Stop Letting Rotating Shifts Rob You of Sleep

Bart Leger (00:00.814)
It's the second time this week you've been lying in bed thinking, why can't I get to sleep? I've worked all night. I'm dog tired. What's wrong with me? Or you finally get to sleep and your eyes snap open at 2am staring at the ceiling while your brain kicks into overdrive rehashing calls from the day and worrying about the pile of paperwork waiting for you. And it's making rest seem like a distant dream.

Well, I've heard it a thousand times before. Well, heck, that's been me. No matter how hard you try, nothing seems to work. And that's why I'm excited to welcome Dr. Philip Connor to this episode, because if there's anyone who can help you get to sleep and stay asleep, it's Dr. Connor. He's helped thousands of shift workers and others find sleep. Keep listening for his prescription for you. Insert show intro here.

Welcome back. This is episode three, and we're talking about sleep or the lack thereof. I've had more nights and mornings after shift when I couldn't get to sleep no matter how tired I was. Just recently, I think I saw just about every hour on the clock go by during the night. That's why I can't wait to hear from our guest who will help us find effective ways to go to sleep, stay asleep.

and wake up rested and refreshed. Dr. Philip Connor attended LSU or Louisiana State University in New Orleans to receive his medical doctorate and did his residency and family practice. After which he practiced for over 20 years. After becoming interested in the medical implications of sleep problems, he went back and trained to become board certified.

in sleep medicine. Dr. Conner is board certified in both family and sleep medicine and he's a member of the Calcasieu Parish Medical Society, Louisiana State Medical Society, American Academy of Sleep Medicine, and American Academy of Family Practice. Since then, he has dedicated himself to improving his patient's sleep quality.

Bart Leger (00:01.146)
Well, Dr. Connor, thank you for joining us today. Why don't you start by telling us a little bit about yourself and where do you practice?

Dr conner (00:08.386)
Hi, yeah I'm in Lake Charles, Louisiana I have been practicing sleep medicine for about eight years full-time and prior to that was in family practice for about 18 years so I've always been local to this area and I'm happy to be here

Bart Leger (00:28.674)
Well, great. Well, great. I've been in your office before and there's something that, uh, just about every wall in your practice. Uh, it's about a little known rock group, right? The Beatles, a little bit of a Beatles fan, huh?

Dr conner (00:40.282)
Oh, right. Yeah. I'm a little bit of a yeah.

Yeah, yeah, pretty passionate about it pretty much my whole life. I had an aunt who had a bunch of the original sort of LPs and she gave them to me. And since then, I've been collecting memorabilia and I spend more time in the office than I do at home. So I figured I would display it there and kind of be able to enjoy it all day long.

Bart Leger (01:09.154)
Well, that's pretty cool. Pretty much. Well, really just about every, everything from your waiting room to your, um, your treatment rooms have, have all the memorabilia. It's pretty neat.

Dr conner (01:19.086)
Oh yeah, for sure. Yeah. I'm, I'm running out of space to some degree, but, uh, it's fun. You know, uh, people oftentimes ask me, you know, how much money you have invested in, and it's really not very much. They made so many albums that it's more of a treasure hunt, uh, just kind of searching through to find these little gyms and these little stores and so it's, it's a good little pastime.

Bart Leger (01:44.234)
Yeah, now we're both from Louisiana and I know firsthand that Louisiana has some amazing cuisine. Do you have a favorite local dish or restaurant that you'd recommend for any of our audience that might be traveling through the area through South Louisiana?

Dr conner (02:00.93)
I've always liked, is Patsy Henderson, I've always enjoyed. It's very close to the interstate and especially if you want to kind of get a taste of what Louisiana is like, I think it's a good option. They did a full kind of remodel after the hurricane and it's, it's a really nice spot.

Bart Leger (02:18.462)
It is, it is. I have an interesting story about Pat's of Henderson. I knew Pat Huval, when I was in Henderson and, quite often when he had his restaurant there in Henderson, Louisiana, quite often he would, we would, I would see him in town. Of course he was also the mayor and, and he would say, Hey, you and your wife, come on, he said, I'll, my treat. And so he would feed us quite often. I know, I know. Yeah. I knew him, knew him pretty well.

Dr conner (02:24.114)
Oh really? Yeah.

Dr conner (02:31.468)
Right.

Dr conner (02:42.606)
Oh, that's great. Huh. That's a coincidence. Yeah.

Bart Leger (02:45.942)
You know, I'm pretty, pretty well. And, and matter of fact, my wife and I went over to Pat's for our anniversary, um, back in March. So pretty neat. Yeah. Well, now I've known you and I've known you for a number of years back when you were in family medicine, and then now you're the medical director of the sleep disorder center of Louisiana. Now what, what inspired you to specialize, obviously in family medicine, but then what inspired you to?

Dr conner (02:54.478)
Fantastic. Well good. Well, yeah, it's a really

Dr conner (03:03.234)
Right.

Bart Leger (03:15.931)
specialize in sleep medicine.

Dr conner (03:17.898)
Yeah, I, it's fascinating because you're, you're able to really have an enormous impact on people's quality of life as well as their, um, uh, health by sort of examining and looking at some of the frameworks surrounding sleep and then coming up with, with motive strategies to kind of impact that in a positive way. So it really, there's a direct line and there's a lot of, um,

work satisfaction with being able to perform these studies, getting people the help they need and then seeing them back and seeing the really impact that it's had on their lives. It can be dramatic, especially in our modern life where we have so many distractions that kind of preclude us from being able to get good sleep. Being able to impact that is got a lot of job satisfaction. I really enjoy it. I really enjoy interacting with people.

with my patients and kind of helping them navigate this process to get them to where they're sleeping well.

Bart Leger (04:21.438)
Right. Well, sleep really affects all of the buckets in our lives, if you will, the emotional, the physiological, everything. I mean, sleep is really other than our food, really affects everything. Now, our ideal, our listeners are pretty much first responders, those in frontline professions. But we also have

Dr conner (04:29.303)
For sure.

Bart Leger (04:48.85)
a lot of shift workers in our area. We're a largely petrochemical area. In your experience, what are the most common challenges shift workers face when trying to get enough sleep?

Dr conner (04:52.004)
Correct.

Dr conner (05:01.874)
Yeah, it's, it is difficult. And I think some of it is, is defined by the nature of the work and the demands that it puts on the individuals that are kind of working that schedule. Our brains were evolved and at a very fundamental way or hardwired for a day night cycle based on the sun. And so that's what we call circadian rhythm.

is definitely hardwired. And so when we're exposed to light in the morning and then when the light begins to diminish in the evening, it sends certain triggers and certain signals throughout our entire system to let us know, okay, it's time for rest, it's time for sleep. That gets completely upended with someone's working shift work because they're no longer able to use those natural cues to sleep. And in some ways, it's...

actually combating their ability to sleep. And so we're going against our nature. And unfortunately that does have a significant amount of, like you mentioned, physical, emotional, neurological impacts in terms of health.

Bart Leger (06:14.186)
How do the rotating shifts affect? I mean, my middle son works law enforcement, but he has, he works strictly night shifts and he works seven days on, seven days off. But many people will work days for a couple of few days and then nights off, back and forth. How does that affect?

Dr conner (06:18.05)
Yeah.

Dr conner (06:30.208)
Right.

Dr conner (06:34.43)
In some ways, it's more problematic, because I think if you can establish yourself on a strictly night schedule, there are ways that we can kind of artificially reestablish that normal day-night cycle. The challenge with someone who's shifting is it's constantly a moving target in terms of the internal dynamics of the sleep-wake cycle. So we're trying to kind of behind the curve constantly. Your body never really be able

is able to catch up and become reestablished. It's, the analogy is kind of like you're in a constant state of jet lag. You know, you're never able to really get on that normal rhythm that allows you to sleep effectively. So it can be an issue. And even if you're working just straight nights, the week that you're off, a lot of times people will try and reestablish that day cycle for that week. And that, that again, is just as.

damaging because you're still not able to get on a normal consistent rhythm.

Bart Leger (07:37.726)
Well, we know that our social support system is very important and pretty much everybody else is on that day-night cycle. And in order to be with their family, in order to be, you know, watching kids ball games, you know, so they have to switch back and forth. So it can be problematic. Now, I know some of several of the most highly publicized industrial accidents in the past several decades have largely been associated with sleep deficits. So

Dr conner (07:46.368)
Right.

Dr conner (07:53.198)
Exactly.

Dr conner (08:05.086)
Yeah, it's true.

Bart Leger (08:06.658)
Considering those implications, how can you explain maybe improper sleep, how it affects our safety and our performance? Because these were some high stakes occupations.

Dr conner (08:14.804)
Yeah.

There was a study that was done, which is a fascinating one, in which they looked at progressive sleep deprivation, and they looked at it over a significant amount of time, and they did it by measuring reaction times. And it's almost a linear decline in reaction times over a certain time span, where they became worse and worse at performing certain tasks.

The interesting thing about the study though is that their perception of how they were doing was that they were doing fine, that they weren't aware of that decline in activity and reaction. And so the combination of that together really results in a very high risk of industrial accidents or highway accidents, driving accidents.

anything along those lines because the deficits are there but the cognitive perception of those deficits is not and so that risk goes up exponentially with that.

Bart Leger (09:26.178)
Well, that can be very problematic because if you don't think you're sleepy or if you don't really, you know, you know, you're maybe drowsy, but you think, oh, I can, you know, I can still do my job. And, and there are many who literally have to make split second decisions that not only affect their own safety, but maybe the safety of, of many others as well.

Dr conner (09:30.291)
Exactly.

Dr conner (09:47.527)
Oh, for sure. And that especially you have to be able to react in an appropriate way and in an appropriate time span, which is going to be very compacted. And I think industry is aware of that and even in first responders are aware of that. And there's ways to mitigate it and there's ways to sort of work around it.

I think the first step in trying to overcome it is just the awareness and realizing that look this is a problem and not thinking that you can just power through and cut those corners in terms of sleep and still be able to perform at your maximum potential.

Bart Leger (10:15.736)
Hmm.

Bart Leger (10:27.478)
Well, how would you say a person could preserve their sleep quality, considering the irregular schedules?

Dr conner (10:33.906)
Yeah, yeah, I think one of the ways is just to being consistent, um, in, in giving your body these unconscious cues that it's time to rest. And so if someone's working nights, we'll, we'll generally say whenever you get off in the morning, try and avoid sunlight as much as possible. So wearing sunglasses, tinted windows, going straight home, having a bedroom environment that's already kind of established and prepared. So a cool room.

blackout screens, because if remember, sunlight is the key. And so what I find in my practice is that a lot of people when they get off after working nights, that's their time for errands, or a lot of people have second jobs, or a lot of things are occurring in those morning hours. Well, when the sunlight hits the eye, it's sending a signal to the brain that it's time to wake up. So.

when they finally do commit to laying down to sleeping, they're getting a very counterintuitive type of response because their brain has already been told it's time to wake up and now you're trying to induce sleep. And so the sleep quality is gonna be impaired. So it's very important to kind of maintain that consistency in the rhythm. And then on the backside, so that when the sunlight begins to go down, we use, well, normally our brain produces melatonin.

at sunset or dusk. And so we use it in the same kind of role for people when they're working nights is to try and get some sunlight late in the evenings to kind of offset that melatonin spike and get a little bit of an energy surge so that they can get into the work schedule.

Bart Leger (12:24.002)
Now, I know we talk a lot about sleep hygiene and some pre-sleep routines. What, I know you mentioned the blackout shades or the curtains, other things. What, what would you recommend as a good pre-sleep routine?

Dr conner (12:44.702)
Yeah, I think the, and I'm going to, I've kind of harpooned this a lot, but a lot of it is consistency. You know, so taking a shower at a roughly the same time, trying to avoid a lot of stimulatory electronics, like, uh, you know, an action movie or a horror movie or anything that's going to be really, or the news for a lot of people that's going to be really stimulating.

Try and focus on more quiet activities, whether that be reading, praying, puzzles, crosswords, something to kind of settle your brain down. And then try and engage with sleep at a routine kind of pattern. I always recommend for people that are struggling with sleep is for journaling. If you can spend 15, 20 minutes in the evening and just kind of write out your day.

usually just a stream of consciousness, just writing out your thoughts on paper is a very good release of tension. So that when you do lay down, it's not the first time you've sort of reflected on the day. You can refer back to what you've journaled and some of the solutions you've come up with and allows that transition into sleep to be a little bit more smooth and even.

Bart Leger (14:01.314)
No, that's great. By the fact that accomplishes a number of things. I recommend people when they're dealing with stress or when they've been through trauma is to journal and even if they simply tear it up or shred it, they've put it on paper and as you say is that stream of consciousness that they've verbalized to themselves and just got it out even if they don't want anybody else to hear about it.

Dr conner (14:16.974)
Sure.

Dr conner (14:26.378)
Yeah. For whatever reason, psychologically, the act of writing something down almost give you permission to kind of release it. And I try and reiterate to them is that kind of to your point is that to make sure that this is something that no one's ever going to read, you know, that it's right. Exactly. It's the act of writing even, not typing, writing.

Bart Leger (14:33.562)
Correct.

Bart Leger (14:41.846)
Right. Don't do it electronically.

Dr conner (14:48.586)
and it's completely private, no one's ever gonna see it. So you can be brutally honest, you don't have to worry about someone coming back and judging you for something you wrote. You know, you just put it all out there. And when you lay down, you're gonna find that it's much easier to put those thoughts away.

Bart Leger (15:03.638)
Right. Now you mentioned shower, uh, before, before bed. Now there's a slight drop in body temperature. I know signals the body to, uh, to, to sleep. And I, some recommend, you know, take a, maybe a warm shower, warm bath, uh, before bed and then that, then you're, as your body does, has that drop in temperature, that's the signal to sleep. What I would, is that something that you would recommend or, or is that one of the mechanisms that work?

Dr conner (15:11.501)
Right.

Dr conner (15:28.99)
Yeah, yeah, I do. Yeah, you know, you don't wanna do it too close to bed, cause like you said, you wanna have that sort of transition where that temperature drop is occurring, because that will help to kind of aid sleep. I think, and more importantly, I think, is you wanna give your brain sort of these unconscious cues that, okay, we're transitioning into sort of a restful time.

It's the same reason we have challenges when people are waking up in the middle of the night. What do they do in those timeframes is so important in terms of overcoming any kind of maintenance type insomnia is that you want to reinforce the need that this is a restful time. This is a time transition into sleep. And so anything that's activity wise that is...

inducing sort of a restfulness is going to be a positive.

Bart Leger (16:29.706)
Yeah, so how important is that physical cue to signaling your brain that it's time to sleep? I know those who have those who are on a CPAP or BiPAP, almost the very act of putting on the hose, it's like within a minute or two, they're fast asleep already.

Dr conner (16:41.383)
Oh yeah.

Dr conner (16:51.07)
It's very important. I think it's similar to certain people that will pick up a book and the act of reading induces sleep because they have this sort of associated, I hate to use the word Pavlovian, but it's almost this learned response that whenever you do this activity, okay, now it's time to transition into sleep.

Bart Leger (17:07.351)
Right.

Bart Leger (17:14.766)
Well, I know for me, it's, I like sleep masks and the very act of putting on a sleep mask to darken everything. Because I mean, no matter how much you try, there's going to be a light coming from somewhere. That just the act of putting on the sleep mask signals my brain. It's time to go to sleep. Now, what about sleep masks? Is that something you recommend or is that something that you've seen can help people?

Dr conner (17:32.715)
Right.

Dr conner (17:39.154)
Oh yeah, I think it's, and it goes back to the light as being such a critical component. Particularly if your schedule is such that you're going to be in bed after the sun comes up in those early morning hours, it helps to maintain that sleep a little bit longer. One of the things that's important to kind of recognize is that all sleep is not created equal. Our sleep is sort of divided into.

90 to 120 minute segments. And so we cycle through all four of our stages of sleep every two hours. Stage one, two, three, and then a dream state. And then that starts over again and you go through the same four stages. Within that structure, there's a higher structure whereby each sleep stage has a higher percentage of REM.

And so the early morning hours are really where we get a large preponderance of our REM sleep or deep sleep. And so we have to kind of go through this regimented process in order to get the sleep that we need. And so being able to keep those early morning hours to keep that sleep continuity as good as sort of maintained as we can, will really go a long way in maintaining your sleep quality.

Bart Leger (18:59.93)
Right. Now, how important is the initial stages of sleep? You know, some people will maybe sleep same similar number of hours, but yet they'll go to bed after midnight versus going to bed a little earlier or maybe losing a little bit of sleep in the beginning. How how does that impact individuals?

Dr conner (19:24.931)
Well, yeah, I think it's our starting point is going to be, you know, pushed backwards. And so there are really complex interactions between sort of the physical and the neurological. And so the temperature variation is kind of what you alluded to earlier, our temperature kind of reaches its low point sort of in the early morning hours. And then

We begin to shift from there and we begin to sort of gear up for the day. The closer we get to waking up. And so we begin to see spikes in blood pressure, cortisol levels, things like that in the early morning hours, right before we wake up, that sort of will set the barrier, if you will, that will.

prevent you from going further in terms of your sleep cycle. So the later you get started on that, the more challenging it is for the brain to kind of get in the REM that it needs or the deep sleep that it needs in order to feel rested. And oftentimes I'll kind of divide it up for people in that there's this progressive increasing amount of REM that occurs throughout the night, but only flip side of that, there's a decreasing amount of what's called stage three sleep, which is deep sleep.

And at a sort of a simplistic way, but a fundamental way, deep sleep is more kind of physical recovery from the day. Our joints, our bones, our organs are recovering from the wear and tear. And then REM is more neurological recovery, higher functioning recovery. So they're both equally important and they're shifted throughout, you know, which time of the sleep cycle that they're occurring.

Bart Leger (21:09.61)
So what about, I know for many, for many of our listeners, numbing is one of the things that we, we tend to, to go to. We just want to shut our brains off. Uh, and maybe an extra drink or two in the evenings. And what about the alcohol consumption late, later in the evening or late at night?

Dr conner (21:27.276)
Yeah.

Dr conner (21:31.07)
Yeah, it's kind of fool's gold because it, it will make you sleeping and it will put you to sleep. But the challenge is that it's very rapidly metabolized. And so we get a, we get a metabolism of around four or five hours. And so the second half of the night tends to be much, much more disrupted. And so its impact on, on our REM stages are, is significant. And so it

it is a little bit of a negative in terms of your overall sleep quality.

Bart Leger (22:06.692)
So it could almost be put like we're sedating ourselves, we're being sedated rather than actually getting a restorative sleep. Could it be put that way?

Dr conner (22:14.302)
Yeah. I mean, it's just, and it has to do with sort of how alcohol works on the brain. You know, it, it does, it kind of numbs sort of that electrical activity, but then once it's gone, there's almost a rebound and there's a.

Bart Leger (22:29.998)
So would there be maybe a cutoff time where someone would say, well, you know what, whether a person drinks or not, it'd be a cutoff time that would not maybe adversely affect their sleep.

Dr conner (22:35.978)
Right.

Dr conner (22:41.002)
Yeah, probably four hours. I think in a perfect world, four or five hours before, so that you feel like you're really metabolized that out of your system beforehand. And just kind of gauge how you respond to it. If you find that you get a lot of rebound insomnia after it wears off of your system, then that's a good tell that, okay, well, I need to back off.

Bart Leger (22:49.849)
Mm-hmm.

Bart Leger (23:03.074)
Yeah. Now, we talk about, I've mentioned the three, two, one, at least three hours before we go to bed, have your last meal, at least three hours before, a couple hours before, you know, you want to front end your hydration. So don't be drinking too much right before bed, catch up. And then at least an hour before bed, your electronic devices, shut those off. So,

Dr conner (23:14.07)
Mm-hmm.

Dr conner (23:23.014)
Yeah, exactly.

Dr conner (23:30.126)
Correct.

Bart Leger (23:33.046)
Food, late night snacks, late night food, how does that, how might that affect our sleep?

Dr conner (23:39.882)
Yeah, I think a lot of it is, if you're referring to like in the middle of the night eating,

Bart Leger (23:49.819)
Or maybe, let's say we go to bed at 10 o'clock and, you know, 9, 9.30, we, you know, we eat right before we go to bed.

Dr conner (23:55.841)
Oh, yeah.

Yeah, I mean, a lot of that is sort of insulin metabolism too, where you're going to get a spike in insulin levels, which sometimes can make you sleepy. But on the flip side of that, as that kind of comes down, your brain is having to exert a certain amount of activity and the GI system is having to exert a certain amount of activity in order to process that food. And that can be very disruptive to entering a quality sleep cycle.

Dr conner (24:29.442)
prediabetic or diabetic, you know, that insulin spike could be significant with a resultant drop off in sugar levels, you know, two to three hours later, which can be, which can potentially wake you up. Um, the other issue with it is, is obviously reflux is another big issue. And if you eat too late, when you lay down, there's going to be that risk of, of that causing an arousal during the night too.

Bart Leger (24:54.27)
Right, now I've got that's my issue. That's why I have to be careful that at least wait, have at least three hours before eat before I go to bed. Now let's move on to some of the go ahead I'm sorry

Dr conner (25:02.754)
Right.

Dr conner (25:06.238)
And then the other thing is, another thing too is medications. You know, I think as long as we're talking about that is medications are critically important and what you're taking at night can have a profound impact on the quality of your sleep. And oftentimes people don't recognize some of that stuff. Even something as innocuous as an antihistamine, you know, for allergies, is one of the big time triggers for.

Bart Leger (25:28.9)
Hmm

Dr conner (25:36.042)
restless legs, muscle cramps, things like that. And so we'll see a lot of people that come in taking their Allegra or Zyrtec at night, or they're taking a Tylenol PM at night to sleep, not realizing how much of that can have an impact on your sleep quality.

Bart Leger (25:51.866)
So how does that have an impact?

Dr conner (25:54.79)
Oh gosh, it's like gasoline on a fire for muscle activity. So if someone has a tendency to have like restless leg syndrome or muscle cramps at night, any histamines of any kind, um, can be astronomically worse than those symptoms. And yeah.

Bart Leger (25:58.721)
Really?

Bart Leger (26:12.186)
the best time to take. Yeah,

Dr conner (26:15.946)
Those, generally in the morning is when you need to take them. I think Zyrtec is probably the closest to Benadryl, so it's the most sedating of the quote unquote non-sedating antihistamines. So you have to be a little bit cautious with that. Also, if you're going to be working nights, be careful with Zyrtec. So the antihistamines that I generally will recommend is Allegra, because it's stronger than Claritin, but it's not as sedating as Zyrtec.

Bart Leger (26:45.274)
Okay.

Dr conner (26:45.418)
So it's kind of a happy medium that will help to kind of get the symptoms under control.

Bart Leger (26:50.17)
Now, since we're talking medications, let's move on to maybe what are some common medical problems that might complicate our listeners ability to get some restful sleep?

Dr conner (27:01.778)
Yeah, pain is a big one. Joint pains, back pains is a common problem that we see. Sleep apnea obviously is another common problem that we see with it. Heart conditions such as heart failure, a lot of people end up having to go to the bathroom a lot because they are on diuretics, as well as being able to get comfortable at night, you know, when you have heart failure or even COPD, asthma.

being able to lay flat sometimes can be challenging. And so you find yourself having to sleep on an angle in an effort to try and ease that breathing a little bit. So those are very common things that we try and intervene with as best we can and ask questions about that because oftentimes people don't really recognize how much of an impact that's having.

Bart Leger (27:51.898)
Right. Now I know there are a lot of people who, and I've heard this quite often, people who are tired during the day or tired earlier in the morning, tend to attribute it to, oh, you know, I just got a lot of stuff in my mind, or I just didn't sleep well. Could maybe someone maybe need to look into if they have sleep apnea and would that be something that might affect their being tired in the morning?

Dr conner (28:01.239)
Right.

Dr conner (28:14.949)
Yeah.

We, for sure, we see that a lot. You know, people always attribute it, and I hear this every day, you know, people say, well, I'm just getting older. And it's not really an accurate sort of perception of how you should feel. You should feel rested in the morning. I mean, that's a pretty fundamental thing. And if you're not, you know, trying to pursue it and figure out why that's happening is worth the effort. Because it could be something along the lines as in,

as sleep apnea or it could be related to some other medical condition that could be intervened with and improved. Sleep apnea at a fundamental level, the way I describe it to people is that people, your brain will sacrifice sleep quality for oxygen every time for whatever cause. If it feels that oxygen level is unstable, it's going to keep you at a very shallow, very...

inefficient level of sleep in an effort to maintain that oxygen level. That in turn leads to the fatigability. So if you're waking up tired it really is worth it to kind of drill down a little bit and see what's going on.

Bart Leger (29:29.658)
Okay. What about snoring, you know, other than being potentially obnoxious to your sleeping partner? Could that maybe signal a medical issue that maybe should be looked into and addressed?

Dr conner (29:35.95)
Sure.

Dr conner (29:39.434)
Yeah. Oh yeah. I mean, it definitely is going to be a big red flag for apnea, but a common misperception is that everyone that snores has apnea and that that's not true. We see it a lot. Think of snoring is sort of the first phase of a continuum that leads to apnea. So whenever that airway begins to narrow to some degree, as the air flow has to get across that narrowing space, it results in rattling and the sound of the snoring.

that will kind of progress in a crescendo type pattern until as that airway becomes more and more tight, until it tips over into apnea. So it's just simply a risk factor for underlying apnea, not necessarily diagnostic for it.

Bart Leger (30:26.458)
Right. Now, there's, this has been, some have called it a fad. I know there's a paucity of research on this. Some have recommended what's called mouth tape to keep your mouth shut. Is that something? What's your take on that?

Dr conner (30:41.734)
Oh yeah. Yeah.

Yeah, I think if it's truly apnea, it's probably not gonna make a big difference because what happens when you're mouth breathing is that in someone that has apnea, is that think of it as kind of like the safety valve. You're not getting enough air through the nasal passages, therefore you're gonna open your mouth to get more volume of air through, very analogous to like when you're running and you exert yourself, you're gonna start breathing through your mouth.

to try and get more air. So when someone has apnea, that's the way it's going to occur. Now, the mouth tape will keep your mouth closed, but if you're having apnea, you're not gonna keep it closed, your mouth is going to open. The mouth tape kinda helps in people that have mild snoring or moderate snoring, just because it helps to prevent some of that rattling that occurs in the back of the throat. So it's certainly worth a try.

But if someone truly has apnea, it's not going to manage that or treat that.

Bart Leger (31:49.434)
Are there any, now we're moving maybe to some short term or some taking care of some sleep issues, are there any over-the-counter remedies that maybe that can help promote and do you even recommend this?

Dr conner (32:03.062)
Yeah.

Dr conner (32:07.55)
One of the things, so you always want to look at, so anything that can cause an obstruction from the point that the air enters the nose until it reaches kind of the larynx can cause apnea. And so we'll look at sinus issues as a big part of it. So trying to address underlying sinus issues. So breathe right strips sometimes can help in order to increase airflow through the sinus passages, getting on medications to help mitigate some of the congestion.

nose sprays like nasonex or I've had a lot of luck with Astapro which is an old prescription medicine that's over the counter now just to kind of help open up the passages and then you move down a little bit they have mouth guards that you can wear that have sort of two plates on them and when you put the mouth guard in it kind of gives you an artificial underbite it moves your jaw

Dr conner (33:06.11)
And so by moving the jaw forward, it actually will kind of lift the tongue off the back of the throat to kind of give more room back there. So those, and then lastly, is sort of positional therapy. So we try and keep off the back. When you're on your back, you get kind of the full force of gravity forcing the throat closed. So if you can stay on your side, whether with a wedge or with a certain type of apparatus that attaches to your back to keep you off your back.

Anything like that is helpful. People that do have some underlying heart or lung conditions, elevating the bed helps. Also with reflux, elevating the bed helps. You can put a couple books under the headboard, just elevate the bed a little bit. That will also mitigate some of the snoring.

Bart Leger (33:55.066)
Okay. Something that has come up a number of times, you know, people have to miss sleep for whatever reason. There are many who... I spent many years on call and sometimes had to be awakened middle of the night quite often. Catching up on sleep, is that even such a thing to say, look, I'll sleep in tomorrow and I'll catch up?

Dr conner (34:25.246)
Yeah, it's okay. Our brain does kind of keep a running ledger of particularly REM loss. And so we'll see an increasing percentage of REM sleep whenever we are catching up during those timeframe. The, why I hedge a little bit on that is that I see it a ton in people that have insomnia is that.

their, their response to a bad night's sleep is to sleep in. And in reality that tends to perpetuate the insomnia because you're, you're rather than catching up, you're really stealing from the next night. So if you're prone to insomnia, I generally tell people to keep a very, very rigid wake up time, irregardless of how your, uh, your night went because you want to

maintain that rhythmicity of that sleep-wake cycle as best you can. So that's why we avoid naps. We avoid naps. That's why we avoid trying to let that wake-up time drift a whole lot. So yeah, you got to be cautious with it.

Bart Leger (35:38.81)
Yeah, now I know you mentioned nap. That's another thing. Pros cons afternoon, 20 to 20 minute nap. What good bad

Dr conner (35:47.518)
Yeah, intrinsically I think it's helpful. I do, I think I always tell people to keep setting an alarm. That's probably the best advice you can give and limit it to around 30 minutes. Because what you don't wanna do is to go into REM sleep during a nap. Because what happens in that scenario is that when you wake up, and I think we've all experienced that, is when you go on a nap and you wake up.

Bart Leger (35:52.73)
I mean, I enjoy my naps.

Dr conner (36:15.99)
and you feel like you never fully are awake, you just kinda go through the motions the rest of the day and you just feel cruddy, that's probably because you went into REM sleep during that nap time. If that old adage of a power nap is very true. So if you're limiting it to around 30 minutes or so, that's really where you, that sweet spot where you're gonna wake up feeling refreshed from one.

Bart Leger (36:36.89)
Okay. Yeah, I mean, been there, done that. I have slept a little too long and actually was more tired when I woke up.

Dr conner (36:43.614)
Mm-hmm. That's exactly right. And generally that's usually when you go into REM sleep You're you're there's sort of what we call REM momentum that your body's almost Compelled to finish that cycle. And so when even when you wake up you still feel exhausted

Bart Leger (37:01.274)
So having considered all of that, what we've talked about so far, at what point maybe someone should consider seeking professional help for their sleep issues, and what does that process typically involve?

Dr conner (37:12.43)
Sure. Yeah, I think if it's kind of hark back what we had talked about if you're waking up feeling like you're not rested or you feel like you're not getting the quality sleep that you need it's worth that intervention to kind of go the next step and see. Oftentimes I'll tell people to maybe track your sleep you know there's a lot of and that's a very prickly subject too.

is the tracking of sleep with some of these like the Apple watches or the garments or the Fitbits and all of this stuff. It can be a little bit of dangerous to get too obsessed with that, but keeping track with your sleep for a couple of weeks and just seeing where you're at and see if that correlates with how you're feeling in the morning is a good kind of indicator and how much is that sleep really impacting how you're doing in the daytime. What the reason I hedge on some of the

devices is that they become sort of an end into themselves, that people just ignore how they're feeling and they want their sleep to match up to this algorithm that the device is telling them, right? And so they may feel fine. I have this, people happen to this all the time where people come in and they give me reams of data and you just ask them, well, how are you feeling? And I feel pretty good during the daytime. I was like, well, don't, don't.

Bart Leger (38:21.338)
this ideal.

Dr conner (38:37.482)
You don't need to track this. It's pretty simple. If you're feeling rested in the daytime, you're probably okay.

Bart Leger (38:45.05)
Well, I've recommended for those who were having sleep issues to keep a sleep diary. And if nothing more than just simply to see if there's a pattern, but don't get too hung up and say you have to do it for the rest of your life.

Dr conner (38:52.908)
Yeah, absolutely.

Dr conner (38:57.17)
Exactly. That's exactly right.

Dr conner (39:02.726)
Exactly. I couldn't agree more. You know, I tell them usually to do sleep diaries for about two weeks Bring it in. Let's look at it and see if there's some tells there that kind of give us some insight in terms of What we can work on to kind of move it in the right direction

Bart Leger (39:12.058)
Mm-hmm.

Bart Leger (39:17.754)
Yeah. Now, before we wrap up Dr. Connor, is there any final advice or maybe key takeaway you'd like to offer to our audience, um, who are maybe doing their best to get whatever sleep they can.

Dr conner (39:27.526)
Yeah, I think that one of the first casualties of poor sleep is confidence. You know, confidence in your ability to sleep is very fragile. And so I would leave people with the advice that really tell yourself that you can intrinsically get the sleep that you need. That we're really fundamentally hardwired to really get to sleep. And that if we intervene and we do the right types of processes...

and combinations of practice, patterns, medications, we can get you to a point where you can wake up and feel rested.

Bart Leger (40:04.57)
Well, thank you. Thank you very much. Now, on a personal note, what's something fun that you're going to do today or maybe I've already done to help you recharge?

Dr conner (40:13.854)
Yeah, I mean, I always try and dedicate some time. And so I like, I enjoy painting. And so I've been working on a painting for a while now. So I'll probably, when I get back from my clinic this afternoon, work on that for a while. So that's kind of my escape.

Bart Leger (40:29.658)
Oh, that's interesting. I didn't know that you painted.

Dr conner (40:32.874)
I do. Yeah, I had some before the hurricane and then they all got destroyed. So kind of had to start over from scratch, but it's, it's completely a, the, the process is the joy of it.

Bart Leger (40:37.786)
Oh no.

Bart Leger (40:45.466)
Oh, well, that sounds great. I'd like to see some of your paintings sometime. Yeah. Now, lastly, where can our listeners learn more about your work, your practice, and how can they get in touch with you if they need assistance, if they're in the area or just have questions about their sleep health?

Dr conner (40:50.562)
Well, thank you. I appreciate it.

Dr conner (40:56.586)
Yeah.

Dr conner (41:03.466)
Yeah, we're the Sleep Disorder Center of Louisiana on our website. If you Google that, it'll pop up and you know, we're available for telemedicine. We're available for in-person visits. We're about to open a location in Lafayette. So we're in Lake Charles. So I think we're, we're accessible to just about anybody. We want to be there and, and just try and help as best we can to get your, your sleep to its maximum level.

Bart Leger (41:28.794)
Well, Dr. Connor, thank you so much. I've thoroughly enjoyed our time together. And I hope our listeners have gotten something that they can apply to their own lives. So thank you.

Dr conner (41:38.168)
No, I appreciate your time and yeah, I really enjoyed it.

Bart Leger (41:43.066)
All right, well, I'm sure we'll see you in the office sometime. Have a great day. All right.

Dr conner (41:46.326)
You have a wonderful afternoon. You too, sir. Bye bye.

Bart Leger (00:00.622)
Thanks so much for joining us today for another episode of Surviving Your Shift. If this episode has hit home for you, then don't settle for another bleary -eyed day or a caffeine -fueled night. There is a way forward. The Shift Worker Sleep Solution, a step -by -step guide to restorative sleep, is tailored just for you. This ebook isn't just another list of tips. It dives into the why,

and the how giving you a structured approach to reclaim your sleep and with it your energy and health. Head over to the show notes right now and download your guide. If you found value in today's episode, don't forget to subscribe and leave a review. Tell us what resonated with you. Your insights help us grow and create a community that supports one another. In the next episode,

We're talking with Ken McGregor, U .S. Coast Guard retired, where we'll be talking about what to do if you hear those dreaded words, you're being medically retired. So stick around and I'll see you on that episode. Till next time, let's learn how to thrive, not just survive.