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This Is Perimenopause
Menopause isn’t the end, it’s just the beginning. Hosts Michelle and Mikelle are on a mission to help others be better informed than they were when they started their perimenopause journeys. The podcast is a blend of health, education, mindset, and personal growth. Michelle and Mikelle along with their guests are sharing real-life stories and expert advice to help you navigate perimenopause, menopause and beyond.
This Is Perimenopause
Sleepless in Perimenopause? How to Get Back to Sleep with Dr. Woganee Filate
Counting sheep not cutting it anymore? You're not alone.
Up to 60% of women in perimenopause struggle with sleep issues. And it might not be the wine or worry that’s keeping you up. It could be sleep apnea. And you thought that was just for overweight men.
Join us for a deep dive into sleep apnea with our guest, Dr. Woganee Filate, a sleep medicine physician. She's pulling back the covers on:
- Why hormones are hijacking your sleep.
- The surprising link between hot flashes and sleep apnea.
- How to tell if you're one of the 40-60% of women struggling with menopause-related sleep issues.
- Surprising ways sleep apnea can impact your health - from heart attack to diabetes to cognitive decline.
- How to advocate for yourself and get the help you need from your doctor.
- Simple, effective treatment options for sleep apnea.
Plus, Woganee shares her personal sleep routine and tips for teaching good sleep habits to kids.
Tune in for a better night’s sleep.
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Yeah, I think you know the main thing I want people to take home is the knowledge, like we talked about all the different ways that our sleep changes in perimenopause and menopause. The behaviors that I had premenopause about going to bed super late, waking up and expecting to be 10 out of 10 on productivity, you know, having coffee late, drinking alcohol right before I go to sleep I always try to tell people our sleep is drinking alcohol right before I go to sleep. I always try to tell people our sleep is changing so our behaviors have to change. And so it always comes back to really prioritizing your sleep.
Mikelle:Welcome to. This is Perimenopause, the podcast where we delve into the transformative journey of perimenopause and beyond. I'm one of your hosts.
Michelle:Michele, and I'm your other host, michelle, and we know firsthand how confusing, overwhelming and downright lonely this phase of life can be.
Mikelle:Join us as we share real-life stories and expert advice to help you navigate this journey and advocate for your best health.
Michelle:We used to think menopause signaled an end, but really it's just the beginning.
Mikelle:Today we're talking with respirologist and sleep medicine physician, dr Wagani Filate. From the importance of sleep for our health to why it becomes such a struggle in perimenopause, dr Filate is giving us her expert advice, including some surprising statistics about menopause and sleep apnea. Check out the show notes for more information about Dr Filate and please send this episode to anyone you know who is struggling with sleep.
Michelle:Wagani, welcome. We're so thrilled to have you here today.
Woganee:Thank you, I'm so excited to be here with you.
Michelle:I think one of the reasons we're so excited is because sleep is, I think, paramount in everyone's life, and it's also one of those things that, as we age, we start to sleep less and less or it feels like we're getting not as great quality sleep definitely in perimenopause and so anytime we can talk sleep, we're thrilled to do so, and so we're thrilled to have a sleep medicine practitioner here on the show today.
Woganee:Oh, my pleasure. Hope I can help and provide some insights and some really useful tips for everyone.
Michelle:Can I ask you, did you like in the in your twenties when you decided to go into this? I really want to know your history because I think in our twenties we don't even think about sleep.
Woganee:It's very, very true. It's very true. I even remember during residency, sleep was like an afterthought. I would go, you know, 36 plus hours without sleep, crash for a solid 12 hours and get up and it was like nothing ever happened. Yeah, so I didn't plan on becoming a sleep doctor. I didn't even know it was a field of medicine you could study.
Woganee:How I ended up in this practice is well, I started in internal medicine and when you do that as a residency, you get to explore all the different subspecialties within medicine cardiology, endocrinology, etc. And I really gravitated toward respiratory medicine. I really enjoyed it. I thought it was so intellectually interesting. And then, when I went into the respirology residency program, sleep medicine was actually one component. And I just have these distinct memories of helping patients with their sleep disorders and seeing the after effects, of how much better they felt once their sleep disorder was treated. I mean, people would hug you in the office, they would get teary, they would say you know what, now that I'm sleeping better, I'm a better parent, I'm a better spouse, I'm a better person like I'm nicer right. And I thought, wow, what a field of medicine. If you could be a part of that every day. It's so rewarding and, yeah, that's how I ended up here, so it was not planned in advance whatsoever.
Michelle:I love that, and it couldn't be more true. Like I didn't sleep last night. My husband and my son are away. I don't sleep well when they're not here and I'm a bag of tricks today Like I can barely get my coffee, like I've had way too much coffee, so I might be talking a little quickly. Even just losing a couple hours of sleep a night impacts the rest of your day and everything.
Woganee:A hundred percent, yeah, and your mood and your emotional regulation. So really it's not just a health component, but it also is a lot to do with your mood and how you feel.
Mikelle:Fascinating and kind of terrifying, considering how we've all been so dismissive of sleep for most of our lives Waganiive of sleep for most of our lives Wagani. I think that for most of our listeners in perimenopause, sleep disruption is just the name of the game. Unfortunately, I think also for our listeners who don't think they're in perimenopause yet, or maybe don't realize they're in perimenopause yet and are having trouble sleeping, that can often be the first telltale sign. It certainly was for me in a big way. Could you tell us a little bit about why sleep changes in perimenopause and menopause?
Woganee:Yeah, that's a great question. So we know that between 40 to 60% of women in the menopause transition report difficulties with sleep, and it can be, from you know, difficulty falling asleep, difficulty staying asleep, having lots of wake ups at night or even waking up earlier than your desired wake up time, and so there are many factors. So if we look at the reproductive hormones and their role in sleep, it's really fascinating. So, for example, estrogen has multiple roles in our sleep cycle and our sleep health. So, first of all, it blocks a lot of the wakefulness promoting neurotransmitters. So we have chemicals in our brain that signal to our brain be awake, be alert. You know serotonin, dopamine, etc. And so estrogen blocks those when it shouldn't be active, and so estrogen blocks those when it shouldn't be active.
Woganee:Estrogen also, as you probably know, is a core component of regulating our internal body temperature at night, ensuring that our temperature goes down so that we can fall asleep and stay asleep. Estrogen also plays a role in our REM sleep. So REM sleep is that state of sleep where we do our dreaming that when you wake up from you feel really, really rested. We tend to go into REM sleep between 3 am and 6 am, and so estrogen's role is to help you get into REM sleep and stay in REM sleep. So its main job is what we call consolidate REM sleep. We want you to have nice long chunks of REM sleep.
Woganee:And when you are in the menopause transition and post menopause your estrogen is going up and down and eventually declining. Well, you lose all of those benefits. And that's when you hear a lot of people say you know, I wake up at 335 every morning. I can almost time my wake. Yeah, you can time your wake up like you don't even need to look at your clock or your phone. You know and that's the role that when you're having lower estrogen, that you're not having that consolidated REM sleep.
Woganee:And, interesting, progesterone also plays a role in our sleep. When progesterone is broken down, it attaches to a receptor in the brain called the GABA receptor, which releases a neurotransmitter that helps you feel relaxed and it's a sedating effect similar to how medications like the benzodiazepines work, the Ativan. They work on that same receptor and progesterone also is a respiratory stimulant so you can keep breathing effectively during the night. Our melatonin goes down as we go through the menopause transition and our circadian rhythms are affected. We have what's called not everyone, but a lot of women in the transition will have what's called phase advance, so your whole circadian rhythm has kind of moved forward and you end up waking up earlier than your desired time.
Woganee:So for all of these reasons, it's such a time of flux. It's almost like the perfect storm, if you will, because you have all of these physiologic changes related to your decrease in estrogen progesterone, your melatonin secretion, and then add like life factors that happen during this time too. Right, you are caring for teenage children, or your children are leaving the house, or you're like me, you still have young kids, you are trying to climb the corporate ladder, you may have be suffering from depression and anxiety, your parents are aging, so again, it is almost that perfect storm where your physiology is changing and your life is changing and your sleep definitely gets affected.
Mikelle:Well, we've talked about sleep disturbances, which most of us can relate to, unfortunately, but something we weren't familiar with are sleep disorders. Can you tell us about sleep disorders?
Woganee:Yeah, great question. So when I think of sleep disorders in women across the menopause transition, I think about what are related to menopause symptoms and what are not related to menopause symptoms. So think of hot flashes and night sweats. Well, those will disrupt your sleep. If you are suffering from depression and anxiety, that can disrupt your sleep.
Woganee:But aside from that, you know individual or bona fide sleep disorders are common at this stage, including chronic insomnia. So difficulty falling asleep, staying asleep, waking up earlier than your desired time, feeling tired. Other things that become common are restless leg syndrome can become common around pregnancy and also during the menopause transition, and another big one is obstructive sleep apnea. And I find that that's not on many women's radar during the menopause transition and it's something that we should really keep in mind because, compared to pre-menopause, perimenopause and postmenopausal, women are two to three times more likely to be diagnosed with obstructive sleep apnea, independent of weight changes. So even if your weight stays the same across the menopause transition, you are more likely to have sleep apnea. So we think of menopause as an independent risk factor for obstructive sleep apnea. And so we think of menopause as an independent risk factor for obstructive sleep apnea.
Michelle:That's crazy, because in my mind you say sleep apnea, I think older, heavier man 100%, and it's not just you, I think.
Woganee:The medical community, that's what we're taught. You think of the prototypical patient. It's a male, overweight, large neck, snores, gasps for breath at night, and that is what people think of. But for women who are in menopause and have sleep apnea, you can have a lot of those symptoms of snoring and things like that. But you can also have a lot of what's called non-specific symptoms. So think of things like irritability, daytime fatigue, daytime sleepiness, impaired concentration. So you can think of many other disorders that can present like that. So sleep apnea is not necessarily on people's minds during this time.
Mikelle:What exactly is sleep apnea?
Woganee:Yeah, so sleep apnea is a sleep disorder, no-transcript of stopping breathing, waking up stopping breathing, waking up and when I say waking up, you don't necessarily have to come to full alertness when these wake ups happen.
Woganee:We call them arousals and they're really just a characterization of what happens to your brainwave patterns when you're sleeping. So you could be in one stage of sleep and then you've been, you know, taken out of that stage of sleep and you go back to sleep, and so sleep apnea is that repetitive stopping breathing. But what's important to remember is it's actually normal to do this a little bit at night, and that's where I find patients are like wait what? It's normal to stop breathing. And in fact we can stop breathing up to five times every hour, and it's normal. What? And your reaction is totally normal. I see this every day, and if you think about what sleep is, it kind of makes sense. Think of sleep as a state of muscle relaxation, right? So all of your muscles are relaxed when you sleep, and so too can your muscles in your upper airway, so they can stop breathing or they can collapse and have you stop breathing up to five times an hour, and it's normal.
Michelle:That's really interesting and it doesn't cause me to be exhausted in the morning Like no, not if you're.
Woganee:If you're what we call the apnea hypopnea index, which is that measurement of how many times you stop breathing. If it's less than five, it's considered normal. Wow, that's wild, yeah. And the theory. So people say well, why, what's happening to me during the menopause transition that's making me have sleep apnea if my weight isn't changing? Because I thought it was a disorder associated with obesity, and it still is. But the unique thing with women during menopause is we know that estrogen plays a role in our muscle tone, and specifically the muscle tone in our upper airway. So when the estrogen levels go down, our airway is more collapsible. So that is why we are more likely to see sleep apnea during the transition. And so patients will say to me okay, well, if I take hormone therapy, will my sleep apnea go away? And the answer is no. We don't have data to date that shows that menopausal hormone therapy is a treatment or even prevention of sleep apnea.
Mikelle:What are treatments for sleep apnea treatment or even prevention of sleep apnea.
Woganee:What are treatments for sleep apnea? Yeah, so the treatment of sleep apnea really depends on someone's severity. So remember I was talking about that apnea hypopnea index. That's the scoring metric we use for sleep apnea. So someone has mild or moderate sleep apnea and again, this depends on how symptomatic they are. But we will often recommend weight loss. We can often recommend having your dentist make you a very sophisticated dental appliance, kind of like a fancy retainer that moves your bottom jaw forward. That can also help with sleep apnea.
Woganee:Some patients will have sleep apnea exclusively when they sleep on their backs. So one type of therapy, if you're mild and moderate, is well, avoid sleeping on your back. And it's not good enough to just say, okay, well, I can eat tonight. Just don't sleep on your back, right? Because once we're asleep, we're not in control of our position. So I often encourage patients to either go online and purchase what's called a positional device, which is something that velcros over your stomach and at the back you'll find like a styrofoam wedge. So you put that on top of your pajamas, you fall asleep on one side and as your body tries to go on the back at night, you'll feel that obstruction and then it moves you to your side.
Michelle:Oh my goodness, Like I'm already envisioning how much less sexy I'm going to be at bedtime.
Woganee:Yeah you're not alone. Everyone says that. But my counter argument is you know, what's sexy is a well-rested person, right? So if that's the price you have to pay, so be it. And then in terms of, like, severe sleep apnea. So these are people who are stopping breathing 30 times or more per hour. They often will be very symptomatic, sleepy, fatigued, etc.
Woganee:We recommend what's called CPAP therapy. You've probably seen commercials online and essentially what it is. It is a mask that you wear at night. It can go over your nose, under your nose or covering your nose and mouth, and it's attached to a hose that sits at it or attaches with a machine that's at your bedside table and what that machine is doing is so simple it's just taking regular air, pressurizing it. That air now goes through that tube into your nose, down into your throat and keeps your airway open. So you're having zero snoring, your apnea numbers go back to normal and you feel better. Your oxygen levels are better and I have seen so many people's lives transformed.
Woganee:I can't even tell you. I've had patients tell me that they will never be without their machine. They take it on vacation, on camping trips, on boating trips, like they will do whatever they have to do so, that they take their CPAP machine with them only because it has such an impact on how they sleep. They don't want to go back to sleeping how they did before.
Woganee:And I have so many you know anecdotal cases of patients who, for example, I had one woman who was driving to her cottage I think it was about 200 kilometers north of the city. She was 150 kilometers into her trip. She was going to be gone for a week, realized she forgot her CPAP machine, drove all the way back home, picked up her machine and drove all the way back and she told me. She said they're in no way, shape or form. Was I going to go one week on my vacation? Wow, I've even had patients and this is a true story just recently, a couple months ago, someone said they went on vacation and I think they were in the Amazon jungle, so somewhere could not get more remote realized they didn't have their CPAP machine, was trying to communicate with their family at home to go to their house, get their machine and FedEx it to the Amazon. I mean, you cannot get much better stories than that, like how much it improves and improves people's health.
Michelle:So I need my husband, desperately needs this, because he's and it's starting to show like he's becoming more stressed out and he's just less patient and with me I mean I'm wonderful, how could you be impatient with me? But, thank you, I'm going to get on him after this.
Woganee:Just to round out the discussion on treatment, because in the last week or two weeks there was new treatment that came out, the new research study that showed that weight loss drugs for those that have obesity and sleep apnea this was men and women that they were all able to decrease their apnea levels by half using these weight loss medications for a year and the weight loss was more significant and the improvement in your sleep apnea was more significant if you did the weight loss medication plus your CPAP. So I think in the coming years we're going to see a lot more research coming out that combining CPAP therapy with these weight loss medications for those that are overweight really have significant impact.
Michelle:Wow, that's incredible. I'm really curious how do I know if I've got sleep apnea? What are some of the symptoms?
Woganee:Yeah, it's a great question. So think of your classic symptoms. So if you have been told that you snore, if someone has actually seen you stop breathing at night or even simply feeling tired, headaches in the morning, irritability, decreased concentration, changes to your mood, those are all sort of concerning features that there could be a sleep disorder. I mean, granted, you know, if you're feeling tired or irritable, there could be other factors. I always want to make sure that patients are making sure they're getting enough sleep right, because if you're sleeping four hours a night or you only have four or five hours of sleep consistently, if we try to improve the total length of time, will that change symptoms, at least with regards to fatigue?
Woganee:That's part of the recommendation. But as soon as anyone who has any concern about sleep apnea, I always say talk to your primary healthcare provider and request a sleep study, request a referral to a sleep study sorry, sleep clinic. And you know, sometimes the best thing we do also is not make a diagnosis right. So not everyone who comes is going to have a diagnosis one way or the other, but it is still a great opportunity to learn about your sleep, learn about the important components of having a good night's sleep and really getting reassurance that you know what I don't have a sleep disorder that's putting me at risk and then you can try some other ways to improve your sleep.
Mikelle:What are the risks Wagani for undiagnosed or untreated sleep apnea, particularly in menopausal women?
Woganee:Yeah, so again it goes back to severity of sleep apnea. So for you know, the day-to-day side effects or risks would be like we talked about so decreased concentration, decreased work productivity, forgetfulness, irritability. But for those that have severe sleep apnea, the risks are quite significant and this includes up to a 50% higher risk of heart attack, stroke, high blood pressure. So these are real risks. There's even data now linking sleep apnea or severe sleep apnea to liver dysfunction, new onset type 2 diabetes, depression and even cognitive impairment. So it's not just saying, oh, sleep apnea, is I just snore or, you know, I'm irritable the next day. There are real health implications from untreated severe sleep apnea. Wow.
Michelle:This is some pretty scary data points, and especially in light of the fact that women, as we reach menopause, are more likely to and I don't want to say this incorrectly, but our risk of heart disease, cardiac disease, increases as well.
Woganee:Yeah, this can be an additional risk factor, right? So if somebody has sleep apnea, yeah, the risks would be additive, it's kind of like double whammy.
Mikelle:Is it easy to find you or someone like you, and when I say this, you're a sleep medicine physician, but I wonder how many sleep medicine physicians have the in-depth knowledge you do about menopause, perimenopause and the hormone impacts on?
Woganee:sleep? I don't know the answer to that. I don't know how many of us have knowledge or expertise in this area, and I think partly is it's not taught, just like the way menopause isn't part of the regular medical curriculum, at least when I went through training, and a lot of what I've learned I've actually it's been self taught right, seeing patients in the office, educating myself, reading up on studies, making sure that as a clinician I can be most empowered to help people. But I'm sure I have. There are colleagues out there that are doing the same, but I don't know. You know how many of us as sleep physicians really have the interest, perhaps, as well as the extra knowledge, to really educate and support women?
Michelle:Well, we have trouble. You bring up a point that menopause is not commonly taught, or it hasn't been in the past. It's getting better, but in medical school, if I go to my doctor and I'm presenting with some of these symptoms you've just told us about, am I going to be dismissed? Do I need to beg and barter to get myself into a sleep clinic?
Woganee:Yeah, I mean, every interaction with the healthcare provider is different, and some physicians are probably more open and have more knowledge, and so we'll recognize some of these symptoms. But I think, like with everything in in healthcare, and especially women's health, we have to be our own advocates, right? We can't expect someone else to think about something that they were never taught about, right? So it's not even the physician's fault, right? If they were taught about it, then if they missed it, that's a different story. But if they were never, if it was never placed on their radar, it really now behooves us as women as you know, a collective group of us to say to your doctor you know what? I'm really concerned that I might have sleep apnea. I've done all of the sleep hygiene techniques, I'm giving myself enough time for sleep and I find that I'm not sleeping well. I would really like a referral to a sleep clinic.
Mikelle:Would you add in the soundbite that they have learned from you and on our podcast that women who are menopausal perimenopausal are two to three times more likely to develop sleep apnea?
Woganee:If you remember that, good for you and tell them, because then they may be like oh, I had no idea. You know, you're right, let me go look that up. And so you've also helped right that physician's knowledge, so when the next patient comes in it's on their radar, right, and they can say you know what? I'm going to refer you to a sleep study. You may, you may not have sleep apnea, but it's a really good test to do and an assessment to undergo, even to rule it out.
Michelle:Can you tell us a little bit? What does the test involve?
Woganee:Yeah, so this is the part that people love me for, and I and I say that facetiously, because what the gold standard is for diagnosis of sleep apnea is an overnight in lab sleep study, also known as a polysomnogram big fancy word it's essentially you coming into the sleep clinic and sleeping over, and why that's important is because when we have you sleep with us, we monitor many, many components of your sleep. We measure brainwave activities to decide when you've fallen asleep, when you've woken up, how much of the night are you in the different sleep stages and what it looks like. We measure your oxygen levels. We measure your heart rate and your heart rhythm. We measure movement. If you're having a lot of unusual arm and limb movements, sometimes we can also do additional testing to see if there are seizures at night. So the whole point is that the overnight sleep study is the gold standard because it gives us such tremendous data on your sleep and that's how we make the diagnosis.
Woganee:Many people say to me well, if I'm not sleeping well at home, how do you expect me to sleep well in a sleep lab? And granted, I 100% agree that it is a strange environment. You're in a different place, you're all wired up, you feel like self conscious. What I always try to reassure patients is I don't need a textbook night of sleep, right? I don't need eight hours of you sleeping soundly to make a diagnosis. Even if we get a few hours of sleep, even if they're fragmented, because we are correlating your sleep parameters with brainwave activity that is consistent with sleep, those behaviors don't change. So if I tested you at home with an overnight sleep study, if I tested you in a hotel with an overnight sleep study, the findings are what happens with your body, and so that is simply how you are sleeping. So I always reassure people I don't need a ton of sleep. Do your best. We will collect the data and analyze the data together. That's interesting.
Michelle:I yeah, that's really cool. Thank you, mikkel. Anything else on this?
Mikelle:I don't think so, wagonee, is there anything else that we haven't talked about that we should?
Woganee:highlight. Yeah, I think the main thing I want people to take home is the knowledge like we talked about all the different ways that our sleep changes in perimenopause and menopause. We can't change that right. I can't change what happens to my estrogen levels. I can't change what happens to my melatonin production, but what I need to do is my sleep is changing so I need to change the behaviors that I had pre menopause about going to bed super late, waking up and expecting to be 10 out of 10 on productivity, you know, having coffee late, drinking alcohol right before I go to sleep. I always try to tell people our sleep is changing, so our behaviors have to change, and so it always comes back to really prioritizing your sleep, making sure you have the most optimal environment for sleep at night. So that includes a dark bedroom, a cool bedroom, take out distractions, take out your computer, take out your you know notebooks and this, and that, whatever that is going to, it could stress you out right and have a routine that is really going to set you up for success for sleep.
Woganee:And the big thing that I spend a lot of time educating women on is the role of alcohol in sleep, and I don't make friends when I have this conversation, but I think it is so important that women realize that alcohol is a very, very strong sleep disruptor. And patients will say to me, dr Falate, you're not fun Like I want to have fun. And patients will say to me, dr Folletti, you're not fun Like I want to have fun. And you're telling me I can't drink. And I, you know, I'm not the alcohol police, but what I'm trying to educate people is that if you are struggling with your sleep, take a, take a time. Take, give yourself one to two weeks.
Woganee:Cut out alcohol, cut out caffeine late in the day and actually do an inventory of yourself and see how much it affects your sleep and most likely you will see that you are sleeping better and perhaps you are more mindful of when you drink. So if you know you have a lot going on the next day, maybe that's the night at dinnertime. So you know, I'm gonna, I'm gonna forego that glass of wine because I really want to prioritize my sleep tonight. So I think just giving people that awareness and permission, right that you can put yourself first. And, yeah, you probably are going to have strange looks from friends or people are going to say, oh, that doesn't happen to me, or I'm fine and that's fine. Everyone is different, but I always say, if you are struggling with your sleep, really do a deep dive and inventory on your behaviors that are helping or hindering your sleep.
Michelle:Wagani, do you have a solid sleep routine? What does your sleep routine look like?
Woganee:Well, I'm not perfect. I'll be the first to tell you. But what I do is I give myself a lot of grace and if I see myself scrolling on social media watching another Netflix at night, I say you know what, tomorrow night's a fresh start. So every night I can do better. Every night I can optimize my sleep. But what I try to do is really what I tell my patients. I try to make sure I go to bed at the same time every night and I know how much sleep I need. I mean, the general recommendations are seven to nine hours, but I'm the person who needs between eight to nine. If you want to catch me at my best, that's my window. So I do a wind down around 830, nine o'clock. I'd like to read a book.
Woganee:I often tell patients if there are things that are bothering you or you're worried about something, or you know I have to do this and this and this tomorrow. Write it out, right. Get a journal, get a piece of paper. Clear your mind, write all the stuff that's worrying. You put it on a piece of paper and almost like clear your head so that you don't take it with you to sleep. Now, that's not always going to work, but it is just habit forming, right that you are saying to yourself. You know what? I know. I have a lot on my mind. There's nothing I can do about it between 10 PM and 6 AM, so I'm just going to write it all down. Do a worry, dump, dump all the worries on a piece of paper and then have the freedom to go to sleep without that, you know, holding you back.
Michelle:I love that. I actually used to. My sleep has gotten much better. I've done, I've cleaned up my routine. But there was a time when I really was struggling with insomnia and I would keep that piece of paper and a pen by my bed and in the middle of the night I would just like write down all the stuff and in the morning I could never read what I had written. It was all all over. But just that, that process of dumping. It was really helpful for me. Yeah, I like that one. Yeah.
Woganee:I'm so happy to hear. Are you a good sleeper?
Mikelle:Wagani.
Woganee:You know it's yes and no. I think if I do all of the things that I tell people to do, you know it does work in my favor. But again, there are so many things outside of our control. You know, if you have young children or you have a partner that is snoring or disrupting your sleep, there are things that are sometimes out of your control and that's normal and happens. But do whatever it is you can to optimize your sleep. And I try to prioritize my sleep as much as I can only because I know for myself when I don't sleep well, I'm no good to anybody, right? I'm not a good mom, I'm not a good wife, I'm not a good doctor, I'm irritable, like nobody wants to be around me. So I prioritize my sleep so that I can be the best that I can be for those in my life.
Michelle:And speaking of being a mom, what kind of sleep hygiene or techniques or tricks do you have that are that you're teaching your kids?
Woganee:Yeah, I mean, it's the same thing that we did, and I'm sure you did the same thing too, from when they were babies. Right, it's just having that same routine, and you know they're older now. But you would do the bath, you would do the book, you would do like a song or whatever it was. You'd give them the same routine. And what I try to tell my kids is that, yeah, you want to watch another episode of TV. I'm sure that sounds like a great idea and I would want to do it too if I were in your shoes. But no, it's time to go to bed. When you don't sleep well, you're not going to grow as much, you're going to not listen in school, you're not going to be, you know, a good friend and it doesn't always work, but I try to reinforce these strategies to my kids as well.
Michelle:I love that. That's great. All of this information has been fascinating. Is this the kind of info? I know you're going to be at the National Menopause Show in Toronto in October. Is this the kind of information that you'll be talking about there as well?
Woganee:Yeah, I think I'm going to be again reviewing about how our sleep changes during menopause, really educating women on the things that should be on their radar, especially as it relates to sleep disorders, and really giving women a lot of helpful tips and tricks, like we talked about, so that you can start tonight on how to improve your sleep. And you know, it doesn't have to be a solitary activity. Find a friend, do it with your partner so that you have an accountability partner, because it's often can be lonely and if you're having the wherewithal to really focus on your sleep but your partner is doing the complete opposite, well it's not going to be really successful for either of you. So it's something that you can, you know, incorporate your family to do, your partner to do, so that you're on that journey together.
Mikelle:Well, what is the one thing you want every woman to know about sleep and perimenopause?
Woganee:Yeah, I want every woman to know that sleep matters. Right. It's not a something you think about later, it's not something you just hope will happen on its own. It is something that is so paramount to our whole health not only our physical health, our mental health, our emotional health. So I really want everyone to think of it as an active process. And just the same way you prioritize exercise, the same way we prioritize eating healthy, we should put sleep at the forefront as well, Because, in my opinion, it's the bedrock of our whole health. You could be exercising, you know really well, you could be eating really well, you could be looking after your mental health as best as you can, but if you're not sleeping well, it has no foundation to sit on. Great advice.
Michelle:So true. I absolutely couldn't agree more. I love it. Thank you so much for coming on and for chatting with us and educating all of our listeners. It's been an incredible conversation, thank you.
Woganee:Well, thank you guys. This is something that's near and dear to my heart and, you know, if I could help one woman today, then it's all worth it.
Michelle:Thanks so much for listening to the show. If you like what you hear, please take a moment to rate and subscribe to our podcast. When you do this, it helps to raise our podcast profile so more women can find us and get a little better understanding of what to expect in perimenopause.
Mikelle:We also read all the reviews the good, the bad and the ugly to help us continuously improveopause. We also read all the reviews the good, the bad and the ugly to help us continuously improve our show. We would love to hear from you. You can connect with us through the podcast, on social media or through our website. Our information, as well as links and details from our conversation today, can be found in the show notes. This podcast is for general information only. It's designed to educate, inspire and support you on your personal journey through perimenopause. The information and opinions on this podcast are not intended to be a substitution for primary care diagnosis or treatment. The information on this podcast does not replace professional healthcare advice. The use of the information discussed is at the sole discretion of the listener. If you are suffering from symptoms or have questions, please consult a qualified healthcare practitioner.
