#74 The Healing Power of Sleep and What Happens when Sleep Goes Wrong-Part 1

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In today’s episode you will hear from Dr. Stephanie Green, a family medicine specialist in Long Beach, CA. 

Dr. Green has been practicing medicine for nearly 20 years but in the past decade her practice has increasingly embraced sleep studies as she’s seen the incredible impact that getting the right kind of sleep has had on her patients. 

You’ll hear Dr. Green talk about how disturbed sleep can result in low oxygen levels and put you at an increased risk of breast cancer, heart disease, anxiety, depression and other health issues. 

You’ll learn about sleeping patterns, sleep hygiene and you’ll hear real life stories of her patients who have experienced life changing results just by treating their sleep.  

Dr. Green’s interest in sleep and sleeping disorders started when her father was forced to complete a sleep study prior to surgery.  

Shocked that her father, a retired physician, had no idea nor recognized the symptoms of his own severe case of sleep apnea she began to research this area with Sleep specialists. The results have been so astounding that I couldn't stop listening to her. 

She has so much good information to share that this podcast became a two-part episode. 

In part one you’ll learn: 

-What sleep apnea and UARS are 

-Who is really susceptible to sleep disorders...it’s not "your dad’s syndrome" any more 

-What a natural circadian rhythm is 

- How to practice proper sleep hygiene 

Resources:
 

 

Read below for Full Transcript:  

0:01   

This is Laura Lummer, the breast cancer recovery coach. I'm a healthy lifestyle coach, a clinical Ayurveda specialist, a personal trainer, and I'm also a breast cancer survivor. In this podcast, we talk about healthy thinking and mindfulness practices, eating well, moving your body for health and longevity. And we'll also hear from other breast cancer survivors who have re-engaged with life and have incredible stories to share. This podcast is your go-to resource for getting back to life after breast cancer. 

0:38   

Well, hello and welcome to another episode of the breast cancer recovery coach Podcast. I am your host Laura Lummer. And I know I say this all the time. I'm super excited about the show today but I am so excited about today's show, because it is a fascinating topic, but more than that, our guest today Dr. Stephanie Green is an absolutely amazing physician human being so wonderful to talk to. I could literally listen to her for hours. Dr. Green is a general family practitioner. She is a partner in a private practice here in Long Beach in Southern California. And I think she is the kind of doctor that you want every doctor to be, because she not only really wants to understand what's happening with you, but she wants to make you better. And she wants to understand the problem. And she wants to see you happy and healthy and well with as little medication and as few side effects as possible. And she really takes the time to go into not just understanding what's going on with the person but explaining in terminology that non-medical professionals can understand. What is happening in a body when there's a problem, which makes her even more fascinating to listen to? So, when we decided to do this podcast and you're going to hear all about why we decided to do it, because we are talking about sleep, and sleep disturbances, the importance of sleep, the fact that sleep is an important pillar of health. But as we got into this topic into the subject, and I started to hear stories of her patients, and her experiences, and the science behind all of the ways in which sleep or I should say, not getting the right kind of sleep impacts our health, I was blown away. And we ended up talking for so long that this is going to be two podcasts. So, what you're going to hear today is part one, in part one, we're going to talk about all the ways in which sleep is a pillar of Health, how it impacts our lives. And if we have a sleep disturbance, like a sleep apnea or UARS or and various types of sleep apnea how they can have a severe and serious impact on our health. And then in next week's show, we're going to hear even more detail about sleep hygiene, and sleep habits. And if you think if any of this resonates with you that you'll hear Dr. Green talk about in today's show, and you want to follow up on getting a sleep study or finding out how to do a sleep study. Next week is going to have all that information. And she goes into great detail on what your options are, and what insurance covers and pricing and even resources for providers and support for your own physician. So, I love, Love, love this show this one and next week, super excited about it. I think it's fascinating stuff. So, we're going to get right into it. In one minute here, because before we do, I just want to give a listener shout out to Heidi. And I think it's Heidi ESL or Heidi. So, I really wish that you could put your first name on these iTunes reviews. But Heidi left a review for the breast cancer recovery coach podcast, and I so appreciate it. She said life after cancer is hard. This podcast will help you navigate with grace and so much more. I highly recommend you listen to all of it. And I just want to share with you that I add some really exciting news. My goal for this podcast is that it gets into Apple top 100 charts and stays there that it's consistently in the top 100 because that will just allow so many more survivors to have access to this information. And because you are listening, and because you're so supportive, and the because you guys take the time to leave these reviews and ratings for the podcast, we have actually hit the top 100 spots three times already in 2020. And I'm super excited and so grateful for all of the support that you have given to this podcast. So, I'm going to give you a big virtual hug and I give really hard hugs, so know that it's a good hug. And I just want you to know how much I appreciate your ongoing support for the breast cancer recovery coach podcast, and we just had even better things to come. So, something I want you to know about this before we get into listening to the show in order to break it into the two episodes, so you didn't have to listen for like two hours straight. It's got a little bit of an abrupt ending, there was kind of no good place to end it. So, when it gets to the end, just know it's going to be kind of abrupt, but of course I'll pop back in and let you know that it's over. Anyway, enjoy the show. Take notes on this information. This is some good Good stuff. And come on over to the Facebook page of the breast cancer recovery group on Facebook or find me Laura Lummer on my Facebook page and let me know your thoughts on the podcast. I would love to hear what you think of this information. So, without making you wait any longer.

Here is Dr. Green. Dr. Green. Welcome to the breast cancer recovery coach podcasts. I'm so happy you're here today.  

6:25   

Hi, thank you for having me. 

6:26   

Yeah, it's my pleasure. So, I want to go right into talking about how you became aware of the impact that having good sleep patterns good sleep hygiene has on our health overall. 

6:41   

Well, my father, who is a retired physician, was obese and went to have surgery for gastric bypass. And his surgeon wanted him to have a sleep study before they would put him to sleep for the surgery. He said that he felt sure that he did not Sleep apnea and therefore did not need to do a sleep study. And he's a doctor and trust me I know. And, you know, he felt very certain that he didn't have it. He definitely snored. But he thought, since his snoring was a regular rhythm without gasping and you know that he could fall asleep anytime, anywhere, anytime. He thought he was certain that he did not have sleep apnea. So, he didn't want to do it. The doctor said, I won't operate on you unless you do a sleep study. So, he forced him to go do one and he's one of the worst cases I've ever seen. He's got severe obstructive sleep apnea, holding his breath like 60 times an hour with his oxygen dropping into the 50% range. 

7:38   

So, it's like every minute. Yeah, every minute more than that. It actually might have been 70, 75 times an hour. Yeah, more than once a minute. Oh, holding his breath for longer than 10 seconds. So that's, it's longer than 10 seconds. Yeah. Definition of apnea is no airflow for 10 seconds or longer. Wow. So, when he did this is that what led you to Like, Oh, wait, do more people have sleep apnea? And don't realize it? or How did you know of all the areas that it is?   

8:07   

So, I had heard of sleep apnea in medical school when I trained, but since he was so severe, and he was my father got me more interested into learning more about it. I was like, holy cow, how could he be so severe and not realize it? And he's a physician, like you think he would be educated and recognizing the signs of it? Right, right. Yeah. So that that kind of made me go, Wow, how many of us also have it and don't know? So, I actually went and spoke to his sleep doctor who did his sleep study. And he came to my office into the lecture for my partner and I, oh, which was really cool. Yeah. And then 10 years later, I'm still into it and learning more. And now we have home sleep studies, which is sort of the new evolution of sleep studies. Not as good as an in-lab study, but much cheaper, much more convenient done in the comfort of your own bed. So much more people are willing to do it. Single people. with small children who can't leave for the night and can now do it because they can do it in their bed. I'm now involved with a sleep doctor who reads those home sleep studies. And when I got him on the phone, we talked for a couple hours one Friday evening, and I'm like, I could talk to you forever. So interesting. So, it's amazing what you learn from how sleep can affect your health. So, he came to my office as well and did a lecture for my partner and I, so we had like a recent sort of update on you know, another person's perspective. And, you know, not enough studies have been done. So, we're still learning so much about it. But that's kind of how I got more into it. And my husband who's also a physician feels like I'm so interested by it. Why don't I just become a sleep specialist so that I feel like as a family doctor, I'm exposed to everybody. Yeah, everyone has a family doctor. How many people go to a sleep doctor only it's your really severe, can't figure it out. You go to sleep doctor. I don't want to be that I want to. I want to treat everybody, and I want to be able to you know talk to everybody. Yeah, you have a bigger impact. Yeah. So, let's give some foundation, there's sleep apnea. And then if people think, well, I don't have sleep apnea, like your dad said, I don't gasp I don't do this. But there's also a lesser version. It's not really sleep apnea, but it's still disrupted breathing. Right, right. 

10:17   

Yeah, let's talk about those. So that's called so obstructive sleep apnea, the definition is you're holding your breath for 10 seconds or longer. No airflow at all. And insurance is as far as insurance paying for treatment of it. They're only interested in how many times an hour Do you have apnea and a large drop in your oxygen, okay, so it has to be five times an hour or more that's called your apnea hypopnea index, your ah I and it has to be five an hour or greater for insurance to pay for either a C pap machine or a mouth guard or some sort of treatment. However, what I learned when this when the home sleep studies came out, what I learned from that doctor, is that you can have an apnea and hold breath and not drop your oxygen, it can be a long time before your oxygen drops. So maybe you're in good shape, or you took a deep breath right before it happened. And so, you can go 20 seconds before your oxygen drops. So, if you hold your breath 10 seconds, you don't get a drop-in oxygen and then you breathe again. Okay, so insurance looks at that and says, you don't have apnea, we're not treating you. However, that apnea event, even without the big drop in oxygen causes a stress response. Like if you're hiking in the woods and you saw a bear, your body would tense up and get ready to run, you'd send more blood flow to your muscles and be like, let's get out of here. Right? Right. So that is you. You put out more stress hormones, more steroids, it's a stress response. Okay? So, apnea with or without an oxygen drop causes a stress response in our body. So even the avenues without oxygen drops matter to our body. So that's something new that I learned with these home studies and talking to that second doctor. The other version that you're talking about is you AR s. upper airway resistance syndrome, that is resistance in your airway. So, a partial collapse of your airway, a partial blockage of airflow, but not complete, so you still have airflow. So, insurance doesn't treat that at all. They don't pay for any mouth guard, which can be expensive, you know, or sleep apnea machine or anything like that. So those often go undetected and untreated. If I did a sleep study on somebody, a slim woman with a narrow airway that has upper airway resistance syndrome, if I did a sleep study on her, and the apnea index comes back less than five and our insurance says you don't have apnea. So, I would tell her Oh, you don't have it goodbye. And that lady is going untreated. And and it's a real disservice. One more thing about the UARS, the upper airway resistance syndrome. We talked about that's a partial blockage of your airway due to relaxation, partial collapse of the tissues in the throat, the way that The sleep doctor that reads my sleep studies and when he came into the lecture the way he described that, to me was picture of six lane freeway with four lanes blocked and everyone has to drive through those last two lanes, you're going to have traffic for miles. It's, it's not adequate. So same thing with us. It's an it's a partial blockage of our airway, but there is air flow. So, it's not apnea, but it's not adequate airflow to do oxygen exchange and all the things that we need. So, people with upper airway resistance syndrome exhibit an alpha delta sleep, this means they're very easily aroused from a deep sleep to a shallow sleep okay. receptors in the throat become much more sensitive to negative pressures, the autonomic system, which is the nervous system can be actually under activated which leads to a low blood pressure, and that low blood pressure can even lead to daytime syncope, which is passing out calm, so people that have really low blood pressure and pass out my thing. I don't have sleep apnea, that's heavy people with high blood pressure. Yeah. So, in this way it can cause low blood pressure. So that you know, slim woman with low blood pressure. You think she doesn't look like health problems, right? 

 14:11   

Yeah. So, what could happen? Why would insurance want to treat it? Like how can it impact our health? 

14:18   

So I'm learning and I'm learning, partly from reading more about it partly from the lectures with asleep doctors and partly from my patients that I am now doing lots of home sleep studies on and treating and I'm seeing their blood pressures come down their anxiety and depression, improve their insomnia, asthma, allergies, literally every medical condition I can think of I'm seeing it improve by treating people sleep, and I have taken more people off meds than I feel like I've started new meds in the last couple years. There's a doctor I'm not going to say this right, but Dr. Depok shivers stava at UC Davis School of Medicine his studies show that intermittent hypoxia which is like sleep apnea, selectively activates inflammatory pathways, decreases the number of lymphocytes, which reduces the effectiveness of the immune system. And sleep deprivation also is linked to decrease production of T cells. And interleukin 12, which is also a weakening of the immune system. And they showed an increased level of B cells, which increases allergies and asthma. Wow. So, I was really surprised to see treating sleep apnea treat asthma and allergy. Yeah, I just didn't see that connection. No, first I couldn't get it. Right. Because I'm thinking physically holding your breath. So, I would that cause asthma, allergies and your nose. Right, you know, yeah. And this is the mechanism. And I've also had patients that I treated their sleep apnea. I wasn't thinking about their allergies, but they said, you know, I don't need singular anymore, and I'm not using floaties everyday like I used to. I don't use anything anymore, and I breathe great. That's amazing. Yeah, it's so incredible. It gives me goosebumps because I just feel like how much medicine that we're doing is really because we're treating something caused by sleep, where we could fix sleep and not have the medical problem. And we're just throwing medication at the medical problem, like high blood pressure, right? So, I had a patient who I've been seeing since she was in her early 20s. And she got high blood pressure. Everybody in her family has high blood pressure. And that can be something that runs in families. And of course, there's things you can do about it like exercise and, you know, less sodium and caffeine. So, there are lifestyle things to do about it. But sometimes when it's in your family, no matter what you do, you're going to get it okay. And so, she looked like one of those cases, you know, everyone in her family had it. So, she was on blood pressure meds, she ended up meeting to blood pressure meds at maximum dose before she was controlled. And she stayed on those for 10 years. So, I took her through a pregnancy we switched to the pregnancy safe blood pressure meds, and then back to her other meds after the pregnancy and you know, so she's been nicely stable for 10 years. But when the home sleep studies came out and I learned about them and how easy they are and affordable, I told her Why don't you just do this to see? Make sure you don't have sleep apnea? Well, she did have sleep apnea. So, we got her a C pap machine. And I have to say I'm proud of her because she's got a new baby and you know that you're exhausted? 

  17:19   

Yeah. My God 

17:20   

She put the machine on every night. Yeah. And be faithful about it. Yeah. You know, with a new baby and a job and all those things she did. Her blood pressure dropped and dropped and dropped. She was getting lightheaded and dizzy because she was too low. I had to lower her meds lower meds, she ended up off medication with a blood pressure of 100 over 60. So normal is 120 over 80 or less. Her natural blood pressure was 100 over 60 Wow. So, it gives me goosebumps even now because I've been treating her personally for 10 years with blood pressure meds. She doesn't need them anymore. She just needed to sleep. 

 17:55   

Yeah, not crazy. So, my question is, does everybody in her family truly have high blood pressure or do they untreated apnea. Do they have Yeah. 

18:02   

Yeah. So, I think when we talk about sleep apnea specifically, I know for me, I always thought that's my dad. That's a big fat old man. Right, right. And that's not true at all right? Right. Let's talk a little bit about that. So, who is actually getting susceptible to sleep disorders like this?  

18:22   

So back in the 70s, and earlier, we did definitely think it was heavy people with big heavy necks. Yeah. So, it's, it's obese people and men more often than women. And, and then you see those big football players. So, it doesn't have to be just fat, it can just be baby. So, it's simply the weight of your neck. Okay, so you lay back and the weight of your neck collapses your airway. That's what we thought, Okay. And so, we focused much more on men and much more on really heavy people. What we're learning now with this upper airway resistance is that your airway can be narrow all the way down, not just the back of your throat and your tongue, but all the way down. on to your lungs, your whole airway can be narrow, okay. And you actually see that more in slim people, men and women, but you know, equally so in slim, slim people with a narrow face, narrow, high arched palate, and just a narrow airway. So, you definitely see it in that regardless of the size of your neck, people with large tonsils causing less room in the back. And actually, they're saying now that getting your wisdom teeth out, causes some resorption of the bone. And so rather than having a larger bony structure, keeping your airway open, it might possibly to a smaller airway and more apnea. So, all these things are contributing to it now, which has nothing to do with being obese. And I had a patient who was in her early 60s. She had no complaints at all. She said, I wake up wide awake. I feel great all day. I don't nap. I have energy. Exercise, I'm happy. I'm not depressed. She had zero complaints. She only came to me for an annual physical she was establishing with a new doctor. When I examined her, I couldn't even see the back of her airway. So, when you stick your tongue out and say and open your mouth wide, I should see the back wall of your airway, you know, the back behind your tongue, your uvula hanging down, you know, the sides, everything. all I could see was her tongue as wide as she opened her mouth. I couldn't see the back of her airway. And I said, you have an incredibly small airway. Would you mind doing a sleep study on me? I mean, on yourself for me, like, I just want to see, I know you have no symptoms, but I can't believe it without airway that you could be breathing normally at night that wouldn't just easily collapse. She did a sleep study and is also one of my worst patients. You are kidding. Her oxygen was in the 60s. She held her breath over 60 times an hour. She had no idea and she had no symptoms. So, then I asked myself, are we doing her a favor by tweeting her because I got her a seat? machine and she now uses it. And so now she is not having this chronic low oxygen hypoxia all night long. 

21:06   

What is the oxygen level that would be acceptable? 

 21:09   

So, we should always be 100 you should always be 100% but when we sleep and we're more relaxed, we're not breathing as deep or as rapid, it can drop to 95 you know, around there, we still consider 100% Normal. I wouldn't even worry about anything like that. So below that it's starting to be abnormal definitely into your 80s is abnormal and for sure. 7016 Yeah. So, I felt guilty after getting her the C pap machine that I just took this woman with no complaints and put her on a machine for the rest of her life. Right. Right. She you know, like, Am I doing the right thing? I mean, you got to always question why are we doing what we're doing? Is it really making a difference? Are we right, you know, yeah. And I had a conversation with a sleep doctor about her and he said, as low as her oxygen was going all night long, repetitively so many times at night, she was absolutely headed for increased risk of heart attack and stroke in her sleep. Hmm, who knows what else, you know all the in her sleep in her because while the deprivation right while she's sleeping, 

22:08   

okay, so he said at the very least, you know treating her has lengthened her life by, you know decreasing her chance of heart attack and stroke. Yeah. 

22:20   

So, I love that you're talking about this oxygen deprivation and you and I had a conversation about how a sleep disorder affects someone's risk of breast cancer or breast cancer recurrence. And it was fascinating because you're talking about how what happens with our blood vessels. And what happens with this is it is a hormone that were the end of the factor, the growth factor is a hormone was that whole cycle if you have some kind of a sleep disorder is, we may not even realize it right? may not even know that you snore, do you have 

 22:55   

to snore if you don't have to, you know, and a lot of people think I don't snore. So, I don't habit. And its very, very much people think that they know they don't have it because they don't feel symptoms. And look at that one lady that I just told you about. I mean, she had no clue. So, it's not that. And there are different types of apnea. So, there's sleep apnea, there's obstructive sleep apnea where your airway is literally obstructed. So, your airway collapses, your tongue falls back, or you are heavy and the weight of your neck collapses, you're away. So that's one type of obstructive. There's central sleep apnea where it comes from your brain. So, if your brain doesn't send the message to breathe, then you can just hold your breath. And a lot of people find themselves during that during the day to people will tell me all the time, I'm at work and I just realized, I'm not breathing brave, and allow myself figure it's happened to me as well. I felt it before really, um, you start to get a feeling like in your chest, like you're holding your breath, and you realize you are no breathe. And so that happens in your sleep too. And that's central sleep apnea, and it's believed that more stress causes more of that. Okay, you know, so there aren't Types of acne and there's other types to with your blood flows past your lungs and your red blood cells pick up oxygen from your lungs from your breathing, obviously, and deliver it everywhere in your body everywhere they deliver it to your lungs, to your heart to your eyeballs to your big toe everywhere. So, think of them as a like a little car that drives past the lungs and picks up oxygen and then delivers it. So, if your oxygen is low, for whatever reason, your body will respond by saying we need more blood to be flowing by the lungs to get more of this oxygen that I'm now in short supply, okay, and so you your body puts out something called endothelial growth factor. endothelial growth factor causes your body to make more blood vessels and that means more blood flowing past your lungs and that should mean more oxygen. That's your body's response. On another note, cancer is an abnormal it's an abnormal, we're constantly replicating our DNA and making new cells and That. So, with that process gone awry, and then that leads to an abnormal cell to cancer cell and it goes from there. But our body is constantly repairing. So, if it's something in the DNA replication goes wrong, we have a natural system to repair it. And that is supposedly happening in our body every day. But if if something got out of control, and we weren't able to fix it, and a little cancer is trying to start, it needs blood flow cancers are rapidly growing most of the time they they demand blood flow. So, when we're doing ultrasounds on tumors or masses to see if we think they look cancerous or not, one thing we're always looking for is is there a large feeding vessel? And that would be a bad sign? Yeah. Because cancers demand that so with more endothelial growth factor flowing around in your body, it's easier for a cancer to take hold, and to grow and to make it and to recur, and to get its own blood flow. Yes, yes. And so that's how repetitive low oxygen all night long from sleep apnea. can lead to increase endothelial growth factor in your system, which can help cancer start. So, they are seeing more breast cancer in women with sleep apnea untreated than in women without 

26:13   

that's so interesting. And you were saying there's a second aspect to that as well. One is the endothelial growth factor, and another is with that low oxygen level, then your body tends to bring the oxygen out of the peripheral areas 

 26:27   

right away from at the moment that your oxygen is low at that moment, your body is going to go into preservation mode by sending more blood flow to your vital organs, your heart, your brain, your lungs, and so it gets pulled away from the periphery, your arms, your legs, which includes your breast. So, decrease blood flow, which is obviously not good for any tissue. Yeah, that happens as well. There's a study that I read called fragmented sleep accelerates cancer growth. That talked about studies showing that women who sleep less than six hours a night are more likely to develop breast cancer. Hmm. We know that sleep disruption negatively affects the immune system, and this can also open up the door to cancers taking old okay and you know being able to get past our block or you know, repair system disrupts both disrupted sleep and obesity or risk factors for breast cancer. So, obesity can cause sleep apnea, sleep apnea actually can cause obesity, and they're both risk factors for breast cancer. 

  27:26   

And I think we know too that with obesity, it increases your risk for breast cancer, but it also is an indicator of poor outcomes as far as mortality it right had breast cancer and you're obese, right? 

27:39   

Yeah, fat can store estrogen and you can have higher estrogen levels and women with obesity, that some breast cancers are fed by hormones and some are not. So if you have the type that is hormone receptor positive, and you are obese, you're at that puts you at a little higher risk as well in a study called sleep disruption predicting survival of women with advanced breast Cancer showed that women with breast cancer who have fragmented sleep have higher mortality rates than breast cancer patients who sleep well. 

 28:07   

And we just we don't talk about that. I think people don't value their sleep. If we can sacrifice anything, what we give up is sleep. And it's such an essential pillar of health, just like nutrition and exercise. 

28:21   

Just recently read about the most important factors for a healthy life is nutrition, exercise and good sleep. Those are the three pillars of health. Isn't that interesting? I just said that. Yeah. Going back to the endothelial growth factor and being able to more easily get blood supply. Yeah, it's a critical factor in the growth and metastatic spread of malignant tumors. So, having more endothelial growth factor is a very important factor to a cancer being able to metastasize. 

 28:51   

Which totally makes sense. That totally makes sense. And that's one of the fears we have after completing cancer treatment. They get everything So keeping getting good sleep, keeping the oxygen level up right is something that's fundamental to supporting that lowering the risk of to 

29:08   

that one self staying dormant. Yeah. Dying versus Yeah, growing and taking off and becoming a metastatic 

29:15   

so fascinating. Let's talk about some of the things that really well, first of all, we were talking a little bit before this about circadian rhythms. And some people know, and I've heard that terminology, but I think a lot habit. And with my background in Ayurveda, being a natural health science, it's very tied to the circadian rhythm is tied to seasons and the foods that you eat in certain seasons and your habits throughout the day. Not just what you eat, but when you eat it and when you sleep and all of these things. So, let's talk about what is a circadian rhythm and what does that have to do with good sleep hygiene, good sleep habits. 

29:56   

So circadian rhythm is your sleep wake cycle. We have a piece gland that actually senses light, it's located near the top of your head. When it senses light, it changes your hormones and your steroids to get you to wake up and more blood flow to your brain and things like that. And then when it senses darkness, it calms you down, slows you down, changes your natural body makeup to go sleep. And before we had artificial light, when the sun came up, we got up and when it went down, we went to sleep. And that was a natural circadian rhythm. Your body knows what's coming and knows how soon you're going to be going to bed and it prepares you accordingly. And now with our natural lights, we change that and and also without getting natural sunlight. You know, somebody might wake up and go right out to their car go right to their office. They're indoors with artificial light all day long. And by the time they get out at five or six at night, it's already dark. Uh huh. And they come home, you land a vampire lifestyle. You literally see the light of day so that just confused Is your body you don't have a circadian rhythm; how does it know when to put out the steroids and the hormones to make you awake and to make you tired? It's all messed up. So, having a regular sleep pattern as much as you can obviously the week usually varies from the weekend or whatever your days off are. But having a regular sleep wake cycle, whatever it is, having a regular pattern helps your body so much and increases your health and improves your sleep. And they have shown that people with graveyard shifts definitely have a shorter lifespan, worse health and just health issues in general. And I write a lot of sleep meds for people that just need help with that, really, and they go I just need, you know, either a sleeping pill or they use caffeine to wake up when they need to wake up because they're going back and forth from work to try and have a normal life on those few days off well and they're just they never get a good sleep pattern. Yeah. So, is that how that works? Why it's exactly common. If you don't sleep, a sleeping pill sounds wonderful. I'm just getting me to sleep. Please. You know, but if you think about apnea, and the response your body has to it, it makes you grind your teeth to move your tongue out of the way it makes you roll on your stomach to breathe better. You're, you know, you're doing all these things, to make yourself brave, you know, gasping some people, you know, all the different mechanisms that your body is doing to breathe because the oxygen dropped, or your blood pressure and your pulse went up. If you have a sleep aid on board, you're not going to listen to those warning signs, those you know, from your body to breathe. So, you therefore can just lay there holding your breath even longer, your oxygen can drop even more, and all the cardiovascular bad, it's much worse. So my patients that are diagnosed with sleep apnea that have C pap machines, or mouth guards, you know, we're human, and there's going to be nights that we just fall asleep watching TV and we didn't put our machine on or we just don't feel like it tonight, or we went on a trip without it. There’re different reasons that people sleep without their machine. And I tell them you cannot take your sleeping pill on nights that you don't use your machine. As long as you have your machine on and you know that you're breathing well all night. Absolutely. You can take a sleeping pill if you need it, you know? But it's just too dangerous to take sleep aids even over the counter Benadryl, Advil pm Tylenol PM, you don't want to take them if you don't know why you're not sleeping yet. Yeah, you know, because you could be increasing your chance for heart attack and stroke during your sleep. And, you know, most of us have heard stories of people that died in their sleep. You know why? And we're like, what a blessing. Yeah, I didn't there's no way everybody should know like no sleep apnea. 

33:37   

So, when we breathe, our diaphragm pulls down, which creates a negative pressure in our chest. And that sucks air in and the pressure should get to like negative five and air just comes in. Then we're doing that all day long. We're doing it right now. When you're sleeping, and you have an airway collapse, your diaphragm is pulling down trying to pull air in, but it can't because there's no no open airway. I'm there. So Is the diaphragm pulls down harder and harder and harder until it gets area. And I mean, that's our body's response to not breathing, that increased pressure, the pressures in your lungs can get up to negative 80. And that increased pressure squeezes your heart raises your pulse raises your blood pressure, and eventually oxygen drops. And finally, it's enough to move your tongue or open your airway and get Aaron Wow. And all that is happening naturally. And if you have a sleep aid on board, you're ignoring all those signs and symptoms.

34:30   

yeah. So, let's talk about we're talking about having a heart attack. So that's, you know, an acute thing in a moment where you're having low levels of oxygen and this pressure is happening in your lungs. But over time, if you were having this unhealthy sleep pattern, or unhealthy sleep hygiene and consistent low levels of oxygen that's going to impact our heart health. 

 34:52   

Absolutely. Your body when you have sleep apnea, your body is having a stress response. So, we talked about earlier Your adrenaline levels increase your blood pressure and heart rate changes. And I've seen it because I'm looking at all these sleep studies, and it tells me what the average pulse was most of the night. And then what it was during their apnea is, and I've had people that went from 50 beats per minute, which is low. I mean, that's like a we think of it as like a healthy athlete. Yeah, I blood, you know, pulls over 200 Whoa. And a lot of times the home sleep study shows possible cardiac dysrhythmia and I have to do a referral to the cardiologist. Oh, wow. And it's great and they had no idea. And so, your pulse can just race when you're having apnea. So, Hmm. So eventually your oxygen drops, your carbon dioxide levels can increase. This is causing a fight or flight stress hormone response, your adrenaline, your cortisol spikes. That's what we talked about, like hiking and seeing a bear wood. Yeah, I have that same response. These are all linked with cardiovascular risks. And it's been shown that obstructive sleep apnea increases the risk of heart failure by 140% low the risk of stroke by 60% and the risk of coronary heart disease by 30%. Wow. And those have been shown in studies. Another thing is weight reduced amounts of sleep, cause a decrease level of a hormone called leptin. This is a hormone that signals us that we're full. It also causes an increased level of a hormone called ghrelin gr e h, Li n, which is another hormone that stimulates appetite. So, it puts them in the opposite, you know, how they should be. And so typically, when we have our last meal of the day, it's evening we're following our circadian rhythms, our body knows we're going to sleep in a few hours we have that last meal, we should feel full and satisfied and not feel like eating all night long. But these opposite levels of leptin and ghrelin from what they should be stimulating, you know, our appetite to be gone. It's the opposite. So, we we specifically crave fats and sugars in the evening. Well, when we should be feeling naturally full and naturally, not wanting anything else. It's the opposite is the natural cycle of those hormones would make you not crave those things right at night, right? Because we're not sleeping right right. We're reversing that effect. Hmm. 

37:11   

We have decreased leptin and increased because you don't know anybody who goes home and SATs all night long day. Never heard of it. So, it causes us to crave foods, especially junk food and sugary food, which of course leads to weight gain, and we're sitting sleep. One study shows that 82% of diabetics have obstructive sleep apnea. 

37:32   

Wow, that doesn't cause us to crave tuna. Right? Why is that? Why don't we create a game project and broccoli? 

37:41   

That's study was the sleep and wellness medical associates LLC, the Academy of sleep medicine, so they've proven that it specifically causes you to crave those types of food macronutrients and those foods not crazy. That is crazy. But if you're not sleeping while you should ask why. 

37:59   

Yeah, and you should figure it out. Yeah. And I think what we tend to do is blame ourselves. I'm just stressed. I'm just anxious person, we always turn it back on ourselves or we make excuses like I always blamed it on. Well, I had four kids. Yeah. Which was my choice and I love it. Yeah, I'm not going to ever sleep well, or, you know, I'll sleep when they're all 18 God. Yeah. 

38:21   

So, um, studies are also show that about 25%. They think about 25% of kids diagnosed with a DD or really untreated sleep apnea. And they're just tired. They're tired. They're not going to tell you that they don't realize it right. But they're not functioning in school. They're hyper they're bouncing off the walls there or, or without hyperactivity, just add, they can't focus. Yeah, there isn't magnetic therapy that treats PTSD and autism and just recently in the last several weeks has become approved for the treatment of ADHD. And the way it works is by fixing sleep pattern. So, it helps people be really awake when they're awake and really asleep when they're asleep sleep well and have this good pattern. And it's really interesting because it's it's proven and FDA approved and used and insurance pays for it. all it's doing is fixing their sleep and correcting autism PTSD by giving them better sleep. Yes, that's so now at Where can I get it? I know. 

39:26   

So much. I mean, you know this, and I know this that I'll be trying to work and if I haven't had good sleep, I'll catch myself going. I don't even know what I'm doing. Yeah, right. I have no idea. So, then we label them as add Yeah, put them on Add ads and really are at my age, we just label them as like early onset dementia. 

39:48   

Yeah, it's so interesting. And I, I you know, the doctor who reads my my home sleep studies that came into the lecture said that he put up a he did a slideshow for us and he put up a graphic How Sleep Affects every disease basically known demand. And so, one thing you talked about was asthma and allergies, and that there's increased inflammation everywhere. So, nose, sinuses, lungs, and I thought, Oh, that's interesting, but I saw it in action when one of my patients that I wasn't treating her sleep because she had asthma. I was just treating it because she had symptoms. And so, we did a sleep study and she had, and she got on a sleep and she, she stopped all her asthma meds. Last time I saw her She said, I haven't taken anything. And she was on high dose steroids every day. inhaled steroids, not horrible. But yeah, high dose inhaled steroids. And the medications that open your lungs which have side effects, they cause heart palpitations and you know, it's not something you want to be on if you don't need it, right. She hadn't taken any of her meds and she hadn't needed to rescue at all. And we did a pulmonary functions study on her in my office and it looked great and she was off meds and I that was the first time I saw it myself in person in action. I was like, wow. treating your sleep apnea, just treated your asthma.

41:04   

Unbelievable. That is fascinating. And I’ve read other studies you had mentioned earlier that you see it treating anxiety and depression as well. And I had read some studies recently that were saying that they think a large portion of people diagnosed with depression, are untreated sleep apnea cases like

41:21   

Absolutely. You're so tired. How can you deal with life? Yeah, you know, and you just get depressed. I've taken a lot of people off anxiety meds off depression meds. And what's interesting is it seems to hit around two and a half, three months after starting treatment. The sleep doctor that came into the lecture for me was explaining if you have a patient who's hungry and you give them a sandwich for full and they're happy if you have a patient who's emaciated, starving skin and bones and you give them one sandwich, it doesn't do much. They need a sandwich every day, couple times a day for months before they have some meat on their bones again, right. So, he said it's the same thing with with apnea treatment when you first start using C pap machine, you feel a little better, because you're not going to be waking up as much at night or getting up to pee. So yeah, you feel a little bit better. It's, it's a couple months of taking away that lack of oxygen that you've had for years. So, fixing that and staying oxygenated, you just improve and improve and improve with time. And he said, it's around two and a half, three months where you you really have another oh my gosh, I really am a different person.

That's fascinating.

And I've seen it in action. So, I had a patient with severe anxiety and depression on two medications maxed out, and she I saw her after about a month of C pap usage, and she said, I do feel better, like I'm waking up easier without headaches, more I feel a little more mentally clear. You know, I'm not like what was that word? You know, feeling foggy all the time? Uh huh. But she still wanted her meds she was like don't change my meds. I'm like, Okay, okay, no problem, you know, right. And then I saw are about two and a half, three months after using her see pap and she said, I feel so amazing. Dr. Green, I do not need these medications. I have never been happier. And I said, Okay, well let's go slow. Yeah, so I just took one of them and we cut it in half or when we saw her back, we cut the other one in half. So, her back took one away, sorry, back to the other one away. She was on no medications and feeling Amazing and happier than she'd ever been. 

43:16   

I just like right now want to stop the podcast will get some blackout curtains and go to bed. I just need to take care of stuff. 

43:25   

And she's been on these meds for most of her life. And I am definitely not a specialist in sleep apnea. I am somebody who's very interested in it, and I'm learning all I can and I'm implementing it in my practice, because I'm just seeing firsthand its effect on everything. And, you know, sometimes I get teased by my family or my coworkers. Oh man, don't say you're tired in front of her. She's going to diagnose you with sleep apnea. And yeah, you want a machine but maybe you'll be healthier for it. I can't help being excited about it because, you know, I've been at for 20 years and we prescribed a lot of medications, and in these last couple years that I have been testing a lot more since these affordable home sleep studies came out, I am just stopping medication left and right. And I'm hearing people tell me how their lives have been changed and approved. I have a patient that always felt a little bit off balance wise. And she said it made her nervous to go anywhere walking down the hall at work, she just she didn't want anyone to see her and think there's something wrong with her She don't want to stumble, you know, and just by her C pap machine, she said I wake up and I bounce up no problem. I walked down the hallways with confidence. It has changed my whole life. And she's like, I mean, I've had so many stories like that that just to me make all the hours you know, in the late nights in my office it makes it worth it because I feel like I'm helping people and changing lives for the better enough and changing the world is such a great feeling. And just by making people sleep which is crazy!

44:57   

But you know what, so let's talk about that. That to your point of your family teasing you and saying Don't tell her you don't sleep? Well that's the thing about those three pillars the sleep nutrition exercise. Yeah, how many times you have to tell someone to exercise every day all the time? How many times? And what is the issue with food in our society? So, are we constantly trying to help people eat better? And when they do or make those dietary changes, don't they feel better? We're trying constantly to get people to exercise for a minimum of 115 minutes a week, a minimum right? About 30 minutes a day, five times a week. And when they do, though, they feel better changes. Right. So, so it's, it's fantastic and with exercise to it's so underrated because people associate exercise with weight loss. Oh my god. It's not about weight loss. It's about health, health. It's about everything functioning properly, your enzymes, your hormones, your bone health, your sleep, right and it's all connected. You eat well, you exercise, you sleep well. You sleep well. You feel better. You want to eat better, right? It's so connected, you can get these three pieces into play, which, again, I think is simple, but not easy. 

46:09   

Yeah, right. 

46:10   

It's that very simple formula, sleep well eat well, most of the time, right? Most of the time, you can't do it all the time, and move your body and everything will start to change. So, when you think about it in terms of that as one of those pillars, well, then it's no different than the common. I don't know, advice lecture that you have to give to everybody eat better and exercise more 

46:34   

and then go to your health in a way that you're eating. Well, you care about your diet and your fresh vegetables and all that if you're putting that effort in why you wouldn’t put the same effort into your sleep and sleep so much easier to do? Some nice.

46:43   

Okay, I told you it was an abrupt ending. I wasn't kidding, right. But good stuff. What a great show. I had no idea. No idea how Getting the right kind of sleep, the right duration of sleep, how much it can impact my health and I got to tell you that Dr. Greene has been telling me for a while I needed to do a sleep study and I just kind of went okay okay. Because what so if I snore now and then like, Okay, my husband can deal with it. But now, yes, I have a sleep study I got I went to my GP I got a referral for a sleep study. And I am actually super excited to do this study because I do have some of the issues that she addressed, you know, the dry scratchy throat and the sometimes waking up tired and, and the heartburn and the challenges with weight loss. So, I am super excited to get the sleep study and see what the results are. So, make sure you tune in next Thursday where you are going to hear so much more information on getting the sleep study where to go. What that cost is what you can do and what resources that you can turn to. If you don't have insurance or even if your copay or your deductible is really expensive, or your doctor isn't familiar with sleep studies or providers of sleep studies, Dr. Green is going to give us some great information on a very affordable resource. And what you can look for and expect out of both the home sleep study and in lab sleep study. And we're going to go into even more of her patient stories which I absolutely love, love, love, love hearing. So, I hope you enjoyed that. I hope you're looking forward to hearing the rest of its next week. And I just want to say one more time, come on over to Facebook, jump into the breast cancer recovery group. Let's get this community going. Talk about what you hear on the podcast and reach out for the support you need with other like-minded survivors to get what you are going through. Now I know you guys are waiting unreadable five, getting more people on the waitlist all the time and it's coming. We've been doing filming, we're getting a lot of the work done. We've got, I'm super excited about it. I've got some bonus workshops, some guest coaches, this is going to be just a huge, huge program. It's so much bigger than what it's ever been before. And I'm really really excited. So, it's the clock is ticking. It is going to be launching here in February and I am going to keep you posted on it. So, keep listening, check in with next week's show and I'll let you know where we're at with it. And meanwhile, if you haven't gone to my website and downloaded care the four steps to healing after breast cancer, then go and do that. That's four foundational steps. self compassion, awareness, rehydrating your body, and moving your body and an understanding and explanation of why these are important pillars for you to lay this simple, basic foundation for restoring your health after breast cancer treatment. With resources and steps and some guidance to do it super simple, free resource. You can find it at Laura Lummer calm, and I will look forward to seeing you in the group and to talking with you again next week. 

50:15   

You've got your courage to let all your doubts Your mind is clearer than before. Your heart is your futures. 

 

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