Why Women’s Sleep Falls Apart

As a woman, how do these hormones and sleep go together?

And that's what no one really connected the dots for us. The importance of REM sleep specifically is where we really form those bonds of emotional connection. We're moody. That during REM sleep is when hormonal regulation occurs. That's actually when we balance and reset those neurotransmitters. That's why we look at sleep from a neurological perspective. What is going on in your brain during menopause, during perimenopause, during your period at 15? Like, what's going on there? So we're going to look at sleep across all the generations. So how these hormones affect our REM sleep is what we really, really need to be looking at.

So today we're talking about something that almost every woman has experienced, but Very few have actually ever had properly explained. So why does sleep fall apart before your period? Why does anxiety spike in your 20s and 30s even when you're doing everything right? And why does postpartum brain fog feel so real and so frightening? And why do 3 AM awakenings suddenly appear in perimenopause? And why are so many women told it's stress, it's just hormones, it's aging? What if the real conversation is actually about REM sleep stability and women's brain health? It's a whole new idea and concept to me. So I'm super excited to dive into this today with you, Nyree, because as we were kind of talking about before we started recording, women's health is overwhelming. And I know that you're focusing on women's health in March. So today we're just gonna kind of dive in and really unpack what's happening neurologically across the female lifespan and why restoration, not sedation, may actually be the missing piece. So how are you doing today?

Wonderful, Layla. Thank you so much. Spring is among us, time for restoration and refreshing and restarting. So we're definitely going to take that perspective on sleep and women's health.

Absolutely. And we talked a little bit about REM sleep in the previous episode as well, but Why is REM sleep particularly vulnerable across the female lifespan in particular, especially from menstruation to menopause?

There's so many different reasons, Layla. Just like, you know, we, we, we said before that, you know, sleep is so intrinsic, right? It's not just— you can't just fix one thing. You have to fix some, you know, multiple things along the way and/or at least identify what's affecting those those things. Sleep is the secondary effect to every problem, right? So, we have to rewind and get back to what is the real problem. You know, with sleep, we've mentioned before, there's 2 sleeps. There's brain and there's body sleep. A lot of the medication out there focuses on, you know, sleeping, resting your body, but nothing out there before ProSomnia Sleep had the ability to restore your mind, right? And your brain. So that's why we look at sleep from a neurological perspective. What is going on in your brain during menopause, during perimenopause, during your period, you know, at 15? Like, what's going on there? You know, so we're going to look at sleep across all the generations and how it affects women.

Absolutely. And it's so interesting, especially as a woman, to really think about how it changes so much. Over the lifespan. There's so many cycles of, of life for us women, right? Menstruation, periods, now perimenopause, which is new to me. I recently heard about this for the first time, and menopause. So it's so interesting to really see how things change over the course of your lifespan.

As a, as a woman, how do these hormones and sleep go together? So, you know, the importance of REM sleep specifically is where we really form those bonds of emotional connection. You know, we're moody, right? That during REM sleep is when hormonal regulation occurs. That's actually when we balance and reset those neurotransmitters, right? And so REM sleep is almost the mediator to all those things. So how these hormones affect our REM sleep is what we really, really need to be looking at.

Absolutely. And even talking about moody and all these hormonal changes that also coincides with menstruation and periods, right? And I think it's common for women to really notice worse sleep before their period. So what's actually happening neurologically during that phase, especially as progesterone drops?

So it, you know, to keep this as a podcast, not a webinar. I do, you know, as women, you know, I will say we will just focus on, like I said, it's a network of 9 to 10 neurotransmitters that affect our sleep. But as women, what actually the main neurotransmitter hormones specifically that we'll focus on is progesterone, estrogen, oxytocin, and cortisol, and how those affect our sleep. So during early, right before our When they say we're PMSing, right, our premenstrual syndrome, what's actually happening is progesterone and estrogen really work together in tandem. So if they're high, they're high. If they're low, they're low. They're both, they really kind of go together. So progesterone and estrogen always seemingly, if one's up and one's down, that's usually how it goes. But usually right before our period, there's a sudden drop, right? Progesterone in itself Is a direct modulator of GABA, right? GABA is a neurotransmitter that makes us sleepy, one of 3 that make us sleepy. So how estrogen and progesterone affect GABA is what we're really looking at, our ability to get sleepy. So progesterone is very, very high right before our period, right? So it's our direct sleepy drug. That that's why we sleep. And side note, progesterone— progesterone is a precursor to estrogen, right? So you need that to kind of break down into estrogen, which also has a sudden drop, which contributes to the depression and the moodiness that we feel right before, right? So if there's a sudden drop in all those hormones, we're very, very sensitive as women. You know, to those hormones because we only have them, right? So, you know, we, when those are off or dysregulated for what, for, for our period, you know, that's what happens. And so we start, we do, we exemplify the, the long phase of being sleepy and then all of a sudden our period comes and we can't sleep, right? Because once our, you know, the whole purpose of those is for reproduction and fertility.

Mm-hmm.

Right? So when all those other things occur, it's a secondary effect is our sleep.

It's just, it's so interesting to hear the breakdown of it because this is not something that we're ever really taught unless you really dig deeper. And even from looking into some questions and research for the podcast today, I learned that young women actually experience Higher rates of anxiety and insomnia, which I had no idea that was more common in younger women. But how does REM sleep actually interact with emotional regulation and fear processing? And could REM instability actually sustain anxiety at all?

So sleep in general is a cycle. It goes in waves, right? You have 5 to 7 waves of sleep throughout the night. The later waves, wave 5, 6, and 7, is when REM sleep usually occurs. So GABA has to be pretty high. So that's what makes us sleepy. So we have to be asleep for at least 2 to 3 hours before our bodies actually get into REM sleep. Those later evenings, those 2 to 3 AM awakenings that occur affect our REM sleep because that's usually when our REM sleep occurs. So now, not only we're on our period, we're cranky, we're groggy, we're moody. Because that emotional regulation and consolidation couldn't occur or it was fragmented because of our inability to stay and get into a REM sleep state.

Interesting. And I don't know if that contributes to brain fog as well, if it correlates directly, but with postpartum, brain fog is incredibly common. But what's actually happening in the brain? after estrogen withdrawal? And how does fragmented REM impact memory and even cognitive clarity?

Absolutely. So the main thing with the postpartum, you know, you've had a baby, your hormones are all over the place, estrogen and progesterone, they really are more for menstruating. But during our pregnancies, what happens is it's the oxytocin. And so it's that oxytocin That ability to bond. You know, we have a new baby. You know, it's ongoing throughout our life, but it's very, very high during pregnancy, right? We're bringing life into this world. You want that to be very, very high, and it is. But as soon as the baby is born, there's a sudden drop, right? Usually when we go through these rapid swings in emotions, it's due to a rapid swing of one of our sex hormones. And specifically with pregnancy and postpartum, fog, it's oxytocin. And the role of oxytocin is it shifts. And when it shifts, it also— there's an estrogen crash. And then there's this sudden like REM sleep inability to go to sleep in general, right? And then the oxytocin crashes, but you still have this protective mechanism in place for this new baby that's here. It's just so many hormones are all over the place.

Yeah.

So you have, in addition to all the, that now you can't sleep, right? And so your REM sleep is fragmented. Now you're, you're brain fogged. Now the adenosine sleep pressure builds and your brain hasn't been able to rest. And it's just a, you know, it's just one of those, it's a cycle.

Absolutely. And how does that affect women who are not particularly in postpartum? Is there a big difference? Is it just the hormonal differences that women experience having brain fog even if they're not in postpartum?

Not necessarily. The brain fog is, well, you know, usually when you hear brain fog or even when women are pregnant, you hear this brain fog, right? And it's specifically usually due to oxytocin. And I do wanna make a little side note and maybe a disclaimer. I am not an OB-GYN. I'm a sleep and brain health scientist. And REM sleep specialist, okay? And I can look at things from the neurological perspective on sleep. When it comes to oxytocin, you'll also hear the word Pitocin. Pitocin is a synthetic drug of oxytocin, which does affect the body differently, right? So with the postpartum brain fog, it's important to understand if there's any other medications interacting with the potential inability to sleep or The need to sleep more because that can happen as well, right? You have this new baby, you're physically exhausted, you're mentally exhausted, you're going through all these hormonal changes and that's okay. You know, and the main message I really want to really portray is this isn't a gloom and doom situation for women. It's like it gives us no hope for the future. Like we're supposed to be like these asexual zombies walking around like taking care of kids. Like I'm not really sure what we're supposed to. It doesn't have to be this way. I get so frustrated because it's like, where is this information coming from? Yes, it happens. Yes, there's a decline in estrogen. Yes, whatever. But that's normal. It's not terrible. It's just normal. These are things. But when we recognize what's happening, that definitely allows us to find a better and better solution for You know, the changes that we may be going through. Yes, you're going to have hot flashes if your estrogen goes down. Yes, that's what happens, right? Hormone replacement therapy, go work out, right? Another side note. So like I said, progesterone— let me get my little chart here. Progesterone is a precursor to estrogen and testosterone. So it's also important to know that women also do produce testosterone in the adrenal glands, right?

Right.

But 50% of it is in muscle. That's why they highly recommend that as we get older, we start doing more weight-bearing activities to increase that testosterone, which will definitely increase our libido and our energy and our drive and our motivation, right? Which are seemingly all the things that are lost with menopause, you know? So, you know, balance it out. Just like estrogen drops, testosterone drops. Just balance it out.

And it's so important to have this explained because, you know, women, we go through our lives and we were kind of touching on this earlier about how it's a doom, right? You get your period as an adolescent and then you hear—

Oh my God, I got my period.

Okay.

You're a woman.

It's so scary. And it is, but it's always this doom. It's, you get your period and then Pregnancy, if you have a baby, and then postpartum, and then menopause, and now perimenopause is being talked about. It's all these things and phases that are scary and—

Normal. We are women. We do— we have— we are like roller coasters. We are. You're welcome. Your life would be boring without us.

You wouldn't have life without us.

1,000%. You know, and this is the consequence. Deal with it. Okay? But so, you know, it's— and for us, we just want to stay healthy, right? There's a lot of information out there, right, wrong, ugly, indifferent science. You know, follow whatever your path is. But neurologically, let's look at our hormones. What's going on in our body, right? What's going on in our brains? And this is really the contributing factor. And that's look at your sleep. What, you know, I want people to really leave here with some solid things. Look at your sleep, right? What's that look like? All right. And then work backwards. You know, are you, I don't know, drinking coffee later at night? Have you noticed, you know, you notice, do you feel more depressed? You know, are people saying you're more cranky? Okay. Let's just look at it and get a handle on it. Call ProSomnia Sleep Health and Wellness. We measure all that, right? And then we go through, we look, okay, your serotonin's high. Why is your serotonin high? It's high. Because I went to GNC because I'm trying to lose weight and it actually makes my body produce a lot more. And I'm sorry, I don't mean to say anything against GNC. I'm just saying a lot of these supplements on the market are not FDA approved, right? And you don't know what they're doing to your body. There's a lot of them out there who increase— that increase your serotonin, right? That's not a good thing, right? To have off— there's levels. There's low levels. There's high levels. But high levels also affects your sleep, right? And so when people come to me, we definitely do medication management. I need to know all the supplements you're on. Okay. Come to find out this supplement is making your serotonin high. Come to find out you're super sensitive to certain foods that make your body, that initiate a really large serotonin surge in your body, right? It's a, it's a system. And that's what we need to look at that has roller coasters and mood changes. Mm-hmm.

Just yesterday I was on a podcast about supplements and how exactly what you said, a lot of them are not FDA approved. And without the proper knowledge, we think we're doing something right for our bodies, but we actually can be doing more damage. We don't really know how certain supplements are affecting us personally.

Mm-hmm.

Because we're all so different and we can hear, oh, you know, For example, take vitamin D or take magnesium, and it might be actually either not doing anything helpful at all or actually hurting us without the right breakdown.

Or, or might be, it might create an adverse effect with some medication you're already taking, right? So especially magnesium, you know, people have to be very, very careful with that. So there's, there's, it's so important. Like I said, sleep affects everything. So did you start taking a new supplement? Right? Something that's going to happen in the very near future, we're putting the clocks up. This daylight savings time thing is horrible. Horrible. Like, I'm— look, this is going to be my next mission. This whole day, like, you do— how it— we do not understand how it affects our neurological system. Just shifting the clock 1 hour. Just like I said, your REM usually happens between 3:00, 4:00 AM. We're shifting the clock up now. Now you've lost the ability to have a good 1 hour of solid quality sleep because somebody told us we need to change the clocks.

I could be wrong about this, but I feel like, I think we're one of the very few countries or like the only country that still does that.

Absolutely. Everybody realized what? No, I need that quality sleep. Our kids need that quality sleep, right? Like that's, come on, especially kids. They still have growing brains. We want to establish a healthy neural system for them, right? And shifting the clocks is detrimental. It's not anything to be taken lightly or casually. It's causing neurological harm. And if we look at it that way— And it's not criminalized. Right, right. If we look at it that way, then it sits a little different.

Like, why is that a thing?

Why is that a thing? I'm going to tell you why it's a thing. I'm going to tell you why it's a thing in Florida. Okay. I'm not gonna get into politics, but def follow the money trail. That's all I'm gonna say. Golf is huge down here in South Florida. They play golf outside. Just saying.

Yep. See, that's a whole nother perspective too. Right.

Florida is not on the bandwagon to change it to keep, you know, one standard time.

Yeah. That's so true.

Arizona. I'm surprised Arizona has it, but that's probably smarter, right? You can't play golf at a different time? We got, we need, like, come on, one more hour? I know there's a lot of golf advocates out there. It's not like, but really think about the big picture, right? And the effects it's doing on us physically and neurologically because we still do follow a circadian rhythm. This is, I, you know, I say we focus on neurology and sleep from a neurological standpoint, our brain health, our sleep health, but circadian and body health is still very important. They're very— Interconnected, interconnected. And that's why we refer to the neurotransmitter GABA. You know, that's, that usually goes with melatonin. You'll hear that a lot. People take the melatonin supplements. Another disclaimer, melatonin, when you get melatonin that hasn't been qualified by some outside organization, you don't know how much melatonin you're actually getting. Consistently, right? Because you say, oh, I'm building up a tolerance to melatonin, when in fact you could own— you could also be getting a different dosage than what's advertised. So it's very, very important that if you're going to supplement melatonin, you either stay with the same brand or make sure it's with one of these quality regulated organizations. And they have them, you know, just make sure it is what they say it is.

It's one of those things too that it's, it's so confusing to, to navigate and you need advice. You need an expert to guide you through this because—

I know a person.

I know, I know someone too.

No, I know a company. That's what we do.

If you're listening, you're in the right place.

Exactly. And that's what I'm saying. Like, who would know to look at their supplements? We do medication management plans. We do nutrition plans. We measure the neurotransmitters. We measure your hormones because let's look at what's happening. Now, and then if all of that is good, then we're like, okay, step 2. All right, we're going to start looking at a prosomnia sleep plan. Let's regulate, reset everything. Let's do a diagnostic screening. Let's get in your brain, figure out what's going on. We'll do our diagnostic. It's like, oh, okay. What's happening is Your cortisol levels are too high, right? You have a lot of prefrontal cortex activity. So that is what's actually preventing you. Your sympathetic system is too high. You're too anxious. You're too stressed out. You're whatever, right? That's what we do with the screening. You know, we identify where in your brain is this hyperactivity going on? Where are you hyper-aroused, right? Is it trauma? Is it stress? Is it anxiety? Like, and so that's what we, we, we do a screening. So that's our, that's our prosomnia neuroassessment that we do, um, to, to identify what's going on in your brain and where and why.

And that's, that's so interesting because you can really pinpoint it in a way that you can go to a, you know, a PCP or a therapist or a different specialist or even OB-GYN and they'll focus in on You know, this could be an issue or this could be an issue, but being able to pinpoint it the way that you explained is so interesting and very unique, I feel, because—

Right. And that's, that's, that's the invention with prosomnia sleep therapy. We do use anesthesia to do that, but what other way could you suppress the brain to find out where the hyperarousal systems are? Right. And because we're all anesthesia professionals and we use an EEG monitor, We can identify those areas and that's our specialty of prosomnia. And, you know, and so, you know, from that perspective, and we hear wired and tired, right? That's another thing we say all the time is because you can get a normal PSG, the polysomnography, which, you know, a lot of people do, but that measures movement and your ability to have any respiratory changes. That doesn't identify what's going on neurologically, right? And that's what we do. You can, I have plenty of people who have normal PSGs all the time. All the time, but they're still exhausted. I've had people literally collapse from exhaustion with a normal PSG exam.

And even, and I could be completely off or wrong in this, but something you said about where the activity lies and for example, like high cortisol and things like that, that could also help pinpoint, and I don't know if diagnose is the right word, but identify rather, like PCOS, for example, which I know so many women struggle with. And I think it's been talked about a lot more now than it has been before. And I hear, you know, high cortisol all the time, and that's where I, I go to. And a lot of people struggle with PCOS and not being able to get a proper diagnosis or really understand what it is because it's not really talked about much. It is now more so than before, but—

So PCOS, um, is also— is actually PCOS is from insulin resistance, right? And so this is Also why we look at nutrition, right? A lot of us, you know, me included, you know, we have established just through our American, normal American diet has created an insulin-resistant society, right? It's not just about being diabetic. It's not just about being overweight. It's about being insulin-resistant to where your body isn't even receptive. We eat so much sugar. So our bodies are doing exactly what it's supposed to do. However, now part of the secondary effects of high insulin resistance is with women, PCOS, right? And so what PCOS is, that limits, that suppresses that GABA, that ability for us to go to sleep. So a lot of people, and it affects our leptin, it affects our cortisol, ghrelin, and it's just that domino effect, right? So when our sleep is affected, it's pretty bad, right? And so that's when we have to take a step back. No one tells you how you got PCOS. They just tell you you do, right? And here, take this or take this out or don't do this or lose weight or whatever, whatever. And so it's important to understand how all these things affect us. So PCOS and how our sleep is affected, that right there, the hormone insulin is actually a bridge. To sleep in PCOS because it suppresses GABA.

That's interesting. And I think that, you know, people that are going through, like we talked about a little bit earlier, perimenopause, a common complaint that they have with their sleep is waking up in the middle of the night, waking up at 3:00 AM. And I think that that's a classic complaint for those experiencing perimenopause.

Exactly.

And maybe even menopause, but what's actually happening with the cortisol rhythms and, you know, melatonin signaling and arousal regulation at that stage of life.

Especially with, um, so as, as women, you know, our estrogen levels start to decline, right? So as estrogen declines, that's why I said one of the precursors to, um, is progesterone. Estro— progesterone kind of stays, but estrogen specifically, you always hear estrogen being referred to even though they're kind of Partners is when the estrogen declines, and so it's the gradual decline of estrogen. We'll start getting the hot flashes, right? So one of the CBTI—I'm sorry—the cognitive behavioral therapies, you know, for insomnia is to keep it cold and dark, right? So when you start having the decline in estrogen and you're hot, now you're hot, and now you're hot at 3 a.m., right? Now your REM. is fragmented. Now you're sleepy and groggy and it becomes a vicious cycle. And now perimenopause is the cause, right?

Mm-hmm.

No, it's just a natural decline of estrogen, right? So a lot, you'll hear estrogen supplementation, hormone replacement therapy, whatever, do what you gotta do, right? Some women don't experience that, right? So it just depends, like, where do you wanna keep it? The main thing is why? Find the root cause. Is there something else going on with you? Is there a reason? Is it the PCOS that's causing this sudden decline of estrogen and you're 30 years old and you don't understand why you feel like a 50-year-old, right? Your hair starts falling out or getting thinner. You start having these new onsets of something else for women to look at. Look at your testosterone. Are you healthy? Are you trying to live a healthy lifestyle? Are you exercising? Are you doing weight-bearing exercises? Are you at least trying to maintain your testosterone levels to at least keep some motivation in there to keep on living since you're about to go into menopause? You know what I mean? It's just, you know, it's just, it's just a healthy balance, right?

Mm-hmm.

And that's something we look at. We try to— part of the treatment programs we try to establish, you know, a healthy neurotransmitter level, change your lifestyle, change whatever it needs to be. But we're there to help you through because sleep is a secondary effect.

And speaking about estrogen specifically, I know that estrogen is actually often described as neuroprotective. So how does menopause, sorry, how does menopause actually affect REM architecture over time? And what does that actually mean for women's long-term brain health?

So with estrogen specifically, estrogen serves a couple of different purposes, um, for, For women when we're having babies and fertilization. And then the neuroprotective effects is specifically for the ovaries and the eggs, right? It maintains a healthy balance for the trans— I'm sorry, for the transition and the growth and neuroregulation for the baby and baby formation, right? So with estrogen, estrogen plays a key role in GABA, like I said before, that one that keeps you sleepy. It also keeps you calm. Right? And so as that goes down, you'll notice you get more road rage. People aggravate you more. You have no tolerance for anything at all. That's that estrogen. The estrogen is what keeps us women, I'd like to say, that keeps that feminine, that calm, that peace, the parasympathetic side of us, right, is the estrogen. And then during REM sleep, it facilitates that. So we, we reestablish that neurotransmitter, we reestablish those regulatory mechanisms, and we recreate that potential to bond.

I love really like learning about how these hormones have and the effects that they have because as women, it's like, I'm cranky, I'm crying, I'm upset. Why? And then 2 days later you get your period and it can happen every single month and every month, it's like, oh yeah, this happens every month. And every month I'm wondering why I'm feeling like this or not.

Exactly. And it's— and right. And who are you going to go to, right? You can call your doctor and be like, I'm cranky before my period, right?

Right. Yep.

But we understand, right? That's what we're here for, to help you through that. Because— and it's not that, you know, for some women, especially during perimenopause, that's when the irregularity starts to happen. Right? That's really where that 3:00 AM thing starts to happen because now it's not— we might not be getting a period, but now we're starting to still have the same hormonal premenstrual syndromes, right? We still get moody, we still get cranky, but we're not getting a period, right? And so that's the perimenopause and when all that starts. So that 3:00 AM wake-up is not necessarily uncommon, right? It's just a gradual decline. Or increase, you know, cuz they're all over the place at that point. But overall they start to just have a gradual decline. That's fine. Just be aware of it and manage the symptoms appropriately. But most importantly, REM sleep is where you can reset and rebalance those hormones. And that's why REM sleep is so important.

And with perimenopause, do you get a period or do you not get a period?

You'll start getting it more irregularly. Because progesterone levels change, the estrogen levels definitively change. And also what occurs too, and it's not just the hormone levels, this is something else, like I said, we look at it, prosomnia, it's your brain's ability to be sensitive to the presence of estrogen and progesterone because you have receptors, right? And it's almost like we call it a closed loop, like use it or lose it type of thing. If your body's gradually Isn't going to have as much estrogen, it's going to stop using those estrogen receptors. So you don't have the same response that you used to when you were like, you know, in your preteens or during, you know, the time that you had your period, right? Because at that time they needed to be high. And then as you get older and you start fertilization and you start having babies, you need those high receptors, all those receptors, the sensitivity. To have the baby and do what we're supposed to do and procreate and jealous. But now that you're older, you don't need 'em as much.

They start downregulating. And during perimenopause, I think it's super common that women will either gain weight or notice metabolic shifts during that stage. So how does REM sleep influence appetite regulation and dopamine balance and metabolic stability?

Right. So essentially the main thing is to provide a A normal system. I say normal loosely, right? But just a consistent system, just like anything else. Your brain needs a consistent system. If it knows it's going to sleep at this time, waking up at this time, you know, this is the consistency. So when you get into deep REM sleep, your brain has the, just the cognizant awareness to be like, okay, I can rest. I can restore, I can reset, I can rebalance, I can check in. And then in a safe way, because this is the time when we're supposed to be asleep, right? So as we get older, again, the same thing with the hormones and the estrogen and the oxytocin and all those things that we need as women, as those start to naturally decline, our brains are like, okay, like we have a silver sleepers program, right? And with women, older women who don't, who are fully menstruating, who have very, very low estrogen, than quantity sleep.

That's so interesting too, cuz I feel like that's almost the opposite of how we tend to think about it. You think you get older, you rest more, you sleep more, things like that. And versus, you know, everyone knows babies need quality sleep and X amount of hours of sleep, but they wake up every few hours where you think of someone who's older and you think that they'll sleep more versus actually needing less sleep.

Yeah. So with, with all our silver sleepers, um, they come, I, I've I call them very circadian-like, right? They definitely follow the sun. Their thing is they may not, they still may only sleep for 6 hours, but they go to sleep earlier.

Mm-hmm.

Right? So it looks like they need more sleep when they may be getting up very early in the middle of the night with the same 6 hours. So again, you know, everyone's different, you know, but when it comes to hormones specifically, you know, same thing with them. They have a very, very low decrease, you know, estrogen, progesterone. Testosterone level, right? Especially for men, right? We'll talk about that more next month. You know, sleep and men's health, we're definitely going to dive into because, you know, people don't say, you know, they may not get a period, but they definitely get manopause. You know, like, again, go back. This is, I'm not, I'm not, but look, this is what's happened neurologically.

Yeah.

This is the precursor to testosterone, right? Progesterone. They are affected just the same. It's a direct neurotransmitter. Why do teenage boys sleep for 12 to 18 hours a day, right? It has to do with the testosterone formation, the high testosterone rate that directly affects GABA.

And speaking about, you know, sleeping for X amount of hours and, you know, how sleep hygiene and getting sleep stability is so important, sleep disruption happens so often, but It can also actually affect libido, which we touched on a little bit on our last episode. But how is REM sleep connected to dopamine and, um, sexual health beyond just hormones, and how can it affect the libido?

Yeah, absolutely. So dopamine, definitely there's a lot of dopamine release during REM sleep, and that's our, our motivation and our reward system, right? Like we, we had talked on some of our previous episodes as well. We're on dopamine overdrive with our phones, right? Biologically, you are, you have more dopamine being elicited from your body. You have a higher upregulation of receptors, right? And so now you need more and more and more dopamine, you know, to experience any type of pleasure or joy. Same thing with sex, you know, more so with the testosterone and the estrogen, but dopamine definitely plays an effect in that. And that's all released during REM sleep.

And what about women whose sleep study may be normal, right? They're not showing these signs, but they still wake up exhausted every day. They still feel all this fatigue. What might traditional testing actually miss about REM fragmentation and restoration capacity?

The, when you say like a sleep study, sleep studies, specifically the PSG, the polysomnography, right? Which is very common. However, that doesn't, it's not a diagnostic. It doesn't measure insomnia, right? Insomnia is a diagnostic clinical diagnosis. So clinically, they can diagnose sleep apnea, like whether or not you're breathing or if you have any type of moments, hypoxic events where you stop breathing during the night. Or if you have like restless leg syndrome, are you moving? They do a lot of ocular movement and rapid eye movement. That's where REM sleep came from. So that's what they measure during a polysomnography. Unfortunately, it does not measure the nerve— how many— or excuse me. Unfortunately, that does not measure what's going on cognitively. You know, what is going on? neurologically in your brain that's preventing you from getting quality REM sleep and creating REM fragmentation. However, ProSomni Sleep Health and Wellness is here to help you.

Absolutely. 'Cause it's, it's so true. Like how often do people, especially women, go to the doctor and are just, I'm tired, I'm fatigued, I don't know what's going on. And they get their labs back and they get their, you know, general annual checkups and, you know, there might be some numbers that They could equate to certain things, but overall they seem normal, but you still have that fatigue all the time. So it is interesting to realize it could be this.

Yeah. And what's gonna happen naturally, she's gonna go to her OB-GYN and just be like, hey, I'm having problems sleeping. Naturally, it is what it is. OB-GYN may prescribe a sleep, you know, medication, a sedative, um, to help you go to sleep at night, but you're still waking up. exhausted. You're not getting REM sleep. That sleep drive, that adenosine sleep pressure is not being released, right? Your brain's ability to rest is not being restored. And that's what we do, our neural assessment at ProSomnia, right? We do the assessment and we figure out in your neurorestoration assessment and we figure out your ability. Do you have the ability? We break people down into phenotypes. So, It's your every— a mom, right? She just had a baby. She may not— her ability to get into REM sleep specifically, structurally, may still be there. She just hasn't had the opportunity or her hormones are off. She doesn't have the ability to actually get into deep REM sleep, right? And that's what we can gauge. So she can still get into REM sleep. She has a restorative ability. Mm-hmm. She just hasn't been able to. So she's REM sleep deprived. Whether some people, especially with chronic medication, specifically chronic sleep medication, it actually creates a structural change in your brain. What wires together fires together, right? If you haven't been able to get into REM sleep on your own without this drug, it's not like you think you're going to stop taking it and all of a sudden be able to go to sleep. Your brain has been permanently rewired, right? Your receptors, like I talked about before, have been downregulated because you have this drug. So we can identify, do you have the ability to still get into REM sleep, right? And so that's what most sleep studies cannot determine or gauge. And that's what we do at Prosoni Sleep Health and Wellness with our neurorestorative assessment.

And speaking a little bit about that, you know, you tend to emphasize not sedation, restoration. So what does true sleep restoration mean for women's brain health specifically? And how does your framework really help to identify and actually correct instability?

So to answer your first question, the, the effects of the lack of REM sleep specifically on a woman is tremendous, right? First and foremost, we're women, right? You can look, if we are not happy, nobody's happy, right? But it's the, you know, how do you feel? You know, we have so many responsibilities. How do you feel? Wired and tired, right? I'm up. I have to take care of the baby. I got to go to work. I got to do this. I got to pick up— I got to go. We put these permanent S's on our chests, right, for whatever reason and what sacrifices Is our sleep, right? So when we can't get quality REM sleep, our brains can't work. You know, lack of REM sleep is the equivalent of being drunk. You brain fog, you can't, you asked me about brain fog. It's the adenosine sleep pressure. When that builds up, that second sleep, that brain sleep, you can't think, you can't function, you can't make logical decisions. You know, you're not happy to be around. You don't feel well. Your immune system starts to suffer.

Mm-hmm.

And cortisol's through the roof, acetylcholine's through the roof. From a health perspective, it's just a domino effect. So when we don't get quality REM sleep, our emotional ability to bond diminishes for our children, our coworkers, our significant others, our friends, our family. It's just, it's a vicious domino effect. So for women, everyone, REM sleep is so vitally important. Because it's actually medicine. It's not just let's lay down and go to sleep. It's our ability to restore, become restorative to our bodies and our brain. And that's why I say we don't sedate, we restaurate, right? It's not sedation. This is not something you come— this is not a long-term thing. When you asked me about the treatment programs, when we identify from your assessment what's going on, do you have the ability to still have restorative sleep? That's when we develop a 12-week personalized sleep plan for you. Everyone is different. We go through your lifestyle, your medication management, your nutrition. We deal with all that, and we provide a nutrition plan in addition to prosomni sleep therapy because now that we have a targeted approach and we can figure out what's going on in what area of your brain, we design your program specifically for you.

It is. That's amazing. I really need to come and see you because it's like you try to work on one thing and then you realize you need to work on another thing. And this is just, you know, so inclusive of all of these different layers that need to work together to make you feel better. And being that sleep is so important, and we've talked about this before, it's one of the things that are kind of ignored. You think about, oh, everyone knows they need to get X amount of hours of sleep, but When you break it down like this, it's just such another way of really thinking about it and understanding.

Yeah. Sleep is medicine. You know, that's, you know, that's just, it is. It absolutely is. You know, so many great ideas. You feel better. How many times have you heard, oh, let me just go sleep on it, right? It's, I think, you know, it's very underutilized, best medical tool that we have.

Absolutely. And If you're listening, ever been told it's stress or it's just hormones or it's part of getting older, it's part of aging. I hope that this conversation really gives you a different lens. It just definitely gave me a different lens. So it's also important, I really think, to realize that sleep is not a luxury. It's not a personality trait, and it's definitely not a weakness. It's actually a reflection of brain stability. And across a woman's life, that stability is dynamic, responsive, and deeply biological, as we just really, really learn. So the goal is not to knock you out. The goal is restoration, restoration, restoration, restoration.

I really, like I said, I really want to leave everyone with some actual action things to do. Like I said, this month is, March 15th is World Sleep Day. So, you know, be very conscious of that, but also March 5th in the United States, we do change our clocks. Really be cognizant, and I would even encourage you now to really start solidifying your sleep schedule. 2 things, figure out how much sleep do you need. I know a lot of people think that you need 7 hours of sleep, but in honor of my dad, he only needed 4 hours of sleep. My dad, Albert Harris, he only needed 4 hours of sleep and functioned just fine, right? And so everyone doesn't need 4 hours, 6 hours, but figure out how much sleep you do need. And figure out your ideal sleep schedule, even if you're not able to maintain or keep that. Figure out, go through your life, figure out what is your ideal sleep schedule and start working on it now because that 1 hour of sleep, quality sleep, is going to change. And after that, notice how you feel. If you start feeling cranky, if you start feeling wired and tired, if you start feeling like you're not getting quality restorative rest, That's another indicator then that that one hour of time is very precious for you, very necessary for you. So, you know, these are some action steps you can start doing now before we change the clocks. And as women, start whether it's us or anyone else, but get your hormones measured. Where are you? You know, men are always bragging about my T levels are in the da da da. Okay, well, where are your E levels? You know, let's start taking responsibility. You know, we look at them, but now what, right? Is that affecting our sleep? Maybe, you know, call us, let us help you. Let's do your assessment. Let's figure out what's going on. Let's look at your sleep, and then we'll take a course of action to get you real restorative rest.

Absolutely. And you just touched on a, a thought that I had earlier was about the amount of sleep and REM sleep, because they, you know, they say 6 to 8 hours or 8 to 10 hours or whatever it may be, but There's people who say, if I get 8 hours, I'm overly tired. I wake up feeling fatigued, but if I get 4 or 5 hours, I'm functioning well. Like you mentioned with your dad, my grandfather was the same way, and sometimes I'm the same way. If I sleep 8 to 10 hours, I think I should wake up feeling refreshed and I am groggy. So I, you know, it's important to realize what does work for you.

And you can get too much sleep. Mm-hmm. How much is too much? 8 hours for me is too much sleep. I know exactly what you mean. That's excessive GABA. You don't feel better, you just feel sleepy. You feel like you took a melatonin, but you're like, I just slept for 8 to 9 hours, but you don't. So that lets you know you don't need, you don't need that much sleep. I need like 7, 6 to 7, right? Know your number, know your sleep number. That's your real sleep number.

Absolutely. Mm-hmm. I'm gonna start paying attention to that as well because it's like when you were talking about that earlier, what the question that went through my mind was, How much do I need sleep to get into REM sleep? Because it's not a, an hour of, you know, particular amount. It's just really—

And that, that also comes down to how much sleep, um, debt or pressure, how much sleep pressure, that adenosine sleep pressure. That is that like you've been up for 8 to 10, 12, 15 hours and you're like, I don't lay my head down, I'm gonna lose it. You can get into REM sleep like that. Right? So that's, that's the time of sleep latency. How much time does it take for you to get into REM sleep, right? And so when you're really, really tired and you have a high sleep debt, it takes no time, very short time. But if you're sleeping for 8 hours, 8 hours, you're on vacation, right? You know, it's by the end of vacation, you're like, you're ready to go do stuff. You have all this energy because you're rested.

Absolutely. So remember everyone, the goal is restoration. If this episode resonated with you, share it with a woman in your life who's been quietly struggling with sleep and As always, we're here to keep reimagining what health looks like from the inside out. Thank you so much, Nyree. I'm excited to send this episode to all the women I know and Women's Health Month. Um, so I'm excited. I'm excited for everyone to really listen to this cuz it's so informative.

You want, like I said, all that I explain in my book on Amazon, Why We Don't Sleep: The Biological Secrets Behind Insomnia. Um, and I dig deep and give you more information and how all that Plays a role in your rest. Absolutely.

That's amazing. I'll link that in the show notes as well. Thank you so much, Nyree. It was a pleasure speaking with you as always. I'm looking forward to our next episode, but have a great rest of your day and we'll talk soon.

Thank you.