Recharge and Refuel: The Vital Connection Between Sleep and Nutrition
Valerie Cacho, MD, is a board-certified sleep medicine specialist and the founder of the online educational company Sleephoria. She is triple board-certified in internal, sleep, and integrative medicine.
Leslie: Tell us about your background, your journey. How did you end up working in this space?
Valerie: That’s a great question! I'm an integrative sleep medicine physician. So I went to medical school and got my MD. And then I went into Internal Medicine Residency, which is training for adults, and is a three year long residency. And then after that I went into sleep medicine, and so that's a one-year fellowship. And then after that I did an online training program through Dr. Andrew Weil in Arizona in integrative sleep medicine. When I was thinking about what specialties I wanted to go into sleep medicine– actually it's not too common, some people don't even realize it's its own field– but one of my dad's good friends is a pulmonary and sleep doctor and I heard him give a lecture on it and it just really sparked my interest. There’s not really a sleep emergency. Lifestyle medicine and preventive health are really important to me to prevent chronic disease, and sleep is the foundation for that.
Leslie: So why is sleep so important? Like I think like you said, there's no emergency with it. So there may be folks out there that are thinking “I'll sleep when I die”. Tell us, why does it matter?
Valerie: I think I like to make things super simplified, and I'd say sleep makes everything better. And you think of sleep just like the fuel tank in your car or your phone battery. How well does it function on low or empty or almost zero percent, right? You can't really do much and so when you're sleep deprived or if you have an underlying medical sleep condition, it just makes things a lot harder. If you’re not getting enough sleep, you build up these toxins that don’t get cleared out, and it wreaks havoc on your performance. When you’re not sleeping well, then you can’t sleep well, and it can make you feel either more depressed or more anxious.
Our bodies were made to rest, we aren’t meant to keep going and going. Data shows that with less than six hours of sleep leads to higher rates of irregular heartbeat, high blood pressure, heart failure, strokes– our bodies need to slow down, we need to rest. Sleep is really good for your immune system as well, especially going into cold and flu season.
Leslie: How much sleep do people need, and what other guidelines are there?
Valerie: If you take a look at the National Sleep Foundation, they recommend between seven to nine in adults and there's a u-shaped curve. So where you are along that curve, meaning are you closer to seven or closer to nine? I personally am about like eight and a half. I probably do my best at that. I would not recommend less than six hours. Some people do feel great about six and a half and if you don't have any underlying heart disease, I'd say probably that's okay, but one of my favorite things that encourage patients and folks to do is figure out how much sleep you need to feel good. And what does that mean?
It could look different for everybody, meaning are you needing to drink more caffeine or coffee? Do you feel like you need to take a nap? Do you feel like you're just not as sharp? And also match that to what you're doing the next day. So if it's a lazy weekend where you're just gonna do some errands or just sort of puts around the hall at home. Maybe you're okay on a little bit less energy or a little bit less sleep versus if you have meeting after meeting, you're working on a project, probably best to have your battery in your tank as full as possible.
Leslie: So it is connected to what you're actually doing the next day. Is it a day by day kind of thing?
Valerie: I'd say most traditional sleep doctors would probably say get enough sleep between seven to nine even within half an hour on the weekend. But realistically speaking right, I have a six year old and a three year old. Sometimes both of them are in our beds at night and we're trying to put them back in their beds and shuffle around, and you just do what you can do with the situation that you're in. Certainly it’d be ideal if we all got the best time to sleep every night, if we wake up refreshed, but it just depends on your lifestyle.
Leslie: So tell us, what are some issues that you see most commonly in your clients, or that people struggle with most often when it comes to sleep?
Valerie: Yeah, so as a medical sleep physician, a lot of the training that I did in my sleep fellowship was for obstructive sleep apnea. And so that means people who snore, stop breathing, and choke. Sometimes for women, they don't have those symptoms, but they're just feeling really exhausted throughout the day or they have headaches or maybe a little bit more irritable. We do sleep studies and put people on therapy. I would say that's a big bulk of it and insomnia is certainly something that I help patients with as well. So people who have a hard time staying asleep and then daytime consequences– feeling really awful difficulty with their focus, memory, concentration– sometimes it's actually due to untreated sleep apnea. Sometimes it's a circadian rhythm issue meaning where you're a night owl trying to live a day person's life and that causes a lot of distress. I have a handful of folks who have an underlying condition called narcolepsy and that's a condition in typically younger folks, but you're sleepy all the time regardless of how much sleep, due to a disruption in your sleep stages. So, we talk about how important sleep is for our overall function to make everything better and then sort of matching that to some of the lifestyle techniques, maybe they're drinking too much caffeine at the end of the day. It's really disrupting the quality of their sleep or a lot of times it's stress, just people just have a hard time winding down.
Leslie: What are some of the things that you are recommending to folks for winding down or adjusting their sleep schedule? Tell us more about those recommendations.
Valerie: So what's the best wine down practice? The one that you enjoy doing. So for some people it's listening to soft music, for some people it's things like knitting. I always say come up with a list of 10 things that you can do at night that don't require any bright light or screens. Some people like to really be on their phones and watch a show and that helps some sort of wind down. I'm like, the light isn't so helpful. So can you find maybe a podcast or something on YouTube or you can just listen to it instead.
Leslie: You mentioned medications, so what is your position on sleep aids? People that say I need to take something, or even people that are like I need to drink at night to sleep or whatever. What is your thought on all that?
Valerie: It's one tool in the toolbox. It's certainly has its time and place. I would say not long term, especially if we're in our sort of older years of life– senior citizenship– because it's associated with things like memory impairment and gait instability.
Leslie: What is the role of nutrition supplements in your diet in all of this? Is that part of your recommendations or thoughts?
Valerie: Foods are the nutrients, the building blocks of the nourishers that really help us live well and thrive. So what they consist of– certainly plant-based foods are sort of really good for everything– and diet certainly can help. So when we do research where we take a look at specific macronutrients thinking things of more saturated fats versus complex carbohydrates. Things higher in fiber have been shown to help improve the quality of our sleep by waking us up less. So we have less arousal if we eat high fiber foods, such as fruit and vegetables. And then if you have foods with more animal products, saturated fats are associated with more arousals.
Leslie: Do you have top tips? If you were to say here's my top tips, everyone should try to do this– what would that be?
Valerie: Number one is to prioritize sleep because it's so important. It impacts so many different aspects of your life. Number two is figure out how much sleep you need, how full does your battery need to be if you're going on a long car trip? You're gonna plan your fuel tank ahead of time, or your battery if you have an electric car. And then number three is to match that to your circadian rhythm– when do you feel tired?
Leslie: I'm sure there's a lot of people listening thinking that they would love to learn more. So where can people find you if they want to get in touch?
Valerie: I have a YouTube channel through my company called Sleeporia, which is an online educational resource that helps women improve their sleep health and their whole life. And the mission of Sleeporia is that a well-rested woman has the energy, clarity, and drive to change the world.
