Why You Can't Sleep at 3am and the Truth About Midlife Sleep Apnea with Dr. Shelby Harris
Show Snapshot:
Lying awake at 3am replaying tomorrow's to-do list? Surprise! Your nighttime sleep issues may be a daytime problem. Back for a third time on A Certain Age, board-certified sleep expert Dr. Shelby Harris, author of The Women's Guide to Overcoming Insomnia, helps us stop hitting the snooze button. We cover why consistent wake times are an overlooked reset, how light exposure is as powerful as caffeine, and why scheduling "worry time" keeps your brain quiet at night. Bonus! Sleep apnea and snoring often begin in midlife, with serious health risks. Yet, a simple at-home test can catch them. Listen in for your best sleep!
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Dr. Harris’ Book:
The Women's Guide to Overcoming Insomnia: Get a Good Night's Sleep Without Relying on Medication
Quotable:
"People always think about sleep as a nighttime process — it's really 24 hours. When I start an evaluation, I always start with the morning, not the night. The day informs the night."
Transcript:
Katie Fogarty0:00
Welcome to A Certain Age, a show for women who are unafraid to age out loud. I'm your host, Katie Fogarty. Beauties, you know that feeling when you finally get into bed, exhausted, ready for sleep, and then nothing? Your brain has other plans. Or maybe you fall asleep just fine, but bang, you're up at 3 a.m. wondering why your boss hasn't emailed you back, or worrying that you missed your Amazon return window. Sound familiar? Here's what might surprise you: the reason you can't sleep may have nothing to do with what happens at night and everything to do with what you're doing during the day. I am thrilled to welcome back to the show the phenomenal sleep expert, Dr. Shelby Harris, for her third appearance on A Certain Age, because Dr. Harris knows sleep. She ran the behavioral sleep medicine program at a major New York City hospital. She's the author of The Women's Guide to Overcoming Insomnia, and she's a regular media expert. You've probably seen her on GMA or the Today Show. Today, we are going deep into sleep: how your daytime habits can make or break sleep, what you need to know about snoring and sleep apnea in midlife, and how to sort real science-backed sleep advice from the noise that is flooding your social media feeds. Consider this your sleep master class, part three. Welcome back to A Certain Age, Dr. Harris.
Dr. Shelby Harris1:28
Thank you, Katie. It's really a pleasure to be back talking with you.
Katie Fogarty1:31
I am really excited, because I put into practice all the great information you shared on show one and show two. Listeners can find those shows over in the show notes — I'll be sure to link out to them. But today I want to talk about something that is a little bit surprising. Most of us think about sleep as something that happens at night, but I know that you have opinions about how our daytime habits set the stage for what happens when we hit the pillow. So walk us through what a smart sleep day actually looks like.
Dr. Shelby Harris2:01
Yeah, it's interesting. People always think about sleep as a nighttime process, but it's really a 24-hour process. When I worked at Montefiore here in New York City at the sleep center, our sleep center was literally called the Sleep-Wake Disorder Center. So we really want to think about the day informing the night. I think we always want to start with the morning, and whenever I start an evaluation with someone, I always start with the morning as opposed to the night. So: what time are you getting up? Is it dark out? Is it light at that time? Are you using an alarm clock? The ideal would be to really get up around the same time every morning. Consistency is actually really useful — it doesn't have to be exact, but sleeping in on the weekends can actually cause more problems. So getting up around the same time, using an alarm clock if you're risking sleeping in, and then light exposure. I have an alarm clock that has a light come on as well, and I find that very alerting for me in the morning. It really helps to start my day in a good way, because it's dark out a lot of the mornings, especially in the winter. And then I always start the day with a big glass of lukewarm water. Then just start your day — do you have coffee routinely? Try to keep some kind of routine. And then think about the day: where are you sitting, are you very sedentary, are you at a desk all day, do you get light exposure during the day? Light during the day is really helpful to keep our circadian rhythm going, strong and consistent, and helps with alertness. And then also think about: do you eat your meals at routine times? Do you take breaks? Are those things very draining for you mentally? Do you have the ability to decompress a little bit? Really, light movement, eating at regular times, and thinking about your caffeine use are all wonderful during the day. Then when you get home in the evening, are you allowing time to have a routine dinner? Not exercising too close to bed — that's really important, so exercise earlier, but not within about three hours of bed; no vigorous exercise. Are you having dinner earlier? Dinner too close to bed is not great either. Think about your alcohol use — if you want to have a drink, have it more than three hours before bed. Any big liquids, have those more than three hours before bed as well. And then are you taking time at night to decompress? Are you getting out what was on your brain that you might not have had time to think about? Are you sitting and actually coming up with a to-do list, writing down the things that are concerning to you, and thinking about how you might tackle them tomorrow or next week? You really have to allow some time to process, because if you're not, it's all going to pop up at 3 a.m. when you've already been sleeping for a few hours. Then dim the lights before bed, and then dark, quiet, cool, and comfortable at night — and repeat the next day when the alarm goes off again.
Katie Fogarty4:55
So many smart strategies. We're going to explore them all in a little bit more depth. But let's start off by talking about light and how it impacts the sleep-wake cycle. You talked about daylight helping reset our circadian rhythm. What do we need to know about how our circadian rhythm actually works? And if light in the morning is powerful for our sleep, is the absence of it at night equally important? Do we need blackout curtains? Do we need eye masks? Do we need to limit our blue light? Walk us through light and how it impacts the cycle.
Dr. Shelby Harris5:31
Light is really the most powerful thing that keeps our circadian rhythm going — or rather, the absence of light, shall I say, helps with melatonin production. Melatonin is produced in our bodies naturally — forgetting about the type you can take in pill form, or what we call exogenous melatonin. It's made in our body, and we like to call it the "hormone of darkness," because it really needs darkness at night to do what it needs to do. It comes out throughout the night, and then as morning starts to come, it begins to lessen. With light exposure in the morning, that's what stops melatonin production. So you really want to be thoughtful about having a dark room. Having it cool also helps with melatonin production and helps to keep our circadian rhythm going. Dark at night is really important. A good test is to close your eyes, take your hand, and move it across in front of your eyes. If you can see a little change in your eyelid as your hand passes, you probably have too much light in your room and should work on making it even darker. Darkness is really helpful. Now, some people have a history of trauma or don't feel totally safe at night, so a night light is okay — it's just not ideal. The other thing to think about is a cool and quiet bedroom, because that helps to really keep the circadian rhythm doing what it needs to do throughout the night, and helps melatonin continue to come out. When you wake up in the morning, light is super important — you really want to get light exposure in the morning to keep that wake time nice and strong, and maintain light exposure throughout the day. A lot of people feel a little bit of a dip after lunch, which is really common and totally normal. That's why certain countries have siestas. However, if you go outside and sit in the light for about 20 minutes, that can be just as alerting as a cup of coffee for some people. Light is really powerful for helping to keep us awake as well.
Katie Fogarty7:42
I love this recommendation, particularly because here in the Northeast, where I live and where I know you live, we're finally moving into springtime weather so we will be able to actually be outside eating our lunches. So this is a great hack to use if you're somebody who needs a cup of coffee midday — just maybe even a walk around the block in the sun, eating your lunch, can really help reset you. I'm so intrigued by this notion of melatonin being the hormone of darkness. I personally love an eye mask. I feel like I've talked about this on the show a lot — I've talked about it so much that I had a wonderful woman from an eye mask company just mail me one because she said, "You love eye masks, you're gonna love mine," and I do! I truly cannot sleep without them. And this has really come in handy now that my husband and I are empty nesters and we've moved back to New York City. New York City has a lot of — I guess it's not ambient, because ambient is sound — but there's just a lot of light happening even when you've got the shades drawn. The city does not sleep, and it wants you to see its shining lights. So I do use an eye mask, but then I'm not getting natural light in the morning to wake me up. You mentioned that you have an alarm clock that actually brightens and shares light. Is it important to pull the eye mask off at some point to have the natural light kind of wake me up? Where do you land on eye mask usage?
Dr. Shelby Harris9:07
Eye masks are totally fine. I'd rather you get the sleep at night. If the eye mask helps keep it dark, all you have to do is use an alarm clock. You don't even need a sunrise alarm clock — just have a regular alarm clock go off. A lot of people will get up in the morning and keep all the shades closed and kind of hang out in a half-awake state for a while. Instead, I'd rather you take the eye mask off right when you get up in the morning and then open up the shades and get as much light as you can. Even if it's not nice out and it's a cloudy day, that still has a lot of impact. Even in the winter, if it's too cold or not great to go outside, just sit and eat your breakfast in front of the window if you can — try to bathe your body and your brain in light.
Katie Fogarty9:48
I love it. It's like we're going to be cats — we're just going to nap in whatever little pool of light we can find throughout the year to help with this. So this is terrific advice. You mentioned something earlier when you talked about what makes a great, sleep-healthy day in order to get ready for your night. You talked about managing stress, getting down on paper what you're worried about. I want to talk a little bit now about daytime rumination — the mental chatter, the worry spiraling, the mental to-do list that so many of us have. Modern life is busy. How does what's happening in our heads during the day show up and truly impact our sleep at night, and is something like journaling or list-making the right move?
Dr. Shelby Harris10:29
Yeah, there's no one right technique for everybody, but there are a few things that I find can be really helpful. What I hear all the time from women — and it happens to me as well, because I'm a human being in today's world — is that if you're so tired, you've been busy all day long, you finally get home, and you crash into bed and fall asleep because you're so sleepy. But you haven't really thought about anything during the day or all the things you have to do. You might fall asleep with no problem because you're so sleepy, but then you might sleep for four or five hours, wake up at 3 a.m. or whatever time it might be — because you've already slept for a few hours, that appetite for sleep is not as strong, so whatever your brain is trying to process is going to be able to break through a lot easier because it hasn't been allowed to process earlier. So what I love to recommend is: I'm a big fan of meditation for everyone. Just five minutes a day — that's the biggest time investment you're making. People make meditation out to be a lot more complicated than it needs to be. Spending five minutes during the day — not at night, not right at bedtime — to just allow yourself to focus on something, and when your mind wanders, bring it back. There are a bunch of apps out there. I literally just look out the window every morning when I get up — that's my meditation. When my mind wanders, I bring it back. You get better at letting go of thoughts with that mindfulness practice, so that when you do wake up in the middle of the night, you can let go of those busy thoughts a lot more easily, because you're stronger from that daytime practice. Then list-making is a great thing. If you find that you have a lot of things on your to-do list that you never write down, get them out of your head. Write them down, and then maybe prioritize: what do I want to do tomorrow? What needs to get done tomorrow? What can wait for a week or so? And then finally, for some people who tend to have a lot of worries going on at night — they just can't let go of the worry — there's a technique I talk about in my book called "worry time," where you allow yourself 20 minutes every evening, not right at bedtime, to worry about everything. You can write down the next step and how you're going to deal with it. And sometimes the next step is simply: "There's nothing I can do about it." After 20 minutes, you put the worry time pen down, and then any time for the rest of the night or the day — until it's worry time again — you say to yourself, "Not now. That's for worry time." So you allow yourself to worry all you want, but only for 20 minutes, and not 24/7.
Katie Fogarty13:05
There are so many great options, and that worry time is such a phenomenal hack. This is the third time we've had this conversation, and I don't remember you sharing this before — so every time I talk to you, I take something new away. For me, I know myself — I love a color-coded calendar, I have a lot going on, and I manage it by time-blocking. And this really speaks to me deeply. These 20 minutes where you're going to worry about this, and then you're on to the next thing. My brain loves that. I love being told what to do next. I'm done worrying — I already did that. I'm moving on to my new thing, which is hopefully meditating and relaxing.
Dr. Shelby Harris13:43
I always think about worry time like the whack-a-mole game at a carnival. Every time a thought pops up, it's like: notice me, pay attention to me. And you're like: no, I don't want to think about you now. You keep hitting it down, but it keeps popping up stronger. With worry time, you're allowing all the whack-a-moles to happen for 20 minutes and saying, "I see you. I'm going to deal with you. But I'm not going to let you pop up all the rest of the time."
Katie Fogarty14:05
I absolutely love it. All right, Dr. Harris, we're heading into a quick break, but when we come back, I want to ask you — you used the word "siesta" before — I want to ask you about daytime naps, and then I definitely want to explore why midlife women are often grappling with an onset of sleep apnea or snoring issues. We'll be back in just a minute. Dr. Harris, we're back from the break. We are talking about how to set up your day to make sure that you're hitting the pillow at night in the best shape possible to get a great night's sleep. You've given us a lot of fantastic recommendations about what we could be doing during our daytime hours. I want to ask you about napping. You mentioned some cultures have siestas. We don't really have that here in the US, but for people who are dealing with insomnia, who are up, who are struggling and are trying to catch up, a nap can seem really enticing. Where do you land on daytime napping? Is this something that you could use episodically — like if you're jet-lagged — or is it something you'd ever say people should stay away from altogether?
Dr. Shelby Harris15:06
Naps are not inherently a bad thing. Power naps of around 20 minutes — I usually say give yourself 30 minutes, but you'll sleep about 20 minutes — are not a bad thing for many people in terms of productivity, mood, and memory. They help a lot. But for some people with insomnia, it's almost like you're snacking on sleep and having sleep at a time when it makes it harder to sleep at night because you've already had a snack on it earlier. So it's a little bit of trial and error. I love using a sleep diary for this — I have an old-school sleep diary in my book and on my website that you can just print out and fill in by hand. If you notice that when you take a 20-minute nap earlier in the day — generally we say by 2 p.m., about eight hours before you're going to go to bed — it doesn't impact your sleep at night, and it helps you feel refreshed, then keep napping, it's fine for you. But if you find that it makes it harder to fall asleep or stay asleep at night, then you might want to eliminate it. Of course, there are going to be exceptions — you might be sick, or traveling with jet lag. I take a short nap a lot of times when I'm traveling with jet lag. It's not an all-or-nothing thing. But for people with insomnia, we tend not to love naps, because it's snacking on sleep.
Katie Fogarty16:25
Okay, so it's a case-by-case basis. And for listeners who want to head to your website to get the sleep diary you just referenced, where would you send them?
Dr. Shelby Harris16:34
You can go to DrShelbyHarris.com — it's just DrShelbyHarris.com.
Katie Fogarty16:39
Phenomenal. I'll also be sure to link out to that in the show notes. So let's move into sleep apnea in midlife, because this is a big one. I've learned in preparing for this show that untreated sleep apnea is tied to increased risks of high blood pressure, heart disease, stroke, and diabetes — really serious things. Why is midlife specifically a time when sleep apnea can emerge or worsen for women? Is there a hormonal connection? What's driving this onset?
Dr. Shelby Harris17:03
So it's typically a hormonal connection. It's interesting: in women and men, up until perimenopause and menopause, men have a greater risk of having sleep apnea. But once you hit the perimenopause/menopause stage, the rates actually start to even out between men and women. The hormonal changes — decreases in estrogen and progesterone — actually cause a loosening of your airway, which is largely responsible for obstructive sleep apnea. So you have a loosening of muscle tone, and because of that loosening, you have an increased risk of snoring and pauses in your breathing. The other thing is that some people can see more weight gain in that age range — not always, but that can be an additional risk factor. All that said, the hormonal changes in and of themselves are often a reason for apnea. There are plenty of women in their 40s who are thin and fit — you would never think in a million years they meet the criteria for apnea — but we find out they have it because there are pauses in their breathing, they're having broken sleep at night, and they don't feel like their sleep is restorative.
Katie Fogarty18:20
Yeah, it's interesting. I had read about the link between weight gain and sleep apnea — that as you put on weight and your neck changes shape, that can impact how your airways are operating, which makes a lot of sense. Your point that sometimes people who are thin are still having this, and it might be going undiagnosed, is important. So how does one get a diagnosis? Is it your partner sticking their elbow in your side multiple times during the night to tell you to be quiet? Or if you're waking up exhausted, should you get yourself to a sleep expert? Do you do at-home testing? Do you have to go to a lab to work with an expert? What are the steps to accurately diagnose this?
Dr. Shelby Harris19:00
First and foremost, when it comes to recognizing symptoms for yourself, it doesn't have to be the loud snoring we typically think of with stereotypical sleep apnea. It can just be pauses in your breathing, little puffs of air at times — it doesn't have to be so significant that someone else can hear it. It gets missed because other people might not notice it. If you're waking up to use the bathroom a lot at night, if you're waking up with headaches in the morning, if you're waking up with a dry mouth, if you wake up in the morning and feel like your sleep wasn't as restorative as it used to be — all of those are reasons to get evaluated. And if someone says to you, "Well, you're a woman and you're thin, you don't have it," find someone else who will listen to you. When it comes to diagnosis, most of the time if we're looking for sleep apnea, they're going to start with an at-home sleep study. At-home sleep studies can vary based on the provider — often it's a chest band with a little box on it, a pulse oximeter on your finger, and sometimes a nasal cannula that you just tape lightly under your nose. Other providers use ones that are literally like a watch with a little pulse ox on the end. They're really good screeners for your breathing at home. They're not a substitute for an in-lab sleep study, but if it shows you have apnea, you very likely have apnea. Now, if it comes back negative but you still feel like something is off with your sleep, I would encourage you to talk with your sleep specialist and push for an in-lab study, because there might be other things going on, or the at-home study might have missed something.
Katie Fogarty20:42
Yeah, this is fantastic advice. Work with a doctor who's going to listen to you, and make sure you continually advocate for yourself. And it's fascinating to hear that you can do these simple at-home screeners. I have a parent with sleep apnea who had to go through a sleep lab at one point, and I'm delighted they did because it's getting handled — but it's great to hear that there's an easier first step we can take to figure out if we're a candidate.
Dr. Shelby Harris21:11
I use myself as an example all the time. A number of years ago — and I've shared a lot of this on my social media — I felt like something was off with my sleep. I would snore once in a while, but not routinely. I also had a lot of nasal congestion and just felt like something wasn't right. So I had a home sleep study, and it came back negative. But I still felt like something was off. So one of my friends and colleagues at Mount Sinai in Manhattan helped me do an in-lab study, and it turned out that I didn't have a snoring issue, but I had a condition called periodic limb movement disorder — I was kicking my legs a lot at night and had no idea. My husband had no clue either. And then I needed to get treatment for that, because that's why I was having such unrestorative sleep.
Katie Fogarty21:52
I love this story — thank you for sharing it. We really have to do the due diligence, even when you're an expert. I had another doctor on the show recently, Dr. Jane Morgan, a cardiologist, who shared that she had gone in for an annual physical, gotten one piece of advice, showed up the next year, and there was still an issue. She was like, "Wait a minute." So it's great to hear that even doctors really need to put the work in on their own health, and it's a great reminder to the rest of us to keep going when you don't feel good. When you're waking up and not feeling great, if there's any kind of issue going on, you need to keep going until you get the relief you need, because help is out there. Thank you for sharing that story. So for people with sleep apnea or snoring issues — are snoring and sleep apnea inextricably linked? Can you have more benign snoring? Snoring is the punchline of many jokes, and I have learned that in midlife, menopause and hot flashes are the punchline of many jokes as well. But truly there's nothing funny about changes to our health and bodies that impact our overall well-being. So talk to us about snoring. Is it ever benign, or should we be taking it seriously as an indicator that something else might be off?
Dr. Shelby Harris23:07
Yeah, if snoring is happening routinely and it's not just linked to alcohol or losing a few pounds making it go away, then for most people, if it's happening routinely, we do encourage you to get evaluated. Some sleep specialists will say snoring is benign if it doesn't show anything on an in-lab study and no medications are worsening it. Others will say we really need to do something about any snoring that's happening chronically. Honestly, it's a big debate in the field. But I think if it's happening consistently and you feel like there's an issue with your mood or your sleep quality, I would 100% get it evaluated first before you make any assumptions that snoring doesn't mean anything.
Katie Fogarty24:11
So reducing alcohol sounds like it can impact our snoring. Obviously, reducing alcohol improves our sleep quality in general. What are the other lines of treatment? Talk to us about the CPAP, and then I'm curious to hear your take on other oral appliances that keep the throat open, and whether positional therapy can do anything at all to help with this condition.
Dr. Shelby Harris24:34
There are a lot of different treatments out there. The gold standard is still PAP therapy. There are different types — CPAP, BiPAP, auto PAP — and most people are going with an auto PAP nowadays because it adjusts throughout the night. The most basic way to explain what PAP does: it's kind of like a splint for your finger. If you break your finger, you need a splint to keep it rigid. That's what PAP does — it's essentially forced air with pressure that keeps your airway open. It's like a splint for your airway. Now, there are other things. Sometimes, if we see that you only have apnea on your back or in a certain position, we might have you train yourself to sleep on your side. We can use a tennis ball sewn into the back of a pocket t-shirt worn backwards — that's actually an old-school technique. There are all kinds of devices and things that can help with your sleeping position and train you to sleep differently. Then there are also oral appliances — usually a sleep dentist is the person who deals with those the most. They can work for some people with mild to moderate apnea. It doesn't work for everyone, and sometimes you need to combine it with PAP therapy. There's also myofunctional therapy or myofacial therapy — and something called Excite OSA — which essentially strengthen your tongue and airway through exercises, giving them more rigidity and strength to stay open at night. And then there's GLP-1 medication: Zepbound was approved for moderate to severe apnea in people who need to lose weight, where weight is a factor in their apnea. So it's really not one size fits all. I think everyone just assumes they're going to go home with a PAP, but it doesn't have to be that way. And one more thing I always want to add: so many people come to me saying they wake up at night and are on Ambien or taking Xanax at night, or whatever it is. If they have apnea that's not been diagnosed or isn't being treated, they're taking a relaxing medication for sleep that might actually be making their apnea worse. Some medications can relax the airway so much that they worsen apnea.
Katie Fogarty27:03
That's fascinating. And you blew my mind with the tennis ball in the t-shirt. That's really smart.
Dr. Shelby Harris27:11
You know what you can also do? A fanny pack, because they're easy to find nowadays. You put it on backwards.
Katie Fogarty27:17
I am literally picturing those 1980s neon nylon fanny packs on your waist. That's hysterical, but so many helpful devices that can get you in the right position or open your airways. Interesting that you mentioned Zepbound — I just had the pleasure of interviewing Dr. Rocío Salas-Whalen on the show a few weeks ago. She talked about her book Weightless and GLP-1s and she mentioned Zepbound. I'm going to link out to that in the show notes as well if anyone is curious about that conversation. Shelby, talk to me about sleep dentists, because I hadn't heard that phrase before. Walk us through what that is.
Dr. Shelby Harris27:57
Yeah, I think the thing is, with sleep medicine, people think it's just one kind of doctor. When it's done well, it's actually a very interdisciplinary field. There are people like myself — psychologists who specialize in behavioral sleep medicine. Then there are MDs: pulmonologists, neurologists, who all come at it from their own areas of expertise. And then dentistry is a whole other subspecialty. Some dentists in general practice might notice if you are someone who grinds their teeth — what we call bruxism — and say, "You should probably get that evaluated." They'll usually recommend having a sleep study or seeing an MD sleep specialist. But often the MD sleep specialist will refer out for an oral appliance if they think that's the best treatment option. The doctor who diagnoses you with sleep apnea might say, "Let's start with an oral appliance," and they'll give you the name of a dentist who is trained in sleep dentistry — that's a whole subspecialty — and that dentist will fit you properly for an oral appliance.
Katie Fogarty29:07
Yeah, it's fascinating. I love to hear that it's multidisciplinary.
Dr. Shelby Harris29:10
The best labs have people of different specialties all working within sleep.
Katie Fogarty29:14
Yeah, it totally makes sense. And that's a great segue into my next question, because I think my listeners — like me — are all bombarded with health content online on various topics, but I see a lot of sleep content too. There's Instagram wellness advice, I see mouth taping, there's the sleepy girl mocktail, magnesium, TikTok advice. How do we, as patients, sort out what's actually evidence-based from what's just trending?
Dr. Shelby Harris29:44
I'm a fan of just looking at the person's specialty and what kind of training they've had. Everyone thinks they can be a sleep expert because everyone is ideally supposed to sleep, right? The gold standard is: has the person gotten board certification in sleep — either sleep medicine, which is for MDs and DOs, who are the ones really board certified in general sleep medicine — or are they someone like myself, who is board certified in behavioral sleep medicine? Look for certain letters after their name, or that they say they've gotten extra training, fellowships, and have taken exams, so you know the person knows what they're talking about. Another thing I caution about is: are they selling a hack? There's no easy hack — no one hack fixes sleep problems. It's not that simple for most people. So if someone is saying, "This is the one thing," or "Contact me for my five- to ten-day sleep anxiety fix," I'd be skeptical. If they're always pushing a supplement without any real data to support it, that's a red flag for me as well. The quick fixes — unfortunately, there really isn't one out there.
Katie Fogarty31:18
Yeah, credentials matter.
Dr. Shelby Harris31:20
They absolutely do.
Katie Fogarty31:20
So where do you land on mouth taping? Is that something where you're like, "Why are people doing this?" Or, since I've got you, I'm just going to ask — I see it everywhere.
Dr. Shelby Harris31:31
Every day I get asked about mouth taping. I don't have a problem with it, as long as you've been evaluated by a sleep specialist. Most people who are doing it are waking up with a dry mouth and are snoring, and they're doing it to stop snoring. If you're doing it for that reason, and there's any apnea or any spectrum of apnea going on, you might actually make it worse. So it's not an actual treatment for apnea. I always have people get evaluated first, and if once they're evaluated the doctor says, "Go ahead, tape your mouth — it's fine," then I have no problem with it.
Katie Fogarty32:03
All right, so work with a trained specialist.
Dr. Shelby Harris32:06
Yes.
Katie Fogarty32:07
I have one last question for you before we move on, but I'm curious. You mentioned these sleepy girl mocktails — I see them on my Instagram too. I think it's because I've been drinking more mocktails in general — not to go to sleep, but just to have less alcohol — so Instagram is like, "Oh, here's a sleepy girl mocktail." Obviously, what we eat and what we consume impacts our body and our overall wellness. Beyond not drinking alcohol, or drinking it further away from bedtime, are there foods or drinks we can be consuming that help optimize our sleep and put us in the right frame of mind when we hit the pillow?
Dr. Shelby Harris32:50
Yeah, if someone has a real entrenched sleep problem — like insomnia or apnea — then things like that are probably not going to make or break your sleep, or meaningfully help or hurt it. But if you have the occasional problem with sleep, yeah, there are things. You don't want to eat too much food that's too heavy, too fatty, or too rich within three hours of bed, because that can really impact things like heartburn — that happens all the time for people. Alcohol is a big one. Liquids are a big one. You want to really limit those within three hours of bed. Just try to be mindful of not having too much sugar as well — sugar is going to end up spiking and then crashing at some point. Sugar doesn't help. But that doesn't mean you can't eat before bed — about an hour before bed, a light snack can often help people. Intermittent fasting is fine, but for me it's actually a disaster because I wake up with headaches in the middle of the night or the morning. A light snack that's a mix of a protein and a complex carb is usually really helpful for people. And then you can think about magnesium-rich foods — things like nuts, seeds, greens, and eggs naturally contain magnesium, and those can help as well, as long as it's not too heavy a food. What I have most nights is either a little nonfat Greek yogurt with some raspberries and PB2, or I'll put a little bit of granola in it — that's my go-to snack most nights before bed.
Katie Fogarty34:26
Shelby, I was really hoping you were going to say chocolate-covered almonds, but...
Dr. Shelby Harris34:31
I don't eat any chocolate — I get migraines from it. But a little bit is fine for most people, just not too much.
Katie Fogarty34:38
No, I love Greek yogurt and raspberries.
Dr. Shelby Harris34:40
Oatmeal is another good one — just a little bit.
Katie Fogarty34:43
Smart advice. Okay, final question for you: if a listener could just do one thing starting tomorrow to meaningfully improve their sleep, what would you tell them?
Dr. Shelby Harris34:52
Have a consistent wake-up time every morning — within about a half hour.
Katie Fogarty34:55
Okay, we can do that. We can do hard things. We can all do that. I love that recommendation, and you've made it before. I will say I've gotten better — there are times on the weekends when I do sleep in, but I do try to prioritize a good wake-up time, and you were the one who put that on my radar. So thank you so much for coming back for episode three and giving us a master class in what we can be doing during the day to make sure that we're getting into bed and giving ourselves the best chance at a great night's sleep, which keeps all the trains on the tracks. And I was really excited to walk through the sleep apnea and snoring question with you, because I know this is something that is an onset for a lot of women in midlife, and it's important to know what to do, how to get it handled, and where to go for help. Thank you so much for being with me today.
Dr. Shelby Harris35:39
Thanks for having me. I appreciate it.
Katie Fogarty35:42
This wraps A Certain Age, a show for women who are aging without apology. Dr. Harris always comes through with amazing sleep tips. I'm going to try working on scheduling my worry time so I'm not up at 3 a.m. with things flooding my brain. I love her tennis ball trick — and that fanny pack trick — for adjusting your sleep position at night if that's something you're working on. And this idea of keeping your room cool and quiet at night is something I need help with. So if you have a white noise machine that you love, let me know — I am a New Yorker once again, and you know what we are: the city that never sleeps. It's kind of noisy out there. So if you have a recommendation, send it my way. You can let me know in an Apple Podcasts or Spotify review, you can DM me what works for you on Instagram, or email me at katie@acertainagepod.com. Special thanks to Michael Mancini for composing our theme music. And as always, keep aging boldly, beauties — and sleep well.