Unlocking the Secrets of Sleep with Dr. Catherine Darley

Elizabeth: I always begin an interview with the same question, and that is about your journey. think a lot of times people in helping fields have their own journey of healing or finding balance. That brings us to where we are in our work. I'm curious if you can talk a little bit about what you do, and a little bit about your journey of arriving here.

Dr. Catherine Darley: Sure. I'm a naturopathic sleep expert and when I was looking at all the different ways that you can approach sleep from a medical perspective. Natural products, perspective psychology research.

I kind of ruled out the other professions. Research generally takes 17 years from the time it's found. A finding is made to when it impacts people's well-being. And I just thought, I want to have bigger impact than that.

Sleep is such a basic physiological process that it just didn't make sense to me to use a bunch of pharmaceuticals or High Force interventions. And so, I chose to approach sleep from a naturopathic perspective where we try to treat the cause, and we use what we call the least force medicine that will be effective.

So, for example, with sleep, if there's a type of behavioral therapy as there is for insomnia that's going to be effective. We use that first instead of going directly to pharmaceuticals.

Elizabeth: Do you find that, in using these other measures, pharmaceuticals just aren't necessary?

Dr. Catherine Darley: Oh, totally - particularly in sleep. Insomnia is one of the most common disorders, and pharmaceuticals are just not the recommended first line therapy. In naturopathic medicine, and it starts with foods and lifestyle and then goes into herbs and therapeutic nutrition supplements - those kinds of things - and then gets into pharmaceuticals. But you start with those easier things that are less likely to have negative side effects.

Elizabeth: I think all of us know sleep is important. But I but I imagine that you have quite a bit of knowledge and wisdom to impart about why and how sleep matters for our wellbeing. 

Dr. Catherine Darley: In sleep medicine, we actually think about wake and sleep as not just wake and sleep; but rather wake, non-rem sleep, and rem sleep. These two different main categories of sleep really provide us different types of healing, and we need both. The non-rem sleep. Particularly stage 3 sleep is all about physical repair in two important ways.

I'm sure, people have heard of human growth hormone, which helps us physically repair our body. What people don't know necessarily is that the majority of our growth hormone 75% - even up to 85% - of growth hormone is secreted just during deep sleep. This is stage 3 sleep. So, you want to be sure that you're getting enough sleep to have that growth hormone. It also has a role in cleaning our brain. 

I'm sure many people have heard about Alzheimer's disease and are concerned about Alzheimer's and other types of dementia. One thing that is super cool and just so fascinating about stage 3 sleep is that during stage 3 sleep we have this lymphatic system in our brain that actually opens up to almost twice its size and helps clear the metabolic waste products from the brain. Even some of those waste products that are implicated in Alzheimer's get cleaned out of the brain during sleep. So how cool is that?

Elizabeth: Wow! Is there a certain length of time that you have to sleep in order to get that that stage.

Dr. Catherine Darley: Fortunately, deep sleep tends to be more in the first half of the night. It seems like our body prioritizes deep sleep, and the longer you go without sleep, the longer your deep sleep will be when you finally do get to have rest.

The other main category of sleep is rem sleep - which stands for rapid eye movement - sleep. And this is the type of sleep that the brain waves are fairly similar to wakefulness. They're low amplitude, and faster than other stages of sleep.

Rem sleep happens more towards the morning hours – 4 o'clock, 5 'clock in the morning. We tend to have more. Rem is really important for those cognitive functions and also emotional control. This can vary from really simple cognitive tasks to complex tasks, problem solving. Those are all going to be impacted by rem sleep. If people are chronically sleep deprived, they may be shortening their rem period and therefore having some issues in memory, cognitive thinking and also emotional regulation.

Elizabeth: Sometimes people will talk about getting too much sleep is that, does that impact any of these stages at all?

Dr. Catherine Darley: I don't really think getting too much sleep is an issue for the majority of people. Sometimes you can have an illness that causes you to sleep more. You'll have thyroid disease, or you have depression or cancer, or something of that nature, a traumatic brain injury or something. Outside of being ill, we don't generally think of a person getting too much sleep. And, if you're using an alarm clock to truncate your sleep, to wake up, that would indicate that you're not getting enough rest.

Elizabeth: because naturally you would wake up on your own?

Dr. Catherine Darley: Exactly: when you're done, and when you've gotten the sleep you need.

Elizabeth: I have one other just quick, follow-up question. Sometimes I have clients tell me that they just don't need as much sleep as other people. And I'm curious: is that something that is true? Do some people need less sleep than others.

Dr. Catherine Darley: Yeah. So, we think about sleep need as a bell curve where people fall, you know, maybe on the shorter end, maybe around the longer end. But the bell curve tales are around 7 and 9 hours. So when we think about people getting 6 h or less, it's probably only 3% to 4% of the population who actually do fine and are well rested when they're getting that little amount of sleep.

The concern is that it's about 36% of adults who are getting 6 hours or less on workdays. For the majority of those people, it's not enough sleep. And one of the interesting things that happens is after just 3 nights of not getting enough rest is that your self-perception of how impaired you are is lost. And so you don't realize any longer how you're not operating at the top of your game.

Elizabeth: That's so interesting. I think about when I had a newborn - my body just adjusted, and I didn’t feel tired the same way. I bet that's what you're talking about. I probably just didn't have the same sense of how tired I was.

Dr. Catherine Darley: Yes, and sleep deprivation is a stressor, and our body will respond to sleep. Deprivation like it does to any stressor increase in cortisol increase in other stress hormones having to do with our blood sugar control and our appetite, and just lots of changes. It's a stressor.

Elizabeth: Is napping helpful for those who maybe had disrupted sleep or didn't get a good enough night's sleep? There seems to be conflicting opinions about napping. I'm curious what you think?

Dr. Catherine Darley: I think actually, napping can be constructive and helpful if you're doing it kind of in line with the evidence. And that would mean that you're having your naps early enough in the afternoon that they're not interfering with sleep. 

From the time we wake up until the time we go to sleep, we have a sleep drive that builds and builds and builds. So, if you stay awake all day, and then you take a nap, maybe at 6pm or 6:30pm after dinner, it's going to discharge your sleep drive, and you're not going to have enough time to build it back up before bed. 

So, you want to take your naps at 1pm or 2pm in the afternoon, rather than later. You also want to take a 30-minute nap or an entire sleep cycle, which is about 90 min to 110 minutes. If you nap for about 45 minutes, you'll wake up out of that deep sleep and feel groggy and be impaired for about 20 minutes.

Elizabeth: One of the things that we talk about in my Calming Ground Membership, which is a self-care membership, or in my psychotherapy practice, is the outdoors as an incredible source of practicing mindfulness, practicing, coming and back and connecting to the self. 

You had an interesting take about another element of the outdoors. I wonder if you can speak to that a little bit today?

Dr. Catherine Darley: Yeah. I'm glad we're getting into nature cure, because that is a fundamental principle of my work and of naturopathic medicine. One of the things that is super important that we're getting when we're exposed to nature is the right types of light at the right times of day. 

One of the things that really is impactful that I think people don't realize is that over the last 200 years or so with the invention of electricity, electric light, refrigeration, etc., we have moved indoors and largely separated ourselves from that natural environment.

The light queues that we're missing are really critical for our us, our sleep, health, and our Circadian health. I think of it as a model that we have with the earth. The earth has this circadian rhythm, this 24-hour pattern in light and dark and temperature changes. Then, of course, there's seasonal patterns. And then we have our circadian rhythm that links us to and kind of reflects those circadian rhythms of the earth.

That 24-hour pattern of sleep and wake is clearly an obvious pattern. But what people may not know is that in every organ system in our body we also have a 24 h pattern. 

For instance, digestion is really set to be on during the day, and not very active at night. If you've ever worked shift work or stayed up late to do a project, and then snack at 3 o'clock in the morning (when you're usually asleep) the food can just kind of sit there and not be digested very well. Our digestion has the Circadian pattern. 

We need to get out in the morning. Go outside and get bright light. There are always questions that come up: “well, if I turn on all the lights in my home, or I sit next to the window, or start my day with a commute in the car, ss that going to be enough light?” 

It's actually not enough light. We really can't get enough light being indoors compared to outdoors.

Elizabeth: So, what do you recommend? That someone take a walk outside in the morning? And for how much time?

Dr. Catherine Darley: Well, the recommendation is 20 minutes or more - 20 to 30 minutes in the first 2 hours of your day outside.  You could do anything. I love walking because that's going to also increase your blood flow and get some good oxygenation that's going to help fuel your day also. But people can do anything. If folks are really time pressed, even just sitting outside with your phone or your computer and getting to your tasks while the sun is hitting your eyes - that's fine, too.

Elizabeth: The importance of this is to kind of wake your system up or get enough light, so that later on you will be able to have a good night's sleep. Am I understanding?

Dr. Catherine Darley: Yeah, both of those are true. We have this hormone system that also has a Circadian rhythm. People have probably heard melatonin and cortisol. Melatonin is the hormone of darkness, and we need it to help us sleep. When we first wake up, our melatonin is still slightly elevated. Because our melatonin is very strongly suppressed by bright light, going outside and intentionally getting that light is going to suppress our melatonin and help us wake up.

Cortisol has the opposite effects. Cortisol typically starts to rise in the morning and helps us get going. It's it helps us be active. Having that light queue in the morning is also going to help our cortisol, which helps us be active, energetic and ready to go for our day.

Elizabeth: For those who don't live in rural areas, we are typically getting light artificially all the time at night. I'm wondering if that messes with our circadian rhythms at all? 

Dr. Catherine Darley: Oh, absolutely. Artificial light at night can have a huge impact on our melatonin. Basically, Elizabeth, if a person can hold their hand out at arm's distance and see their fingers wiggling, that is too much light at night. So, I like to give people actionable steps, and one tip that you might people might find helpful is on your smartphone. You can download what's called a lux meter app that's spelled LUX. You can use it to test your light levels. 

There are free versions. You just hold the little camera function at your eye and just look around and see how much light you're getting. The recommendation is 250 LUX during the day. Then, 3 hours before bed, 10 lux. Ten LUX is the light of about 10 candles - not very much light – that allows your melatonin to start to rise. This helps you feel sleepy by the time you get into bed. During sleep hours, we need 1 LUX or less.

I find that the recommendation of 10 LUX for 3 hours before bed is not realistic for a lot of people, because 3 hours before bed we're often in a pretty active part of our day. We might be helping with homework, dinner, house tasks, computer tasks. So, an alternative to turning down the lights to 10 LUX is to have blue blocking glasses.

If you're going to get blue blocking glasses, you want to make sure that the lenses are this reddish orangish color. Those are going to be the most effective type of lens for this purpose.

Elizabeth: You would wear those glasses 3 hours before bed up until the point you go to sleep?

Dr. Catherine Darley: Yes. Of course, you may be at the grocery store, and you may not want to be wearing these glasses, so an hour is better than not at all. Two hours is better than an hour. Just do what you can. 

This is shown to help people who have insomnia - people who have what's called “delayed sleep phase”, which is being extreme night owl. Just a couple of weeks of wearing those for the hours before bed will offer a greatly improved sleep.

Elizabeth: That's so helpful. I'm thinking about the just so many levels of this - both your sense of alertness and vitality and energy in your day, your sense of balance emotionally, and maybe even, spiritually, in your day, as well as your physical health. Right? 

Dr. Catherine Darley: I think about how, through most of human history (up until the electric light) in those hours before bed we had to be in dim light. It was dark outside. We might have candles. We might have firelight. If you've ever had a night when you are like, I'm not going to turn on the electric light. We're just going to have fire or candlelight. Is this a very different experience? And in that setting our melatonin starts to rise on its own. So that helps us feel drowsy when we get into bed. 

For people who maybe have that racing mind at night, let’s put physiology on our side by avoiding the blue light for those hours before bed and see how that shifts. I think for a certain percentage of people just changing the light, not doing any other practices to calm the racing mind can help because you're physiologically switched into sleep mode when you get into bed.

Elizabeth: That's great. Are there any other thoughts that you have, or wisdom or tips that maybe I haven't specifically asked or haven't come up in this conversation yet that you think might be helpful?

Dr. Catherine Darley: Well, I also like people to remind people just about the overall health benefits of being connected to nature. They're quite profound. Everything from the physiology of the that wonderful smell of pine – that is something we call volatile compounds, and those volatile compounds stimulate the immune system. 

Just one day in nature is shown to have positive effect on measurable compounds in your immune system for 2 weeks. So, getting outdoors and having that benefit is awesome. 

Then, there are so many other benefits from the cardiovascular system, on blood pressure, on depression, on anxiety, on relationships – actually, more positive family relationships when you can have some family outings that are out in nature, even beyond the sleep beyond the Circadian rhythm. 

I do some teaching on this area. It is shown that just 2 hours per week of time out in nature makes a measurable impact, and that impact improves and increases to the 6 hour per week mark. I really encourage people to think about how you can incorporate nature in your overall lifestyle. 

Elizabeth: Yes, I love that. Absolutely. It's something that these days, unless they have a lifestyle in their work that allows them to get outside, people have to like really make that time for that – especially in winter.

Dr. Catherine Darley: I just wanted to point out that even having plants or having artwork that shows nature measurably improves wellbeing. 

In a hospital setting, if there is a painting of the sky with clouds and blue, and maybe some birds or something, people heal better than if the ceiling is just white.  I put a plant purposely in my background, so that whenever people are talking to me online, they're getting a little bit of nature cure. 

One strategy that I did couple of years ago is, I basically just sat in every seat in my house and purposely made sure that from whatever seat a person chooses, they get some nature cure. 

Even those little tiny things add up over time.

Elizabeth: Yeah, and so much of what you're speaking to also is echoed by the practice I do. I'm a forest bathing guide and we talk about the same thing: the importance of being outdoors and for immunity. I love also the idea of a ceiling painted with clouds, as even the image offering healing. I also think about something else I heard about birdsong as having such an impact on our nervous system. 

You are a sleep doctor, and yet we're really also talking about wakefulness and exertion, right? 

Dr. Catherine Darley: Being amongst the trees or a tree, a plant, and then also having that rest – it’s just the importance of that whole balance. The phrase I think of is a healthy lifestyle - having a lifestyle that includes the sun. 

If we have an indoor lifestyle, when we go outside, we're taking a mental break from our tasks. We're having a change of scenery. We're having some movement as opposed to sitting. So that is itself is a bit of a rest – just taking a a break from our tasks. 

The other thing I think about is that, if somebody is rushing and in a sympathetic fight or flight type of energy and state throughout their day, it's like going 70 on the freeway and then slamming on your brakes. That's not going to be good experience – rushing through your day and then thinking, “Oh, I'm going to hop into bed, and I'm going to be out and sleeping deeply.” We need to be traveling at a little gentler speed throughout our day, so it's easier to stop. 

We also need to have an off ramp, which is that idea of dimming the lights a couple hours before bed, switching into more of a restful activity and pace is going to translate into good sleep and overall, and better health, too.

Elizabeth: Yes, and I love that image the 70 miles an hour and then braking. That would be pretty jolting and jostling for your body. Can you tell us a little bit about where to find you? 

Dr. Catherine Darley: Yes. I'm on social media and the Internet at skilled sleeper. So that's how you can find me. I have tips on Instagram and tick, tock and shorts. And then I have long-form once a week, video on Youtube. And then, if people want to do a deep dive, I offer courses at skilledsleeper com. Most of them are on sleep. There is one on nature cure. There is one on Circadian rhythm and health.

Elizabeth: Wow, beautiful! Thank you so much. I really appreciate all that you're offering and your wisdom, and just the overall message of life balance. 

Dr. Catherine Darley: Thank you for having me. Sleep well, everyone.