Mastering the Mysteries of Sleep for Family Wellness with Savannah Hipes

Imagine unraveling the mysteries of sleep, from the erratic slumbers of a newborn to the regimented cycles that govern our adult lives. That's precisely what we accomplish with Savannah Hipes, a sleep therapy connoisseur, in our latest conversation. We navigate through the ebbs and flows of sleep patterns, examining how routines and exposure to light orchestrate the symphony of our circadian rhythms. As a parent grappling with the nocturnal nuances of spirited and sensitive kids, I've gleaned some valuable strategies from Savannah to ensure that all of us get to slumber away each night.

Teenage sleep quirks and the acknowledgement of unique circadian tempos take center stage as we probe the science of slumber in adolescence. The dialogue turns to how embracing these biological disparities, particularly in young people, could lessen the burden on families, with later school start times posing as a potential salve. We also cast a spotlight on the critical role of natural light in regulating our internal clocks, pondering over ingenious solutions for those in dimly lit locales. I share my own epiphanies here, reflecting on devices that mimic the sunrise for those dark winter mornings.

Venturing into the realm of sleep disorders, we dissect the telltale signs of conditions like obstructive sleep apnea and their impact on our health, especially the heart. The conversation doesn't shy away from the gritty details of physiological causes, nightmares, and the puzzling nature of night terrors. In a candid reveal, Savannah discusses the intersection of anxiety and sleep, and how education and mindfulness have revolutionized many people's nights. If Savannah's insights resonate with you, her website is a trove of personalized advice, beckoning anyone who seeks solace in their quest for restful nights.

To find Savannah, you can visit her website at www.savannahhipeslcsw.com or on Instagram, Facebook or LinkedIn at @savannahhipeslcsw. Here's her direct contact info: Phone: 407-720-9903; Email: connect@savannahhipeslcsw.com

Find Carrie Lingenfelter at https://linktr.ee/hearttoheartparentspodcast
You can email Carrie at: info@hearttoheartlife.com

Transcript

Savannah: 0:01

For humans of all ages. The thing that helps our body know what time it is, the thing that helps the circadian rhythm to function well, is routine behavior and light exposure. So when we get up in the morning and our eyes take in some daylight, our brain goes oh, it's day and it starts sending out alerting signals to the rest of our body and brain saying be alert, it's daytime. The more light we get, the more our body clock feels confident that it knows what time of day it is. And then when we get up and have breakfast and we go to work or we go to school, we have lunch, we do all these things at regular intervals. Our socializing happens around the same time every day. Our movement, our physical body movement, happens around the same time every day. All of those things are communicating to our brain. Yep, your body clock is on track. You're right, it is noon. Good guess.

Carrie: 0:59

Welcome to Heart to Heart Parents. Let's connect with our kids and learn together. I'm Carrie. I was a former teacher and speech therapist. I'm also a parent of two spirited, gifted, highly sensitive kids. I was quickly brought to my knees as a parent when I thought that I would see a rosy lens version of parenting, just as they present on Instagram, but I quickly learned that's not real life. I will provide real life experiences and transform them into moments for connections and change for you to use in your house. Hi and welcome back to Heart to Heart Parents. I'm Keri and I'm here with a guest, savannah Hypes. Did I say it right? Yeah, great, yay, hypes here, and she has an amazing background in sleep and sleep therapy and she's an expert in this area. So, miana, can you tell us a little bit more about yourself?

Savannah: 1:55

Absolutely. Thanks so much for having me. Yeah, so I am an insomnia and anxiety therapist. I work primarily in Orlando, florida, but I also see clients virtually in New York and I specialize in helping highly driven sleep deprived professionals who feel exhausted and on edge to finally sleep through the night. So I use a lot of different techniques, but primarily cognitive behavioral therapy for insomnia and acceptance and commitment therapy for insomnia. I got my original sleep training working at the VA during a fellowship program helping veterans who were having trouble sleeping, and I just really loved it. I love how, with sleep, you can make some simple, concrete changes and it vastly changes your sleep very quickly. So that's really satisfying for me to see in my work.

Carrie: 2:48

And that's a little bit about me. I love that. I love your background and that's amazing that you worked with veterans too. I know that's a huge piece of the puzzle for people, so that's amazing. And as a parent of a highly sensitive, gifted, spirited child, I know sleep has been a hard one in our family and in our house, so I'd love to dive right in and pick your brain today if that works for you Totally.

Savannah: 3:17

Take away.

Carrie: 3:18

All right, let's do this. So what would you say sleep looks like for the lifespan of people.

Savannah: 3:23

So what would you say sleep looks like for the lifespan of people? That is a great question, because sleep changes significantly as we age. From early childhood to middle adulthood to late adulthood Things look very different. I would say, you know, if I were to start all the way back in infancy, that infants, for the first 12 weeks of their life they don't have a circadian rhythm. So the circadian rhythm is what regulates the timing of our sleep. Our brain and our body knows how to sleep on its own and usually that works really well. Sometimes things get in the way and we end up developing something like insomnia or trouble sleeping, but unless there's a really big factor that's preventing our sleep, like anxiety or a traumatic event or a really big life change like having a baby, which we'll talk about later. But for the most part our sleep is regulated on its own and the circadian rhythm is part of what regulates that. So that's our internal body clock that tells us what time it is.

Savannah: 4:24

You might have heard of melatonin, which is a hormone that is secreted during certain times of day. Now, that doesn't cause us to be sleepy or force us to sleep, but it sends indicators to our body to start some of the other physiological processes that tend to happen right before we go to sleep, so it lowers our blood pressure. That tend to happen right before we go to sleep. So it lowers our blood pressure. It lowers our core body temperature, lowers our heart rate, lowers our you know digestive functioning so we can smoothly transition to sleep.

Savannah: 4:54

Infants don't have that. For the first 12 weeks they have no sense of night and day, they have no sense of what time it is and I believe they're not really even secreting melatonin that early. It's not until the three to six months range that they start having any sense of day is different than night and really having any kind of schedule. So for those first couple of weeks they're sleeping 12 to 18 hours and it's just interspersed all throughout the 24 hour period, which is really exhausting for our parents who are trying very hard to support these little ones. But you can expect them to be sleeping in three or four hour chunks but they're usually waking up briefly at each hour during that time.

Savannah: 5:41

So, a lot of up and down. Something maybe to note about that time frame is that children who are breastfed might wake up a little bit more often just because breast milk digests a little bit faster than formula does. But that's normal and nothing to be concerned about. So once they get to that three to six months range, then they start realizing oh, wait, a minute. Months range Then they start realizing oh, wait, a minute, there's time, there's day, there's night, and they get into a bit of a routine for sleeping primarily at night and then still for good long chunks during the day. So they're still sleeping like four hours during the day, but they should be getting a good chunk of time that they're asleep at night as well. Okay, and part of what helps that is that we set them on a schedule. It's like before their body has a clock, we have to be their clock by helping them get into a pattern. So it will make sense for parents if you're having a lot of inconsistency for those first couple of weeks. But once you get past that first few week stage, you'll want to really try to start creating a schedule and sticking to it.

Savannah: 6:48

For humans of all ages, the thing that helps our body know what time it is. The thing that helps the circadian rhythm to function well is routine behavior and light exposure. So when we get up in the morning and our eyes take in some daylight, our brain goes oh, it's day. And it starts sending out alerting signals to the rest of our body and brain saying be alert, it's daytime. Um, the more light we get, the more um our body clock feels confident that it knows what time of day it is okay.

Savannah: 7:21

And then when we get up and have breakfast and we go to work or we go to school, we have lunch, we do all these things at regular intervals. Our socializing happens around the same time every day. Our movement, our physical body movement, happens around the same time every day. All of those things are communicating to our brain. Yep, your body clock is on track. You're right, it is noon. Good guess. So that really is how our timing works. And for babies, we have to kind of do that for them in the beginning and then continuing for toddlers and for school age children, we really have to be enforcing that schedule to help their body confirm what time of day it is, so that they will get sleepy when it's bedtime and be alert during the day. I know that's a lot of info to throw at you just beginning.

Savannah: 8:11

What are your thoughts so far?

Carrie: 8:13

So I had a thought about the zero to three months and when you mentioned breastfeeding, that they're awake more often. So I nursed both my kiddos. They're awake more often, so I nursed both my kiddos. And one thing that was really special, that really helped me, was oxytocin. As soon when they're up, all those times and I mean you're wide awake, you're alert when they wake up and then you nurse them and you get that release of oxytocin. Oh man, did it help me go back to sleep? So, even though they were awake so often, it really was helpful to have that piece to just help me go back to sleep. So, even though they were awake so often, it really was helpful to have that piece to just help me go right out really quickly. So it wasn't too painful, it actually helped a lot.

Savannah: 8:51

Yeah, and I think everybody has a different experience. But you're right, Our body knows what we need and knows for the most part how to get it to us. I also have a hunch that we kind of are sleep deprived during those early parenting months because our body is saying stay in and get to know your kid. It doesn't want you to go about your normal schedule, it wants you to really focus, and sometimes we have a hard time slowing down. So maybe our brain's like let me force you to slow down.

Carrie: 9:22

Yeah, yeah, that's true. And try to like, regenerate and recoup. Yeah, I think that's amazing. I love that point of view. My son definitely did not want me to put him down and I didn't realize it right at first because I was like mom needs a break. But looking back, it goes so fast that really it's awesome to have that time together. Yeah yeah. There was another thing I thought of too when you mentioned schedule and having that consistent schedule for them. Whenever I'm talking to neighbors, as school is or summer is ending and school is getting ready to start, I know a lot of our neighbor friends and families and friends are out late at night with kids and just letting them run around in the neighborhood. So I always drop the hint of start getting them back on their regular sleep schedule for those 6.30 wake-ups a couple of weeks before school starts Absolutely, because it takes a while to adjust.

Savannah: 10:19

We're taking a lot of sunlight in much later in the day during the summertime, so our circadian rhythm naturally shifts a couple hours and then we have to shift it back and it can be hard to do that very suddenly. So adjusting bedtime and wake time by like 15 minutes every couple of days or every week or so during those last few weeks, I think is a fantastic idea to help smooth that transition.

Carrie: 10:42

Okay, I love that. Yeah, that's great info. And then also I thought of my son and how we call him, the teenager, since he was born, because he loves. Even when he was two years old, he wouldn't want to go to bed until like 8.39 PM, and then he wants to sleep until like eight or nine in the morning. So what is that? What is that about, do you?

Savannah: 11:05

have any ideas.

Savannah: 11:07

Yeah, these are genetic and biological differences, so everybody's sleep doesn't work exactly the same. It all typically uses these same parameters of the circadian rhythm as well as the sleep drive, which is basically like our drive for food and water. You know, we get hungry for food the longer we haven't had it same thing with sleep. The longer we haven't had sleep, we get hungry for it, and that chemical pressure builds up on our brain so that by the time it's bedtime we're really hungry for sleep and we'll fall asleep quickly and easily and sleep through the night, and then when we wake up we should be feeling refreshed because we've just had a full meal of sleep. You could say so. Those things regulate our sleep really naturally, but there's going to be differences person by person, especially when it comes to circadian rhythms for teenage. Well, ok, so you're talking about your baby?

Savannah: 11:58

being like a teenager because they like to stay up later and sleep in later. That just might be a biological difference, that their circadian rhythm is a few hours shifted and that is just fine. I recommend people as much as possible to let yourself and your kids sleep in the window that feels best for them. If they're getting their best sleep in those hours as opposed to the hours that you think they should be sleeping in, let them do that. It's hard to work your life around that, especially for adults who have a difficulty with their circadian rhythm. So for some people, when this is really severe, it's actually called a circadian rhythm disorder.

Savannah: 12:39

For people who have shifted circadian rhythm, that's very delayed, meaning that you know even throughout adulthood they don't really get sleepy and desire to go to bed until like 1 or 2 am and then they typically sleep best, you know, until like 10 am and then they do their best. You know they feel their best in the morning at like 11 or 12, as opposed to that 9 am. In the morning at like 11 or 12, as opposed to that 9am that we tend that other people who have a typical circadian rhythm function well in. Um, that might just be natural for them and I encourage them to to use that. To sleep in that window is if they can manage their life around it. If they can't, then we have to shift their circadian rhythm back to a more average schedule and we can do that by manipulating their light exposure.

Savannah: 13:27

So I definitely recommend this for teens, because teenagers, their circadian rhythm shifts multiple hours and delays just naturally. When we're babies and infants and young toddlers, our circadian rhythm is very advanced, meaning they're going to wake up really early and they're going to want to go to bed really early, and that's just where their body clock naturally goes. As we get older, that shifts into a middle range. For adolescence it shifts way over here to the delayed phase and they don't get sleepy until much later and they get their better sleep Later in the morning. Yeah, and so I'm a big proponent for pushing school start times because we're really driving our kids in America. But yes, yeah, I don't know if you have thoughts on that too.

Carrie: 14:18

Oh yeah, we. We just actually changed schools. We moved from our neighborhood school to a school that focuses on social, emotional and project based learning and it was amazing we switched from 7.50. Start time at the neighborhood school to the school is 8.30, but it has like a rolling window, it's like 8.15 to 8.30. And it's just that half hour or 40 minutes, I guess, is so much less pressure on our kids and our house and just letting them sleep a little later. It's amazing.

Savannah: 14:50

Yeah, and they're not getting less education and it's not like they're at school till 6 PM and they don't have any time to do anything in the evenings. It's just everything shifts a little bit so that they can function a little bit better.

Carrie: 15:02

So that's, really normal.

Savannah: 15:03

If you have adolescents who are, you're pissed because they won't get in bed at 10 like they need to, because their body doesn't want to do that. They're fighting their own body's signals. It's not like a rebellion thing for the most part, but you can help them to shift. You know, to counteract that circadian rhythm delay by getting as much bright light as possible in the morning.

Savannah: 15:26

So first thing when they do wake up. If you can allow them or encourage them to sit by an open window, open the blinds as soon as they get up, or even sit outside for like 15 minutes while they eat their breakfast, that's really going to help tell their brain it's morning time, rather than kind of being in the dark for the first hour of the day. As they're getting ready and then getting out of the house an hour later and getting daylight, their brain is like was it morning an hour ago or is it only morning just now? And so that pushes their tired bedtime a little bit, depending on when they get light during the day in the morning. So light is really important for us.

Carrie: 16:06

Yeah, that's really interesting as far as like in the winter. Do you ever recommend I've seen like these devices that they start to they naturally, it's like, so it's supposed to emulate the sun coming up, I think. Have you ever?

Savannah: 16:20

what are, is that. I think that can be super useful. So, depending on, I know some people who live in places like Alaska where it's either day or it's night all day long.

Savannah: 16:30

They really really need things like that that are going to simulate the sunrise and sunset specifically to communicate to their circadian rhythm what time of day it is For those of us who don't have that drastic of a change, but in the winter we do lose a couple of hours of that light. I do recommend that people have you have to be strategic about this, because if you misuse it, you could really mess yourself up.

Savannah: 16:53

But, right, um, if you get a light box that is at least 2000 lux, l-u-x um and I recommend white light, so not necessarily like a red or a blue, but a white, white colored light um, and you just give yourself like 15 minutes of that in the morning If you're wanting to shift your circadian rhythm a little bit earlier, like for your teenagers or even for older adults, if you are, you know, in the geriatric population and you're really having a hard time staying awake until 8pm, and then you're waking up at 4am, refreshed and ready to go, you can actually use some of that lightbox exposure in the evening at like 8 or 9pm, and that will also help push the timing of your release of melatonin and your circadian rhythm when I'm treating a circadian rhythm disorder. But you can also utilize it a little bit during these stages of life where your circadian rhythm maybe isn't so delayed or advanced that you're having a real life issue, but it's just based on your age, shifted a little bit out of place.

Carrie: 18:02

Right, I love that. Now, okay, my kids have like eight sleep gadgets and I mean we've got noise machines, blackout curtains, nightlights, ceiling fans, tents over their beds, down comforters, special levies you thought my list was short, but it went on and some people believe that we shouldn't be using these kind of crutches or things with our kids when they're sleeping. What are your? Do you have any thoughts on this?

Savannah: 18:35

Yeah, I think every kid is really different and you have to kind of notice how they're utilizing it. So something to understand too about sleep is that while our body and our brain regulates it on its own, our brain also has an emergency brake system and that's called our arousal system, has an emergency break system and that's called our arousal system. So if we experience fear or we feel like we're in threat of danger, our brain's going to say, nope, no sleeping, you got to stay awake to keep yourself safe, and that's a really useful tool that's biologically extremely useful for us. However, we used to maybe fear like wild animals or things that really were a physical threat to us. As opposed to in our current state of society. It's kind of shifted to like our own internal thoughts have become threatening to us and we internalize those as threats and things to be feared and things to be feared. So sometimes our arousal system, that emergency break to all of our sleep functioning, gets triggered kind of as a false alarm and we have to do something to help ourselves feel safe in order to fall asleep. You won't fall asleep if you don't feel safe. That's your body's trying to keep you safe mechanism. So if your kids are needing something to help them feel safe, use it. I think that's absolutely fine.

Savannah: 19:54

What gets in the way eventually is if there are so many things that they're using that they are not able to fall asleep in any other circumstance Now for a while.

Savannah: 20:05

If this is just a stage for your kid, you might just adapt your life to that and I think that's perfectly fine.

Savannah: 20:11

But if it's getting to a point where they're older and they can't go to sleepovers, or because they won't have all their right stuff, or they're constantly crawling into bed with you and you are not able to get the rest you need to be a good parent and make decisions for your family then it might be worth making some adjustments and changes and you can do that through exposure therapy.

Savannah: 20:36

So if a kid is afraid of the dark, you slowly practice exposing them to those dark situations or being alone in their bedroom, using like different games or stickers and rewards for spending, you know, 30 seconds alone in their room and then again for a minute alone in their room, and you slowly practice exposing them to these more challenging or fearful situations with a lot of reassurance and comfort and support in the process, doing that really slowly. So those are some different ways to think about it that I think it's absolutely useful to use those comfort, those safety signals and, at the same time, if it becomes that those things are ruling your life and it's at a point where you're not able to function outside of that, then you might consider some other options.

Carrie: 21:28

Okay, I love that. We definitely did a reward system type approach with my daughter with her thumb sucking at night as her comfort, as her dentist was like she's turning five, she needs to stop this and she's been thumb free for a year, so it's a celebration.

Savannah: 21:46

Yeah, yeah, and that sounds like a way that you guys decided okay, these things are are totally fine for my child to use as safety signals. This thing the thumb sucking is going to have a larger detriment that we need to do something about, and so you found a way to adjust that.

Carrie: 22:01

Yeah, yeah, I. So I love that approach and I love that you can have it in a positive and a feeling based version. Like you, don't just stop the thumb or just toss it.

Savannah: 22:14

You're not locking them in the dark room and being like, okay, bye, yeah.

Carrie: 22:19

Yeah, sleep well. But yeah, yeah, and I agree with you that some of these things we have to think about it functionally. Like, if I I mean my son he's able now, he's almost nine, so he can go and sleep at a VRBO I can't take the blackout curtains, I can take the noise machine with us, but definitely my daughter, who is just turned six. She has a harder time at VRBOs because we can't bring all of the gadgets. We can't bring the down comforter and the blackout curtains and we have the noise machine and the nightlights. That's what you get and a stuffy. So, it's true, we have to think about it functionally and trying to expose them. So I'm writing down your tips. I love this. It's super helpful, yeah.

Savannah: 23:01

And it's okay to have a few bad nights, I think, especially when it comes to treating insomnia, which I do primarily, there's a lot of fear around. Oh, I can't bear to have a night of bad sleep, so I have to use all of these things. You know, for kids it's the stuffy and the nightlight, but for adults it might be your Ambien. Or going to bed super early and spending two hours trying to do this wind down routine that you're obsessing over there's things. Or drinking three cups of coffee extra so that you can down routine that you're obsessing over there's things. Or drinking three cups of coffee extra so that you can make sure that you're not tired during the day. Yeah, we don't. It's okay for us to not get a great night of sleep, or even a couple great nights of sleep, Because our drive is going to be higher, Like when we are sleep deprived. It actually means that we're supporting our future sleep. That's a weird concept I know of like oh so I want to sleep better, which means I should sleep worse.

Carrie: 23:58

But I'm not trying.

Savannah: 23:59

I don't try to sleep deprive people, but in the short term it's okay to not get very good sleep because it will actually cause your next couple nights of sleep to be better. So we kind of even as adults, have to expose ourselves to the discomfort of being tired during the day and learning that that's not going to ruin our life and we can usually function just fine.

Carrie: 24:21

Okay, yeah, I was just going to ask you like do you have any tips for these sleep deprived, tired creature parents? Well, okay.

Savannah: 24:31

So with early parenthood you're going to be sleep deprived and that's going to be for a while, so you have to take what you can get. So in those circumstances I do encourage napping and sleeping where you can, as opposed to being worried about messing up your circadian rhythm. For parents who are older and they're not in those early parenting periods where they've got a little bit more flexibility with their sleep, then I encourage people to try and not do a lot of napping, try not to go to bed too early, try not to sleep in, because you actually want your sleep drive to build and get higher and if you sleep on an inconsistent schedule, your circadian rhythm is going to get confused. And if you sleep on an inconsistent schedule, your circadian rhythm is going to get confused and if you sleep in, your sleep drive is going to be lower that next night and you'll have a harder time falling asleep. So it really just depends on your life stage and what's going on for you. But for those newborn or early children, parents try to have a very dim light on during the night. If you have to get up to handle your kid, you're not wanting to super wake yourself up, so keep those lights dim. Try to keep your sleep schedule as consistent as you can, but take that extra sleep when it comes.

Savannah: 25:39

And I think the biggest part here is communicating with your partner. So, if you're a person who's in a partnered relationship, talking about strategizing how you can support each other, which parent is going to do what tasks and when? When it comes to childcare, in the evening or at night, that might mean the nursing parent is primarily waking up with the baby, but the non-nursing parent is going to be the one to do the diaper and do the rock back to sleep. Or maybe you're going to alternate weekends or alternate nights. There's a lot of different creative ways that you can brainstorm how to split up these tasks, but it's really important that we're talking about that Because, if you just assume, well, I'm the mother, so I'm supposed to do all this stuff right.

Savannah: 26:24

You throw yourself into the deep end and then you're having such a hard time that you really can't parent how you want to, and it just creates a lot more distress and self-blame, which is also going to lead to more anxiety and insomnia. It's just a terrible cycle.

Carrie: 26:39

Yes for sure. And my husband. I feel like he used to have challenges falling asleep, but since becoming a parent it has helped him so much falling asleep. But since becoming a parent it has helped him so much. He's so tired he just goes straight out and he nothing can wake him in the night. Now, children coming in crying, which I'm the complete opposite. Our daughter comes in with a nightmare and I'm up instantly like what's going on? Where's the fire? It's crazy how the mom, just the hormones and everything, just kick me out of bed, but he's out.

Savannah: 27:12

Absolutely. That's actually great to hear that. I think that's similar to when someone's experiencing insomnia and they think that they want to get more sleep, but the more sleep they give themselves, the worse the problem gets.

Savannah: 27:24

So, it is good to hear that when you focus on the values in your life, like serving your family, doing your job well, being the kind of person you want to be, if you're doing that as more of your focus, as opposed to how can I get more sleep, then you end up usually sleeping better and sleep naturally just kind of starts coming.

Carrie: 27:44

Yeah, yeah, it's been amazing. He's like 10 years in and very excited to get to sleep again. He's like I haven't had this my whole life. So there's a positive, for it's worth it to get through those tiny beginnings and one day you will sleep.

Savannah: 27:58

That's what I love to tell you it will return.

Carrie: 28:01

Yeah, it's not going to be forever. So when somebody I actually have a random question that jumps into the health areas when somebody works with you and they start out with you, do you look at any health concerns with their or do you have them chat with their doctors about any areas in particular?

Savannah: 28:19

Absolutely so. When I first start working with someone, I'll do a full evaluation before I recommend any particular form of treatment. I'm a behavioral sleep medicine provider, so my treatment is behavioral, meaning we're changing the timing of your sleep, we're changing your actions during the day, we're changing the way you're thinking about your sleep and how you're dealing with those anxiety thoughts at night. But there's a lot of other options. There's a lot of people come to me and they're already taking a sleep medication. Maybe they've been taking it for a long time and they're trying to get off of it. There's also a lot of other sleep disorders other than insomnia, like obstructive sleep apnea, that might need to be addressed with a non-behavioral treatment, with something like a CPAP machine which is going to open your airway and allow you to get oxygen during the night. So there's a lot of different things that I have to assess for. Usually I'll assess for obstructive sleep apnea, which means I'm asking do you ever snore during the night? Does your partner say you snore really loudly? Do you feel really tired during the day? Do you have times where someone has observed you kind of like gasping during your sleep or like you wake up and boom, like you kind of do that awkward gasp. Maybe you remember it, maybe someone just observed it happening for you and are you a person who has high blood pressure? Those are all indicators that you might be experiencing obstructive sleep apnea, which is where physiologically, something in your throat or airway is collapsing. You might just have lower muscle tone based on different hormone levels that you're experiencing, depending on like how much like fatty tissue you have around your neck. That could also impact your windpipe. So you're just not getting the oxygen needed during sleep and that's a really big risk for cardiac disease down the line. So that's really important to assess for cardiac disease down the line. So that's really important to assess.

Savannah: 30:14

For. I'm also asking people if they're having nightmares, because that's going to be also an important part of treatment. If you're experiencing insomnia but you're also afraid to go to sleep so you're avoiding it because you don't want to have a bad dream. Or if you have other physical things going on, like you're experiencing menopause or perimenopause, and that's impacting your sleep. Or if you have a lot of restless legs, like you feel the urge to move your legs. You have like kind of an itchy, tingly feeling and when you move your legs around it stops. These are all things that are important to involve your doctor in the conversation. So I'll assess for all that and then if behavioral treatment is the right way to go, we'll talk about that. But I'll always loop the doctor back in and say, okay, let's tell your doctor this is our plan, see what their thoughts are, if they have any other concerns, and then also involve them in the process, especially if we're going to be having a goal to taper you off of a sleeping medication.

Carrie: 31:08

Did you? I'm trying to remember back a while ago when we chatted. I thought you had mentioned that iron deficiency might be a cause of some pieces as well. I'm trying to remember.

Savannah: 31:20

Yeah, With restless leg syndrome, an iron supplement is kind of a first go-to in treating that, because when your iron goes down I don't know exactly why, but when you have low iron it often results in that tingly urge to move your legs.

Carrie: 31:35

Okay, wow, this is really interesting. I am definitely one of those snoring people in the night, so I get really great sleep, but it's really interesting to think about the oxygen level, so I really need to try to look into the sleep test. I really appreciate this info.

Savannah: 31:51

I agree, because that's so people, people won't think that they have a problem with obstructive sleep apnea because they perceive that they're sleeping.

Savannah: 31:59

They're like no, I slept for 10 hours last night. They don't realize that even though they slept a long period of time, their quality of sleep was very low because, even though they don't remember it, they likely awoke many times because they stopped breathing. So you don't remember most of your awakenings. But if you stopped breathing and then your body has to kind of jerk you back awake, you won't remember it, but you won't get into those deeper stages of sleep that you need, like that deep, restorative levels of sleep. You'll stay at very light sleep because your body wants to keep you breathing, so it'll keep waking you up. So you'll feel exhausted during the day. You might have a lot of headaches in the morning and you might think I don't know why I feel this way.

Savannah: 32:39

I sleep great, but really you're getting a lot of sleep but it's very poor quality. So if that sounds like you or any of your listeners, please talk to your doctor about it. This can be assessed. You know, they'll ask you a couple of those same questions that I just mentioned and then they might send you for a sleep study, which can be done either at your home or at a sleep lab and that will record your levels of blood oxygen throughout the night, and so that's really important, because it's going to save you a lot of energy and headache in the future, as well as really lower your risk for heart disease.

Carrie: 33:13

Okay, I love that. Thank you so much for sharing that info. I'm writing down sleep study for Carrie. Mom needs to take care of herself too. So you mentioned nightmares and being scared of going to sleep. You had also told me at one time there's a difference between nightmares and night tears, which I found so fascinating. I didn't know there there are different pieces. Can you tell us more?

Savannah: 33:40

This is really cool to think about. So there's lots of different stages of sleep. There's REM and non-REM. Rem stands for rapid eye movement, and that's a stage of sleep where most of your dreaming, as well as nightmares, happens. During that stage of sleep, your brain is functioning almost as if it was awake. Your brain waves look very similar to your awake brain waves, so you're doing a lot of like re-imagining scenarios. Your brain is categorizing information. It's replaying things you maybe have experienced. It's trying out new scenarios and learning from that. See, okay, what if I did this? What if I did this? It's doing a lot of learning.

Savannah: 34:17

During that time, during that stage of sleep, you have a muscle atonia, which means that you're basically paralyzed, because if you weren't, you would be up and acting out all your dreams and that would be really dangerous for you. So that's normally when sleep and when dreaming and nightmares happen. However, there are parasomnias, which is where abnormal sleep behavior is happening, not during REM, during the non-REM stage of sleep, when you're not having that muscle atonia. So your brain is very, very deeply asleep. Your brain waves are very slow, so it's not acting as if you were awake. However, your body can move and so if you experience a night terror, you might get up, you might be screaming, you might be acting extremely distressed, your eyes might be open, you might be walking or running around. Parasomnias also include sleepwalking, sleep talking, behavioral sleep disorders, like if you were to get up and, you know, be violent during your sleep. These are all things that happen during that non-REM stage. What's important about these is that it's more likely to happen when you're sleep deprived. There's a genetic component to this. If you have a family history of it, it's more likely for your kid to experience it. But usually this is more likely to happen in the like five or six year old school age. That's when a lot of this stuff is happening. Usually you grow out of it by the time you get to early adulthood.

Savannah: 35:52

But it's important to know the difference because if your child is having a night terror, it's going to be really distressing to you. You're going to be panicking and feel awful, but your child is actually not experiencing any distress. So this is a thing you're witnessing, but they are not going to remember it. They're not going to have any memory of feeling distressed about this.

Savannah: 36:13

If your child is having a nightmare, if they wake up and they tell you oh, it was so scary, and they're crying. That's distressing to them because they remember it. So if it's a nightmare, you can go comfort them and wake them up and rock them back to sleep and talk about it. If it's a sleep terror or a night terror, you don't want to wake them up because that will actually prolong the episode, it will make it last longer and it will further sleep deprive them, which will make it more likely for them to continue having those night terrors. So if that's something your child is experiencing, where they're waking up or they look like they're waking up during the night and they're screaming and crying, but then if you just leave it, after 20 minutes or so it just stops and they just fall back asleep or you're trying to talk to them, you're waving in front of their face and it's obvious that they are not interacting with you.

Savannah: 37:03

You can tell that they're asleep still. If that's happening, don't wake them up. Keep them safe, keep them from running into something, keep them from you know going outside. Just watch them and be observant and keep them safe and let it end on its own. If they fall asleep on back to sleep on the kitchen floor or on the couch or whatever, then just move them back to their bed and then try over the next couple of days to help them get a little bit of extra sleep. So if maybe they skipped a nap, try and make sure that nap happens. Try and make sure that they're going back to a normal sleep schedule that works for them. So it might be more likely that when their schedule gets really disrupted, that's when that episode of a sleep terror might happen.

Carrie: 37:48

I think it's really interesting that you bring up the five to six year old range. There's so much stress that goes into their bodies when they're at that age. I know both of my kids went through these sensitive periods during those ages where they didn't want to wear socks, where they didn't want their hair brushed. They just their body felt very taxed. It was usually we were moving from preschool into kindergarten. We're learning to read, so there's a lot of stressors being put on their body at that time. So I find that really interesting and it just kind of overlaps together. And I did have a follow-up question. So my daughter, she had her first sleepwalking experience a couple of months ago and we didn't know it was a sleepwalk. We thought she was just going in to use the restroom. But we went in, we're like what's going on, are you okay? And she just started crying and bawling and we didn't know what she said. How did I get here? So do you have any tips for these?

Savannah: 38:46

types of moments for us. Yes, I would say comfort her and explain to her that while you're sleeping, your brain is doing lots of processing and it might've just been trying to play out a scenario Like just explain to her that's a normal part of your brain's functioning and that when you wake up, go back to your bed or make sure you're safe, do a quick check and say okay, I haven't lost any fingers or toes. Do I need to get some water? Do I need to go back to sleep? And really that's an indicator that they're needing to get more sleep.

Savannah: 39:16

So those episodes are happening more frequently when they are sleep deprived. So basically, if that happens, that's just an indicator to you as a parent that we need to go back to making sure that the sleep schedule is really tight and that they're getting all the rest that they need.

Carrie: 39:30

Okay, and if I see her walking around, do I just lead her back into the bed? I don't have. I try not to wake her up, is that?

Savannah: 39:37

also part of it too.

Carrie: 39:38

Okay.

Savannah: 39:39

Um it it. Whether you wake her up or not, it isn't going to be a huge deal. Um, I think a sleep terror is a little bit more like.

Savannah: 39:49

They're a lot more um aroused during that time like uh, physiologically, so that when you try and wake them up from that it just kind of extends the episode. Sleepwalking is a little bit less intense, so just guide them back to bed. If they wake up, no big deal, Just comfort them, Say oh you were, you were out here walking, your brain was just trying to practice for tomorrow. Let's go back to bed.

Carrie: 40:10

Yeah, that makes sense. Okay, I'm glad I didn't do the wrong thing. Mom guilt over here. I also told my husband. I was like maybe we need to put in some locks on the doors if she's sleepwalking in the night and we don't hear her.

Savannah: 40:25

I do think that's valid, that whenever there's a parasomnia where there's behavior happening while someone is asleep the primary thing you want to do is just make sure they're safe. So if it might be happening while you're not aware of it, then make sure that all the surroundings are safe when you guys go to bed, you know that all the doors are locked, you don't necessarily have to lock them in their bedroom. Oh no, no, unless, it's a really severe case no.

Carrie: 40:49

No, I just meant the doors on the house.

Savannah: 40:52

Yeah, absolutely yeah, just take those basic precautions and, you know, just try and keep an ear out. I know, as mothers, we usually do keep an ear out.

Savannah: 41:02

Yeah, yeah, just try and kind of keep note of it, especially if it tends to, if you see a pattern that it's tending to happen around the same time of night. For sleep terrors in particular, part part of potential treatment strategies is to wake the child up like half an hour before the sleep terror is going to start. If it's always like at the same time, you actually wake them up before and then have them go back to sleep, because it'll change the stage of sleep that they're in. They'll hit a different stage.

Carrie: 41:34

Okay, that's super helpful and you have so many techniques. Can I ask, when you work with clients, what does that look like?

Savannah: 41:42

Yeah.

Savannah: 41:43

So after we do that whole evaluation that I just talked about, if we decide that behavioral treatment is the best course of action that really fits with them and what they're looking for, then we usually meet somewhere between six and eight weeks and we make a lot of changes, first talking about how sleep works and doing a lot of this education so that they can identify for themselves like, oh, if that's how it works, it makes sense that me sleeping in is actually not helping.

Savannah: 42:11

So we make a lot of changes that are just minor things but that are going to maybe feel really difficult. Just minor things but that are going to maybe feel really difficult. Like when you're really sleep deprived. It's hard to get up on a Saturday at six because you have to get up for six at six for work every day. But keeping that schedule consistent is really going to help reset your circadian rhythm. So we do a lot of things like that that for some people might might seem obvious or maybe oh, I've read that before, but it's really hard to do it on your own.

Savannah: 42:42

It's uh, it's hard to keep the faith that it's going to work because you do it for a night or two and then you're like, oh, this isn't working, I'm exhausted and you want to give up and really you've got to do it for like two weeks straight and then you will see a huge change. But it kind of sucks during those like that first week.

Savannah: 42:59

So that's why doing it with a professional who's going to be able to help you stay motivated and help you troubleshoot when barriers are coming up. I think that's primarily what I do with people is helping them retrain their body and brain to sleep as it as it needs to, as it already knows how to do, and help them identify the ways that they are getting in the way that they didn't realize they were Um, and just helping them stay confident and motivated throughout the process. For a lot of people, anxiety is a big part of their sleep problem. Maybe initially they had difficulty sleeping because they got a new job and they were really excited about it. You know the schedule changed so they had a few weeks of poor sleep, but then they started thinking, oh my gosh, what if I perform poorly at my job Cause I'm not sleeping well?

Savannah: 43:46

And then they started hyperanalyzing how many hours am I getting every night? Let me check my tracker, Let me check it every day, multiple times a day. And then they started feeling anxiety creep up in their body when it gets dark out, because they're like oh no, is it going to be a bad night again? Am I going to lay awake for two hours. So that anxiety piece creates arousal in our body and our brain and it does that emergency brake system that we talked about of giving people education and helping them find out for them in particular, what are the things that are getting in the way of their body's normal sleep rhythm. And then how can we go around that, how can we find a new way to respond to that? With anxiety, it's okay. Let's identify some of the thoughts that your brain is interpreting as threats and keeping you awake to defend you against the threats, and find a new way to respond to those thoughts and to calm your body down so that it feels safe enough to go to sleep.

Carrie: 44:43

Wow, there's so much mindfulness in this. I love it. It's great.

Savannah: 44:48

There's a lot of mindfulness, yeah.

Carrie: 44:50

Yeah, you are a wealth of sleep knowledge, savannah. Thank you, yeah.

Savannah: 44:55

What's fun for me is that it works so quickly. Like as soon as I give that sleep education, they're like oh okay, well, then I should totally do this. That makes sense. Yeah, we tweak it for a couple of weeks and then things change so fast. So that's really gratifying for me, especially when people come to me who've not been sleeping for decades. Oh man, we can get off that sleep med. They never thought they'd be able to sleep without. It's just the best feeling.

Carrie: 45:23

That's amazing. That's such growth. I love that empowerment. So, savannah, can you tell us how we can find you?

Savannah: 45:30

Yes, so you can go to my website. There's a lot of different guest podcasts on there that you can hear more about my work. You can read some of the articles that I've written but also just get a better sense of does this feel right for me? And on my website you can book a free consultation with me. If you have more questions about working with me, or if you even need sleep treatment, I'm a great place for you to just kind of bounce some ideas and brainstorm for you to figure out what your next steps are. That website is wwwsavannahypeslcswcom. So that's two N's in Savannah and then two H's back to back for end of Savannah, first of Hypes H-I-P-E -S.

Carrie: 46:12

Yes, and I'll include it in the show notes too, so that way it's linkable.

Savannah: 46:17

Thank you so much. I'm excited to hear from people. I love collaborating and I love supporting.

Carrie: 46:22

Yeah, thank you so much for being here today. I've learned, I've taken my notes and I'm ready to try to check into a sleep study for myself. You've really empowered me in my sleep, so thank you so much for joining us today. Thanks. If there's a parent that you think this could resonate with, please be sure to share it with them, so we can all benefit from each other. Follow Heart to Heart Parents Podcast on Instagram for daily fun ideas and tips. Happy week.