Dr. Elissa Epel
speaker
631 appearances
3 recordings
2 series
first heard Nov 2024
last heard 23 Jun
Dr. Elissa Epel’s voice in public audio — every appearance, attributed to the second.
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recordings per month · last 12 monthsRecordings per month over the last 12 months — 1 in all, peaking in Jun 2026 with 1.
Appearances
but the more you worry about it, the harder it gets to sleep.
Right. So I do think that there's a need to address underlying contributors to anxiety and depression, independent of their impact on sleep. So talking about what's going on, bringing in some kind of breath-based practice, whether that's yoga or Tai Chi or meditation, just to ratchet everything down. That's another important component of it.
And thirdly, you've already touched on a little bit about the dopamine with the phone, but it's also the dysregulation in our circadian rhythms. You know, we think about how there's been a lot of research about how important it is to avoid light exposure at night, for example.
But everything we do during the day and when we do it is ultimately going to influence our ability to go to sleep when we want to and get the rest that we want to. So in other words, when we're eating all day long and snacking late at night and watching TV at night, that's signaling on our computers. That's telling our bodies and brain that it's day, it's day, it's day. So we want to actually...
could reestablish a consistent circadian rhythm meal timing. So we're having eating earlier in the day and then building in a fasting interval before we go to bed.
No. Interestingly enough, there's as you know, there's a connection as well with digestive function that eating late at night not only disrupts your sleep, but it's contributing to higher reflux, which can also interrupt sleep. So everything's interconnected.
It's interesting. They even looked at LED streetlights disrupting the circadian rhythm of animals and insects too. So it's not just humans that are being impacted by this.
Well, one of the conditions is restless leg syndrome. It's hard to diagnose. It's more of what we call a clinical diagnosis. People describe this creepy crawly sensation in their legs or this irresistible urge to rub their feet together. Typically, it's treated with dopamine medications. It's connected to relatively low dopamine levels in the brain.
Dopamine, yes, revs you up, but dopamine also seems to play a role with movement. So it's treated with some of the same medications they used to treat Parkinson's disease. But it turns out that that can be more prevalent in people who have autoimmune conditions, in which case we want to address the underlying autoimmune conditions.
There are some nutrient deficiencies that are going to make the symptom of restless legs more significant. Low iron, low vitamin D, low folic acid, low magnesium. So we really want to look at somebody's nutritional status.
So if we identify a nutrient deficiency, for example, the next step is why? What's the why that somebody's nutrients might be low? And there we come back, like so many other things, to the function of the gut. And interestingly enough, there is a higher correlation in people who have small intestinal bacterial overgrowth also having restless leg syndrome.
maybe because it's contributing to ongoing inflammation, maybe because it's also contributing to difficulty absorbing those nutrients from your food. So we're even going to go a step further and say, is there an underlying issue with digestive function, absorption and assimilation of nutrients that are.
Right. Lead, mercury, things that that are under the radar for many, many people and unfortunately can be a problem.
What happened with your sleep?
Well, I think it's the time to take a history and really understand all of the other interconnectedness that could be going on. For example, somebody with sleep concerns might also have digestive concerns, and then we might be thinking about assessing their digestive function, looking at a nutritional assessment.
But I think there's a time and a place and there's tremendous value in screening somebody with a portable sleep study because that gives you a tremendous amount of information. And we're using it, yes, to diagnose sleep apnea, but also to say, how often do you wake up during the night? How much percentage of time are you spending in REM sleep and deep sleep?
Are you tossing and turning all night long? So it can give us a tremendous overview in terms of somebody's sleep throughout the night. And from that, we can also decide, okay, what else do we need to explore?
Right, so this is somebody that, and one of the things I wanna plant the seed for is sometimes we start with what we think is the most likely issue and we gradually uncover more potential contributing issues and peel the layers of the onion. And this was a woman that I had known for years. She was pretty healthy in terms of her lifestyle. She exercised. She wasn't overweight.
She ate a healthy diet. She didn't drink any alcohol. She was treated with antidepressants. She was on a serotonin reuptake inhibitor and Welbutrin for her depression. And she was also on hormone replacement therapy. She was post-menopausal in her 60s. And she started complaining of fatigue and difficulty concentrating and just felt scattered. And by Sundays, she would...
had the need to take a three-hour nap. So well, that's unusual. So we did some of the usual testing for causes of fatigue. We tested her thyroid. It was OK. We looked at her iron levels or sugar levels. They were OK. So I decided to screen her with a sleep study. And it turned out you would not have looked at her and said, oh, yes, she is the poster child for sleep apnea.
Showing 541–560 of 631 · page 28 of 32
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