push online. And that's, uh, I think will do a ton of people a lot of good. So thank you so much for coming today.

    28. SRStephanie Romiszewski1:02:06

        Thank you so much-

    29. SBSteven Bartlett1:02:06

        Appreciate it.

    30. SRStephanie Romiszewski1:02:06

        ... for having me.

Episode duration: 1:02:32