In this episode we talk with the multi-talented sleep and anxiety expert, Dr. Melissa Milanak, concerning the truth about sleep along with new insights and helpful tips to improve our sleep and our overall well-being and balance. Learn more about Dr. Milanak's work at www.mindimpactconsulting.com.
Introduction: This podcast is brought to you by the South Carolina department of mental health a healthcare organization providing innovative mental health and Wellness services across all of South Carolina learn more about our services and resources at www.scdmh.net.
Moderator (M): In today's episode we talk with the multitalented sleep and anxiety expert, associate professor at the Medical University of South Carolina, clinical psychologist, and founder of Mind Impact Consulting – Dr. Melissa Milanak. It turns out that most of us take sleep for granted but exciting new research is debunking myths and offering new insights into the power and importance of sleep for well-being and balance. What follows is an important conversation about sleep that will both surprise you and offer new possibilities to improve your overall health and well-being.
Welcome Dr. Milanak I appreciate you being here and we're going to talk about sleep today. All the work that you've done - I know you've done a lot of research and you've been really all over across the globe with all these different academic institutions and seminars talking about sleep. And so I'm excited to get your time so we can have this conversation. Why don't we just get right into the nitty gritty of it and talk about some things that I know my audience is interested in and that is what are some common myths that you know about or misunderstandings or whatever it may be around sleep?
Guest (G): Well thank you David. I'm really happy to have the chance to be here and there are a lot of myths that are out there about sleep. For many people they really think that the duration, how long you're sleeping, is the main thing that matters and what we know is that number 8 is an average and so yes for most people they are not getting enough sleep and you hear lots of the pressures of society - you snooze, you lose; time is money. People try to convince themselves that they can get by on less sleep which is a whole other method itself but I think the thing that's really important and key here is to recognize it is an average and so it's really determining what the ideal amount of sleep is for you, for your body, for your mind, for that restorative sleep for your current stage of life. Your physical activity, your psychological mental activity, and that will change over the course of Life.
M: So some of the criteria for assessing what's the best sleep for you is where you are in your life in terms of your stage, your age, what other things would determine that in terms of whether you should have more sleep or less sleep. Or is it trial and error? What are things that contribute to that?
G: We know that as we get older we typically need less sleep and if you think about how much sleep a newborn gets versus 6 month old, a 2 year old, a 10 year old we know that sleep is important for cell growth for obviously restoration and repair and there are lots of reasons that sleep is important. But we see a significant amount of growth of sleep needed when individuals are younger. Once we had a certain stage of our lives the only thing really growing is our waistline and that's something that we typically would like to see not happen and actually when you're not getting the ideal amount of sleep through your body that can have a negative impact on your weight and on your ability to maintain healthy weight and to lose weight which is another key piece because a lot of people are getting up really early. They want to make sure they can spend hours and hours in the gym and while we know that exercise is really important for health when you're reducing the amount of sleep that you're getting you're not going to be getting the benefits that you want to many times from your workouts. But to get back to your original question, yes it has to deal for many people for your age. The older we get we do see a change in the amount of sleep that's recommended and that the typical average person needs additionally it does play a role in terms of how your body works. People cycle through sleep differently the same way that we see metabolism to people can look exactly the same and one needs 1800 calories and one needs 2500 calories. So the same thing with our sleep is people cycle through their stages of sleep and process sleep in different ways and depending on how physically active we are how much more repair is needed will depend on how much sleep we need, how psychologically active we are, and how much time our brain needs to convert short term to long term memory and things. So there are a number of different factors from genetics, from physical and psychological activity, from age, and many other things that contribute to how much sleep each individual person needs. It is very individualized.
M: And so who are these people who need only 3 hours of sleep and they're just charging through the work day? I guess it just depends on you and your body and who you are?
G: There are a number of things that can contribute to that. We do know that for individuals, when they are younger, because of their repair rates and because of many other reasons that they may not always feel the impacts of not getting as much sleep as they need or be as aware of it because they are able to repair faster and as we get older they see that things have an impact on us in in different ways. Just like we know that sleep is important for our bodies to heal well as we become older, more mature you get injured it takes longer for your body to repair. So sometimes people will feel that differently. Additionally, we know that individuals that do have insomnia, chronic insomnia, do tend to be better at pooling their resources because they spent such a long time not getting the quality restorative sleep that they've learned other strategies and they pool their resources. But plenty of times what ends up happening is when we're sleeping we'll see a prioritization on our physical body being repaired before the psychological, before the mind being repaired because it's evolution. We want to make sure that our physical body is able to protect us from threats. We need to be able to fight or flight, run away, fight it off and so when we're not allowing our bodies and minds to have the full amount of sleep that it needs. We may get the physical repair first and wake up feeling somewhat physically rested but our mind may not be as sharp. That's why people don't always realize how much sleep impacts memory, attention, focus, concentration and all these other things. So we may wake up and think we're rested but we don't realize that we're really cheating ourselves out of the optimal sleep and that ability to have optimal performance personally and professionally.
M: OK so that’s one myth - the 8 hours is the steadfast rule you know that is a myth and it varies depending on the person so what's another myth out there around sleep that that many of us probably have?
G: So another myth for many people is that if you're having difficulty falling asleep or if you're waking up in the middle of the night that you should stay in bed and try to force yourself to sleep. Same thing where you hear people say I have a really big day tomorrow I have to go to sleep now. If I asked you if you've ever had that and when you tried to force yourself to fall asleep how well has that worked?
M: Yeah never well. A lot of tossing and turning.
G: So what ends up happening is when we're staying in bed and either our body is not tired or it hasn't built up enough sleepiness to fall asleep and that's part of it too is there's a significant difference between being really fatigued and being mentally fatigued versus being actually sleepy. So this tired versus sleepy piece for many people there's a lot of stress as we know we've engaged in for the last few years and for many people for decades. And so when we're psychologically fatigued and we're exhausted many times we misconstrue that as being physically tired and sleepy and ready to go to sleep. So we get in bed and then we can't fall asleep and then we start to associate our bed with frustration then we're laying in bed and it's the first time we've gone it's first time it's throughout the day that we don't have other distractions. So we're alone with our thoughts our minds start running and racing and worrying or planning and so we started to associate our bed with that frustration with that process time and instead of our brains connecting the bed with sleep with being able to decompress and shut down and relax and go to bed it starts to be connected with this place of worry and a frustration, which is completely counterproductive to our sleep. So if you've been in bed for longer than about 10 to 15 minutes and you're not falling asleep it's actually best to get out of bed and do something mundane, something boring, something that can just allow your body and your brain to have that decompression time. And then get back in bed when you're actually tired so that you build up that connection. It's the same reason that when our minds are running and racing one of the best tips you can do is to actually get out of bed sit with a notepad and a pen and start doing your writing. It's a tip that I share with individuals across the spectrum you can have stay at home parents, you can have corporate executives, students everything in between that one of the best things you can do is to allow your brain the opportunity to process, which we don't usually give ourselves that time for but it's so desperately needed. Take about 15 to 20 minutes before bed with a notepad and a pen right on the right side your To Do List for the next day so you're not laying in bed trying to plan it out and your brain is trying to figure out if it should shut off or stay awake even start with a quick 5 minutes with a timer and write everything out that's running through your mind. You'll start to bring all these things to the surface that you didn't realize were there and as you're doing that not only are you problem solving through but you're downloading that you're freeing up that space in your mind so it knows that it gets that time to process and it doesn't have to do that in bed. So you put on the night stand, you get in bed and if your mind keeps running and racing you get out of bed and you write more and you keep doing that just like you would teach a puppy to potty outside. You're teaching your brain that it's not allowed to process and worry in bed like that.
M: Here's a question for you around that is because you didn't mention anything about using technology so I'm assuming there was a purpose for the notepad and the pen versus us being on our phones before we're saying goodnight?
G: There's so much when it comes to technology and sleep and there's some amazing experts out there that talk a lot about digital Wellness and what we find is that one of the first key things is recognizing that light has such a significant impact on our sleep. If we think of again I talk about history and science and evolution our bodies are designed that when the sun is out that's when it's safe to be out and hunting and gathering we think throughout all the centuries and generations. And when it's dark that's time to go and be in a safe place where we can be protected our body produces different chemicals based on when we have light. So, for instance, when it starts to become dusk and the sun starts to set that's when our body actually starts to produce more melatonin usually about four to six hours before it's time to go to sleep not just right before bed, which is a another myth about when people take certain over the counter and medications. And I want to be cautious as a non-prescribing provider with recommendations but this feeds into from the technology standpoint. We know that light triggers our brains and the sleep centers of our brain to say it's time to be awake and when it's darker it's time to be asleep. So when you're on your technology, when we think about how much light that emits that actually can again be sending messages to the brain that it's light out and it's receiving light so we should stay awake. There's research that shows that being on technology can actually delay people's ability to fall asleep by hours and that when you wake up in the middle of the night and you check your phone not only does it wake up the brain from a cognitive and processing standpoint but that light also wakes you up more which makes it harder to fall back to sleep. That's why we recommend using a night light instead of an overhead light. If you wake up to use the restroom in the middle of the night you can also use light to your advantage so when you are tired in the afternoon instead of relying on caffeine and other things to wake you up or if you wake up before the sun in the morning turn on all the lights. If you can you know open and the sun is out open the windows get that exposure that boost from light that will help to keep the body going. Instead of having to rely on chemicals to wake you up so you can use light in both directions but technology the lights the big piece it also many times instead of us being able to have that decompression time and shutting down our minds when we're on our technology and we're checking our phones and our emails and other things. It keeps the brain active and so again it makes it harder for it to have that true wind down time to be able to then get prepared to fall asleep and with the same thing applied to so like you're going to bed and you can't get to sleep you know a good thing to do would be to get up and maybe do something or use this technique around the pen and paper. Let's say that it's early morning and you've woken up and you can't get yourself back to sleep. I've certainly done this and you just toss and turn because you're like, wow, I need more sleep but it's probably better to get up correct or not correct. So yes, it's a really important thing that if you were tossing and turning in bed and you've been awake for more than 10 to 15 minutes and you're not falling asleep it's best to get out of bed. Now with that being said one of the first tips we usually would share with people is that if you're alarm has not gone off do not check the clock. It actually doesn't matter what time it is because what happens is you start checking the clock and now you're thinking to yourself well I have to be up in 45 minutes am I going to fall back to sleep doesn't matter. Should I even try? And then again you get yourself more anxious and worked up versus it doesn't matter what time it is. I'm going to roll over and try to fall back to sleep so there's some of those things that we often do that we think are going to help our sleep, which we can talk about more myths and such that actually can hurt our sleep but if you are lying in bed and tossing and turning and you really are not going to fall back to sleep it is best to get out of bed. That you need to use technology when you're out of bed again we want to be cautious of the light piece so put it in night mode so that it's going to be the dark background with white lettering instead or watch television that's further away instead of potentially on a device that's closer to your face. So the amount of light that you're taking in and that you're perceiving is going to be less. There's strategies that you can also try to read something or do something that's going to be less likely to get you more amped up and activated. So don't check work e-mail. Maybe read an actual physical book right one of the things I'm going to do is turn my clock away so I don't check it and you don't want to use new technology in bed. I do have to comment that specifically because we're confusing our brain should I be awake right now or should I be asleep right now so if I said to you I was going to go to the movies and see a movie what snack would I most likely get? You think of popcorn of course so movies-popcorn. I want your brain to think bed-sleep. Not bed- eating, bed-reading, bed-doing my work, bed-stressing. The two best things that you can do to get quality sleep are going to want to be really shift the way that you're using your bed and looking at your bed to strengthen that connection is that no matter what bed you're going to be sleeping and if you're traveling for those travelers and in a hotel or visiting family you can see the bed and fall asleep. And the other piece is a consistent sleep schedule, a consistent bed and wait time seven days a week.
M: You mentioned a myth about weight gain, did I hear that correctly, or around weight gain in sleep and because I think that would be one that we would all be pretty interested in knowing about.
G: Sleep does play a role in metabolism and it plays a role in how our body processes different things. So from a weight gain standpoint there are a number of things that play a role here. One is the fact that when we are not getting enough sleep our body is going to try to find ways to have fuel to have energy to make sure that it can function. So you'll see a change in the chemicals that are produced and the way that your body what makes you feel full and satiated versus feeling hungry. You'll see that you start to crave different foods so when you're not getting the quality sleep that your body needs you create more of the sugars and the carbohydrates and the things that your body can use this quick fuel and energy and additionally what happens is that you'll see there can be shifts so that your body will oftentimes we can see for people that aren't getting the quality sleep it can even potentially start metabolizing muscle before fat because it's wanting to hold the fats to have that as a store for energy. Because you're not being able to get enough of the restoration and has to find other fuel sources to have that energy. So what I was touching on is that for some people they'll they aren't giving themselves the quality sleep and then they're waking up really early because they want to get a 2 hour workout in and have a really intense workout. And so we would talk to them about potentially sleeping longer and maybe shortening the workout or are there ways that we can figure out how we find that balance of exactly how much sleep your body needs and prioritize the sleep as much as the exercise. So both can be happening and you can be getting the ideal out of your workouts because some people will say but I'm working out for hours I'm not seeing the benefits that I want and sometimes sleep can be the culprit I want.
M: I know there's many more but I want to talk a little bit about this relationship between sleep and mental health. It's more of a bidirectional relationship right? I think in in the past that had been that people thought well lack of sleep leads to mental health issues but it's both ways. It can be that but also that'll help issues can lead to sleep problems and I don't know just in the work that you do can you talk a little bit about just that relationship that dynamic between the two?
G: Sure and I think that what you're highlighting is a really important factor here. We do see reciprocity in both directions so for many individuals that do have mental health concerns we do see that sleep is a big part of it sometimes. It would be considered a symptom so you'll see an individual for instance that may be severely depressed and they talk about where they're spending more time in bed and they're sleeping again. This is sometimes we see that myth or that inaccuracy of just because somebody doesn't have a lot of energy and is feeling more sluggish and or we hear the psychological terms psychomotor retardation and slow movements and other things but just because someone is experiencing that doesn't always mean that they need more sleep but it may just be they don't have the energy or the ability to be able to get themselves out of bed for a number of reasons. We can see the reverse where for a lot of individuals that are struggling with anxiety that the anxiety can prevent them from getting the sleep because they aren't able to shut their brains off. Their body is in this heightened state Of protecting itself because they're receiving so many threats and no matter how exhausted you are if there's a real threat your body is not going to let you sleep because sleep can be seen as a vulnerable state where you're more likely to be injured or have those threats because you can't protect yourself. And as we know for people with anxiety, many times there's a difficulty in discerning between what is an actual threat and what is the perceived or anticipated threat and so our body has the same physiological response whether the threat is present or not. We see for individuals with trauma, with PTSD there is significant research that's come out over the last ten years that's showing that sleep disruption is actually one of the most prevalent symptoms that individuals with PTSD are experiencing and not just the nightmares but the insomnia itself. Difficulty falling asleep, difficulty staying asleep, waking up early, daytime fatigue and so it's this is a great example of that reciprocity because individuals that are struggling with sleep problems end up being at higher risk of developing PTSD after experiencing a potentially traumatic event. So there's so much back and forth where when we're not sleeping in the ideal amount we know that it does have such an impact on our minds ability to process information that it can impair our learning and our creativity but also even the way that we're responding to certain types of therapies and treatments and things as well so there's a lot in both directions. How sleep unfortunately can perpetuate current mental health concerns and mental health disorders but it also can be an outcome of having them and so substance use is another really really big one.
M: Oh yes talk about that a little bit more I mean that's something I had thought about and I'm glad you brought that up so we make sure we do discuss that.
G: Well we tend to find is that many times people are either using to try to sleep or not to sleep in both directions or the sleep isn't having an impact on them. They're using so it could be the person that they are so tired and they are so anxious and they are very stressed and so I'm going to have a few drinks to just try to knock myself out and we know that sedation is different than actual restorative sleep and that's a whole other conversation we can have about how substances such as alcohol a lot of people are turning to that to try to fall asleep and while they fall asleep it actually disrupts their sleep more. It can actually suppress their ability to get certain stages of sleep like REM sleep where we are having that memory attention focus concentration work happening. For a lot of people alcohol may make them fall asleep but because of the way the body processes chemicals we'll see a few hours later that it can actually wake people up and have them feel more amped up and more stimulated. So just because we're using it to fall asleep in manner always help us to have we won't have the restorative sleep or stay asleep but you can see people using to try to fall asleep, to try to numb out from pain and other things that are happening. Or the reverse - there are individuals that for instance night time isn't a safe time. It's a scary time maybe that's when they were attacked or assaulted or something else happened or when they sleep they have nightmares or other things that they don't want to experience. So they start to take substances to try to stay awake and so we can see using to either try to sleep try not to sleep but we also know that when individuals are not sleeping well that that actually can contribute to perpetuating many different mental health concerns including playing a role even in relapse and such. There was significant work that we just published working with MUSC Center for drug and alcohol programs that specifically looked at when you're targeting sleep and anxiety within an intensive outpatient program that you can have a positive impact on reducing a lot of these mental health symptoms and impacting people's desire to use or feeling the need to use.
M: For me, sleep, I don't think about it that much until there were moments where I had problems with sleep and when that happened I was like, wow, because I think you were referring to the vicious cycle. It got to the point where it would be midday, I'm anxious about how am I going to get to sleep. You know how's that going to work and it's no fun especially when you're not getting the amount of sleep that you need. So to that point, you referenced earlier about things to help people in terms of improve their sleep and maybe we can kind of discuss that a bit. With, for example, the over the counter meds you mentioned that and I'm just curious what your thoughts are on that as sort of a solution or part of a solution for folks?
G: I'm always cautious when I answer that question that I do let folks know that I so let your listeners know that I'm not a prescribing provider I am a PhD doctor not an MD doctor and so I always encourage individuals, even if I was a prescribing provider, each person's the way that their Physiology is or their medications that they're currently taking you would always want you consult with your doctor. I think that's one of the first things is that even when individuals are wanting to use over the counter medications and supplements that they don't always realize that it's really important to still talk to your providers about it because there can be certain side effects or interactions even with vitamins and supplements. So if you want to just make that initial recommendation disclaimer but with that being said we see that there are a lot of natural remedies that people can use to positively impact their sleep. In a number of different ways I think one of the keys to recognize is that sleep is something that is a natural occurring process that our bodies are able to do. I always will encourage people to try to do behavioral changes first so that we don't become reliant on any type of medication. If we're able to have our bodies function in the ways that they were designed but there are times where we need that. We know that people's bodies may be deficient in certain vitamins and so that's why they're taking them and for instance we know that as we age we start to see a reduction in melatonin production for instance and so melatonin is one of the ones that is commonly utilized. I think that what's important is for individuals to be able to understand the correct ways to use that and what I mean is that based on the research we know that melatonin production typically happens at the highest peak around four to six hours before going to bed. Melatonin is not designed to be what we would call a sedative or hypnotic to make you fall asleep. We do know that it does help as it builds up in the system for us to feel tired and sleepy but at many times helps with what we call a phase shifter of adjusting our circadian rhythm and when we feel tired and sleepy and so if you're taking it right before bed it may not always give you the effects that you wanted to have. Additionally many times people will take really high doses and we find that and again you want to talk to your prescribing provider but that smaller dosages like 1/2 of a milligram up to three or five like the smaller doses can be enough to sometimes give the body the boost but if we are taking higher doses then sometimes our bodies will actually stop producing it altogether because it's getting it so much from external sources. So we want to be careful about too much of a good thing and lastly, because it's not regulated, it doesn't have the FDA regulation you have to be really cautious of which brands you're using. A recent study came out in the Journal of Clinical Sleep Medicine that looked it over thirty types of over the counter and found that it ranged from less than it was a minus 80 some percent to over 400% of the active ingredient depending on which brand was being utilized and about a third add serotonin and other things added to it. So there's a lot of over the counter supplements that not just melatonin you hear people talk about magnesium and other things that definitely that can have a positive impact on your sleep. It's just really important to make sure that you're using the supplements that are actually what they're said to do and designed in the way that they would be because otherwise it can be counterproductive and disrupt your sleeping in ways that aren't actually helpful.
M: So the natural remedies and I know you mentioned you like to do the behavioral changes first - would you talk a little bit more about those?
G: Sure so as we alluded to a little bit earlier a consistent sleep schedule is a really important thing and so the reason that it works that way is that your body then knows when to feel tired and knows when to wake up and it also knows how much sleep it's going to get so that it can work on that balance. We had talked earlier that as we sleep we go through different stages of sleep from falling asleep to our body physically repairing itself to that psychological repair and mental health and memory and all those pieces. And so when we're getting approximately the same amount of sleep every night our body and brain is going to be able to adjust and say you just had a really busy workout or a busy weekend or really busy work day where we using more of our mind, more of our body a little bit balance. Did you just have a medical procedure? And we need to spend a little more time with the body being repaired for a while it can balance that knowing how much time it's getting. If you were eating dinner at the same time every day so you have dinner at 6:00 o'clock you start to get hungry around 5:30 because your body knows food is coming right? And so when you're going to bed at the same time every night your body knows when to start feeling sleepy so for those that have trouble falling asleep that's a really great strategy because your body will know when to feel tired. It also will know when not to feel tired because if you feel hungry at 2:00 o'clock and you don't feed yourself at 2:00 o'clock after a few days your body's going to stop feeling hungry because it's going to realize that doesn't matter this is fruitless it's not going to happen. Same thing with sleep and when you're so if you're going to bed at the same time every night your body knows. When to feel tired when not to feel tired when you're waking up at the same time every day you'll actually see that your body will transition into the right stages of sleep that make it easier to wake up and feel more alert just like you would downshift a car to neutral instead of just shutting it down in third gear. Our body's going to wake up in the right stage that you're more likely to feel awake and alert instead of in that groggy stage where you wake up and people don't describe it as that sleep hangover. It's the same reason why naps can actually make us feel more tired and disrupt our sleep more than actually helping us.
M: So one of the things that that we're talking about here is sort of a consistent schedule right that will really kind of get the body into its appropriate rhythm which can really help from a Wellness standpoint is what I'm hearing from you so but some and that's a great way to set the stage for better sleep for yourself. Are there a couple more tips that you might give us for better sleep?
G: Sure. I think that there are lots of the dos and don'ts of sleep that you hear people talk about and so first touching on as you were saying the consistent schedule many times people will think well if I didn't sleep well last night I need to go to bed earlier the next night and what happens is when we're disrupting that schedule again if we go to bed earlier then we may not feel we may feel somewhat tired but our body doesn't know when it's supposed to feel tired. It's actually better if we can to wait until our typical bedtime because we keep on that schedule and keep on that rhythm and what is important as along the myths line as well as tips is that we can't exactly catch on sleep. We can't also free and front load sleep so it's not the same as think of the camel hump where you can drink a lot of water and store it from when it needs it later our body is only going to be able to process so much sleep at a time just like calories. If you skip dinner on Friday you may be hungry on Saturday but if you ate two full dinners your body wouldn't be able to fully process those calories in a healthy way and you may feel sick and such so it's better to have a consistent sleep. As we're doing that along those lines with other tips along with myths obviously we know that the sleep environment is important we want it to be cold dark quiet course comfortable we spend a lot of our lives in our beds. There's a lot there that we could talk about ways with the environment and bed partners and if they're snoring and noises and children and pets and many more things we could touch on there but the ideal sleep environment there's also this we talked a little bit about alcohol but caffeine also plays a big role in our their sleep and so I would say that just for individuals to realize from a caffeine standpoint it can take around 7 to 8 hours for your body to metabolize the caffeine in One Cup of coffee that long OK so the half-life is five hours and so if you're thinking about having an espresso after dinner and then wondering why difficult to fall asleep and things as well now some people can say I could have two and three espressos and go right to bed and there are reasons for that we could talk about the tolerance and the build up but also recognizing that caffeine will oftentimes block our perception of being sleepy. So that's why it doesn't mean that it actually makes us less sleepy in some ways their body is still building up sleepiness and so that's why you want to be cautious just because you're drinking a lot of caffeine may not still be the right time to safely get in a vehicle and do a long drive for instance and such so the bedroom environment we see the substances. We've talked about light. We've talked about clocks from we've talked about the importance of being physically active exercise is a great thing the more active you are the more you're exercising the more sleep you will need so if you find that you want to be sleeping more being a bit more physically active will be a healthy way to increase the amount of sleep that your body needs but many times people will spend a lot more time in bed then they actually need so maybe their body needs six or seven hours but they're trying to spend 10 hours in bed to get that we know that that will actually disrupt our sleep more. We'll toss and turn more we'll wake up more time so it's best to figure to be as efficient of a sleeper as possible ideally we'd see about 90 to 95% of the time that you're asleep that you're in bed that you would be asleep.
M: I appreciate all your time and very useful information I think I was telling you I'm writing down notes for myself right now, which will be incredibly valuable things that I really I did not know.
G: Thank you again for having me here today, very excited to share these tips. I think it's really important for individuals to remember that sleep is a natural occurring process and if not tonight the next night if you can take back control over your sleep it isn't a hopeless case and there are strategies out there to help you without having to feel that you're dragging yourself to do so for that you'll never be able to get the quality sleep again so want to give that hope statement to all your listeners that this is something that is such an important naturally occurring process and we can help them to achieve sweet dreams even in times of stress
M: I'm David Diana host and producer of a look within conversations on mental health and well-being we want to thank Dr. Melissa Milanak for joining us today and you may learn more about her work at mindimpactconsulting.com and of course we want to thank all of you for listening and hope you'll join us next time.
Close: A look within conversations on mental health and well-being podcast is hosted and produced by David Diana and the South Carolina department of mental health we hope you'll join us for our next conversation