Dr. Marty Martin: the Importance of Getting Good Sleep

Vicki:

Good day, everybody. This is Christie Hetty with HMC HealthWorks. We are glad you can join us today on our podcast. And we have joining us today, Dr. Marty Martin. He is a professor at DePaul University in Chicago, and the founder of Zesty Sleep. Sleep being a very important topic today. Not a lot of people are getting quality sleep given the season that we are in with COVID and a lot of stressors right now. So welcome, Marty. We are so glad to have you here to talk about this important topic today.

Marty:

Yep. And I’m certainly glad to be here.

Vicki:

One of the things that seems to be pretty, pretty important for people is getting quality sleep. And there seems to be a lack of it today, whether it’s falling asleep, staying asleep. I know there’s folks sometimes who get up too early, even well before their alarm. And they’re just wondering, oh my goodness, how can I feel better? This is impacting my work. What’s going on today? Why aren’t people getting this quality sleep that they need?

Marty:

So. I do want to talk about the quality of sleep, but also want to talk about quantity first and then shift over to quality. Is that all right?

Vicki:

Absolutely.

Marty:

So, for those that are between the ages of 25 and 65, if you look at the recommendations from the American Academy of Sleep Medicine, you should be getting seven to nine hours of sleep every night. It should be, between the ages of 25 and 65, which is generally the working population. However, I know some of you might be saying to yourself is, I’m lucky if I can get by on six. But listen to the language, get by. So you might be able to get by one or two days, but you will not be able to get by in the long run. So, that quantity is extremely important. And the effects of not getting seven to nine hours of sleep, you feel those effects, not 10 years down the road, but immediately the next day.

Marty:

So, you can’t concentrate that well. Your problem-solving might be off. You might be a little bit distant. You might be a little bit irritable. You’re likely to make mistakes and errors. You’re more likely to get into an accident. So, you feel the immediate effects.

Marty:

So, that’s the quantity piece. Now, let’s focus to your question, which is the quality of sleep. So, for many of my patients and clients, they will say, you know what? I slept eight, nine hours last night, but I don’t feel refreshed. I don’t feel restored. So, they slept enough, but yet they don’t feel refreshed and restored. Or their sleep was, they will describe as kind of restless, if you will. And you mentioned it. Is that they woke up two or three times, and maybe the first time they woke up in the middle of the night, they were able to go back to sleep quickly. But the second time they were not.

Marty:

So, quality of sleep really has to do with a number of things, is once you get in the bed and you have the intent to go to sleep, how quickly do you fall asleep. So, in general, 15 to 20 minutes is about normal. And then depending upon your age is how many times do you get up in the night before waking up in the day? So, if you are over the age of probably 45, you might get up one time to go to the bathroom. If you’re getting up more than one time to go to the bathroom, you need to see your primary care and/or urologist.

Marty:

And if indeed is maybe around four or five, o’clock in the morning, you wake up, but you want to get up at six or seven, you can’t go back, then that’s impaired quality as well. So you actually need both to feel refreshed and restored.

Vicki:

You bring up actually quite a few things that are really important. Let’s say you have a situation which can be very common. Someone gets up in the middle of the night, like you said, but they can’t fall back asleep. What can they do?

Marty:

So, one of the things that I learned when I was getting my master’s in behavioral sleep medicine, after I got my doctorate in clinical health psychology, is about the science of sleep, and there’s a lot of science to it. And also as to what’s normal and not normal in techniques.

Marty:

So, here’s the technique that you can do. So let’s say you get up, and you have to use the restroom, and then you come back to the bed, and then you just can’t fall asleep. So you’re tossing and turning. It’s okay to toss and turn for about 20 minutes. If after 20 minutes, you still can’t fall asleep, get out of the bed. Assuming you don’t live in a studio, get out of the bedroom, go to another room, make sure the lights are dim, engage in something that is kind of boring. So, don’t watch your favorite movie. Don’t watch a horror movie. Don’t read your favorite book. Don’t watch anything funny. Because that’s going to stimulate you and hyper-arouse you.

Marty:

Don’t do any work if it’s going to stress you out, because that’s going to hyper-arouse you. So you’re out of the bed, you’re out of the bedroom, and then wait until you get sleepy. So, you have to know the difference between being sleepy and being tired, then once you get sleepy, really sleepy, then you go back into the bed. So, when you do that is you’re more likely to fall asleep because you’re sleepy, but you must get out of the bed. You must get out of the bedroom.

Vicki:

That’s really interesting, because what you’re talking about is what happens in the middle of the night. As I mentioned, it can definitely happen to many of us.

Marty:

Mm-hmm (affirmative).

Vicki:

Now, when you were talking about setting an intention to get good sleep, and there’s a difference between feeling …

Marty:

Tired and sleepy?

Vicki:

Tired and sleepy and getting good rest. How can a person who’s had a long day, let’s say whether it’s someone who has a large family and working with their children all day, or they’ve got a manual labor job outside, or they’re in the client service industry, and they’re wearing a mask all day. You know, those can be stressful, especially today. How could someone like that set and create a really good intention before they get to bed? Are there specifics? Are there details around that to get a really good night’s sleep?

Marty:

There are. Yep. So, the way I would phrase it is this, put yourself to sleep as if you were a toddler. So, imagine if you’ve been around a toddler, maybe three, four or five years old, maybe as a parent grandparent, aunt, uncle, or maybe watched it on television. You have this toddler, and this toddler’s running around and super-active. The parents don’t take the toddler when they’re at a heightened state of activity, put the toddler in bed, and then walk out the room and expect the problem to fall asleep. It’s not going to happen.

Marty:

So, what they do is they do a dial-down or a wind-down ritual. And usually they begin to do this maybe 45 minutes to an hour before they intend for that toddler to be sleepy and fall asleep. So, it may be a story. It may be some kind of light meal. It might be a bath, slowing down certain activities. So ,they create a distance between a lot of activity and getting ready to fall asleep.

Marty:

So, as adults, we need to do the same thing. So you had mentioned, if maybe I’m an essential worker, have a mask all day, I have to deal with some nasty people in the public, I keep thinking about this one nasty comment one person said. So, I’m going to have to separate that. So, what do I need to do to calm down, to relax, to be able to focus? Or maybe I’m in a very high pressure job, and there’s a lot of activities, and I’m worried about tomorrow. So, maybe I need to jot down certain things that I’m worried about. Maybe there are a couple of things that could take only a couple minutes I need to work on now.

Marty:

So, what we have to do is remind ourselves to put ourselves to sleep as if we were a toddler, And the other key aspect of that is consistency and routine. So if you have a toddler, probably the bedtime is going to be pretty much the same Sunday through Sunday, maybe a little bit later on maybe Friday night and Saturday night, but not much later. Because if it’s too much later, you know what’s going to happen is that toddler schedule’s going to be all off. But as adults, we consistently violate that.

Marty:

The difference between our going to bedtime during the work week and during the weekend could be three or four hours. When you do that, you create social jet lag. It’s almost as if you have flown to the other coast. And then Monday you pay for it. Consistency, routine, put yourself to sleep like a toddler.

Vicki:

So that your body can be in equilibrium. That absolutely makes sense. Are there side effects that an individual will feel from not getting quality sleep? I know there’s something called microsleep. Can you tell me a little bit about that?

Marty:

Yep. So, microsleep is this, and it’s happened to me a couple of times. So when you are driving and then all of a sudden is you look up and you see this car, or you’ve passed your exit, or you’re too close to another car. And then you feel all this rush of adrenaline. And what happens is for some nanoseconds, you have actually fallen asleep.

Marty:

You are asleep. Because there are different stages of sleep. You’re not in a deep sleep, but you have an altered state of consciousness. So if you look at, some people may remember the Exxon Valdez disaster. Periodically, there will be things about train wrecks. Chernobyl is an example. All those are examples where the operators fell asleep. And we’ve all experienced this microsleep for a very, very short period of time.

Marty:

So, if you are an accountant, it’s probably no big deal. But if you’re a heavy machine operator, big deal. If you’re a surgeon, big deal. So, for certain occupations, it’s a big deal. And it’s a very big deal for driving as well. Because all it takes is a microsecond for you to cause an accident, and God forbid, somebody is hurt or killed.

Vicki:

Definitely.

Marty:

And drowsy driving is increased. Not just distracted driving, not just drunk driving, but drowsy driving.

Vicki:

Is there a way where exercise or increased exercise would help in these situations, or would they make someone more tired? How does that work?

Marty:

So, I’m going to give you an it depends answer, and some people hate it depends answers. So in general, so say you wake up at seven o’clock in the morning. So, what you want to do is to be as mentally and physically and emotionally engaged and active as possible, because the more engaged and active you are physically, mentally, cognitively, emotionally, then you build up sleep pressure or sleep debt. And right before you go to bed, you want a lot of sleep pressure and sleep debt, because you’ve had a full busy day. So that’s where physical activity is good.

Marty:

What you have to be careful for is this. So for some people, they can’t really engage in strenuous activity too close to bedtime, because they may be hyper-aroused, or maybe they may feel sweaty, or maybe they may feel a little bit depleted. So, what you have to find out for you is when is the best time during the day or during the evening where strenuous physical activity will not interfere with you falling asleep quickly. And that’s where the it depends come in. But as a general rule for everybody, the busier you are, the more engaged you are, you build up sleep debt, sleep pressure. So much easier to fall asleep at night.

Vicki:

Well, that definitely makes a great case to get out there and break a sweat, for sure.

Marty:

It does. It does. And not only that, if you do that, you break the sweat, it also releases some endorphins, kind of feel good hormones. And for many people, it’s a great coping mechanism, and there’s 1,440 minutes in every single day, 1,440 minutes in every single day. So, I’ve had clients say, hey Marty, I don’t have the time. And I’ll say really? You don’t have 10 minutes out of 1,440 minutes in the day? And then they laugh. Because we all have 20 minutes out of 1,440 minutes. Or just say it’s not important to you. But don’t say you don’t have time.

Vicki:

Very well said. You know, you mentioned the feel good state of mind. And I know that when people are on vacation, they always feel good. Most of the time, unless they’re traveling and running to planes, trains and automobiles, for example.

Vicki:

But the idea of getting quality sleep on vacation is common. A lot of folks will say, I just can’t wait to go on vacation. They’ll be able to catch up on their sleep.

Marty:

Mm-hmm (affirmative).

Vicki:

Why is it that people are able to feel better on vacation and catch up on their sleep? Is it just because not working? what’s going on?

Marty:

It’s a couple of things. So, one is they tend to engage in more self-care and self-compassion when you’re on vacation, because it’s more of an inward focus about me. The other thing too is they begin to sleep according to their chronotype.

Marty:

So, we all have a chronotype that is dictated by our clock gene. Everybody has a clock gene. And for example, I’m an early morning person. Some people are intermediate. Some people are late night. So, after about the age of 15, that type is set for life, it’s genetically determined. You can’t change it. You can accommodate, you can’t change it.

Marty:

So, on vacation, what people may do is their sleep routine actually becomes aligned with their chronotype, not their work schedule, not their family schedule, not their social schedule. So, that’s another reason why people experience more rest, because they are falling asleep and waking up at the right time.

Marty:

So, to really improve sleep, you need two things. One that I talked about, you need to increase your sleep debt or your sleep pressure. That’s one factor. The other factor is you need to fall asleep and wake up at the right time for you, which is based on your chronotype. And remember there are three types of chronotypes.

Marty:

And people also tend to be a little bit more relaxed during vacation, unless it’s like a stressful family reunion situation. So, those are some reasons why people are able to have higher quality sleep and more sleep.

Vicki:

So, the idea of getting good sleep during the week when you’re not on vacation can really boil down to something that you said, and we can definitely talk about this, because it’s something that I think is so needed right now, and that is self-care. It sounds like you’re saying that if there’s increased self-care, that can absolutely help your quality of sleep. Can you just touch on that briefly before we close?

Marty:

Yeah, definitely. So, before I get to self-care, self-care are things that you may do for yourself, or things that you’ve stopped doing that you know are not good for you. There’s got to be some self-compassion as well. And the compassion is having empathy and concern for you. But that doesn’t mean you’re egotistical or you don’t like other people, but having some empathy for you, now and in the future. Then the self-care is first recognizing what’s my type? Early morning, intermediate late evening? What do I notice about days when I wake up feeling refreshed and restored? And what happened the previous day in order for that to happen?

Marty:

So, maybe I engage in physical activity for 20 minutes. Maybe I meditate or engage in something spiritual for 10 minutes. Maybe I didn’t eat as many high-fat, high-carbohydrate, high-sugary foods. So, it’s the noticing first. And then it’s being able to focus on one behavior at a time. Make that change, and making that part of your daily ritual, because you know that it’s important for you, and it will be of value to you as well as others.

Marty:

So, I think that’s where really self-care comes in, is noticing what are the patterns that work? What are the patterns that don’t work? Celebrate those that do work. Those that are not working, try to modify one behavior at a time until you develop a new habit and new ritual.

Vicki:

Marty, thank you so much. You have provided us with some excellent sleep tips. I know that those who are listening will walk away with some great takeaways on how not just to help themselves fall asleep in the middle of the night, but also set an intention to have a good night’s rest. Something I know that we all probably need in this day and age. So Marty, thank you so much for your time. We are glad to have you.

Marty:

You’re more than welcome.