The Upside: Invested in Wellness with Jessie Sarafian – February 4, 2026
Join us for a special episode on insomnia with Registered Respiratory Therapist Marlee Boyle. Insomnia affects up to 30% of adults, yet many people are unaware that there is a highly effective, non-medication treatment available. In this session, we’ll break down what insomnia really is, why it becomes chronic and why Cognitive Behavioural Therapy for Insomnia (CBT-I) is considered the gold-standard, first-line treatment. You’ll be introduced to the five core components of CBT-I and how they work together to improve sleep, reduce nighttime struggle and help many people decrease or eliminate reliance on sleep medications.
Transcript
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Hello, and welcome to Invested in Wellness.
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I'm Jessie Sarafian. I'm super excited for today's show.
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We are joined by special guest, Marlee Boyle.
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She's a registered respiratory therapist and co-founder of
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SleepWorks. Today we will dive into insomnia, break
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down what it really is.
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We'll also discuss cognitive behavioural therapy, its core components
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and how they work together to improve sleep, reduce nighttime
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struggle and help many people decrease or eliminate reliance
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on sleep medications.
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Marlee, thank you so much for joining us today.
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Thank you so much for having me back, Jessie.
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I'm so excited to talk about this.
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Looking forward to our conversation.
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Those on the line if you have any questions for Marlee throughout the
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show please type it in the Q&A box at the bottom of your screen.
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We'd like to keep this as interactive as possible.
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Marlee, for those of you meeting you for the first time can you tell
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us a little bit about yourself and your journey in the sleep space?
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I did take a kind of unconventional path into
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sleep therapy. I
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was a registered respiratory therapist working in critical care and
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had to do shift work. I struggled with my sleep myself
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for most of my life and then that disruption of
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trying to stay awake all night and sleep during the
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daytime and then shift back and forth, I knew I was
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kind of falling apart.
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I remember being very early in my career thinking, ooh,
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I think my sleep is going to create an expiration date for my career.
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Ironically, I looked into other areas where I
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could work and I got a job in a sleep disorder clinic and lab.
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It was working there that I found some solutions that I
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had been looking for and a lifestyle that was more conducive to
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better sleep. It was really where I fell in love with sleep as
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part of our health care.
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It's such an undervalued part of our system and
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part of our lives and yet it's so foundational.
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I do believe sleep is the best medicine.
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It was just through being able to
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see people get well and improve quality of life with improved sleep
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and overcome different health problems by
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being able to properly rest and get adequate sleep, I
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just fell in love with it and became obsessed with it and really
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grew from there and went on to do further education so
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I could continue to educate and
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help people.
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I love that and I couldn't agree more. The work that you and your
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team does at SleepWorks is amazing, so we
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appreciate you. I agree, sleep is so, so important.
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If we can't sleep we can't function.
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The big first question, what is insomnia?
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It's such a broad term.
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Absolutely. Insomnia is kind of an umbrella
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term and within that there's short term insomnia.
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Short term or maybe it's lasting a few weeks or
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a few nights and it's generally caused by something kind
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of obvious. It's usually stress, travel, illness,
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a big life change, and typically when that situation resolves
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the sleeplessness resolves.
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Either they're having difficulty falling asleep, staying asleep,
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or waking up too early.
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That's a short term insomnia that most people have
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experienced or will experience in our life.
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Then we look at the more clinical side of insomnia, which is chronic
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insomnia or long term insomnia.
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That's generally where we want to start to address some
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strategies and things because it is so detrimental to our health.
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Chronic insomnia looks like whatever that
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initial precipitating factor was that caused that sleeplessness
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is probably in the past now but the sleep problem is
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still continuing and operating on its own.
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The hallmark
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of that chronic insomnia is that we start to worry about our
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sleep and worry about not being rested, worrying about our health
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and different things from the impact of not sleeping.
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That, therefore, perpetuates the sleep problem.
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That's where we see the chronic insomnia which is people
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having trouble falling asleep, staying asleep or waking up throughout
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the night or too early for more than three nights
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a week for longer than three months.
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Yeah, wow. Why do you think so many people are so affected
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by it? Statistics show that it affects up to
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30% of adults.
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It is the most common sleep disorder in the world, in the developed
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world anyway. I do think that modern day life
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really isn't conducive to good sleep.
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We have very busy schedules.
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We have sometimes 24 hour
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operations of things, irregular schedules, we
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have screens, it's just not that conducive
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to good sleep naturally.
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It is something that we actually have to put effort towards to
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improve our sleep.
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Insomnia does affect women more often
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than men at a higher prevalence rate.
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Stress and all of those things
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that come along with it certainly are factors.
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For women, we're experiencing biological shifts
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and hormones and things like that, hormone changes,
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pregnancy, postpartum, perimenopause, menopause, we have all
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of those challenges to our sleep on top of
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the modern day life.
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Women tend to take on most of the cognitive load, we're the
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glue holding it together, and I do think
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that that's also adding to the higher prevalence for women.
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I can relate, as a woman, as a mom, we take
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so much on in the household with parenting and work and
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trying to juggle a successful and
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healthy relationship with our partner and work-life balance.
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I know when my son was very little, hardly any sleep
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but then I can still function and I can get stuff done which is wild.
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Kudos to the moms out there.
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The mom super power.
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I totally agree. What do you think are some of the misconceptions
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about insomnia?
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I think probably one of the biggest misconceptions about insomnia
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and about sleep in general is that we all need eight hours
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of sleep, and that if we got eight hours of sleep we
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would all be feeling great and doing great and our health would be
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perfect. The reality is that sleep
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varies and the amount of sleep that we need varies throughout
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different times in our lives. What you explained with raising your
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baby and you were getting by on very little sleep.
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You were totally surviving and doing something very important
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but you didn't maybe
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need as much sleep at that time to function.
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There's a big variation. The general recommendation
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is that we're getting seven to nine hours of sleep
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but there's a $100 billion industry that
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is very invested in us worrying
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about not getting eight hours of asleep, and that worry
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actually creates more problems around insomnia because
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when we're worried about not getting enough sleep being anxious or
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worrying is not conducive to being able to fall asleep.
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Our sleep needs vary a lot throughout our
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lives and eight hours is not a magic number.
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A lot of people thrive on seven hours and do very,
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very well. I do think that a
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big misconception is that we need to get eight hours
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of sleep and not getting that's going to cause us problems.
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Humans are pretty resilient and we can usually manage with
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less sleep at different periods of our life.
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The goal is just to get enough sleep that we can function
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well throughout the day. Worrying about not
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getting enough sleep is one of the reasons that we're not sleeping
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well.
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Yes, I totally agree. I want to touch on briefly, because I
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know we brought this up in our sleep series, all these tools, the
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aura ring and all these sleep apps,
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that can be counterintuitive because now you're focusing on, oh, no I
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didn't get the seven to eight hours.
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What are your thoughts on that?
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Great question. Since there's been so much new wearable technology
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for tracking our sleep there's been a new term coined
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called orthosomnia.
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It's essentially being kind of worrying about looking
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at that data and waking up every morning and saying, oh, no, I only
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got 4% of REM sleep.
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It actually does impact the way that they're
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feeling and the way they're sleeping.
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It's creating more anxiety and more pressure on them to try to
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achieve better sleep, when really trying to sleep is usually
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the problem.
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It's more of a passive behaviour. We have to kind of set ourselves up
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for sleep and let it happen.
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When we're so focused on the tracking and the numbers
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it's a lot of pressure.
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Our nervous system responds to that as, ooh, there must be something
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wrong around our sleep because we're having all these worries
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around it.
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Take the wearable information with a grain of salt.
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It is not objective data of your sleep.
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I'm sure if any of you have those wearables
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sometimes you're just lying really still and it's registering
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you that you're in deep sleep and you're, like, I'm sure I'm awake
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right now.
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That's great. I now want to get into the cognitive behavioural
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therapy. Can you explain to our viewers what that is?
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Cognitive behavioural therapy for insomnia is
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a modality of therapy.
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Cognitive behavioural therapy is very common in psychology, very
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effective modality of treatment.
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In insomnia it is the gold standard treatment for those chronic
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cases of insomnia.
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A misconception also would be that
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sleeping pills are the treatment for chronic sleep problems but
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we know that sleeping aids don't really fix the problem because we
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can take sleeping aids when we have these long term sleep problems
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and they either don't work that well or when we stop taking them
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the insomnia just comes right back.
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It never actually addressed the root problem.
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Cognitive behavioural therapy for insomnia actually addresses
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the underlying causes of insomnia which is
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whatever that initial precipitating factor was, it was the worrying
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about it and then our behaviours that followed that really ingrained
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in us that insomnia.
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Chronic insomnia is a learned condition so it can be unlearned
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and the modality is cognitive behavioural therapy for insomnia
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which is considered the first line treatment for insomnias.
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It's supposed to be the first line treatment.
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It's the preferred treatment because it's
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changing the way we think and the way that we behave around our
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sleep. There's no side effects to that which is
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wonderful compared to a lot of the pharmaceuticals that we can take
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that are much less effective for treating chronic
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insomnia.
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I understand that there's five core components of cognitive
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behavioural therapy. Can you explain each one, please?
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Absolutely.
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Cognitive behavioural therapy for insomnia is typically delivered
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over several weeks, one session a week,
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between five and eight sessions is pretty typical for a program.
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Each week you're introduced to a new core component of CBTI.
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A lot of people get cognitive behavioural therapy for
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insomnia confused with sleep hygiene, which is
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making sure your room is cool, dark and quiet and all of those
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things, but not going to be effective if you have chronic insomnia.
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The five core components that really start to change
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the trajectory of insomnia are cognitive restructuring
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is the first one.
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Cognitive restructuring is taking the worries that
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we have about our sleep which are very normal human responses
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when we are struggling with sleep.
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We have those worries, oh, no, how will I be able to function
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tomorrow, or I'm going to get sick because I'm not sleeping enough
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or we start doing the countdown which is very common.
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You see the time on the clock and you're like, okay, if I fall asleep
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right now I'll get six hours.
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I'm familiar with that one.
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It's that very normal human response but that becomes a repetitive
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experience so those worries start to create anxiety
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for us around sleep. That is not conducive to good sleep.
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Those thoughts aren't really helpful.
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They're very human but they're not helpful to our sleep.
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Cognitive restructuring is addressing those thoughts and just
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changing them to more adaptive and helpful for our sleep.
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Instead of lying in bed and being like, oh no, I'm not gonna
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be able to function tomorrow and just perpetuating
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the worry about not sleeping and then continuing to not sleep,
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we can address that thought of like, no, I'll probably be okay
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tomorrow. There's no guarantee that if I have a bad night's sleep I'm
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gonna have a bad day tomorrow.
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The more realistic adaptive thought that we would restructure to
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is, I could have a good day
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tomorrow. I've done this before, I've gone to work with
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less sleep and I was okay, the day went fine, and it could be
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fine tomorrow too.
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It's not that you're telling yourself you're a great sleeper but it
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is changing that so you're not putting so much pressure on yourself,
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I gotta fall asleep right now, which doesn't work.
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That's one component.
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The second component is sleep scheduling, sometimes people call
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it sleep consolidation.
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One of the most common things that people do when they're struggling
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to fall asleep or stay asleep is they start spending more time
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in bed. If it's taking me two hours to fall asleep, well, I'm
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gonna get in bed two hours earlier so I can fall asleep
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by a certain time.
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While that does seem intuitive to do it's actually counterproductive
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because what happens is we have a regulator
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of our sleep, which is how tired we are, when we're
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lying in bed for extended periods of time we're
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not getting sleepy. We might be laying in bed feeling fatigued
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but we're actually feeling that drowsy effect.
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We're as sleepy in a consolidated amount of time to
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be able to sleep for seven to nine hours.
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Sleep scheduling or sleep consolidation therapy involves we
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track your sleep for a period of two weeks, we see what your average
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sleep time is over those two weeks, and we start to
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limit your time that you're spending in bed to get closer to that
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time so most of the time that you're in your bed you're
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sleeping.
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That's probably one of the tougher components for people.
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Stimulus control is a third component. We
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like to kind of rebrand it and call it the 2020 rule.
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Stimulus control is very common in psychology as
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far as Pavlov's Law.
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He would ring a bell and feed his dogs and ring a bell and feed
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his dogs and eventually he could ring a bell and his dogs would
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salivate, they'd be hungry as a response to the bell
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even if there was no food present.
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We do build these subconscious associations with
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our environment.
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When we have gone to bed and struggled with sleep over and over
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again our brain, our subconscious has made the connection with our
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bed, his isn't where I go to sleep, this is where I go to worry about
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not sleeping.
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For a lot of us women we're going to solve the problems of the world,
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organize our family's schedule for the next week, all
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of those things. Our brain is making the association that bed isn't
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for sleeping.
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Stimulus control is a very simple concept.
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It's get out of bed when you can't sleep.
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We don't want to lie there continuing to try.
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You want to remove yourself from the bed, go do something kind of
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boring until you feel sleepy, and then only put yourself back into
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bed when you do feel drowsy.
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So your brain starts to associate your bed with this is where I go
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when I'm drowsy, to fall asleep, not where I go to start worrying.
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That's a big one that's a technique that everyone can use even
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if you're not struggling with chronic insomnia, not lying
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in bed when we're having difficulty falling asleep or
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staying asleep for too long can be beneficial, kind
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of short circuit that spiral of anxiety and thoughts that
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we have while we're lying there, trying to sleep.
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Fourth is more of your specialty, Jessie.
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It is relaxation, relaxation and
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resetting our nervous system.
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We do go through a bit of active relaxation training.
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By no means am I a meditation guru or a yoga expert
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but those things can be so beneficial for your nervous system.
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Most people with insomnia have a
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hyper arousal of their nervous system. Their awake system is very
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strong, they're vigilant, all of those things, but it's hard
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to shut it down at night.
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Our daily relaxation practise, even as little as 10
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minutes per day of actively, consciously relaxing,
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trying to elicit that parasympathetic nervous system, has been
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shown to be very beneficial to our sleep.
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It's not that we need to create elaborate,
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extensive relaxation practices.
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It can be as simple as giving yourself that 10 minutes to reset
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your nervous system.
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The fifth and last component is sleep hygiene.
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Once you can sleep then practicing those healthy habits
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of making sure your room is cool, dark and quiet, going to bed at
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the same time every night, waking up at the time every morning, not
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eating large meals before bed, all of those things that we kind of
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know as healthy sleep habits, then they're very helpful to
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the sleep that we are getting.
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Sleep hygiene and practicing some of those behaviours can be really
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frustrating when we've struggled for a long time and those things
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are not effective.
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We'll often hear from clients, I know I'm supposed to put my phone
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away but I put it away and I'm still not sleeping.
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While putting your phone away is a
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great technique it's not gonna fix a clinical case of insomnia.
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That's where cognitive behavioural therapy is very effective
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and it is an evidence-based treatment with about an 80 to 85%
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efficacy, which is high in medicine.
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That's so informative. I was gonna say our cell phones, the phone, is
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the biggest culprit. As you say, we're laying in bed, we
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can't fall asleep, we're scrolling on our phones which
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obviously does not help.
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That's right. It really reinforces that this isn't where
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we go to just rest. This is where we're going to be stimulated or
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read the news cycle, doom scroll, all of those things, even playing
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games on our phones, sometimes people are like, oh, but it helps
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me down regulate but really the light and the stimulation is
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not helpful to conducive good sleep.
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Totally, and speaking of not functioning we have two
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questions from our audience.
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One of our viewers, they get about six to seven
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hours of sleep but then one day a week
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they get about three to four which really throws them off for
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several days to recover.
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What are your suggestions or tips?
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That can be really tough.
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They're doing a good job on the majority of days
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prioritizing getting six to seven hours.
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Seven hours is kind of the goal to feel well rested,
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the minimum amount.
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On those days that we have those short sleeps or really disrupted
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sleeps it can take a toll on us.
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My advice for those days, one is to not stress
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about it too much.
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There's a lot of research that worrying about, oh, I only got three
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hours of sleep, how will I function today, that actually impacts
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our ability to perform and our mood throughout that day,
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more so than the sleep loss itself.
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Trying to change your mindset going into it and remembering you've
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been doing this once a week for a while, you're probably really good
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at getting through those days.
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That can just alleviate the pressure on yourself which will
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usually relay into better sleep.
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When you do have those off nights, if you can make time for
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a quick 30-minute nap during the
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days of short sleep can be really helpful to fill some of those
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gaps and make you feel better and easier to get through your day.
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Not worrying too much about that one night
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can be a good starting point, to
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not stress yourself out about it because you don't want your nervous
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system to learn that there is a problem.
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That's super helpful. Another question from our audience,
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what are your recommendations for someone who has a learning
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disability and has difficulty using a CPAP machine
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and having difficulty sleeping?
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What do you recommend?
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That's a really good question. Often what we see is
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there's problems with executive functioning, which is difficulty
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making the plan and then following the plan, executing it.
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With neurodivergence, learning disabilities, things like that,
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sometimes it is the executive dysfunction that can really
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prevent us from being successful with some of these treatments.
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On top of that, if you're neurodivergent and then you're sleep
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deprived it actually exaggerates all of those symptoms of executive
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dysfunction so it does kind of feel like you're in this vicious cycle
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of how will I ever get this?
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The good news is, if we can get you ahead with your sleep a little
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bit your executive function does improve and then everything
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gets a little easier.
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What you have to do for a lot of things, for CPAP especially because
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there's so many steps and you might have
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some sensory issues, is perseverance and
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pre-planning, having everything set up so you're not doing it
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when your executive function is at its lowest as you're trying to go
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to bed.
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Our decision making really down goes as the night goes on
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so trying to make those decisions earlier in the day to set yourself
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up for success later at night when we're a little bit more
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compromised is really helpful.
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And looking for specific sleep programs and
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adaptations specific to your learning disability.
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At SleepWorks we do a lot of modifications specifically for
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neurodivergent clients because it is hard to
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keep track of everything, stay on top of it when they're just trying
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to manage the symptoms of ADHD.
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Certainly breaking it down into the smaller
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chunks of when you are higher
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functioning that day can be really beneficial to set yourself
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up for success for a better night's sleep if you're struggling with
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CPAP.
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That's great. Thank you, Marlee. One more question from ouraudience,
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what are your thoughts on white noise?
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Can it help?
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Great question. I actually have a little travel white noise machine
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right here at my desk. I am a
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big proponent of using white noise brown noise, pink noise, there's
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green noise, all the different frequencies.
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Anecdotally
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some people prefer one frequency over the other, personally, I
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find that any kind of consistent sound,
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even if it's just the sound of your air conditioner or your fan in
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your room can really mitigate any of those intrusive sounds
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like traffic or neighbours or anything like that, house
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00:24:41.413 --> 00:24:45.083
sounds, as our house makes noise, the furnace kicks in and
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could disrupt our sleep.
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Having something like white noise or fan noise just
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basically kind of silences out any of these little
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acute noises that can really pull us out of deep sleep.
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I'm an advocate for it because we live in
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a noisy society.
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As a takeaway for our viewers what is one thing they can do
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right now to help with their sleep?
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I want to go back to the cognitive behavioural therapy.
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I think the one thing that I want people
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to take away is having an
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appropriate level of concern for your sleep, not
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to downplay any problems.
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If it's affecting you in the way that you feel and function and
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affecting your health it's certainly worthwhile to address that,
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seek out help, get the supports, the resources that exist.
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Generally, we
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don't want to become obsessed with worrying about our sleep,
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worrying about our watch data, worrying about having one or two bad
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night's sleep. Really, if you haven't had chronic insomnia
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and you do have something that disrupts your sleep short term for
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a couple of days or maybe even a couple weeks, remembering
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that that situation can be temporary. We are
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meant to sleep, we're not broken, just sometimes things can get in
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the way and do not worry about it so it doesn't become this
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ingrained learned condition can help prevent chronic
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insomnia from taking hold.
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So appropriate levels of concern but you don't wanna spend all night
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worrying about it.
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I love that. Thank you so much, Marlee.
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For our viewers, if you have any more questions or if you
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want to learn more about Marlee and her program and her team at
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SleepWorks you can visit sleep-works.com.
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I know Friday, March 13th is World
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Sleep Day. Can you tell us a little bit more about that before we
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end?
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Yes, I'd love to.
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March 13th, Friday the 13th everyone, is World
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Sleep Day. This year the theme is Sleep
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Better, Live Better, or Sleep Well, Live better.
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For World Sleep Day SleepWorks is doing
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a promotion where you can access cognitive behavioural therapy
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00:27:01.786 --> 00:27:04.489
for insomnia, just a self-guided program.
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Typically,
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there's a cost associated with it no matter where you go
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00:27:11.796 --> 00:27:15.367
but SleepWorks likes to provide that on World Sleep Day for pay what
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00:27:15.367 --> 00:27:19.137
you can. You can buy it for as cheap as a dollar on
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00:27:19.137 --> 00:27:22.440
World Sleep Day so if you do want to check out what cognitive
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00:27:22.440 --> 00:27:26.011
behavioural therapy for insomnia is, get a program
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00:27:26.011 --> 00:27:29.481
without breaking the bank, it's
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00:27:29.481 --> 00:27:32.417
very accessible on World Sleep Day through SleepWorks.
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It's just available on our website
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00:27:36.421 --> 00:27:39.824
and it just gives everybody an opportunity to give it a taste without
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that huge financial investment to see is this gonna be the right
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00:27:43.495 --> 00:27:45.230
type of program for me.
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It kind of gives everybody the opportunity to check it out.
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I love that. Thank you so much and thank you again for joining us
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today.
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Thank you so much for having me back, Jessie. It's always so fun.
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I hope everyone has a restful sleep tonight.
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00:27:58.743 --> 00:27:59.744
We'll see you next time.
498
00:28:17.696 --> 00:28:22.000
Thanks for listening to, or watching,
Fidelity Canada's The Upside podcast.
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00:28:22.000 --> 00:28:25.770
Subscribe on your podcast platform
of choice so you don't miss an episode.
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If you like what you're hearing,
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501
00:28:29.641 --> 00:28:32.477
Fidelity Mutual Funds
and ETFs are available by working
502
00:28:32.477 --> 00:28:35.880
with a financial advisor
or through an online brokerage account.
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00:28:35.880 --> 00:28:39.417
Visit fidelity.ca/howtobuy
for more information.
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00:28:39.417 --> 00:28:43.788
While on fidelity.ca, you can also find
more information on future live webcasts,
505
00:28:43.788 --> 00:28:48.326
and don't forget to follow Fidelity Canada
on LinkedIn, YouTube, Instagram or X.
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00:28:51.062 --> 00:28:53.732
Thanks for tuning
in. We'll see you next time.

