Why women's sleep changes across the life cycle

In this conversation, Sarah Bolitho and Dr Sarah Gilchrist discuss the critical role of sleep in women's health and performance - not just sport but business, fitness, and daily life!

They explore the gaps in sleep education among health professionals, the unique sleep challenges women face throughout their life stages, and the shift from the concept of sleep hygiene to sleep health. 

Their discussion emphasises the importance of stress management, practical strategies for improving sleep, and the psychological aspects of sleep. 

They also touch on societal issues like bed poverty and the need for individualised approaches to sleep health.

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Transcript

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Sarah Bolitho (00:01)

Hello and welcome to Creating Active Lives with me, Sarah Bolitho and my regular guests who are all here to share research, strategies, science, tips, whatever to help you create a more active life. something that is really, really important in an active life is getting enough sleep, getting enough rest. And I'm really pleased to welcome back Dr. Sarah Gilchrist to talk.

A little bit more about how sleep impacts on women. Sarah, if you remember from the last podcast episode, she spent well over 20 years working in high performance sport. Lattell is a technical lead for the English Institute of Sport and also senior physiologist with British Rowing. She has a doctorate in sleep and athletic performance and provides consultancy on high performance area, particularly relating to sleep health through her consultancy on focus performance.

Now one of the reasons I've asked Sarah back is she's just published a book called The Essential Guide to Women's Sleep, which aims to support healthy sleep practices for well-being and performance. For me, this is such an important book for anybody who works with women in any capacity whatsoever, whether you're a doctor, whether you're a fitness professional, whether you're a business coach, understanding sleep and how it impacts on women is so important in performance in any field.

whether you're stay at home mum or a CEO, sleep makes a difference doesn't it? So welcome back Sarah, is there anything you'd like to add to that bio or should we just get straight into the questions I've got?

Sarah Gilchrist (01:38)

Hello, thank you for having me back and thank you for the introduction.

Sarah Bolitho (01:43)

Cool, so I think from before, you you've always been interested in how sleep impacts on performance and we know, we all know, don't we? We've had a bad night's We kind of don't feel quite as good the next day. What surprised me, there's quite a few things in the book that really, really stood out for me and one of them is the lack of sleep education, if you like, amongst medical professionals. And I think it's quite low, isn't it?

Sarah Gilchrist (02:11)

It's stark, yeah. Not just medical professionals, all allied health professionals, but particularly medicine. Unless until you specialize, say, cardiorespiratory medicine, for example, or psychiatry, psychology, there is very limited education around sleep in the curriculum. And the curriculum is full. So what would you take out to put in sleep education? But if you think that sleep is the crux of physical and mental well-being, it's the significant impact factor.

on all our pillars of health, really having some education in the medical education syllabus would I think be impactful. But the argument would always be what do you take out of the curriculum to replace it with?

Sarah Bolitho (02:58)

Yeah, and I mean a lot of what we call lifestyle related stuff is lacking generally. And I get that curricula are very, very full already. But it's something that, I mean I've never been asked about my sleep patterns when I've gone along for anything. And I think it's something that quite often it could, like you say, it's the crux of all our physical and mental well-being and health. And yet it's something we just take for granted. We go to bed, we sleep, we sleep well, we sleep badly, whatever.

We never look at it as potentially, actually, it's not the headaches and the aches and the this and the that. It's the fact that we're not resting. We're not getting restful sleep. Now, specifically for women, and obviously men have sleep issues too, but that's a whole other book written by somebody else out there somewhere. The other things that stood out was women generally report better sleep, but have more sleep related complaints. And that's kind of a bit of paradox. So tell me about that.

Sarah Gilchrist (04:01)

I think the reporting bed sleep tends to be because they might pay attention to the sleep more so they might go to bed earlier or wake up a little bit later but that's not to say women are having lines and men are getting up at 6am, that's not the case but that tends to be that women will make a conscious choice to go to bed earlier if they're tired so that tends to be where that information comes from but then whilst we are asleep then we have the sleep challenges across our life cycle so whether it's period pain wakeners up or heavy bleeding wokeners up ⁓ throughout the menstrual cycle or whether it's pregnancy or whether postpartum or perimenopausal symptoms, something throughout our life cycle potentially could cause us sleep issues. Not just the hormone transitions either, it could be shift worker, health and social care is the biggest growing industry in the UK of which women make up the largest proportion of workers in that industry.

So if you're a shift worker, you're in a leadership position, you've got young children, sandwich generation, perhaps you've got older parents as well, perhaps you've got co-morbidity, you can start to build a picture as to why women's sleep might be challenged throughout their life cycle, but particularly as we get into middle age as well.

Sarah Bolitho (05:15)

is always you know there's so many things and it's just like oh it's this it's very menopause perimenopause it's like I don't care what it is I just want to know what to do about it and like you say you know like going to bed earlier and when I've had a bug recently and I've been going to bed much earlier than usual and I was sort of thinking oh you know I'm to bed a bit early and I thought no I'm a grown-up I'm looking after my health if I want to go to bed at seven o'clock read for an hour and then sleep there's nothing stopping me

Sarah Gilchrist (05:22)

That's what you need to do at the minute.

Sarah Bolitho (05:41)

And I'm in a position where I can do that, but I think a lot of women have other responsibilities, which mean that being able say, everybody, I'm off to bed just isn't practical, is it?

Sarah Gilchrist (05:51)

Yeah, and that's one of the things in the book is to say you can't be idealistic about sleep because then you will just get yourself in a mess because you just you can't have perfect sleep all the time and approach you have to be pragmatic and I talk about the five principles of good sleep from Professor Colin Espiony's colleagues you protect, you personalise, you value etc your sleep trust it's a natural process.

And that's very useful advice, but you have to be pragmatic with it. It's all very well personalizing that sleep window and protecting it. But if you've got a huge work project that's landed on your desk unexpectedly, or the children are ill or something, you know, there's a life stressor that's popped up. You can't just park that and go, well, I need to go to sleep at nine 30, 10 o'clock, because that's my sleep schedule. You have to accept that there is a give and take with your sleep. But if you've had good sleep in the first place, you will return to good sleep.  once that temporary life stress is passed or that illness is passed. And obviously for ill you just need to sleep. That is what will accelerate your recovery is getting good sleep during the phase of a period of illness.

Sarah Bolitho (06:57)

Yeah, and it's because I know one of the things you mentioned is, you know, sleep isn't just about recovery. We tend to think, particularly us in the fitness field, you know, we know sleep is where the muscle growth, the muscle repair, injury, things happen. But actually, so it's also about our immune systems maintaining our kind of barriers to bugs and illnesses and things and keeping us fit and healthy.

Sarah Gilchrist (07:23)

Yeah, sure. In the short and long term. So we know that chronic poor sleep, unfortunately, will lead to certain disease states in later life. But also short term poor sleep certainly compromises your immune system. So that is when you're going to pick up the coughs and the colds, particularly this time of year, because you sleep deprived, your immune system is challenged. ⁓ And you're just, know, in layman's terms, you're run down and you're going to pick up those bugs more easily or potentially pick up those bugs more easily than you might if you were running on a full battery, so to speak.

Sarah Bolitho (07:57)

Yeah, and particularly this time of year, batteries tend to get bit depleted, don't they? You do say that, you know, we know food, water, oxygen are absolutely essential. You wouldn't go without water, you wouldn't go without food. And yet sleep, as you mentioned, is as essential. And in actual fact, sleep deprivation is a form of torture, isn't it? Because it cannot, yeah.

Sarah Gilchrist (08:01)

Yeah, I mean, that's no coincidence that, yeah, sleep deprivation is a torture technique. You just feel horrendous if you don't sleep. And the Guinness Book of World Records stopped world record attempts of staying awake because it was ⁓ a life limiting. It was a dangerous, it's a dangerous activity to engage in. And they obviously didn't want to encourage it. So they've stopped that world record attempt being allowed now because it's just not safe.

Sarah Bolitho (08:31)

Really?

Thank goodness for that. Now, one of the things I want to talk about kind of female sleep specifics in a moment, but one of things I really, really like, and I think you've talked about this before with me, but is moving away from the term sleep hygiene, because that kind of, it's a bit fluffy and vague and things, but moving much more towards sleep health. Why are we moving away into more of a sleep health rather than hygiene?

Sarah Gilchrist (08:45)

Yes.  That's it.

I think that the guy who coined the phrase I said in the book originally didn't like it because it has connotations of people assuming well you know how clean is your bed and I think he termed the phrase for lack of a better alternative and it's stuck essentially and it is used a lot by health practitioners because you know it does what it says on the tin but I prefer sleep health because that is it's much more you know in line with physical health, mental health, the language that we tend to use these days around our overall health and wellbeing. And it's an umbrella term that I always describe it encompasses the quality of your sleep, the quantity, the regularity of it, the consistency of your sleep, assuming there is the absence of a sleep disorder as well. And so all of these variables that make up your sleep are summed up in that phrase, sleep health. And it's just a bit of a bugbear of mine that like, I'd rather use sort of a contemporary phrase that people can relate to, rather than sleep hygiene, which the guy who invented it himself said, I don't really like it. And people still do say to me, well, what does that mean? Like how clean is my bed? It's like, well, no. Whereas sleep health people can relate to, I think.

Sarah Bolitho (10:21)

Yeah, we'll on to beds in little bit. But the other thing as well, as I say, we'll talk about specifically on women in a moment, but one in four people in the UK report stress as being a key factor in sleep loss. And again, this is something I think we talk a lot about things like stress management, relaxation and things, but we talk about them as almost stress management techniques rather than as a natural part of our lifestyle.

Do you think that having a regular relaxation or whatever practice in your life, regardless of the stress you perceive yourself to be experiencing, is helpful for sleep?

Sarah Gilchrist (10:50)

Certainly, from a physiological point of view, if you're stressed, your cortisol levels are high, the stress hormone, and whilst it has a natural rhythm throughout the day, what you want to avoid, certainly on a long-term basis, is cortisol levels remaining high, because then your body's in a fight or flight response and stress response, so that is then going to lead to certain disease states later in life, for example, it's going to to short-term health implications and it has a knock-on effect on your sleep.

in terms of the mechanisms that signal sleep and help us get to sleep. Elevated cortisol levels are not our friend when we're trying to be in a relaxed, calm state to fall asleep. yeah, if you can find mind-body exercise, so yoga, pilates, Tai Chi, relaxation is like sleep. It's an entirely individualized process. So me saying to someone, if you do mindfulness techniques, you will feel you will sleep better.

They might hate mindfulness techniques, you know, it's not going to make any difference to them. So it's finding your calm, finding what helps you relax. And for some people, like with the screen conversation, it might be watching TV is what helps them relax. And that's fine for adults, as long as you don't go beyond your sleep time. So you recognize, you know, it's 1030 lights out, you know, scroll through the next Netflix three episodes or whatever. And, you know, having that self-regulation, the hard point with that is that adolescents, children can't do that. They don't have the emotional maturity to self-regulate the screen time. And so that relaxation TV time for them doesn't necessarily equate to good sleep sometimes.

Sarah Bolitho (12:47)

For me it's sketching I love to do little bit sketching at night I find creative stuff like that really really good which is really good. So women then let's move on to how how impacted our lives are at different phases by issues relating to sleep or how sleep impacts on our lives

Sarah Gilchrist (12:52)

Well, it's across the lifespan. And it's not to say that men don't suffer poor sleep, of course, they may well do. But the focus of the book was obviously on women and the point at which sleep differs is during puberty. That's when we start to see gender differences in sleep, driven mainly by the onset of menstrual cycle in girls, obviously, and the fact that it may be that there's some symptoms around PMS, so anxiety perhaps, or elevated core temperature before that period of time, before the period starts. During your period itself, maybe it's pain, maybe it's heavy bleeding. So that's the point in a woman's life where we start to see differences in sleep. then onwards, pregnancy tends to be around mechanical and anatomical changes related to pregnancy. It could be throughout pregnancy or just in the third trimester.

Everybody is different. Some people might not be affected, but some people are affected quite starkly all the way through. And then obviously then you move into newborn parent phase or postpartum and then obviously into perimenopause. And the thing with the perimenopause is that those symptoms can start in your early forties, but the average age of the ⁓ menopause itself, the cessation of periods, 12 months without a period, that point where you have stopped having periods is about 52.

So if you're having perimenopausal symptoms in your early 40s or earlier, but the actual menopause for you occurs in your early 50s, that's a significant period of time where potentially you're having issues with your sleep. And we know that during the perimenopause, sleep is the overarching debilitating symptom. There are obviously other symptoms, but the sleep is particularly affected, whether it's hot flushes, whether it's anxiety and depression, whether it's insomnia, there's lots of reasons why and there's a hormone aspect to it as well. know estrogen and progesterone have a regulatory effect on sleep. They're obviously having their own roller coaster ride during the perimenopause. They don't steadily decline, they fluctuate throughout that perimenopausal phase. So during the hormone transitions of a woman's life, there are certain challenges of the sleep plus also maybe like I said earlier, sandwich generation, young children, parents, shift work, there's an interaction with pain in women's sleep as well, so there's lots of factors that not just the hormone transitions that can influence a woman's sleep across her lifetime.

Sarah Bolitho (15:43)

There are, funnily enough, was talking to someone yesterday about ⁓ greater trochanter, is it greater trochanter hip pain? And of course you can't get comfortable for anyone that's not familiar, it's kind of the head of the femur, the head of the big bone in the body and the hip. And when that's in pain, you just cannot get comfortable and that has an impact. Do you think, I mean, talking about perimenopause, obviously there are lots of changes and quite often people don't realise that they're getting towards that. Do you think it's possible that you develop kind of issues with sleep but it becomes almost like bad sleep becomes a habit.

Sarah Gilchrist (16:16)

Yeah, or an acceptance. It's like, well, that's the phase of life. you know, I'm going to have anxiety around when my period's due because it's a new symptom, but it's just perimenopause and it's going to stop me sleeping. Or the insomnia creeps in. So that inability to get to sleep or the persistent night wakenings and cognitive therapy for insomnia has been shown, you know, proven to have a positive effect on that. But people don't realize you can access it virtually. There are free CBTI apps available through the NHS, through Sleepio, Sleepful from Loughborough University, another free app. So you can try it without having to go and see a therapist and people, think there's a barrier with that or an acceptance is that this is just what my sleep is at this stage of my life and I just have to get on with it. Whereas there are interventions that can help and don't often require a referral from a GP. You can do it from the comfort of your own home, for example.

Sarah Bolitho (17:14)

going back to what you were saying earlier about people having obviously different responsibilities, different things going on in their lives, sometimes it's hard to know where to start and we'll talk about kind of what the sort of things we can do to help it but one of the, and we know anxiety is a big issue with sleep, particularly when you're awake in the middle of the night because you're kind of half awake half asleep and a thought pops in your head that in the daytime you would be like but in the middle of the night suddenly it takes on, oh my goodness we're going to be homeless living under a bridge proportions. But one thing you did, you mentioned when we talked about bed hygiene it's sort of cleanliness, but you mentioned bed poverty which I think is worth explaining.

Sarah Gilchrist (17:56)

Yeah, so unfortunately, that is an issue globally, but particularly in the UK where people don't necessarily have sufficient bedrooms, beds, or mattresses, know, that, can, you know, for their family or themselves or their sharing beds, you know, it's a, it's a real issue in terms of socioeconomic deprived areas where you just, people don't have access to comfortable beds, mattresses, warm beds., or like I say, many people sharing a room, many people sharing a bed and there are certain charities that are looking to help and they're referenced in the book. I know the sleep charity do a lot of work in that area as well, but it's not just a case of thinking, well, how do I get a good sleep schedule? Sometimes it's actually what people are sleeping on and in that is not gonna help either, unfortunately.

Sarah Bolitho (18:56)

I suppose as well you kind of almost get used to a bad bed because it gradually happens and most of us you sometimes you go you sleep somewhere else and it's a very uncomfortable bed you're aware of it straight away but I suppose like anything if it's been creeping up gradually you don't realize the impact it's having on sleep.

Sarah Gilchrist (19:03)

No, and the general advice on mattresses for example is you should replace it every 10 years. Not everyone has the financial means to do that. Ideally that's what you should do in terms of making sure the mattress is fit for purpose and it's comfortable for you. Or a spare room, if you've got sleep apnea or your partner's got sleep apnea so the snoring is perhaps keeping you awake.

Sarah Bolitho (19:27)

No.

Sarah Gilchrist (19:43)

You don't often have a spare room. You don't have the choice to go and sleep somewhere else. know, and sleeping on the day is not really a comfortable option. And then you've got other issues affecting your sleep because you can be not comfortable and you're not in a bed. So it's, it's tricky, you know, in terms of you can't just assume that everyone has an easy solution to, to their sleep for just from a practical point of view in terms of a spare room or a comfortable bed.

Sarah Bolitho (19:48)

Yeah.  And this is it, sleep is such an important part. mean, we spend ideally a third of our lives asleep. Therefore, I mean, that's how important it is, is that, you know, nature has decided this needs to be a third of your life in order to function properly. So.

Sarah Gilchrist (20:16)

Yes, again, exactly. A good sleep system, your bed, your pillow, your mattress, all of that. Yeah.

Sarah Bolitho (20:28)

So as women, what can we do to create positive sleep health? And I know we'll probably talk about lots of different things here. And I know before you said, pick one thing that you think I can actually manage this one thing to start with, rather than thinking, my goodness, they've given us 10 things we've got to do and it's too much. It's kind of here are some strategies. Pick one that you think you can manage. So what is what would be your first recommendation to somebody that says Do you know what? My sleep's awful. Where can I start?

Sarah Gilchrist (21:00)

I would say that giving themselves the opportunity to get good sleep in the first place. So allowing themselves, know, allowing that downtime in the evening, allowing that window of opportunity to get good sleep. You know, so get trying as much as possible, I'd say be pragmatic, but as much as possible get into bed at the time that they want to be in bed, rather than saying, well, I've got to do this, I've got to do that. You know, you will, you will have responsibilities and commitments. But there is a point in the evening where it becomes about you because you've got to get to sleep and it's just creating that opportunity to get to sleep.

Sarah Bolitho (21:29)

Yeah, so pre bedtime management really, it's sort of, know, and structuring any tasks and things that you do so that you've got wind down time. Bit like a workout really, in that you work out, you then cool down. So it's kind of the equivalent of a cool down for your day, preparing you for sleep and managing what tasks you have to do maybe in.

Sarah Gilchrist (21:35)

Yeah, exactly.

Sarah Bolitho (21:57)

maybe having more efficient time management, which is not easy, everybody listening, I know it's not easy. Sometimes you do suddenly think of something you've got to do, but having maybe a checklist that you can just go through and remind yourself. So if people start with a good pre-sleep routine, what else can we do? How can we build on that?

Sarah Gilchrist (22:05)

Yeah.  I think if there's known factors during the night that are, because you will get age related factors that wake up. So the two, three o'clock waking, once you're into your middle age and to later life is, you know, it's age related. might be the fact that you're getting up more often to go to the toilet or it might be like you're experiencing hot flushes or, ⁓ so sometimes it's out of, out of your control, but you can manage around that. And the whole point of if you waking up during the night, if it's been 30 minutes or more, take yourself out of that stressful environment of being in bed and not being asleep. Go to a cool, calm, dimly lit room and do something that's relaxing for you and then take yourself back to bed when you feel sleepy. So it's having management strategies for during the night if there are issues or if you like have a noisy neighborhood, perhaps try some earplugs. There's so many earplugs out there now. I mean, it used to be just those horrible phone ones that really uncovers them. I mean, there's a whole , and I think I referred to it in the book, there's a whole article in the Telegraph last year about earplugs, like who knew? But there are many. So if noise is an issue for you, perhaps you need to look at that. Or blackout blinds, if there's bright lights outside your window. Or eye mask, for example, or heavy curtains, whatever it might be. But again, also then it might be like if it is perimenopausal issues, if it's hot flushes like the chillo, the cool pillows or ice packs on your pillow, water by the bed, a change of clothes, another set of pajamas that's ready to hand so that you can quickly overcome that uncomfortableness of being hot and sweaty in pajamas and then cooling down and being cold, get a fresh pair on, get back to sleep. So where possible, you can't often predict what's going to wake you up in the night, but if you know you're experiencing some symptoms,

And then sometimes it is GP referral and you might need an intervention. If it's sleep apnea, certainly there are interventions available, but that is a GP referral. Or if it's insomnia, like I said, cognitive behavioral therapy for insomnia has a proven technique. There's lots of different ways in which CBT-I might be beneficial for you. And often it's based on the interaction with the therapist as well. You might need to try one or two therapists to see what works for you, or even virtual therapy, there's lots available. So sometimes maybe an intervention is needed, but oftentimes it's the practical strategy that makes a big difference quite quickly if there is no sleep disorder lurking.

Sarah Bolitho (24:55)

Is, I mean, going back to the hot, hot, flushes and night sweats, are there better clothing fabrics to wear? Right.

Sarah Gilchrist (25:04)

Yeah, sure. So cotton, cotton, obviously breathable fabrics. And I think a couple of years ago, ⁓ Donnell Mill even did like a bedding range, you know, more breathable bedding in terms of the duvet. And things like, you know, changing the tug of the duvet at this time of year, you know, starts to get into spring, it gets a bit warmer in summer, obviously you don't want a thick winter tug. Or even the Scandinavian method where you have a different tog basically two separate beds as a double bed so that you know if you're overheating but your bed partner likes to be all warm then you know you can get different tog duvets or even just have two duvets on the bed one for you and one for them.

Sarah Bolitho (25:33)

Yeah. there's no argument then about who's to deal with it.

Obviously, I mean, I'm not going to spend too long with things like alcohol and caffeine, because I think most people will know that they do impact on the quality of sleep. Alcohol is more of a sedative than a sleep aid, and caffeine, for a lot of people, will perk them up rather than calm them down. So I think most people will know. But other nutrition and hydration generally, what can we do?

Sarah Gilchrist (26:09)

Yeah.  So obviously a balanced diet, timing your meals, right? So not having too heavy of a meal too close to going to sleep. Your gut needs to be in a rested state, obviously, help with sleep. You don't want to rest this night sleep while you're trying to process a really heavy meal. Hot and spicy foods, particularly perimenopausal, if you're having the hot flushes, hot and spicy foods aren't really going to help. And regular hydration, obviously, you know, think it's two litres a day is the suggested for a healthy adult.

But if you are having most of that in the hour before bed, then you're going to be awake all night. So you need to obviously hydrate throughout the day anyway, not just for your sleep. But if you know that you've particularly got age related increased nighttime trips to the loo, then maybe that hour before bed decrease your fluid intake.

Sarah Bolitho (27:00)

What about, I mean, there are so many kind of knock-on effects of bad sleep. And I think one of the things you said last time, and it really stuck with me, was, because I don't sleep very well, I haven't done for years, probably got in the habit, perimenopausally, and I've never really got out of the habit of it. And one of the things you said to me, which really struck me was, are you falling asleep? Are you tired? Are you unable to perform during the day? And I went, well, no, there's no real impact.

And you said, isn't that because I wouldn't worry? And that actually helped me because now if I wake up, instead of thinking, oh my goodness, I've got, oh, if I go to sleep now, I'll have five, oh no, it's four hours, oh no, it's three, I just think, do you what, I'm gonna read, it doesn't matter. And that kind of, it lifts the anxiety from me that, do you know what, it's not having an impact on my day. Better sleep might make me perform better, but it's not, I'm not performing badly.

Sarah Gilchrist (27:31)

Exactly.

Sarah Bolitho (27:56)

And I think that was a big thing was kind of shifting the worry about not sleeping and actually folk, and it kind of actually, I don't get as many terrible nights now. I do get them, but I don't get as many. And I think for me that, okay, I'm not falling asleep during the day. It was a big game changer for me because it did stop me fretting when I was going to bed, am I going to sleep well? now it's kind of like I'll sleep well I won't sleep well doesn't make a difference it does but yeah

Sarah Gilchrist (28:25)

And that's encouraging to hear, but yeah, I thinkyou've hit the nail on the head. Like I'm not a psychologist, a lot of sleep is psychophysiological. Then there isn't that huge psychological aspect to sleep. And if you are fretting, like you say about it, then you're not going to fall asleep easily or fall back to sleep more easily. So yes, if the single best marker of sleep subjectively is if you wake up with the alarm bit groggy when you wake up, but on the whole, if you're alert fully refreshed or alert refreshed and fully productive during the working day, chances are getting enough sleep. If you've got excessive daytime sleepiness, so you're falling asleep for lunchtime, know, a cup of coffee normally, you know, helps in the morning, isn't having any effect. You know, all of these symptoms suggesting that really in the daytime, you just want to fall asleep, then clearly you're not getting enough sleep. But if on the whole you're accessing daylight, you've got some movement in your day, you're eating at normal times, you're hydrated you've got a regular sleep schedule on the whole and know accepting there's some age-related night wakenings but it's not impacting on the quality of life the following day then then you're okay you know you're kind of safe in the knowledge that you're not having to address sleep in a major way and those night wakenings you can deal with with some relaxation some reading because that works for you.

Sarah Bolitho (29:50)

and some sleep extension strategies which is a lovely, lovely way of saying, having a nap during the day. I'm a great believer that if you think occasionally, I sometimes think, do you know what, just be like a 20 minute nap. And I do that, it's 20 minutes, I wake up, I absolutely fine. it's, again, it's giving you some permission sometimes, isn't it, to just say, right, I've got 10 minutes, I'll have a quick, even if it's just, I'm just gonna relax for 10 minutes and do nothing.

Sarah Gilchrist (29:52)

Yeah, the body needs, know, we operate in homeostasis in a balanced state and that sleep pressure that builds throughout the day, and we fall asleep at night, napping helps, you know, offset that sleep pressure that builds up throughout the day. And if you've got the circumstances, the motivation and the opportunity to nap, then great, 20, 30 minutes, light sleep, it will help. It's not for everyone, in which case some downtime will be equally helpful.

Sarah Bolitho (30:19)

It's helpful, isn't it?

Sarah Gilchrist (30:48)

If you don't like naps, don't force it. Then you'll get into it. Just, yeah, chill.

Sarah Bolitho (30:48)

Sometimes it's just switching off, isn't it? It's just actually taking time out. And that's again, something having had kind of illnesses recently, I've got in the habit of taking a lunch hour, which is somebody self-employed is sometimes you don't. And I actually take a lunch hour and I do something creative, I do some sketching or something. And I find that I'm a lot more productive in the afternoon as a result. so sometimes it is looking at your day and just kind of just managing your debit better, allowing yourself if you need rest to rest, if you need a nap, have a nap. If you need to go to bed earlier or stay in bed later, although we kind of want to stick to the same routine, don't we? So we know for women then that although, like I say, women kind of tend to say they sleep better, in actual fact, they have more issues. What's the overriding advice that you would give above anything else to women who are listening and saying, know, do you know what, just, don't see that I can ever sleep well again.

Sarah Gilchrist (31:55)

That's a really good question because women, will just get on with it, won't we? As always. Yeah. Yeah, just get on with it. It's always been the case. I just think that have a go at making something, improving some aspect of your sleep, whether it's an appointment with the GP, because if you're honest with yourself, you think actually I might have, there might be some sleep apnea, I'm waking up with morning headaches, which is a particular symptom for women with sleep apnea. So that's that inability to take on board enough oxygen during sleep because the neck girth's too much pressure on the windpipe. And that would require an intervention, but it might be that, you know, in a few months time with that intervention, you're sleeping much better. It might be that just making some changes to your pre bedtime routine is all that's needed and allowing yourself to do that and asking for help.

I think, whether that's in the household or professionally from, you know, referral. ⁓

Sarah Bolitho (32:54)

Yes, and maybe letting go of the need to sleep perfectly and just, you know, tap into sleeping better. So to start with and things like that. Are there opportunities for people to learn more about training so they can support people more precisely, if you like, with sleep?

Sarah Gilchrist (33:04)

Yeah, so the Sleep Charity offer courses, have sleep ambassadors in the workplace. So there's lots of courses on their website where people can if they want to learn more about sleep to help others. There's some opportunities there.

Sarah Bolitho (33:32)

We hear a lot about trauma-informed training and things at the moment, but I think sleep-informed training is also really important, particularly if you're working with anyone whose job requires, or whose day requires them to perform. It's such an important part. Cool.

Sarah Gilchrist (33:45)

Yeah, construction work, and social work, any industry where health and safety is critical, you want to make sure that people are sleeping well. There's enough, I mean, there's examples in the book of where that hasn't happened and there's been catastrophic incidences. So, yeah.

Sarah Bolitho (33:54)

Well, yeah, absolutely.

So just mentioning the book, The Essential Guide to Women's Sleep, published by Jessica Kingsley Publishers. I do have a discount code for anybody who wants to get a copy. So just what was what was the reason behind the book?

Sarah Gilchrist (34:19)

The reason behind the book, a very good friend said to me, you want to write a book, you've got all this information, putting information out on LinkedIn, but collating it, there is no resource for women's sleep. There's books on insomnia and women's sleep, but there's nothing that describes women's sleep across the life cycle and the challenges. So I decided to put it all in a book because I was having so many questions in my webinars, presenting on sleep on lots of different topics. There was always a question.

Typically perimenopause, menopausal based, sometimes related to other aspects of women's life. But that was just, that and sleep trackers are the questions that always get asked. just thought, I'm collating all these resources. I'm going to put it in a book.

Sarah Bolitho (35:05)

have to admit and I'm I think you called them wearables and unbearables or something last time yeah I mean to me I kind of know if I've had a good night's or I haven't I don't need I don't need to track it and I think sometimes it can be a little bit kind of obsessive and things so

Sarah Gilchrist (35:09)

wearables, nearables and unbearables, yeah. them.

Well, that's also the perfect pursuit of sleep and not classed a sleep disorder yet, but it's definitely out there as something that people will suffer from where they just get excessive ⁓ obsession about their sleep data from those trackers. So they're good for a point monitoring change, but be careful.

Brilliant. Sarah, thank you so much. It's for me, as I say, somebody who doesn't take particularly well. I know when we talked before, you kind of removed my anxiety around that. And I know a couple of the things in the book, I'm kind of really tapping into thinking, right, I'm just going to change this, including changing my actual bedding and pillows, because I know that there is time for a change. And, you know, if you can't afford to change the mattress, at least other things or get a topper or something.

Sarah Gilchrist (35:45)

You're welcome. ⁓

Sarah Bolitho (36:09)

But thank  you so much. Where can people find out more about you and about what you do?

Sarah Gilchrist (36:14)

So I'm on Instagram, Gilchrist perf, or you've got LinkedIn, Sarah Gilchrist on LinkedIn, and then website, Gilchrist Performance, and then obviously the book..

Sarah Bolitho (36:27)

I'll put all the links and the discount link for the book in the bio for the episode. Thank you so much for coming back and talking about sleep again, which is such an important part of our lifestyle. Yeah, no, definitely. And thank you all for listening to Creating Active Lives with me, Sarah, and my guest this week, another Sarah. Join me each week for more on how to create safe, sustainable, and most importantly, enjoyable activity in your life.

Sarah Gilchrist (36:37)

You're welcome. I'm glad it helped you, nothing else.

Sarah Bolitho (36:57)

and we now know that sleep is an underpinning part of all of that. So thank you for listening and I will see you next time.