Sleep Talk: Episode 42 – What to Eat

Episode 42: What to Eat

How does what we eat impact on sleep? What foods or types of diet can help with sleep? To help decipher this complex area we talk to Assoc Prof Marie-Pierre St-Onge, Director Sleep Center of Excellence Columbia University, Irving Medical Center.

Dr Moira Junge (Health Psychologist) and Dr David Cunnington (Sleep Physician) host the monthly podcast, Sleep Talk, talking all things sleep.

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Audio Timeline / Chapters:

• 00:00 – 01:41 Introduction
• 01:41 – 23:04 Theme – What to eat?
• 23:04 – 25:45 Clinical Tip
• 25:45 – 29:31 Pick of the Month
• 29:31 – 30:39 What’s Coming Up?

Next episode: Sleep Research Update

Links mentioned in the podcast: 

• Sleep Awareness Week – Aug 5-11 2019
• Effect of Diet on Sleep Quality – journal article
• Napping – podcast episode
• Burnout recognised as a syndrome
• Narcolepsy 360 podcast
• Falling Asleep – website with narcolepsy resources from Eleanor Wales

Presenters:

Guest interviews:

Assoc Prof Marie-Pierre St-Onge is Centre Director of Columbia University Irving Medical Center, Sleep Center of Excellence. A Prof St-Onge has a Ph.D focused in Nutrition from McGill University and is a Fellow of the American Heart Association and Certified in Clinical Sleep Health. In 2007, A Prof St-Onge received NIH funding to study sleep and energy balance and her research now focuses greatly on sleep and its association with obesity and cardiometabolic risk factors. Her research findings show that sleep influences diet and that diet may also influence sleep, allowing her to return to her original passion related to foods and their influence on disease risk.

Regular hosts:

Dr Moira Junge is a health psychologist working in the sleep field, who has considerable experience working with people with sleeping difficulties in a multidisciplinary practice using a team-based approach. Moira is actively involved with the Australasian Sleep Association (ASA) and a board member of the Sleep Health Foundation. She has presented numerous workshops for psychologists and is involved with Monash University with teaching and supervision commitments. She is one of the founders and clinic directors at Yarraville Health Group which was established in 1998. In addition to her expertise in sleep disorders, her other areas of interest and expertise include smoking cessation, psychological adjustment to chronic illness, and grief and loss issues.

Dr David Cunnington is a sleep physician and director of Melbourne Sleep Disorders Centre, and co-founder and contributor to SleepHub. David trained in sleep medicine both in Australia and in the United States, at Harvard Medical School, and is certified as both an International Sleep Medicine Specialist and International Behavioural Sleep Medicine Specialist. David’s clinical practice covers all areas of sleep medicine and he is actively involved in training health professionals in sleep. David is a regular media commentator on sleep, both in traditional media and social media. David’s recent research has been in the area of non-drug, psychologically-based treatments such as cognitive behavioral therapy and mindfulness in managing insomnia, restless legs syndrome and other sleep disorders.

Connect with David on Twitter or Facebook.

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Transcript:

Intro: Welcome to Sleep Talk, the podcast talking all things sleep brought to you by SleepHub.com.au. Here are your hosts, Dr. David Cunnington and Dr. Moira Junge.

Dr. David Cunnington: So hello again and welcome to Episode 42 of Sleep Talk, the podcast talking all things sleep. Hi, Moira.

Dr. Moira Junge: Hi, Dave. Hi, listeners.

Dr. David Cunnington: So the theme this month is what we eat. We talked last month about when to eat and the concept of chrono-nutrition. We are going to follow that up with what sort of foods may promote sleep. So Moira, what has been going on in sleep or what are things to look out for in sleep?

Dr. Moira Junge: Well, yes, I think at the moment what’s pretty occupying me or what we were planning for especially the Sleep Health Foundation and probably Australasian Sleep Association. It’s Sleep Awareness Week in Australia. This year, it’s coming up in early August, August 5 through to 11. And the theme this year is around sleep and the power of sleep for our brain function sort of our memory and cognitive functions. So we were just planning and trying to attract media attention and have special guests and spokespeople from that field, within the sleep field.

What about you?

Dr. David Cunnington: You got your catchy byline sorted out yet?

Dr. Moira Junge: Not really good on the catchy byline. That’s what I will be doing in the next couple of weeks, getting catchy bylines. What about you? What are you up to in the sleep road?

Dr. David Cunnington: I’m clearing out my diary for the week, August 5 to August 11^th.

Dr. Moira Junge: For the sleep awareness week.

Dr. David Cunnington: Yes. It sounds like I need to be some radio interviews and other things during that week.

Dr. Moira Junge: Absolutely, yeah. We will be calling on plenty for sure.

Dr. David Cunnington: The theme for this month’s podcast is what we eat and what foods can help with sleep. The reason to try and talk about this is as we’ve talked about, Moira, it’s a bit of a blind spot for us. Patients ask us this.

Dr. Moira Junge: All the time.

Dr. David Cunnington: But we just don’t have the information to give them about – apart from some motherhood statements like healthy diet and no processed foods.

Dr. Moira Junge:There are bit and pieces, tiny morsels of good quality information.

Dr. David Cunnington: As you’ll hear when we get to our guest who is going to tell us a bit about what the current state of the literature is. It is a frustrating area for people because if you look at both the media and just everyone in their day-to-day life, everyone has got an opinion on what to eat.

Dr. Moira Junge: Yeah. I know. So who do you believe?

Dr. David Cunnington: Exactly. Family, friends, work colleagues, celebrity chefs, exercise wellness gurus, everyone is going to tell you what you need to be eating and sleep. There’s an article we talked about behind the scenes, something on The Conversation written by a qualified nutritionist and you think that should actually be a reputable article. But they actually recommend things that had no evidence behind them behind them whatsoever.

Dr. Moira Junge: Well, hopefully, it sounds like you found someone in USA to dig a bit deeper.

Dr. David Cunnington: I had a chance to talk to Marie-Pierre St-Onge. She is Associate  Professor of Nutritional Medicine at Columbia University, Irving Medical Center in New York. Thank you very much for joining us on the podcast.

Marie-Pierre St-Onge: Oh, thank you. My pleasure. Thank you for inviting me.

Dr. David Cunnington: We are going to talk about what foods can help promote sleep. So what’s the relationship initially between dietary patterns and sleep quality?

Marie-Pierre St-Onge: What we know thus far from population studies is that individuals who report poor quality or who report having sleep disorders tend to have poor dietary intake. So these individuals tend to report higher consumption of sugary food, higher consumption of sugary beverages, energy drinks, skipping breakfast more frequently. They also tend to report having a more irregular eating pattern than individuals who rate their sleep as good quality sleep.

Dr. David Cunnington: And what about the Mediterranean profile? There is a Mediterranean diet that people talk about. Is that associated within benefits for sleep?

Marie-Pierre St-Onge: Yes. So individuals who have higher adherence to a Mediterranean diet tend to also have better sleep or record better sleep quality or even fewer insomnia symptoms for example.

Dr. David Cunnington: Have there been trials done looking at different dietary patterns and the impact they may have on sleep quality?

Marie-Pierre St-Onge: So the intervention studies that are available have been relatively short in duration and quite variable in their study population, study design. So there is not really a consensus in terms of literature where we can definitely say that a specific dietary pattern would improve one’s sleep. What we know right now is that there are associations between various foods, various dietary patterns, and a sleep quality and duration.

And the issue that we have with these population studies is that we don’t know the directionality of the relationship. So when we ask participants to provide information on their sleep at the same time as we ask them to provide information on their diet, we don’t know the association that we are observing. Are the sleep causes the dietary pattern or whether it is a dietary pattern that causes the sleep characteristics that we are observing.

We have quite a bit of information from intervention studies that can provide information on causality related to how sleep influences diet. So we know from sleep restriction studies for example, that if we ask individuals to reduce their amount of sleep quite drastically, so by 2.5, 3, 3.5 hours relative to what their usual time sleeping that they will eat more. We know they eat more calories and we know the quality of the foods that they eat is less good. So they have higher fat intake, they have higher sugary food consumption, they have higher snack food consumption than when they are well-rested. We know less definitively about the influence of diet on sleep.

Dr. David Cunnington: So what are the other aspects about food and what we eat? Is calorie restriction, one of tenets of the dietary movement in the last 50 years or so, is there evidence about calorie restriction and sleep quality?

Marie-Pierre St-Onge: We don’t have so much. So far, there are few studies that I have looked at that are dietary restriction and sleep and they are not very conclusive. Most of those things have found an influence of dietary restriction on sleep from very limited studies that are out there.

Dr. David Cunnington: I get bombarded on Facebook about particular foods. So if we eat more cherries, more kiwi fruit, bananas, you drink milk, they all going to make sleep better. What’s the truth? Are there actually super foods for sleep?

Marie-Pierre St-Onge: Well, there are some studies actually on kiwi fruit and tart cherry juice, not cherry per se but tart cherry juice that show that consumption of those specific fruits can improve sleep. Participants, individuals are being given these foods to consume and their sleep assessed that night for a specific period of time.

There’s one study that they’ve done that showed that it may have benefit, consuming two kiwi fruits one hour before bedtime. And there are a couple of studies, a few studies on tart cherry juice showing that that could also have a benefit on sleep quality.

Well, banana, that’s the first time I hear a banana so I have to look that one up.

Dr. David Cunnington:I’ve got a few people tell me about bananas but I had to look at the literature as well and I couldn’t find anything.

Marie-Pierre St-Onge: Maybe this is just anecdotal. I haven’t seen any scientific studies on bananas.

Dr. David Cunnington: So how do you think the effects of kiwi fruit might be mediated?

Marie-Pierre St-Onge: It’s not quite sure yet. It’s very difficult to determine. But with fruits, it’s maybe the antioxidant content of fruit may have a benefit on sleep. Some say that’s just melatonin content from fruits having some melatonin in them, that may also improve sleep.

We have shown in our research that dietary fiber is one of those things which impacts the quality of sleep at night. So it’s possible that some fruits and vegetables providing high fiber intakes could potentially be linked to better sleep through fiber.

Dr. David Cunnington: One of the things I see in my clinical population of people with insomnia is carbohydrate-seeking behavior either before going to bed or if they wake during the night. So maybe there’s something in associated with carbohydrate that’s high in fiber before they go to bed. Maybe that’s changing some of that sleep disrupting mechanisms.

Marie-Pierre St-Onge: It’s possible. It’s possible with a more stable blood sugar that there will be better sleep at night. But the data also on high glycemic index food and carbohydrate quality needs to be further examined. From our research, what we found was when participants consume more sugars during the day or more simple carbohydrates during the day, their sleep at night had more arousals. So they have more of those micro awakenings in the middle of the night with higher sugar intakes. So potentially with the higher fiber, more complex carbohydrate foods arousals wouldn’t be as prominent.

Dr. David Cunnington: And what about milk? There’s that myth or it might not be a myth, we are all told to have a glass of hot milk before bed. What’s the story with milk?

Marie-Pierre St-Onge: So milk in some research correlates Horlicks, which is a malted milk beverage and those also shows that there may be some truth that consuming this type of malted milk product could have a benefit for sleep.

There’s also a Harvard study where they milk cows at night when melatonin levels are higher and produce higher melatonin milk. I think this was a pilot study, preliminary study, but showing that you can actually increase the melatonin content of milk by the time at which you milk your cows. And potentially, that could also has a benefit for sleep. But that remains to be determined whether that could be sustainable and something that we could see in the food supply in the future.

Dr. David Cunnington: I saw with one of your papers, and it was tenfold increase in the melatonin concentration in milk at night. That’s just fascinating.

Marie-Pierre St-Onge: Yes.

Dr. David Cunnington: My son has got a fascination with cows and maybe that’s what I need to get him into is running a dairy and milking cows at night.

Marie-Pierre St-Onge: Right. Exactly. It’s very interesting.

Dr. David Cunnington: Now, another population that I look after clinically is people with disorders of hypersomnolence or excessive sleepiness like narcolepsy or idiopathic hypersomnia. And there’s some talk in patient forums about ketogenic diets improving symptoms of sleepiness. Is there any data to that?

Marie-Pierre St-Onge: Well, we found a study that looked at ketosis. That study had quite a bit of limitations and it was difficult to actually figure out what the timing of their assessment was because it was a multiphase study where they had an acute phase of very low carbohydrate intakes and then more liberal and they had ketosis in the process. So there is not much research out there about ketosis and sleep. But it’s possible that a ketogenic diet could play a role on sleep.

Dr. David Cunnington: And how does a ketogenic diet differ from say, a low carbohydrate, high protein diet? Are there differences between those things?

Marie-Pierre St-Onge: Well, a ketogenic diet, when you would reach ketosis, you would actually find ketone bodies in the blood whereas just a general low carbohydrate, high fat, or low carbohydrate, higher protein diet, you would not necessarily get into this ketotic state.

When you are following ketogenic diet, it’s quite drastic and it’s a reduction in carbohydrate intakes and it’s very high fat, high protein. It tends to be difficult to follow over an extensive period of time. It mostly advocated where individuals with epilepsy for example, to control epilepsy symptoms.

Dr. David Cunnington: My son has severe genetic epilepsy and we tried the ketogenic diet and I’ve got to say it’s tough, really tough to maintain.

Marie-Pierre St-Onge: It is tough.

Dr. David Cunnington: If people who are struggling with sleepiness then that makes it hard for them to source good food and have the energy to produce food, you’re going to find severe dietary restrictions quiet a limitation and quite an additional thing for them to take on.

Marie-Pierre St-Onge: Yes, I would agree with that. And it’s another challenge. Whether it’s sustainable long term just remains to be determined as well. There are other issues too. When you are reaching for high fat intakes and very low carbohydrate intakes and high protein with individuals who have other health diseases, it’s easy to think about people who have chronic kidney disease for example and be able to tolerate this high protein intake. Individuals who are at risk of cardiovascular disease, you would have to worry about the fat content of the diet and fat quality of the diet. If you are talking about high protein and high fat, you may be consuming quite a bit of saturated fat. So that’s something to consider.

So when we talk about health, there is more – we are talking about food today but there is also other conditions within individuals that need to be taking into consideration their risk for cardiovascular disease, diabetes, hypertension, chronic kidney disease seems to be dealt withas well.

Dr. David Cunnington: Yeah, that’s a really good point because a lot of the patients I talk to, they see that as a low risk option, the ketogenic diet. But it’s actually not without risk particularly as a longer-term strategy.

Marie-Pierre St-Onge: Correct. And it needs to be a diet that’s taken with care. And I would definitely recommend to someone who is considering a ketogenic diet to speak with a dietician and to really be followed for nutritional adequacy and also not aggravating other potential health conditions that they may have.

Dr. David Cunnington: This morning at the Sleep 2019 meeting, where you are in San Antonio at the moment, you presented data that looked at habitual dietary quality on sleep. What did you find as part of that work?

Marie-Pierre St-Onge: We published a couple of things through my lab. One is data from the clinical intervention study. So we did a sleep restriction study where we had participants under sleep restriction conditions and habitual sleep. In the habitual sleep condition, our participants were allowed to sleep up to 9 hours. So they spent 9 hours in bed. Obviously, they didn’t sleep all that much. But they were able to sleep as much as they needed. They were seeing a level of sleep that was sufficient for them which was about 7.5 to 7 hours 45 minutes or so.

And the first part of that phase, we controlled their food intake. So they had no choice in the matter. We gave them everything that they had to eat over a 4-day period. And then after that, we let them self-direct their food intake over a one-day period.

So we looked at whether the diet differed when they self-directed their food intake compared to what we provided for them. The diet that we provided for them was a healthy diet that followed the dietary guidelines for Americans. And what they consumed when they self-directed their food intake was not quite as healthy as what we gave them and that diet was higher in overall calorie as well as being higher in saturated fat and sugar. So we knew that there were differences between what we gave them and what they self-directed.

So then we asked the question of whether sleep at night in those two different dietary conditions differs. And it did. They spent less time in slow-wave sleep so they had less time in deep sleep when they self-directed their diet. And they also took about twice as long to fall asleep when they self-directed their diet compared to what we provided to them.

And this is where we looked at the different nutrients that were related to sleep at night and where we found that fiber, simple sugar, and added sugar as well as saturated fat were related to sleep quality. When they had higher intakes of fiber and lower intakes of saturated fat there was more deep sleep. And the higher intakes of sugars were associated with more arousals.

We also presented data from a population study, the multi-ethnic study of atherosclerosis where we looked at adherence to a Mediterranean diet. And in that study, we did a cross-sectional analysis looking at snapshot in time of participants reporting on their sleep and when they also had been measured by actigraphy and they reported on their dietary intakes. And we found that a greater adherence to a Mediterranean diet was associated with a greater likelihood of sleeping slightly longer compared to short sleep and they had a lower odds or lower likelihood of reporting insomnia symptoms if they also reported a higher adherence to a Mediterranean diet.

We also looked at longitudinal changes in dietary intakes and we found that when they reported stable adherence to a Mediterranean diet compared to those who reported a reduction in adherence to a Mediterranean diet there was less likelihood of insomnia symptoms. And when they reported increasing their adherence to a Mediterranean diet compared to those who reported decrease in the adherence to a Mediterranean diet, there were lower odds of having short sleep and short sleep duration.

So we were finding some hints of a healthy dietary pattern really has potential benefits or influence on sleep quality specifically related to duration and insomnia symptoms. And when we think about a Mediterranean diet, we are thinking about a diet that’s higher in fruits and vegetables, higher in nuts and legumes. So we are talking about a diet that’s higher in unsaturated fat rather than saturated fat, higher in fiber, antioxidants and vitamins. So it’s really complementary to our intervention study where we found that fiber, low simple sugars, and low saturated fat were related to better quality sleep.

Dr. David Cunnington: That’s really nice work. Now, to try and sum it up for us based on your knowledge so far and the work you’ve been doing, if someone is trying to eat well for healthy sleep, what are some basic principles they should follow?

Marie-Pierre St-Onge: Really, increase in fruits and vegetable consumption, reducing saturated fat intake, definitely reducing simple sugars, sugary beverages, sugary snack foods would be something to try to remove from the diet.

Dr. David Cunnington: So not as simple as just having two kiwi fruit at night. It is more about what you are eating right across the day and thinking about it in a whole diet sense.

Marie-Pierre St-Onge: Rather than have a recommendation that you can eat whatever you want, but if you have two kiwi fruit one hour before bedtime you could salvage your whole day of sabotage. But there are some good studies out there about specific foods. The only issue that I have is that these give us so many more questions than answers. What types of food you would recommend? In what quantity? At what time of day? What frequency? Is two kiwi fruit one hour before bedtime all that you need to do? Are there other foods? What about things early in the day that could potentially also influence your sleep at night?

So the problem I think that a whole diet approach, a holistic diet would be more a healthy way to approach sleep that could also be helpful for many other kind of diseases.

Dr. David Cunnington: Great. Thanks for those helpful comments.

Marie-Pierre St-Onge: Thank you.

Dr. Moira Junge: That was great, David. Thanks for that interview. It did certainly cover a range of topics in quite depth. I really feel it has filled a void for us. What was your take?

Dr. David Cunnington: Yeah, I thought that’s really helpful. And I think the take-homes for me were the importance of it’s not about what you eat just before bed. It is that what you eat across the week or across the day and really a healthy diet, higher in fruits and vegetables, less in saturated fats and highly processed sugars is what is going to be healthy for sleep.

Dr. Moira Junge: OK. So not one particular thing. What about avoiding particular things?

Dr. David Cunnington: We actually didn’t get into that much because that’s a little bit more – there’s a lot more work on that and that pretty much better known in the general community. Avoid alcohol. We will talk about that in the future episode.

Dr. Moira Junge: Yeah.

Dr. David Cunnington: Avoid caffeine because it has been bad on sleep. Avoid nicotine. Avoid some of the food additives that are stimulants. That’s something we didn’t cover in the interview so much.

If you are looking for more information, there’s a really nice review paper called The Effects of Diet on Sleep Quality published by Professor St-Onge although we didn’t get her on as a guest for this episode. Professor Felice Jacka in Melbourne published a book, Brain Changer. That’s more about foods for mental health but it does overlap a little bit with anxiety and therefore sleep.

And if you really want to get nutritional advice, you can talk to your healthcare professional about getting referred to a dietician. And I’d much more recommend that than following the latest fad diet which may not necessarily give you the results that you are after.

Dr. Moira Junge: So what’s your clinical tip of the month this month, David?

Dr. David Cunnington: I’m circling back to a theme from a couple of episodes ago. And really, my clinical tip is for healthcare professionals to not tell people, “don’t nap,” to really try and embrace napping. Now, the one time where as healthcare professionals, we tell people, “don’t nap, try and avoid napping,” and that’s what I’m trying to build up homeostatic sleep debt as part of sleep restriction treatment early on when we are managing people with insomnia. But pretty much in all other circumstances, napping can be a great strategy.

Dr. Moira Junge: What do you define as a nap?

Dr. David Cunnington: Because that’s where it’s really tricky because these – I’ll give you a couple of examples that triggered me wanting to talk about this this week. One was in a person who had significant co-morbid illnesses. They had a fatigue syndrome. They had persistent pain. And so they had lots of reasons to really be pretty tired and they were desperately trying to stay awake right across the day because they had been told by a range of healthcare professionals not to nap and they were trying so hard to stay awake right across day that then they were running on nervous energy and so much nervous energy that by the time they got into bed, it was like, “Well, I really need to sleep now,” and “if I don’t sleep. I’m really going to be in trouble tomorrow.”

Dr. Moira Junge: Yeah.

Dr. David Cunnington: And it just put so much pressure on overnight sleep. Another example, I saw someone who is a little bit the opposite but quite significant anxiety and some prior trauma, so high, high levels of hyperarousal and really only sleeping for three or four hours at night because they can – they are talking about as long as their sleep drive can keep them under the surface with that higher arousal but could also nap regularly in the afternoon but was just trying to avoid it because they’ve been told …

Dr. Moira Junge: Yes, it was a wrong thing to do.

Dr. David Cunnington: Yeah, exactly. But they really felt it really helpful to think, “Oh, OK, I could get an hour or so in the afternoon and then it doesn’t matter so much if I’m getting a bit less at night.” and it really took a lot of the pressure off for them.

Dr. Moira Junge: Good. Can you see why though that the general rule has been to say to the general population, “Be really cautious of napping because it will drop – potentially could drop your sleep drive.” Because I think what for me – the bug bear for me is that what people call a nap like they say, “Oh, you had nap.” And seriously, it was about 1:00 to 5:30. But that’s not a nap.

Dr. David Cunnington: That’s a sleep.

Dr. Moira Junge: That’s a proper sleep. Period.

Dr. David Cunnington: Or as I heard David Rye talked about on a podcast recently, it’s a coma. So that sort of sleep in the afternoon is not a brief nap.

Dr. Moira Junge: So it’s nice to try to keep naps short.

Dr. David Cunnington: So Moira, what’s your pick of the month?

Dr. Moira Junge: Well, my pick of the month is it caught my eye recently and I’m sure that you’ve heard of it too, in fact, you’ve alerted me to this is that Arianna Huffington from Huffington Post and now Thrive Global has been working for a number of years trying to get the World Health Organization to recognize burnout as a condition in the international classification of disorders. And lo and behold just recently, there’s a press release saying that it has become a condition. And I certainly got to say I have mixed feelings about that.

Dr. David Cunnington: What is it you don’t like about it?

Dr. Moira Junge: Oh, when I first thought, I said, “Really?” I guess because mostly, clinically, I’m trying to minimize pathology wherever possible and encourage hope and not necessarily get pinned down to an actual disorder particularly burnout. And obviously, we can burn out from work. But it’s not just from work. You can feel burnout from just accumulation of everything like our life outside of work, work as well, we are not getting our sleep for instance or eating the wrong things. There’s a whole stuff in there that I just would have thought, “Gee, that’s a bit …” I think it’s murky territory sometimes. What’s stress? What’s burnout? What’s a condition that’s diagnosable as anxiety, depression? Where does it fit? What does it impact? Is there sleep disturbance or substance misuse?

So there’s just so much in there. I was just a little bit disheartened in a way rather than thinking it’s good news. That’s what I thought. What about you?

Dr. David Cunnington: Similarly. I think there’s good in that it does put on the table that for some people in extreme circumstances, they can burn out and have significant health consequences. But all of us have busy weeks and times when we feel a bit frazzled and feel like we need to pull back and reset a little. And so, where do you set the threshold? That’s really the question for me between normal life, busy life in a modern world and burning out. That’s I think going to be one of the challenges in how you apply that.

Dr. Moira Junge: Well for me, I just think  if people say “I’ve got the condition” I would like to think if there was a burnout that people can actually rest and get better and then don’t have burnout. I haven’t delved into a lot of the commentary around specifically from Arianna’s perspective because I would just like to think, “Oh, let’s shed it as a condition.” Let’s not have it as a, “I’ve got this disorder or this condition that’s a diagnosable thing.” Let’s just have a rest and take a couple of weeks off and you’re not burnt out anymore. That’s what I would love.

What about you? What’s your pick of the month?

Dr. David Cunnington: So my pick of the month is another podcast. So this one is the Narcolepsy 360 Podcast. It’s hosted by Claire Crisp and it’s produced by Wake Up Narcolepsy. And I think it’s a really good podcast series. It features both patient stories. So stories of people with narcolepsy, really talking about living with narcolepsy and some of the challenges that that provides.

Great episode recently from Eleanor Wales who is an Aussie from Sydney and Elle produces some really great stuff on social media, Instagram, Instagram Stories and narcolepsy memes, really showing what it’s like living with narcolepsy.

Dr. Moira Junge: Oh, Elle is someone who has narcolepsy?

Dr. David Cunnington: And she is really open and really honest about her experiences with narcolepsy both in her social media so she is great to follow, Falling Asleep Elle is her handle. She really gives a good account of the challenges of living narcolepsy and her own personal experience in this podcast.

Dr. Moira Junge: Oh, great I have to listen.

Dr. David Cunnington: Another couple of good episodes as well, Jason Ong who we both collaborated with on mindfulness in insomnia. Jason is moving on to try and look at non-drug strategies for managing hypersomnia or narcolepsy.

Dr. Moira Junge: That’s wonderful.

Dr. David Cunnington: And an episode by David Rye I really enjoyed talking about idiopathic hypersomnia. So check out that podcast series. I really enjoyed it.

So coming up over the next couple of episodes, so look out next episode for Dr. Simon Frankel who will be joining us for an update on sleep research. He will be freshly back from the Sleep 2019 meeting in San Antonio. And also, put together some episodes about cannabinoids, alcohol and whether we should be sharing a bed with a partner and how to do that.

Dr. Moira Junge: Thanks for listening. I think it’s time to sign off. Send us any suggestions at podcast@SleepHub.com.au. If you like the podcast, you can give us a review at Apple podcast. Don’t forget you can subscribe anytime or download the Sleep Talk app.

Dr. David Cunnington: Thanks a lot.

Dr. Moira Junge: Yeah. See you next time.

Outro:This podcast is not intended as a substitute for your own independent health professional’s advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider within your country or place of residency with any questions you may have regarding a medical condition.

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