(upbeat music) Welcome back to family Health Matters.

I’m Shelley Irwin with me today, Rachel Van Dyke, nurse practitioner with pulmonary and sleep medicine at Holland Hospital, and Jason Mejeur, founder, CEO of Coya.

That’s COYA.

All right, I’m guaranteed to have a good night’s sleep tonight after this conversation.

Rachel tell me about how you spend your day in this uh niche of sleep.

So I work in the pulmonarian sleep medicine office.

I see um a lot of patients that come in with issues with sleeping, um obviously.

um I see a lot of sleep apnea.

Probably the majority of what I see is sleep apnea, um do a lot of sleep studies and treatment for that.

um about a whole host of different sleep um issues that people can have.

How’d you sleep last night?

Pretty good, actually.

Jason, you are founder and CEO of Coya.

Tell us about you.

Yeah, so Coya is a coaching platform that uh uses wearable technology to attract sleep and coach people on both performance, uh, not just during sleep, but performance in your everyday life and longevity.

And so we have a bunch of coaches on our team that sit with people that are elite athletes, college and professional athletes that are executives or business owners, as well as full companies of folks and first responders.

And so helping people to sleep better so they can show up as better versions of themselves tomorrow and for life.

So sleep matters.

Sleep matters.

We like to say sleep is your superpower.

Oh, nice.

Let me stay on that topic question for you both.

Why does sleep matter, Jason?

Sleep is when your body restores it.

itself.

it’s where you get physically recovered, your muscles and your bones are recovering from whatever stress they were under all day.

and then your mind is recovering as well.

And so like there’s a reasonet happening inside of your brain every single night that you’re sleeping.

And so there’s different stages of sleep where although that happens, but uh in order to sleep, sleep is how our bodies were created, and we need to have a six, seven, eight hours of sleep per night.

and at some level, we’ say the more the better.

uh and and probably just a just throughout culture right now, there’s a there’s a deficit that we’re running at from the sleep standpoint.

Add to that.

And is there an ideal number of hours?

So sleep is definitely super important.

um I like to think of it both from quality of life and quantity of life.

um poor quality of sleep can affect your quality of life, um things like cognitive function, memory, um not having the energy to do the things you want to do during the daytime, um all our kind of quality issues, and then poor quality of sleep also affects our longterm health.

Um poor quality of sleep increases risk of heart disease, stroke, high blood pressure diabetes, high cholesterol, um a whole host of things, um Alzheimer’s dementia.

so both ends of the spectrum, your quality of life, plus your quantity of life are both affected by sleep.

Um and as far as ideal sleep, um, most American academy of sleep medicine usually recommends seven or more hours of sleep for adults.

Um so you want to be aiming somewhere between seven or eight hours.

Um Some people require a little bit more.

There’s a little bit of a spectrum in there, but generally seven hours is probably the minimum we want to aim for.

And the kid?

uh kids, oh man, you’re gonna ask me a tough one because I don’t normally do a pediatric stuff.

It’s completely different for kids.

Um Usually longer, and that kind of changes by age, um as they um go through to.

So obviously infants are a lot longer.

They’re sleeping most of the day.

um don’t quiz me on the hours.

But it does change differently.

But all adults across the spectrum are usually about seven hours or more.

um and it really doesn’t change um 18 and above are about the same line from there.

Let’s just ask this question.

Can I catch up on sleep if I’ve uh missed a couple of hours?

Yeah, I mean, absolutely.

I think there’s the there’s something that’s happening inside your body of the when you’re running out a deficit, uh and you can add more minutes to it the night the next night or the next night.

Your body you’re gonna feel that in your body, you’re gonna feel that in your mind, um, as you uh spend more time in sleep.

And so um we always like to say you can’t uh improve what you don’t measure.

And so actually starting to measure that in in track how much you’re sleeping is maybe the first thing that we can bring to people’s awareness to say, like, how much am I actually sleeping?

Not how long am I in bed, but how how long am I sleeping?

and then use that as like a guidep post to be able to to begingin to see how can I build on that over time as well?

And let me pick your brain on on this.

There are devices that actually tell me there needs to be a stage of R. There needs to be other stages, so sleep staging is another thing that that these devices.

So I’m wearing an aura ring, and so this is a device that I use to track my sleep right from my finger at night time.

The other company that we work with really closely is whoop, whoop sits on your wrist and and tracks your sleep.

Neither of these are the same level of going through a sleep study, um but they’re available off the shelf at a Best Buy or online just to be able to like get started and be able to have a non-invasive tracker that’s available to everybody.

And so those devices measure things like heart rate variability, um sleep staging, your your REM sleep, your deep sleep, uh your deep sleep is and your body’s physically being restored.

Your REM sleep is and your brain is actually resetting itself and being restored and that’s when you’re dreaming as well.

And so you’re able to start to actually see those different stages and how much how efficient your sleep is as well as how long you’re sleeping.

Sleep apnea.

does this and expand into other disorders?

So sleep apnea is a breathing disorder at night.

so basically all of us only have so much room in the back of our throat to breathe through.

um what happens when you lay down to go to sleep is that the muscles in the back of the tongue and throat start to relax as you go to sleep and that opening starts to narrow.

usually when you push air through a narrow opening, it’s gonna create vibrations which create noise and we hear snoring.

So if you ever hear people snore a lot of times, it sounds like a snore, snore, snore, and then you might hear a big long pause, and then a big snort or snore, a big deep breath.

What happens before, that big snort or snore is that the back of the throat’s actually collapsing completely when we have sleep apnea.

And essentially choking a death when that happens.

um and body reacts to the exact same way as if somebody were to be choking you.

Your heart rate goes up, your blood pressure goes up, action levels start to drop.

and it cues your brain to say, hey, if we don’t do something here, we’re gonna die, your brain won’t let that happen.

So the brain releases a little bit of adrenaline, which is that fight or flight hormone that kind of gets your heart race and if somebody’s chasing you.

And that little surge of adrenaline serves to pop you out of any of the deep parts of sleep you’re in.

So like you’re talking about the good run sleep that actually makes you feel good and refresh or restored the next day.

and it kind of pops it into that in between between awake and asleep so that your muscles can take that big, deep breath.

And then that whole process happens over and over and over and over again at night.

And that’s where we create some of our longterm health issues, like I was talking about before with heart disease stroke, um poor quality of life, because you’re sleep is being disrupted um by these um apnas or collapse in the back of the throat over and over again.

Yes.

How is that treated?

So there’s different ways that we can treat sleep apnea.

Some of it depends on the severity of sleep apnea, um, so more mild sleep apnea, um sometimes we can use an oral device, kind of a custom made appliance by a dentist.

most common treatment option for any sort of sleep apnea is gonna be the CPAP machine.

It’s a little machine that sits on the bedside table, hooks up to a tube that goes to a mass, worn over your nose or nose and mouth.

essentially how it works is it puts just enough air pressure in the back of your throat to keep it from collapsing.

So kind of like a pneumatic splint.

Highly effective in treating sleep apnea.

The biggest downside to see pap is that you gotta wear the darn thing every night.

So, um there is a new device out there um uh recently FDA approved in the last few years here, also called an inspired device device, which is another new option that’s available um out there on the market.

Um We haven’t had a whole lot of options for training sleep apnea in years and years, so this is new to have something.

um it’s an implantable device.

um almost like a pacemaker that you put under your skin, they thread wires up into the back of the tongue and throw.

pacemaker turns on at night stimulates those muscles in order to keep them from collapsing.

So um and then weight can sometimes play a role and sleep apnea, too.

So it’s not the only factor um that weighs into it, um, but sometimes weight loss can make it better um as well.

Do you cure it or do you control it?

Um.

There’s a lot of it, yeah, it kind of depends.

Um, there’s a lot of genetics that plays into sleep apnea.

Um, and that’s one of the things, you know, a lot of times when people come into the office they are like, oh, I couldn’t have sleep apnea.

I’m not overweight.

I’m not old.

Well, it really doesn’t make a difference because there’s a lot of genetics that play into that.

We used to only look for sleep apnea, you know, and um, you know, men with thick necks and wide shoulders and big bellies, but as medicine has come further, we’ve found that more and more so.

It’s actually more genetically linked than anything else.

Now, body habitist can play a role in it.

So sometimes weight loss can potentially make it go away, but not always if we have the genetics there.

So for a lot of people, it’s gonna be treatment.

As with your Coya, you Mentioned working with Athletes, how important is a good night of sleep before an athletic performance or taking an important test or or other?

Yeah, sure.

So it’s I mean, I think if you’ sleeping recovery, a lot of times people say, um in our space, it’s not that you’re overaining is that you’re under recovering.

And so a lot of injuries happen when you’re under recovering.

And recovering is happening while you’re sleeping again, Again mentally and physically, maybe in the athiotic side is as as important or more important physically getting your body to recover from the stress and strain you’re putting on it physically.

And so if you’re not sleeping enough, you’re going to be more likely to get hurt.

Your body’s not responding.

Your nervous system is not responding the way that it usually would be.

And when you’re out there making the moves on the cord of the field that you are are used to making.

And so that begins to show up in increased injury levels.

The other thing that shows up is increased sickness.

You’re running your body ragged, you’re not sleeping enough, you’re gonna be more prone to getting sick, which could mean lack of performance or having to even sit out of a game or a a practice.

And so optimizing performance is a big part of where sleep plays a role in that.

And I would say like these schools and in division One colleges and universities and professional teams are spending a lot of money in and investing in all the data that they’ve been collecting in the facility, like seven figures a year on these athletes of what they’re doing for all of their workouts.

And it’s just starting to become mainstream that they’re now tracking their sleep and the recovery.

And so that’s the other piece of the puzzle and if we think even in this current cultural moment of college athletics, where there’s conference consolidation and athletes hopping on planes from California to North Carolina to play a conference game, that all takes a huge toll on the stress of an athlete’s body as a to time change and the time in the air.

and so we’re able to actually begin to see some of the impact that’s having and have a data set we’re able to look at that and aggregate to see what the impacts can be on changing some of their behaviors around what does the hotel room look like that they’re sleeping in?

What are their habits that they’re doing like for the last hour or two that they’re awake to help them be able to all fall asleep sooner um so that they can sleep deeper and better and longer.

Stand by.

We’ll ask about the effect of the phone before bed.

What uh at what point Rachel do I ask for help?

regarding some sleeping problems?

So um I I engage that a lot of times by um your quality of life during the daytime.

Are you making it through your day?

Are you functioning?

Are you doing the things you need to do?

Do you have the energy and stamina, um to make it through your day?

And um and if not, so if you’re having issues sleeping at night and that’s starting to affect your daytime, then that’s usually, I think, a point where we start to ask for help, um, or looking into things.

The other one is the snoring is another big one for for me because I do a lot of sleep apnea, um snoring um can be normal for some, but not always.

And so if you’re being told that, you know, you’re snoring, you’re getting the elbow in the middle of the night all the time to turn over, um and maybe partner or somebody is telling you, hey, you know, you’re having some long pauses or you quit breathing when you’ sleep sleeping, um, that’s not normal.

so again, those would be times to ask for for help, talk to primary care um, and look a little further into it.

And what would a sleep study involve?

So it depends on the type of sleep study that we do.

Um for sleep apneaurely, a lot of our sleep studies now we actually do from home.

um so um home sleep studies are a lot easier to do.

We actually tend to get better data from some of the home sleep studies.

I mean, a lot of people are coming to our office because they already have trouble sleeping, so then if I tell them, oh, you’re gonna come stay the night in a sleep lab with a thousand wires hooked to you, um they don’t always sleep the best.

So home sleep studies are great solution to that.

You wear a few pieces of equipment for one night.

and that gives us an answer as far as the sleep apnea goes.

In lab, sleep studies are another option, too, depending on what we’re looking for or what underlying medical issues there are going on, that gives us a little bit more data into the sleep staging, like you were talking about, we can see full EEG telling us what stages of sleep you’re in.

um, can give us a little bit more insight into, um, some of the other things we might be looking forward to.

And imagine Jason, Jason, with the your ring another over the counter, I know, you know, my watch can tell me where I am in REM.

If if my metrics are showing poor sleep, black of ri, then I start asking for help.

Yeah, I think absolutely.

I’m just an example that you mentioned the broad shoulders thick necks.

Like we had a football team we were working with at University of Miami in Florida and uh the we saw a number of the linemen uh in that on that football program that were having sleep issues.

and we said, we flagged them, we said, you guys need to go do sleep studies and they did, and they had sleep apnea.

as like a 1920 year old elite athlete, right?

But that are are carrying more weight on their bodies.

and when we got them, the CPAPs sleep performance like completely went through the roof, right?

And so we completely changed the recovery of those athletes early indicated by a non-medical device that’s there to to have that just that first data that you can have coming in.

that’s easy to access and see.

Then I but they ran jumped and hopped higher.

Yeah, they were like, all right, let’s talk about some sleep hygiene tips.

Let’s start right away with uh phone use.

Yeah, so we do the three to one rule before you go to bed.

So three hours before bed, no food.

two hours before you go to bed, no mental work, so close your computer, close your textbook, um and start to shut your brain down, and then one hour before bed, no blue light.

And so blue light would be the phone, right?

And so what’s happening actually is you put your phone up to your face at night is it’s messing with your circadian rhythms.

So there’s this this shift that happens when you go from a cortisol to melatone in it.

And cortisol is what’s happening from the bright lights that we’re under right now or from the sun.

and when you bring a blue light up to your face, it triggers the cortisol to pop back up.

Cortisol and melatonin can’t be in your system at the same time, and so melatonin starts to go down.

and when the melatonin goes down, it’s that’s the hormone that helps you sleep, right every night while you’re going through that sleep process.

And so we’re just delaying our actual deep sleep and our our more regenerative sleep that we’re able to have when we have blue light in front of us.

And so our rule is one hour before bed, no blue light, the options for that are you can use the filter on your phone, which is kind of a cheat or you can get blue light glasses that you can put on if you need to have blue light in front of you.

But the cool thing about it is, again, with a wearable, you can start to see like everybody kind of knows it’s bad for you, but you can actually start to measure like what it’s doing to your sleep.

Yes.

All right, no wine before bedtime, maybe?

Yeah.

Unfortunately, that is true.

Um, alcohol does definitely affect your sleep.

Um, and I think it’s kind of a myth that people think, um, you know, oh, I’m gonna have a couple, you know, glass of wine and that makes me fall asleep early easily.

Well, it might knock you out, um, but it definitely doesn’t get you good quality of sleep.

Alcohol actually prevents you from getting to some of the deeper stages of sleep, so it’s gonna give you a more restless sleep and less quality to your sleep.

So definitely avoiding alcohol and caffeine is the other one, too, um which is, you know, obvious to some people, but trying to limit, especially in the afternoons, any caffeine can also improve your sleep, too.

Yes.

What about the art of, say, reading before sleep?

I mean, can I get into the weeds here, but uh, I think reading is okay.

I think as long as we’re avoiding the blue light, um that’s the big thing.

Um, when you’re reading and things, you want to make sure lights are low, um that we don’t have light directly in our eyes, so we’re not suppressing that um melatonin.

um, but I think reading is okay if that helps you kind of wind down.

um one of the big things is just making sure that you have a good bedtime routine, whatever that might be.

um relaxing, quiet, nothing, bright lights, um, and habit with it, too.

So, um stay keeping bedtime and wake time, um, consistent throughout the week, and even on the weekends, um, is gonna help, which I know is talk for some people.

um, but it does help overall if you can keep the same bedtime and wake time, um generally.

Yeah, just to add on to that, like if you think about an athlete, right, again, the context that we come from, um and we teach us to executives and companies too, is that uh when you go for a workout, you’re always going to do a warm-up, but you’re going to get your body ready.

You’re going to do some stretching, you’re going to do some light work, and then you’re going to go after it really hard.

We’ve we as a culture of never really thought about sleep the same way of like, how do I cool my body down?

We just kind of like expect to like close the computer, shut off the phone, put her head on the pillow, boom, I should fall asleep.

No, that’s not like our body likes routine and like I love what you said of just it’s about doing something consistent that your body begins to know, oh, this means that I should go to sleep.

So breathwork or a meditation or a stretching session, a hot shower, which is actually cooling your core temperature, which is actually where you want your body to start to cool down before you go to sleep.

And so those are all things that we kind of teach or talk about are like ways to build a habit stack before you go to sleep to cool your body down, similar to how you’d warm it up for a workout.. And back to uh, I guess getting habits started early, uh the same rules for the kids, especially in a school season and then the summertime, keeping them on a Yeah, I think kids are the same too, as much as you can stay consistent with, um, you know, timing wise.

It’s always gonna be better, um and bedtime routine as well.

Again, I don’t do kids, so I’m not the expert in that, um, but having kids myself, I know that my kids always do better when they’re on a regular routine and have, um, you know, consistent bedtime, too.

Yes.

Jason, um talked to me a little bit about um the senior citizen and why their myth may be that they sleep all the time and I guess we’re going to get into some sleep myths.

Yeah, uh I think like the interesting thing there is like uh as senior citizens like again, it’s it’s about consistency, it’s about the looking at when you what your routines are before and after some are athletes, you know?

Yeah, totally, right?

And so I think it’s I don’t know that there’s a a difference in in how you approach sleep as as age comes, and I think like potentially like even like there’ there’s just a broad spectrum of working with some senior living communities now too, just like, what does that look like across the board?

And some people say like sleep is really hard and some people I sleep like a baby, right?

And so I don’t know that there’s a general perspective of like what seniors habits are or what their sleep performance is necessarily, that is different than the general population.

And so but I think that you’re starting to get into like this topic of like, okay, like let’s build and and figure out what works for you.

Let’s let’s run some experiments if you will on habits.

Let’s tie those habits to your data.

Let’s begin to understand what’s working for you.

and get you believing that too, because so much of this is psychological.

It’s not just about behavior.

Like I have to have the psychology like, how do I change the behavior and do I want to change the behavior?

And when I do, what’s the reward that I’m feeling from that?

And so experiments, results, how do I feel, what does the data say?

We’re constantly going through this cycle with people that are coming through a program.

What about the shift worker?

Yeah, talked to me about the third shift.

Yeah, so shift work can be tough.

I see a lot of shift workers in my practice, but it can be doable.

um, you know, what happens with shift workers is we’re we’re changing circadian rhythms.

and so one of the biggest things with shift work with being successful was shift work, um is to maintain your schedule again.

I feel like I keep hitting on that point.

um but I have a lot of shift workers that, you know, they’ll work third shift Monday through Friday, and then every weekend they’re flipping back to try to be awake during the daytime.

Um Well, your body’s never going to adjust to that.

Um You can adjust if you stay consistent on your schedule, um, your body can eventually shift those circadianum rhythms, um, to be more consistent, um, which I know is tough to do for for those people that are wanting to be awake and with family and things like that.

So, you know, you weigh the the benefits with that.

But um, definitely maintaining consistent sleep and weight schedule, um also maintaining a consistent eating schedule.

Um, when you’re doing shift work, too, that’s another thing that, um a lot of times you can get a lot of GI issues with um changing shifts like that.

um, and so maintaining consistent sleep um and eating schedule both can help with that.

Yes.

Jason, is there such a thing as a power nap?

Oh, absolutely.

And I think like a power nap, you don’t even have to fully enter sleep.

They have this new thing called a nonsleep deep rest, right, where you just are calming your system down and getting to a place where you’re maybe not fully asleep, but your body is actually getting to the state where it’s regenerating or restoring itself.

And I think, uh, you know, 20 minutes, hour five minutes, even in some of those cases, um that can come alongside of, I think we like to teach out alongside of meditation and breathwork sessions so like you can get to a place of focus and really come in tune with your body for those few minutes that you’re working on that.

And so it’s it’s something you do for performance before a game a lot of times, or even like if you had a bad night as sleep and you have a game or an important meeting coming up, what can we do?

just kind of reset yourself mentally and cognitively as you’re going into whatever that big event is.

Yes.

How do you work with teams?

Say someone’s interested and said,Man, I’ve got to have Jason now working on my team.

Yeah, so we have individuals that come through, we run monthly cohorts uh with people that can come through and actually all over the world.

And it’s a one week commitment, you get a coach that works with you on sleep on nutrition on on fitness and on mental performance.

And as you’re going through that program, we’re actually measuring sleep throughout and seeing how all these different lovers that we’re pulling on, how you eat, when you eat, when you work out, how much you work out, how all of those are affecting and being measured through the stress levels in your body while you’re sleeping.

And so that’s a 12 week program.

We can run that program for a team, athletics team in locker room or for a company in in the boardroom for, you know, 100 employees.

And so it’s really fun to be able to be on the kind of the cutting edge of this and to be seeing the impact that we can have on the lives of so many people, um and the energy levels that they have every every single day.

Guaranteed to run faster and longer.

I want to go back to the senior Rachel, if you may, does sleep change as we age?

So actually sleep doesn’t terribly change as we age.

circadian rhythms can change a little bit, so they may shift a little bit earlier.

so geriatric population may have a little bit earlier, bedtime, a little bit earlier wake up time.

But there’s a lot of other factors as we age that can affect sleep overall.

Um so uh, chronic medical issues, um, a lot of times things like arthritis can cause pain, which affects your sleep.

um, that can interrupt sleep.

Um medications is a big one, so we tend to have more medications as we age, and our body metabolizes those things differently.

So they may stay in your system longer.

They may give you more side effects, um, and some of those things may affect sleep.

um so as far as, you know, recommendations for sleep, usually it’s still seven hours or more as we age, um but it’s more so there’s a lot more external factors that can influence those things.

It also limits some of the things that we can do to treat it to, um again, going back to medications if we need sleep medication and things like that, it becomes more difficult in the geriatric population because of the way that we metabolize medications as we age.

and so sedating effects can be stronger, we can have more risk for injury and falls than things like that.

So no big huge shifts other than maybe a little bit earlier bedtime, a little bit earlier wake um time, but it’s a lot of the external factors that affect sleep as we age.

Yes.

All right.

winding down, what do you leave us with, Rachel regarding, uh how I am guaranteed?

Nothing’s guaranteed, or how a best I sleep tonight as well as I can.

So, you know, follow consistent sleep schedule.

um, do get yourself a good bedtime routine.

um make sure you’re in a quiet, dark place.

um, get rid of the screens at night.

um, I know, that’s a tough one.

Um and if that doesn’t work and you’re still struggling, um, and having snoring or daytime sleepiness, um, or real really struggling to sleep at night, then that’s a time to follow up with your primary care, talk to your doctor about it, um talk to your sleep specialists about it, and get some help.ep.

And what do you get out of being a sleep specialist?

M be must be kind of fun to change lives.

It is.

It is.

I think um I’ve done a lot of different things in my in my career and I think this is one that I definitely see huge improvements, um which I we don’t always get to see in medicine, so it’s really fun, um, especially myself sleep apnea patients, you know, getting that fixed and they come back and man, just giving them a whole better quality of life um is really pretty rewarding.. How do we get in touch with you?

Hollandhospital.org/ pulmonary and sleep medicine is a great way to start with, because the pulmonary is part of this issue as well.

Yeah, it does it does cross over into some of the breathing stuff, too, yes, yes, thank you, Rachel.

All right, Jason, what’t you gonna leave us with on behalf of Coya and in this power of sleep we need.

Yeah, I would just summarize everything I say you can’t prove what you don’t measure until like if you’re interested in this, start to find a way to measure your sleep.

And a wearable technology is accessible, and when you begin that journey, um, the opportunities that, like you say, almost endless of ways that you can affect on your sleep performance.

And so, uh get started on that.

And I would also just like say, like with enthusiasm of like, sleep is your superpower, go start to take it on, right?

Be be serious about about sleep.

Yeah.

And let me stretch this just a minute.

We recently obviously changed their cocks.

fell backward uh that was a tough couple of days.

What was that?

Yeah, I mean, I think it’s just what we’ve been saying is like consistency, right?

As soon as you start to move something an hour and it like everything’s shifted by an hour, your body where creatures of habit and creatures of rhythm.

And when we aren’t in habit and rhythm, and that changes, it messes with everything.

Yes.

So get myself a ring, uh see the results and uh uh then I’ll run faster.

Yes.’s all.

All right, Jason, how do we find out about your good work at Coya?

Yeah, just our website is coya.life.

You can find this on LinkedIn or or Instagram as well.

And so come and check it out like an and it’s a journey that we’re all on, right?

The more that we can do this together and find like minded people that are on the journey, the better you’re gonna be on improving your sleep and and the way that you’re showing up, not just tomorrow, but for the rest of your life.

you remember your dreams when you get up?

I don’t, but my wife does.

She’s always talking me.

her dreams.

Yes.

That’s a whole another concept that’s for sure.

Very on.

Thank you both, Rachel and Jason for your lessons in sleeping one of the musts And as always thanks for watching our family health matters, get a good night’s sleep.

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