Episode 28: The Gift of Sleep
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Sick of the fatigue and fog? Fed up with the unpredictable flares? Hangry from the super restrictive diets?
Hello and welcome to the Crunchy Allergist Podcast.
A podcast empowering those who, like me, appreciate both a naturally minded and scientifically grounded approach to health and healing.
Hi, I'm your host, Dr. Kara Wada. Quadruple Board Certified Pediatric and adult allergy immunology and lifestyle medicine physician, Sjogren's patient, and life coach.
My recipe for success combines anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine, and mindset to harness our body's ability to heal.
Now, although I might be a physician, I'm not your physician and this podcast is for educational purposes only.
Kara Wada, MD: Welcome everyone back to the Crunchy Allergist Podcast.
I am so excited to welcome our special guest this week.
Dr. Afolabi Brown is a triple board certified sleep medicine physician who is passionate about helping people discover the gift of sleep as a superpower.
Dr. Brown is a speaker, an educator, a writer, and the founder of restful sleep MD, where she helps busy professional women and their children prioritize sleep.
Not only to achieve their optimal health, but also thrive and live to their fullest potential.
As a physician in practice for over a decade, a mom of two, she fully understands the impact of sleep deprivation on our mental, physical, and emotional health.
As a result of this, she has dedicated her career to helping professional women be their best selves.
She does this through speaking coaching courses and programs focused on educating and empowering busy professional women to make sleep a priority as a critical pillar of their health.
She's a member of the American Academy of Sleep Medicine, the American academy of Pediatrics, and the American Thoracic Society.
She's also a medical advisory board member of baby center, as well as the expert advisor board of project sleep.
She's a frequent speaker at various conferences, summits workshops, and association meetings, both nationally and internationally.
And I am so excited because as we were chatting before we hit record as a mom of three with Sjogrens and a teething baby and a four year old who won't sleep like.
I think this is a match made in heaven. I am so glad you were here and joining us today. And I have loved following your work and have shared your resources with our Crunchy Allergist Email list too.
So thank you so much for joining us, Dr. Brown, and I would just love to hear a little bit about your story.
How did you find this passion of yours?
Afolabi-Brown, MD: Oh, thank you so much. Thank you. I really appreciate and I'm just, I'm such a fan of your work too.
And I saw your email cuz I'm I hopped right onto your email. I'm like, yay. So thank you for doing that and helping me get the word out there and all that. So yeah.
How did I land here?
I think it, it was just me struggling. And really finding that I didn't have to stay in a place of helplessness to my sleep.
Like I cannot be a victim of sleep deprivation and being able to really go through that and come out on the other end to say, Ugh, that feels awful.
Imagine thousands and millions of women like me trying to just be their best selves and struggle.
So that really was what spurred me on.
And also, really when it came to restful sleep MD it started from me just seeing patients in my clinic. I'm a pediatric sleep specialist as well.
So I am, going through those patients, snoring or asthma or allergies or reflux interrupting their sleep and then the moms are like, yeah, I don't even know how I got here. I don't know how I drove here. I'm so exhausted.
Every time he wakes up coughing, I'm not sleeping or runs for another hug or whatever.
That got me going. Wow. Of course, if the kids are not sleeping, no wonder the moms are not sleeping too.
And with Restful Sleep MD, my focus is on women and their children because they are, they could be sleep disrupted as cute as they can be.
Kara Wada, MD: Ah, they're so intertwined.
Afolabi-Brown, MD: Yeah. Yeah, absolutely.
Absolutely. And then the outcomes of the day, right?
It's a lot of it.
We talk about the fact that you are asleep for a third of your life, a third of your life.
So there's a reason that has not changed, even with culture, of course, with society and things with slowly and surely trying to shorten that, but we needed.
And so we need to know how to do it well to make it work the best for us.
So that the remaining two third is just out of this world,
Kara Wada, MD: A third of our lives. I don't, there's nothing else that we really do. Yeah. Longer.
Afolabi-Brown, MD: No, not continuously. No. Cause if you think about it eight hours.
In a 24 hour period, of course for children, it's much more than over time and there's a reason why they sleep so much because their brains are growing.
It's so vital to development, to learning to their mood, to their immune system, emotion regulation, adaptability, all those things.
And they're learning all those skills, but they need sleep to help.
And then of course with time we need less. But we still need it and we need good quality sleep.
Kara Wada, MD: Yeah. We were talking a couple weeks ago with author Donna Jackson Nakazawa just about how rapidly our brains do develop and evolve over the course of childhood.
And what role does sleep then have in our health?
If you could talk a little bit more about that. What are what's its purpose?
Afolabi-Brown, MD: Yeah, absolutely. When I, one thing I say is sleep is not just a cure for sleepiness.
It does cure sleepiness, but beyond that it has so many functions even when you start from right from the top, all the way down.
So there's a system that was discovered recently, which is called the lymphatic system.
So gene lymphatic system. It was just incredible.
This is pretty recently right. Less than 10 years ago.
And so similar to the lymphatic system, which helps, of course, rid of waste products and things, our brain accumulates waste products.
And so sleep is when that system really kicks in.
So essentially wash off those deficits and studies I've shown some of those deficits include things like amyloid beta, which is one of the things that's been found to be associated with Alzheimer's and things like that.
So even from that alone to start and then we talk about our physical health, our cardiovascular health.
Hormone regulation really is impacted by our sleep, our metabolism as well. One of the things that we know is even our immune system is regulated in sleep, right?
So interestingly, of course, we're in COVID pandemic and we talk about like vaccine response is tied with sleep.
And We've done studies where they've compared people who had suboptimal sleep with those who had the right amount of sleep and looking at their immune system and looking at how they responded to vaccine.
The vaccine response for those who were sleep deprived was as low as 50%.
Or even your susceptibility to cold, to the common cold, where they've, graciously giving people and compared those who had good sleep versus who didn't.
And then, there are other things like for me, one of the things for children, right?
Learning a lot of symptoms we see with sleep deprivation is so similar to ADHD.
And even we as parents, we experience that where you just feel like your attention is so divided or your focus is off or you feel like you're living in a fog, all those things.
Yeah, I know, right? It's like ...
Kara Wada, MD: There actually, maybe some out here, but.
Afolabi-Brown, MD: I know. I always say we are exactly like that two year old in the grocery store who is throwing the biggest tantrum because they cannot have a lollipop and all it turns out is because they didn't nap.
That's how we feel, except hopefully we are not throwing ourselves on the floor in the grocery store because your mood is also affected by sleep.
And we know that mental health is at an all time high, right?
A lot of anxiety, depression, unfortunately, suicidality as well.
So emotion regulation is also impacted by our sleep. So literally from top to bottom at the end of the day is impacted by sleep.
Kara Wada, MD: I think I, I was never one growing up through school to try to pull an all-nighter.
It just, wasn't my jam. That was my sister actually.
But what I realized during, in particular, in medical training as a medical student, and then as a resident taking 24 -30 hour call.
I felt like I was physically ill those days after felt hung over, exhausted, my body hurt.
And I would end up in, in thinking back to, my sister too, like we would get either kink or sores or end up with the, a colder flu in those, days or weeks after pulling an all nighter.
For whatever the reason whether it was medical training or a college exam.
Afolabi-Brown, MD: That is so true. It's so tightly connected. Yeah. It is. And, and decision making as well.
Unfortunately, medical errors, road traffic accidents. Your response time is off, right?
You just feel slow.
And so unfortunately there's increased risk of that medical errors, increased risk of road traffic accidents, and things like that, even with sleep.
And as well as, like you said, the soft susceptibility to come on viruses, which you typically should, would've been able to ride through.
Kara Wada, MD: Yeah. And one of the things I worry about, or, I try, I work on my worrying, but viral infections we know are a big cause for flare ups of autoimmune conditions and possibly increase susceptibility.
And so your ability to fight those off is really critical for, I think, more than just the obvious of avoiding runny stuffy nose, sinus infection, asthma exacerbation, those sorts of things that we may see related to them as well.
So as as a busy professional mom of three young kids.
What kind of advice would you give to me or, our listeners that fall into that boat too?
Afolabi-Brown, MD: I think I would start with first, understanding that this is not something that we can continue to get away with.
Like we have to prioritize sleep for our kids. We do it for our kids.
At least we try then for ourselves, we fall off the bandwagon, but we do matter.
And honestly, I feel there have been times when I have not slept.
And I know how I respond to the kids. They don't change. They do. They just themselves.
And I've seen my response after a night where I didn't get enough sleep versus a night where it's the same, it's the same thing they're doing.
They're not, whatever the kitchen's a mess or whatever, it's the same, but it's after a good night, get out the door exactly in the car without bloodshed.
You know what I mean?
We have to, the same thing, it's, it may sound cliche, but we cannot, you cannot pour out of an empty cup.
So you have to make sure your cup is filled, too.
And also the best way you can do that is to strategize and make sure you prioritize their sleep.
Cause when they're sleeping, you can sleep.
And if you have, depending on what age your children are.
Not everybody has to sleep train their children.
Some children are just like good sleepers.
They just show up and they're like sleeping well, and that's no problem.
Most kids may need a little bit of guardian I, I didn't either.
I didn't, but some people are.
But most kids need a little bit of guidance and really teaching them as early as possible.
Honestly, I always say there's no, you can't, it's not too late. It's not too early.
Of course, within the first few months of life, no, don't bother trying to, they just don't have that like object permanent.
They don't, they can't, and they're really sleeping around, around the clock at that time.
But as they get a little bit older, you wanna start to promote sleep independence and studies have shown that if you are able to incorporate and essentially sleep train, or help them gain that, those skills from when they're young, it really helps them on the long run.
And for kids who maybe they, it was just like, like lock of the draw when they're young.
Sometimes those sleep issues do persist.
So just try to invest in that time. It may be uncomfortable, but you are teaching them strategies that would help them on the long run the same way if we're teaching our kids or they're learning how to walk, right?
Your one year old or nine month old is walking. If they trip, you're not gonna be like, you're never walking again.
I don't want you to hurt yourself.
No, you're gonna be like, okay, you get up. We'll do it again.
So this, I think that's the same approach that we have to take where our sleep, where our children's sleep is concerned.
And it may be, you may have had a bad night.
Okay. We'll try again tomorrow. And eventually, usually they say it takes 21 days for a habit to set it.
It may not, it doesn't even have to be up to 21 days actually for our kids when it comes to helping them to promote that sleep independence.
So when you cannot look at it from that, like I am teaching you skills, that's really gonna go with you to help you with your learning, to help you with your growth, your development, your mood.
That's, let's go. Let's do it.
Kara Wada, MD: What are like the conditions that, that optimize sleep.
Afolabi-Brown, MD: So various things. I think one, it depends on what stage or age or phase of life you're in.
Things that I feel help really well for kids and also for ourselves is having a routine and consistency. I think that is so key.
The reason why is right, we have that circadian rhythm, which literally is aligned to, the environment, it's aligned to our light and dark cues.
And lights is one of the strongest cues of our circadian rhythm.
So when you are able to your, either your wake up time to some sort, you're essentially doing this and you're anchoring your so rhythm.
So your body's not just free flowing, wondering when we're gonna go to bed when we're gonna get up, and really trying to keep that schedule as consistent as possible.
I think that is one thing.
And then the other thing is having a routine because one for our kids, again, it's queuing their bodies that it's time for bed.
So when we are done with dinner and we have a little bit of quiet time and we're putting away the devices, and then we are going upstairs to have that bath, that warm bath, which has two things, two benefits.
It's helping with just cleaning the grim and dirt , especially in the summer until it's dropping their core body temperature and our core body temperature drops for us to fall asleep.
So you get that benefit, plus it's calming and relaxing.
So having that routine again, it's queuing them for sleep.
And then also making sure that in that room environment, that bedroom is dark, because again, that light response absence of light is what our brains respond to by then producing melatonin, which is the sleep hormone or the hormone of darkness.
So essentially you're setting the stage with a really nice routine, a dark room. Quiet room.
If you, if your child doesn't like quiet, then having a white noise machine is good.
And also making sure that room is also cool, especially in the winter, sometimes we wanna keep them really nice on bundle, but when they get sweaty, that actually impacts the sleep quality and actually makes it harder for them to stay asleep.
So those are just some things I think is really in terms of setting the stage promoting good sleep
Kara Wada, MD: And what a, a beautiful experience to turn that into like we admittedly we have not done great with the nightly bath in our house for quite some time, but we have been able to incorporate a little story time and and I get the most conversations with, especially my four year old at bedtime.
Yes. Sometimes I have no idea what she's referring to, like it's hard to follow, but really seeing how, how cool these little humans are .
Afolabi-Brown, MD: I know, I love that. And you know what that's so when I usually talk about the components of a bedtime routine there usually I think about three or four, I'll see, depend on how many I remember.
One, I would say is of course nutrition.
So usually at dinner or sometimes if dinner is earlier, you could do a little bit of a snack.
The second is hygiene.
And the hygiene is brushing teeth using the bathroom, if you incorporate a bath or not, whatever, if it's every other day or two days, whatever, that's fine. So that's hygiene.
The third is bonding, that emotional connection and so how does that show up?
It may show up in maybe singing a song, reading a book, or just cuddling with them.
And I feel as for me as a mom, it's also so therapeutic because it's usually the time when I finally also get to slow down.
Exactly. I'm just hearing them go.
Because they love and they, at that time their guard is down as well.
So you can learn so much and it just really does promote that emotional help for them at bedtime. So I love that you mentioned that.
Kara Wada, MD: The thing that I'm also curious about and this is switching gears a little bit, but as an allergist, I prescribe a lot of medications that I know can affect or impact sleep in particular antihistamines.
As allergists, we actually hate diphenhydramine, which is bene Benadryl, which is a very common over the counter sleep aid.
It's what's in unison. And I'm curious, what your take is on some of these, easily obtain generally relatively safe substances that are out there that can promote sleep.
Afolabi-Brown, MD: Yeah. Great question.
So one of the things I usually will say is that you cannot supplement or sleep aid yourself to rest full, but for every situation we have to consider.
So I'll give you an example.
I had a client whose child was just like always waking up. We couldn't figure it out.
They had a phenomenal bedtime routine.
They did everything, whatever they, no devices, all that, but the child was just always waking up and it was around like one or two years old.
So really couldn't really, had allergies. I were like, okay, is this, is he very sniffly? Is he sneezing at night?
Does he have a post nasal drip? No.
It turned out he had pretty significant eczema and that was a sleep disruptor.
Yeah. And so the way we tested it, I think she was like, oh yeah, he was, I thought he was a bit more itchy and I gave some, Benadryl and of course he slept well.
And then we're like, okay. Yeah. ofcourse.
It's the date end, but beyond that, I'm like, He does have allergies. Does he have eggs? And she's yeah. And he's scratching himself.
So then they were able to really get him on a very rigorous, like skincare regimen.
I guess who slept through the night now, so there are situations where, if you do need medication for, like you said, if you need a dry agent, because you have this nasal, this drip that's bothersome, or something of that sort then, then that's fine.
But if the indication is we're using it, forcely.
I've seen it in some situations work the interim, but then on the long term, most of the time you really start to lose the benefit.
So always again, coming back to why I think if for some kids who again, feel so, so congested, really giving them to help them to be comfortable briefly for a very short period of time is fine.
But really making sure that it doesn't become this habitual thing that we are reaching out for, because I've seen that paradoxical effect as well.
You're like, who is this?
Kara Wada, MD: Yes. I recall it's been several years now, but it was a post from a fellow mom who was contemplating using a little Benadryl for a flight.
Not gonna pass judgment, but there was discussion that there are some folks that when they take in particular diphenhydramine or Benadryl, they will have this opposite reaction where they not are not sleepy, but they instead are bouncing off the walls.
And I think it just it's a good example of just saying that every, although we are all human and we all function relatively similarly, there are very, there are unique aspects to each of us and, when we take or use things that we may respond differently than yeah.
Than others. Absolutely. And to just always proceed with caution.
Afolabi-Brown, MD: No that hit the nail on the head. Exactly.
Kara Wada, MD: So I am excited to make sure that folks have your information, we're gonna make sure that Restful Sleep MD and all of your links are in our show notes.
I'm curious if you have any other kind of parting advice or thoughts or wisdom you would love to share with our Crunchy Allergist Community.
Afolabi-Brown, MD: Yeah, I thank you so much for having me.
This has really been such a thrill. I think one of the things I would say is, really no matter where you are on your sleep journey, I want you to know that it can get better.
Really it comes from a place of just setting that intention to prioritize, sleep and understand why you're doing that.
So whatever that looks like for you, if you are finding out you are a bit more, you feel more impatient, you're tired of living in a fog, or you are noticing that you are, your kid is a bit more cranky because they're not getting enough sleep.
So trying to set, attach that goal of, okay, I wanna prioritize sleep with an outcome that you want.
I wanna be a better version of myself.
And then just start from where you are and where you are may be that, you know what?
I have people bombarding me with emails and texts and phone calls at 10:30 PM.
So today after 10:00 PM, I'm gonna make myself unreachable except for the people on my VIP list.
Meaning my, my family, my loved ones.
I'm gonna set those boundaries. Yeah. And that may be all you need to do. That's a good place to start.
And then you just work from there.
Kara Wada, MD: That that is actually one of the, my new's resolutions that I've stuck with.
I had to put because I do take call and thankfully, we don't get called a whole ton in the middle of the night, but I have our fellows on the VIP list, my parents, of course, but otherwise you're gonna get that little automated response of, she has do not disturb on I do need to do better though.
I had moved my power charging cord away from my nightstand for a while.
It somehow made it,
Afolabi-Brown, MD: it made it way back. It's grow,
They do grow legs.
Kara Wada, MD: So that is my intention, I think, after this discussion is because I know, it's, sometimes it is one of those things that it's okay we kind, in some ways know what we need to do.
Like some of it. Yeah, absolutely having expert guidance can be incredibly helpful when you hit, especially when you hit those sticking points, but it also can be so helpful just to have that accountability, that reassuring coach, like figure to say, okay, Let's get you back, let's, let's empower you to do this.
That is so amazing that you're providing like that education and that empowerment and something that is so incredibly critical to our health and healing. .
Afolabi-Brown, MD: Thank you. Thank you so much. I, and that's my mission, really to help because it's like you said it's not so much of not known.
We all know, we all know we need to eat our vegetables. We need to exercise. We need to sleep. Like how does that happen in this life that I have, with two kids and all the other things, my obligations in that sense, my, All my dreams, my as how do I fit it all in?
And so I think that's where that guidance is helpful.
Kara Wada, MD: Yeah. Thank you so much, Dr. Brown. I very much appreciate you joining us and I want to remind everyone to go follow Dr. Brown now over on Instagram at restful sleep MD, and we also will link to her website and Instagram and everything over on the show notes as well. I so appreciate your time, your expertise.
And I look forward to talking again very soon.
Afolabi-Brown, MD: Yay. Thank you.
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