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Episode 62: How to Sleep Better at Night Naturally with Dr. Colin Espie

Brief summary of show:

Are you ready to sleep better at night and do it naturally?

One of the top-rated podcast episodes on my podcast was episode 3, which all about sleep, and I know it’s one of the most helpful topics that you want to learn more about.

In this episode, I speak with Professor Colin Espie, Co-Founder and Chief Scientist of Big Health and Professor of Sleep Medicine in the Nuffield Department of Clinical Neurosciences at the University of Oxford.

A world renowned sleep expert, Professor Espie is focused on improving the clinical assessment and treatment of sleep disorders, particularly using Cognitive Behavioural Therapeutics (CBTx), and studying sleep’s relationship to mental health. He has published more than 300 scientific papers in his career and has been elected as a Fellow of the British Psychological Society, the Royal Society of Medicine, and the American Academy of Sleep Medicine.

Prior to founding the University of Oxford’s Experimental & Clinical Sleep Medicine research programme in the Sleep & Circadian Research Institute in 2013, Professor Espie was the founding Director of the University of Glasgow Sleep Centre. In 2015, he was appointed an Honorary Fellow of the British Association for Behavioural & Cognitive Psychotherapies, and was awarded the Mary A. Carskadon Outstanding Educator Award by the Sleep Research Society in 2017. A highly sought after public speaker, Professor Espie regularly shares his latest research on sleep and sleep disorders, and serves as scientific expert in television and documentary interviews.

Listen in as we talk about:

  • [2:10] Why so many people struggle with sleep

  • [4:00] Do people struggle more with sleep today vs. 30-40 years ago?

  • [5:45] The biggest culprits that affect our sleep

  • [8:00] What cognitive behavioural therapy is and how it can help you with sleep

  • [15:20] The impact of sleep medications, lights, technology, and alcohol are not conducive to proper sleep

  • [25:10] Why it’s important to follow what feels good to you when it comes to sleep

Notes from Natalie:

Resources Mentioned in This Episode:

Connect with Dr. Colin

Connect with Me

View Transcript for this Episode

[00:00:00] Natalie: Hi, everyone. You know, I've been podcasting for over a year now. And one of my top rated podcasts is episode number three, must have tips for better and restful sleep with Suzy Cohen.

[00:00:11] It is still available by the way. And you'll find that link in the show notes today. I want to go even deeper as sleep is like food and water. It is one of life's essential oils, but today, more than ever, I hear people telling me that they just can't get quality sleep. Why? Well, there are many reasons and we're going to get into those today as well.

[00:00:33] My guest is Colin SP he has been researching sleep and. Problems for over 30 years, he is one of the world's leading authorities on sleep. He is on the education and sleep medicine committees of the European sleep research society. He's the membership chair of the world. Sleep Federation and leads it's insomnia task force.

[00:00:56] Before we get started, would you do me a favor? Subscribe in whatever podcast app you were listening in, it would mean so much to me. Also, your reviews are very much appreciated as that is how others know that. What I am doing here is quality work. Thank you very much. And now my conversation with sleep expert, Colin SP.

[00:01:18] Colin. Thank you for taking the time to talk to me today. Sleep is one of the topics that I have requested the most by my listeners and viewers.

[00:01:28] Natalie: So many people struggle with sleep. Why do you think that.

[00:01:32] Dr. Colin: Well, thank you, Natalie. It's great to speak to you and to talk about sleep. It probably is humanity's favorite subject because if only we could get more of it and better quality sleeper.

[00:01:43] And I think we, I think one of the reasons it's, so it's so dominant than mine, just because it's something that can become an issue with. Age or stage in our life, if you got a new baby at home you know, if you've got things in your mind at work, if you get a teenager who can't get up to go to school and can't get to sleep at night, if you're struggling yourself through pressure at work and, and later in life, when your sleep seems to fragment more, you know, it's, it's always a challenge to sleep well because it is nature's provision for us when it isn't working.

[00:02:12] Well, that it really does upset us. It's almost like I can't find any food. I can't find drinking water. You know, it's one of life's essentials. So therefore, when we're not sleeping well, it really does trouble

[00:02:24] Natalie: us. Well, I know that this has been a focus of your life for many, many years. Why did you decide to dive deep into sleep

[00:02:32] Dr. Colin: time?

[00:02:33] Curiosity, I think clinical curiosity, if I take you back 40 years when I first qualified clinically in the early months Uh, primary care doctors said to me, one day, Colin, can you not do anything to help these people that can't sleep? Cause as a mental health specialist, I was seeing people with mental health problems like anxiety, depression, or whatever, and it never had occurred to me until that point.

[00:02:56] That sleep was kind of part of that family, you know, that we need sleep for emotional health. And I said to him, you know, I don't really know. I didn't really know. We hadn't had much teaching or training, but sleeper is disorders. We back then, and even still, I think it's still a bit of a neglected topic.

[00:03:13] And I said, send me a few, send me a few patients. And that's how it get started. Just clinical curiosity.

[00:03:19] Natalie: Do you think in the years that you've studied sleep, that people struggle with it more today than they did 30, 40 years ago.

[00:03:28] Dr. Colin: I think it evolves. You know, I think compared to 30 or 40 years ago, there were probably more and more people working 24 7 because it's possible to do so with the internet, for example I think each generation brings fresh challenges if we, if we I'm old enough to remember gaslighting, at least in some streets and in the UK, it wasn't the norm, but there were still a few.

[00:03:53] Left around. And what that tells us is even electric light is a relatively recent invention. So the ability to stay awake to work you know, work hours of darkness is within recent history within the last hundred years or so. And then of course, within the last 20 years, we've with this 24 7 society.

[00:04:12] So I think things evolve. Uh, And in each generation, there is a fresh challenge, I think, for sleep because sleep becomes no less important. It, your main seriously important.


[00:04:22] Natalie: Hey everyone. It's Natalie. I am excited to let you know that I'm opening up spaces for collaboration and advertising and sponsorship on this podcast. And on my YouTube channel, if you're a brand looking to grow in the wellness family or mindfulness spaces, I would love to collaborate with you. You can find the link to get in touch with me in the show notes, and you can always find out more about what I'm up to on Natalie


[00:04:55] Natalie: Well, you mentioned when you have a new baby at home, of course it's a cycle, but also the pressures to work and work. As you also mentioned, 24 7, but what are the biggest culprits you see that affect ourselves?

[00:05:10] I don't mental health or devices and electronics as big of an issue as we hear often in our ability to sleep well.

[00:05:18] Dr. Colin: Well, I, a movie suggest a two or three things I think are really, really key. I think as a society, we don't value and prioritize sleep at night. Uh, You know, for people who don't sleep well, they may say to that, I give it every opportunity, but you know, thinking, first of all, to answer your question as a society, I think we run a bit fast and loose with sleep, and we see it as a bit of a commodity.

[00:05:44] How can I manage to fit in as little as possible because I'm so busy and important, and we fail to realize that it's sort of sleep. That actually does a lot of work for us. You know, that we need our sleep in order to find. Yeah. You know, so I think, you know, we, over, over my career, I've seen the importance of things like diet and exercise emerge as men, as topics for a medical discussion and put us historically, no one would ever have discussed your exercise regime with your, or your diet.

[00:06:14] You know, that's not what doctors did, but it's become recognized. You know, these things underpin good health. And I think sleep has no getting into that same kind of position Natalie and being seen as art. You know, this is so important. So one thing is, is the importance of of sleep and prioritizing it.

[00:06:32] But I think for those who do try to prioritize it, the main struggle they have is with the racing mind. I mean, most people will say that, you know, if asked, you know, why do you think you can sleep? They'll say, I feel exhausted physically. But my mind. It doesn't let me sleep.

[00:06:51] Natalie: And even when you wake up in the middle of the night, I know many people who tell me, and I have struggled with this too.

[00:06:57] I wake up and then your mind starts going. You can't get back to sleep and it's two o'clock in the morning and you want more than anything to sleep.

[00:07:06] Dr. Colin: And I think one of the. Th th this lesson to one of the secrets of why cognitive behavioral therapy is the best solution for insomnia is a recommended treatment worldwide.

[00:07:19] Natalie: Just a moment. That was my next question. Tell us what cognitive behavioral therapy is and how that can help people. I didn't mean to interrupt you, but I want to take a step back and really dive into.

[00:07:30] Dr. Colin: Yeah. So, so the, the recommended a treatment for a sleep difficulty like insomnia, that's a difficulty getting to sleep.

[00:07:38] Her difficulty, getting back to sleep is something called cognitive behavioral therapy. And the secret is in the, those initials C for cognitive dealing with the racing mind that the primary enemy, if you're like, eh, of, of sleep and B the behavioral bit, which is. What, what should I be doing? You know, what, what is my routine meant to be?

[00:08:03] And they putting solutions to the racing mind and the, call to action together. You get something called CBT. And th th the reason it works is very, very simple. And that is that the secret isn't the town falling asleep. You fall asleep, you don't get to sleep. And I think what happens is wouldn't be developed.

[00:08:24] Insomnia would be trying to get to sleep. We try to make it an active process. We're trying to take control of the situation, and then we try to fit. And actually by trying to fix it and we become more preoccupied with it. And we get into this vicious cycle of the harder I try, I try to sleep. The more we can become, the more frustrated I get.

[00:08:44] Even as we talk about it, we can begin to feel happening. What happens is we get more mentally aroused, then we get more physiologically aroused, and then we realize I can't get to sleep though. Yeah. And yet the person who's sleeping well is no expert. You know, they are they've fallen asleep. It's happened to them.

[00:09:02] So what CBT does is it addresses these psychological barriers to sleep, you know, having the right behavioral pattern in place. We see that with young kids as well, getting them into a pattern and, and dealing with his racing mind deals with those things, and then remove psychology from the equation and allows us to sleep naturally, you know, so that it's actually.

[00:09:24] If anything has struggled to remain awake, which is what the good sleepers is experiencing, that they just need to get to get to bed and they drop over and then they find it hard to hard to remain awake. And that's what we've tried to do with CBT is to get people with sleep problems back into that frame of mind and into that very strong behavioral pattern.

[00:09:44] Natalie: So it makes sense. I understand it, but how does it work? What do you do? How do you work with someone.

[00:09:52] Dr. Colin: Well, what you do first of all, is you figure out what their sleep pattern is like at the moment. And often we work out something called your sleep efficiency. So if I, if you don't mind, I'll ask you then Natalie.

[00:10:05] I mean, how long were you spending in bed? You know, what's your typical length of time to spend in bed? And secondly, how much of that time are you actually using? Okay.

[00:10:15] Natalie: So this is interesting. I've mentioned to you in many of my listeners know that I did a morning show for many years. So my sleep was terrible and I felt the effects of that.

[00:10:25] I started my own business in this podcast. So now a year later, I'd say I'm typically. In bed for eight to nine hours of that, I fall asleep very quickly within 10 minutes. So probably asleep for eight of those nine hours. However, often a few times a week, I will wake up in the middle of the night and my mind starts.

[00:10:52] I get.

[00:10:54] Dr. Colin: So, yeah, so this is the perfect rate. So here we have you as being mostly a good sleeper, but occasional difficulty sleeping, which I guess is normal. We all have that from time to time. So your sleep efficiency there, if you're sleeping eight out of nine hours, you know, if we express that as a percentage, we're talking about somewhere probably towards 90% of your, of your night, your.

[00:11:19] So you a good sleeper, but commonly people with insomnia might only sleep a half of that four and a half of that, or they might not even, you know, might not go to bed for nine hours, but let's suppose I'm there for eight hours. They might only be sleeping six, which is 75%, which means you get 25% of your time lying in bed to do that thinking.

[00:11:43] And that upset that you know, and those occasional nights, when you don't sleep well, Netflix. It is a horrible experience and a, it becomes like a vicious cycle of begin able to get to sleep. So what we do with CBT is we try to reduce those may seem counterintuitive, but we try to reduce the amount of time people are spending in bed initially because your natural instinct, if you're not sleeping enough, is to go to bed for long.

[00:12:10] But all that does is it increases the entertainment bed and reduces that percentage figure. So what we actually do is they spend a shorter period. We call it it's called sleep restriction of sleep compression. And you spend a shorter period of time in bed for a period of time so that your ability to sleep.

[00:12:27] So it kind of catches up with the time you're spending. So at the end, you begin to experience, I kind of wait up till, till that time to go to bed, I've got to go that time in the morning. You know, that, you know, our doctors keeping me awake, I could sleep longer if it wasn't for him really. Right. So then you realize that that your, your street, your sleep drive, this, this drive to sleep is becoming kind of powerful again, and it becomes difficult to resist.

[00:12:53] And in parallel with, with that, we begin to address the racing mind. Th th th the things that get in the way of, of being able to you know, you relax your thinking and put things out to your mind, and there's a number of techniques that I can explain for that. And that includes before you go to bed, you know, doing that kind of housekeeping in your mind, putting the data right.

[00:13:16] Good. Good. Getting ready for bed is not just putting your jammies on. Getting ready for bed is, you know, closing the book on. You know, reviewing things, learning ahead making adequate preparations so that you've offloaded things that are otherwise just going to pop up at your house,

[00:13:33] Natalie: make your list of what you're doing the next day.

[00:13:35] So you're not doing it like me in the middle

[00:13:37] Dr. Colin: of the night. Yeah. And then when you go to bed, I'm flicking the mental switch. And instead of trying to get to sleep, try to remain. No, you're going to bed. Remember for a period of time, it's shorter than you were before you're asleep here. So what we want you to discover is that sleep is very powerful and that actually falling asleep when you're trying to remain awake is actually the ultimate remedy for insomnia, because you think.

[00:14:06] But sleep is powerful. You begin to recognize that again. And in fact it's what normal good sleepers are typically doing again to the point of that yawning at that to get to my bed. And they realize that sleep is powerful and then they just fall asleep when they go to. Because sleep has overtaken them.

[00:14:22] They have fallen. We need to get, we need to get the people who have good insomnia away from this, trying to get to sleep into this falling asleep and the way you do that, it's good to bed. When you're sleepy, trying to remain awake with your eyes open and you begin to yawn, you prevented and you just want to put the light and go to sleep.

[00:14:39] Natalie: Yeah. Let me ask you about a few things. If you could briefly comment on these, how they affect sleep, because I think they are things people go to to try to sleep. They either are helping or they're not number one. Sleep medication,

[00:14:53] Dr. Colin: well, sleep medication is a very kind of short term. Solution to a sleep problem.

[00:15:00] They're very, very commonly available and commonly prescribed, but probably a lot of listeners will be very surprised to know that they are not recommended for insomnia that's longer than a month or two. You know, if you've had definitely sleeping for more than a month or two, you know, the ideal is that you could access to cognitive behavioral therapy, not, not sleeping pills because.

[00:15:24] Th the, not that effective, there are benefits we're off quite quickly. If you use them frequently and they do not give you a normal night's sleep, they changed what we call the architecture of your sleep. The components of sleep are not quite normal. And for some of these medications, you also have withdrawal effects or side effects, you know, but of course, They're used commonly because nothing else is available.

[00:15:49] Yes. And this is one, this is one of the reasons that in the last 10 years or so, I've been involved in developing a digital form of CBT. That is something you can follow on an app or on a website, which takes these cognitive behavioral techniques and helps you to apply them in your life to get the benefit and to, and to it's a wheel also delivering clinical guidelines.

[00:16:14] Care, I should say that it's very, very important that when one considers your treatment options for insomnia, one is thinking of, you know, differentiating, you know, apps from apps in the same way as one differentiates pills from pills. You know, if you, if you go into. The drug store and just buy something a then of course, that that may or may not work, but you know what, that's, that's something you've chosen to buy.

[00:16:39] It's maybe a lifestyle kind of thing, maybe a vitamin, or it may be a homeopathic thing, but it's not the same as if you're like a medicine for the, for the problem. So people understand the difference between pills and pills. And I think it's going to in turn become the same with these apps that are available.

[00:16:58] Some of them will be evidenced by. You know, and, and, and we'll have clinical trials research behind them the make them recognize in clinical guidelines as effective and others are, you know, things that you're free to use of course, but they don't necessarily come with that kind of expectation that they're going to benefit.

[00:17:18] Natalie: Yeah, well, that's fascinating. And I, and we're going to talk in a moment about where people can find that and find more about you, but I want to rapid fire a couple of other things and get your take on them. Um, Electronics, having our phones near us in our bed or watching shows while we're in bed. Talk about that for a moment.

[00:17:37] Dr. Colin: Yes. So this is a relatively modern phenomenon, but perhaps in the past, it wasn't. uh, Or even a telephone, remember that thing on the telephone at the bedside, often people have their telephones in their bedrooms. And of course they're in every hotel room. You know, so, so these things, if you like are there to distract us, you know, from.

[00:17:59] The primary purpose of the bed or the bedroom, which is to sleep. And you, you know, I think nowadays the, the challenges, particularly for many young people is that they're engaged in social activities. So you have to break the social group norm to say, sorry, guys, I need to, I need to get some shadows.

[00:18:19] Now I need to, I need to lie down and get. That can be difficult to do in the same way as it might be difficult to leave a party early, you know, to be the party pooper says, look, I need to get home. You know, so you've got these social factors. You know, are part of it, I think. And of course you might be interacting with people in other time zones as well, who might not actually be ready for that at that point.

[00:18:41] And, and a lot of the games that people engaged in a very stimulating, I think those things are probably more important to be honest, Natalie. Then for example, the fact that the devices in that. That can also, that can also be a factor because our circadian rhythm or biological clock is influenced by exposure to light and the brighter, it is the more alerting effect that is in the brain.

[00:19:06] But I think. emphasizing the other things. I think they're commonly often overlooked, which is really there. The arousal associated with the, the enjoyment of the interaction, the game uh, and the, and the difficulty was drawing from it. It would be best that people could leave their devices in another room.

[00:19:24] And it shouldn't really matter if you're going to bed when you're sleepy and you're going to sleep anyway. And so therefore I think people with insomnia can use the devices as a bit of a crutch because it gives you something to do when you can't sleep. And I have every sympathy with that. But for most people that isn't actually solving the problem, that's just, you know, continuing the problem.

[00:19:46] And that's where the CPT thing comes in really to establish my best sleep pattern helped me to get.

[00:19:52] Natalie: So a few other things I want to ask you about and how they affect sleep. Or if they, if you think they, they're not as big of a deal as we often hear one being different types of foods and the next being alcohol.

[00:20:06] Dr. Colin: Yes. Well the alcohol is easy. Let's deal with it first because alcohol has a sedative effect. So therefore it makes us drowsy and it can actually help us to fall asleep more quickly. And of course that is part of the difficulty, because then if you've got a problem with your sleep, you, you mean.

[00:20:26] Quite easily find that having a drink helps you to get to sleep. But if you were in my sleep lab, I would be able to show you that the sleep that you got under alcohol uh, is not an optimal sleep. A one of the things that alcohol does, for example, is it reduces what's called REM sleep, rapid eye movement, sleep, or dreaming sleep, which is actually very, very effective.

[00:20:51] For our emotional health and for consolidation of our memory functions and alcohol in our system can abolish REM sleep. And then once the alcohol begins to work out of our system, towards the end of the night, you get a search, a rebound effect, and there's REM sleep, which can lead. If you've had a lot to drink a two, two dreams, or even have quite a nightmare.

[00:21:14] Quality. So, so alcohol has effects and has known effects on sleep. But none of those would be seen as therapeutic. You know, no doctor would recommend the use of alcohol. Now food is interesting. I think the most important thing for me to say about food is when you eat and the emote to eat, rather than kind of worrying too much about exactly what it is you eat.

[00:21:40] We talk about, you know, our body clock and we think of our sleep wake cycle, but the whole of our bodies, our follow up follow what's called a circadian rhythm. And that also relates to, for example, when we eat all the organs in the body have this body clock function, there's an ideal time for us to eat and there's a non-ideal time for us to eat.

[00:22:03] And so therefore we shouldn't be eating too much. Before we go to bed and quite often with people's very compressed lives, very busy lives. They're working late and they're getting the kids to bed and they're not settling down. You know, they're very tired. They're not settling down for something property eat until really quite late on.

[00:22:24] And the body's still got to digest all this. And during sleep and that can interrupt a sleep. So if possible, try to get into a sleep pattern as well as any. Regular mealtime pattern. And that's the best advice I could give there. Also, if people are overweight a the, or obese, they, they tend to have poor sleep and poor sleep tends to lead to less good metabolism of your food at night until you get this Fisher cycle.

[00:22:54] Some foodstuffs do have stimulant properties. Like it, like chocolate is good, quite a lot of caffeine in it. So you know, so one needs to be careful about the amount of caffeine. One, what

[00:23:05] Natalie: is the ideal amount of time to give yourself? To eat before you go to sleep to be a few hours.

[00:23:13] Dr. Colin: Yeah. We're definitely talking hours and not, not minutes.

[00:23:19] Do you know what I would encourage? I don't know, liberate people a little bit on this because, because sometimes when you do these kinds of things it feels like you know, it's a ministry of Norfund right. Don't do this. Don't do that. Do what you're told. Yeah. Do you know what I mean? And it also feels that we're entering our kind of value rule-based system, you know I want to liberate people from that a little bit and say to people, experiment, experiment, because we're not all the same.

[00:23:50] We're all we have individual differences. Thank God that that's an important thing, right? And that includes a physical characteristics. The analogy I often give people is to think about your shoe size. I love to be in a big meeting room with a hundred people and say, I've got to answer the question of how many hours sleep we should get.

[00:24:09] And everyone's waiting, what's it? He's the expert. He's going to know the right number. And I'll say, I don't know. I'll see. But I can tell you what the average may be because I can tell you put your average shoe sizes, but you're not, if you swapped shoes, you're not going to be comfortable. And you find that over trial and error, that's fine.

[00:24:29] Natalie: But what's so important about that. And I appreciate that you emphasize that because as a health reporter for many years, I would always tell people. And to this day, I say, you have to know yourself and your body and you have to pay attention to it and not rely always on someone else. So experiment, but then know I slept best when I didn't have a lot of alcohol.

[00:24:51] And to note that and to do something about it, instead of just following what someone else says is right

[00:24:57] Dr. Colin: for you. Yeah. So I think perhaps in modern society, There's greater a respect for people. Who've got a volume based system like that, that I choose not to eat this, or I choose to have my meals at these times.

[00:25:13] And, you know, you know, w you know, as I was growing up, my wife's a vegetarian. Right. But it, it was almost like a strange, suspicious, right. Historically, you know, don't eat meat. There's something wrong with you. Whereas nowadays you would have. Think of seeing that and, and people are catered for it. And we've, I think a better sized, right.

[00:25:33] Right-sized value around that. I'd love to be at the same about sleep that people were able to say, you know you know, sorry, my, my bedtime is coming up for, you know, and people were able to be different from each other and not feel they had to be. The same. So when it comes to like, when you have your meals and when you go to bed, when you get out, what's the right amount of time to spend in bed, how much sleep do you actually need?

[00:25:57] Wouldn't it be great if we could all just discover that and be proud of be different? Sure.


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[00:26:48] I share my designs with my team at school and at home where we collaborate on designs. And I'm going to give you 45 days free of Canva pro. If you go to my website, Natalie Favorites, just click on Canva. Once you get there, I may get a small commission if you purchase through this link, but that's just to keep my website and my podcast going.

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[00:27:24] Natalie: Yeah. Especially if one takes the time to realize what's best for them, but they really document it. A lot of people just say, well, my doctor said, or I read an article or so. And so, and then they just do that versus.

[00:27:40] Really knowing what's best and when new

[00:27:43] Dr. Colin: best. Yes. Yeah. I think that's a great, great point. You know, if people are, are doing this kind of experiment then it is a kind of scientific method as you're seeing. And so therefore people should be obsessing about it, taking a few notes, making a few observations and, and you kind of discover.

[00:28:02] You know, through that. And, and if you went, you know, if we followed the analogy of your shoe size, that's surely what would happen if you, if you went to the shops and you didn't know your size, you would try things on or did they be measured and you would take a note, the measurement, and this is the size shoe I need.

[00:28:19] So when you go from your shoes, what size are you, sir? Then sort? I said, well, I have no idea. You've actually discovered that already. And, and it may, it may be half inch show you're there, but you. You know, and you might try a few sizes and it, each time you're learning new information or you're consolidating all the information.

[00:28:38] And the other thing is of course that I sleep shape and size may change as we get all. You know, we we're familiar with that. Of course, you know, our baby is sleeping longer than a school-aged kid or teenager sleeping more than a young adult and a young adults probably sleeping more than older adults.