87. Dr. Sarah Gilchrist: Managing your sleep

Sue Stockdale talks to Dr. Sarah Gilchrist about the subject of sleep.  With over 60% of the British population reporting that they have poor sleep quality, and an estimated 1 in 3 suffering from insomnia or sleep deprivation, it’s a topic that has a significant impact on our health and wellbeing.

Dr. Sarah Gilchrist FBASES spent over 20 years working in the high-performance sport industry latterly as a Technical Lead for the English Institute of Sport and Senior Physiologist with British Rowing. Her doctorate specialises in sleep and athletic performance, and she now provides consultancy on a range of performance areas, particularly relating to sleep health. She is on the Advisory Board for the Sleep Charity, a fellow of the British Association of Sport and Exercise Sciences and is High Performance Sport Accredited.

Find out more about Dr. Sarah Gilchrist on Instagram : LinkedIn : Twitter : Website 

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Key Quotes

Your Dracula hormone, melatonin only comes out at night, and it reacts to dim light.

Insomnia is the biggest form of sleep deprivation in the UK.

Throughout women’s life cycle, sleep is affected, so it’s normal.

Have you got a strategy to get good sleep? Most people say, no, I don’t think about it.

Dr. Sarah Gilchrist Transcription

[00:00:00] Sue: Hello, Sue Stockdale here, your host of Access to Inspiration, the podcast with a social mission to help you be inspired by people who may be unlike you. I hope you are enjoying our series on the theme of health and wellbeing. Well, today’s guest in episode 87 is Dr. Sarah Gilchrist. She has spent 20 years working in high performance sports, including as a technical lead for the English Institute of Sport and as a senior physiologist with British Rowing and her doctorate specialized in sleep and athletic performance.

She now provides consultancy on a range of performance areas, particularly related to sleep. And I hope today we’ll have a chance to learn more about how sleep plays such a vital role for any of us in being able to perform at our best. Remember, you can read a transcription of this and all our other episodes on our website at accesstoinspiration.org.

Welcome to the podcast, Sarah. I know you specialize in sleep, and the first question that springs to my mind is what makes you interested in the subject of sleep?

[00:01:27] Sarah: I think it’s just everywhere. Obviously, we all do it. It’s universal, and when I was working, my background’s in elite sport supporting athletes, I was a physiologist.

And it struck me that sleep was the most significant impact factor on factors determining performance. So it won’t directly correlate with an Olympic or Paralympic gold medal. If you have good sleep, you’re not necessarily going to win, but sleep will significantly impact on the determinants of performance. Particularly from a physiological psychological point of view, from a public health point of view, we’re short on sleep. That’s no secret in the media, but also my background supporting athletes. There was a bit of a whole, in terms of the knowledge we had about sleep and athletic performance at the time, it’s a lot more known now and it was a really exciting opportunity to investigate that further.

[00:02:16] Sue: So I can see that there is a great need for understanding how we can get better quality of sleep. So we’ll get into some of the practicalities of that in a minute or. Maybe we can just begin the conversation by talking a bit more about that professional background of yours, Sarah, and working in high performance sport. What got you interested in that in the first place?

[00:02:36] Sarah: I was always sporty. I was played tennis when I was younger, and I had a real passion for human biology. I loved learning about what made the human body work, so it was a natural combination really, of my interest in sport, watching any sport, participating in any sport, I was always naturally drawn to that.

My mom was a PE teacher, so that probably played a big part as well, and the interest in in the human body and what makes us tick, what makes us work from a physiological point of view. I was interested in the psychology and that interest grew through my career as well because of the multidisciplinary nature in which I worked.

But certainly just the science of how we move, how we exercise, what happens to our body, the benefits to our bodies from doing physical activity and the fact that I was inspired by athletes as well, how to make those determinants of performance even better was an attractive to work in. I was lucky enough that opportunities came my way at a time when I’d finished my post doctoral at university and I got a job with Sports Wales and then the English Institute of Sport after that.

[00:03:42] Sue: And with your job in the English Institute of Sport, did that involve you supporting the rowing team? I understand.

[00:03:49] Sarah: Yeah. So that was why I moved to the EIS so I’m British rowing in collaboration with EIS asked a senior physiologist, and I got that position. So I was also managing the team at Bisham Abbey which is one of the sites of the English Institute of Sports. So I was managing the physiology and all of the staff within it. And also delivering physiological support to the rowing team, which was both in the UK and on training camps. So it was a bit of a, a learning curve management position and out of the country for most of the year. And a new team of people to manage as well, plus all the rowers and coaches to establish good working relationships with, because that was who I was supporting day in, day out. So yeah, it was exciting, but also challenging.

[00:04:31] Sue: And I’m wondering whether sleep played a role in your performance in those days?

[00:04:35] Sarah: Yeah. I often look back on those days and think if I knew then what I know now about sleep, it’s quite shocking. Yeah. Coffee played a large part and that of burning the candle at both ends. Late, late nights. The mornings for sure. But the rowers were the ones doing the hard work. They were training, we were there to support them, to enable them to make the boat go faster. Can’t complain. They’re the ones doing the hard work. They, they’ve gotta get up and, and deliver the training session.

[00:05:01] Sue: So whether our listener is an elite sports person or somebody in a demanding job, how much sleep do we need?

[00:05:08] Sarah: Generally, it’s totally individualized, and that’s the thing with sleep. It really comes down to the, the individual person. There are guidelines. So a healthy adults in the absence of a sleep disorder or whether they’re an athlete or working, needs about seven to nine hours.. Really the way to establish whether you are getting enough sleep and whether you need seven, eight, or nine, is if you work back from your get up time.

And that’s usually your starting point cos it’s dictated, it’s an anchor point for your day with your commute or school run, whatever it may be. And if you wake up feeling fully refreshed with the alarm, bit groggy, but you’re not falling straight right to sleep. You are alerts and productive during a working day, chances are you getting enough sleep, but if not, then chances are you need to probably just readdress it and you need seven, eight, or nine. Or are you one of those people that are an outlier and need a bit more or a bit less? So it is individualized.

[00:06:00] Sue: and when we’re getting that sleep, regardless of the number of hours, what’s actually happening inside our body when we’re sleeping, for us to sleep

[00:06:08] Sarah: within that 24 hour cycle, we do need to rest for a good number of hours. And that’s a good question. Why do we do that? Some species don’t do that, but, and you would be forgiven to thinking it’s a passive process, but the brain is very much active when our heads hit the pillow. There’s two physiological processes that help us get to sleep. One being related to our circadian rhythms of our relationship with light and dark, and the other being our sleep pressure, the the drive to fall asleep, which is a chemical buildup in the brain that we essentially flip flop between being awake and being asleep.

And those two processes works logistically to get us to sleep.. And then once we’re asleep, it’s a bit of a rollercoaster in there. Your brain’s doing all sorts of different things, but it is organized chaos. So it’s a 90 minute sleep cycle on average, and you cycle through four stages of sleep in that sleep cycle from light sleep, deep sleep, dream sleep, and you cycle through that throughout the night, through your seven to nine hours or whatever it may be that you.

[00:07:06] Sue: So when people talk about taking a power nap during the day, are those power naps good for us? Do they help?

[00:07:13] Sarah: Yeah. Essentially what’s happening is you are offsetting that sleep pressure that builds linearly throughout the day and the the nap will offset that. So it will give you a boost if you like to have some more energy for the rest of the day. So the ideal time to nap is that nodding donkey syndrome after lunch the afternoon nadir, where your body temperature drops. Cause that also has a circadian rhythm, typically between two and 4:00 PM That’s the ideal time, not the best time if you’re in a working environment, but, Perhaps you can have a chat with your employees about that and the benefits of napping and productivity at work for later in the day.

So, yeah, it is good to nap if you’ve got the opportunity, the motivation, and the circumstances to do so. But napping isn’t for everyone. It may be that you don’t enjoy a nap, you can’t nap, but some downtime will be equally beneficial for you.

[00:08:03] Sue: And would the body go through those four stages of sleep that you described earlier, even in a nap?

[00:08:09] Sarah: Typically not. We tend to suggest that a nap should be 30 minutes or 90 minutes, because then you don’t get into the stage three sleep, which is your deep sleep, which is about 45 minutes into that 90 minute sleep cycle. So if you nap for 20, 30 minutes, you’re only in sleep stages one. And which are typically lighter sleep stages, so that sleep inertia to overcome when you wake up is much less than if you’re in deep sleep.

You would benefit from a nap if you’d gone into deep sleep, but you would feel pretty awful when you woke up and those benefits you wouldn’t feel straight away. Whereas that 20, 30 minute nap, you’ll wake up, you’ll feel alert, you’ll feel refreshed. And your sleep pressure has diminished a little bit to allow you that extra energy for the rest of the working day. And then obviously it builds again as you go into the evening and your light dark cycle comes into play then as well.

[00:09:00] Sue: You talk about light dark cycle is reminding me of time zones. Because if we are traveling, we might then adjust our circadian rhythms. I imagine when we’re switching through time zones. For somebody like me who does travel internationally fairly regularly, what would your advice be? Or for a listener who may be traveling to a country on a different time zone, how can they best manage their sleep situation?

[00:09:23] Sarah: So there’s a few things you can do. Essentially what we’re talking about with light and dark and time zones is the relationship between your Dracula hormone melatonin, which only comes out at night, and it reacts to dim light.

It rises in the night, and it helps the precursor to sleep. So when you desynchronized your circadian rhythm in relation to sleep by crossing time zones, so everything gets offset a little bit, it’s that relationship with light, dark, and melatonin that you wanna resynchronize. So when you expose yourself to sunlight, melatonin is suppressed.

So if you get yourself onto the new time zone as quickly as possible, and seek sunlight at key times in the day where you wanna suppress the melatonin, keep yourself. And then get onto the normal bedtime as quickly as possible. So seeking the dim lights, bedtime in your new time zone so you’re not in a dark room in the middle of the day in your new time zone on day one, cuz you will fall asleep.

It is determined somewhat whether you’re flying east or west, but ideally, New time zone, sunlight and meal times. Your appetite has a circadian rhythm and that’s a big driver as well to help you resynchronize your body clock to the new time zone.

[00:10:32] Sue: So in terms of appetite, just wanna pick up on that. What should we do about eating then, when we are changing time zones?

[00:10:38] Sarah: Ideally the new time zones, meal times. So it depends how long you’re going for, but say it’s a, it’s a trip and it’s a week or two, ideally eat at your time zones meal time. So breakfast or breakfast time, not UK breakfast time, and obviously lunch and dinner. And the first day you might want to have an early-ish dinner and go to bed, sort of nine-ish, but nothing too early that you’re then waking up two or three in the morning.

You wanna be able to establish that new routine as quickly as possible. And it’s about synchronizing the body clock to the time zone that you are in as quickly as possible. Some people will respond quite easily. Some people it’ll take a while. It’s usually a day per time zone crossed. So that’s why Australia and New Zealand, it could be 10 or 12 days, whereas somewhere shorter European travel, you might not notice so much.

[00:11:27] Sue: I love what you said about the Dracula hormone. I’m gonna keep that one on my mind. Now , just thinking back to your sporting days, when you were working with Olympic teams, did direction of time zone traveling play a role in where teams traveled to competition?

[00:11:40] Sarah: Yeah, sure. So I remember quite a long time ago now, the rowing team had the world championships in New Zealand and we flew via LA because is the best way to fly around the globe in terms of jet lag, I mean, obviously you’re still gonna be jet lagged, but in order to give yourself a performance enhancement, it’s better to West’s best.

[00:11:57] Sue: Turning our attention back to the British population, I know you’ve got some statistics about the number of people that suffer from insomnia or sleep deprivation. What can you tell us about that?

[00:12:08] Sarah: Insomnia is the biggest form of sleep deprivation in the uk, and it’s about 60% of the population can suffer at any one time. There are other forms of sleep deprivation, but insomnia is the key one, and that’s typically where you are having trouble getting to sleep. or waking regularly throughout the night and having trouble getting back to sleep, usually for three months or more, or their clinicians would advise you, seek advice sooner than that.

Three months is a long time to be struggling with your sleep like that. And we also know that women are more likely to suffer insomnia than men, particularly as we get into later life and hormone transitions, menopause kicks in. So yeah, certainly insomnia. A big one in terms of sleep deprivation, but also periodic limb movement, restless leg syndrome. Other sleep disorders women can tend to suffer from more so than men, particularly in later life. And given then that the impact of insomnia may affect women more than men.

[00:13:06] Sue: From your experience, Sarah, and I know you’ve done a doctorate specializing in sleep and you’re continually researching this subject, what would you offer as advice to women to perhaps help them get a better quality of sleep?

[00:13:20] Sarah: I think to recognize the fact that throughout women’s life cycle, sleep is affected for a start. So it’s normal. So we have significant hormone transitions in a woman’s life, whether it be puberty, pregnancy, or perimenopause. Menopause. We are also more susceptible to pain because of the hormone interaction, estrogen and pain receptors.

And we’re also more likely to work shifts in certain industries. So healthcare industries, things like that. So accepting sleep for women can be affected is the first thing. And then seeking, maybe you need pain management advice perhaps during your menstrual cycle if you’re suffering from painful periods and they wake you up.

So seeking pain management from your gp, maybe during perimenopause menopause, it means that you need some cognitive behavioral therapy to help with insomnia. That’s got a really strong link, positive link in helping with insomnia. Or it may be that you need some psychological input for depression anxiety that’s linked perhaps to perimenopause menopause.

It may be that you need some hormone replacement therapy, and again, it’s seeking advice from your gp. So it’s sign posting to clinical input. Women are also more susceptible to weight gain in later life, which can lead to sleep disordered breathing, and again, that needs a clinical intervention. So seeking advice from your GP if that’s the.

[00:14:41] Sue: Now given I’m sure that many of our listeners are also men , is there anything particular that men should pay attention to?

[00:14:48] Sarah: Well, men and women can obviously suffer from stress, but there is a strong link between mental health, stress work, particularly in men in later life, perhaps in leadership positions.

And that’s not say that doesn’t happen for women too, but. Also when men, later life perhaps get the weight gain, there’s also a link then with sleep apnea, which is, which is a form of disordered breathing when you’re asleep. And also increased urination at night because of perhaps an enlarged prostate. So, you know, there are clinical interventions that can help with that, but obviously you need to seek advice from your GP in first instance.

[00:15:21] Sue: So it does seem like it’s a pretty important area of health and wellbeing that we maybe don’t give enough attention to at times.

[00:15:29] Sarah: Yeah, that’s true. There’s no physiological system in the human body that isn’t enhanced by good sleep or impaired by poor sleep.

And this is why it’s the crux of my doctorate. It’s the significant impact factor on our health and wellbeing, physical and mental. You can have good nutrition, you can have good exercise, you can have good social and family relationships. All of those are. They’re critical and obviously important, but if you’ve got poor sleep, it doesn’t matter if you eat well, it doesn’t matter if you exercise, they’re gonna be affected by the fact that your sleep is impaired. So it’s the number one. I would say, you know, in terms of a pillar of health,

[00:16:03] Sue: if I went down the shops today, I could buy a whole bunch of so-called aids to sleep. I could get myself a comfortable bed. Maybe I could get some tech to measure the amount of sleep I’m getting. From your perspective, Sarah, what are some of the different routes that we could be considering to improve the quality of the sleep that we’re getting or just to be aware of it in a better way?

[00:16:24] Sarah: The first thing is to consider your strategy to get good sleep. Have you got a strategy to get good sleep? Most people say, no, I don’t think about it. Just go to bed. So that’s the first thing. So thinking about your strategy, what’s that gonna involve? Hopefully a routine around your sleep, which on the whole you should try and achieve.

But be pragmatic. Life gets in the way sometimes your sleep system. So your bed, your pillow, your mattress. Particularly in relation to women menopause and hot flushes, having the right texture of clothing, for example, the right bedsheets, if you’re particularly prone to night sweats, that’s that can be particularly important.

But for anybody, a comfortable bed neutral spine, not too hot. Ideally the room 18 to 20 degrees, so a cool, calm environment. Blackout blinds, eye masks, earplugs if you need them. And trying one thing. Don’t try everything cause you never know what’s gonna work. Perhaps some gentle psychological techniques, mindfulness, breathing techniques, C B T if you particularly prone to insomnia.

And also then talking strategies. Journal writing is proven to be quite popular. And then you’ve got the technology side as well and the gold standard of measuring sleep. Poly sonography in a laboratory, which is the electrodes on your head and and your eyes. Now obviously that’s not practical for most people and the sleep gadgets that are out there are good to a point.

They’re not validated, most of them against PSG, against the gold standard. , but they will recognize a change. So if you are trying to increase your sleep from six and a half hours to seven hours, say, and you wanna do that by five minutes a night? Cause we’re talking about behavior change, it might be quite chart to suddenly get an extra hour sleep.

So 10 minute increments over a week, for example, would help. So those gadgets will help you ascertain if you’ve made a positive change in relationship to your. But I wouldn’t get hung up on the data. The ones that provide the sleep architecture data, the 90% REM sleep versus 10% non rem, I wouldn’t read too much into that because you really need to be in a sleep laboratory hooked up to the electrodes to get a gold standard measurement of that.

[00:18:30] Sue: So you’re saying that gadgets could be of some value, but not to rely on them too heavily?

[00:18:34] Sarah: Yeah. Yeah, definitely.

[00:18:35] Sue: I almost want to put the question to you, Sarah, then. What do you use as your strategies to get good sleep.

[00:18:41] Sarah: What do I use my strategy? Professor Colin Esbe from the University of Oxford gave a really good positive outlook on sleep in the sense that there’s five principles of sleep and that you value it and you protect it.

Personalize that sleep window. Trust that sleep is a natural process, and then prioritize your sleep as well. So make it part of your week that it’s like if you’ve got a busy week, but on the whole, you’re gonna get that sleep routine in three outta four days. Or if children are ill or something happens, be realistic about it. So I, I wouldn’t say that I spend money on something, it’s more those five principles. Try to adhere to those as much as you can, and on the whole, your strategy for good sleep health will be a positive one. Those really are the five values I live by and in relationship to my sleep.

[00:19:30] Sue: It’s wonderful to know that you apply what you’re helping other people with to your own situation and prioritize that sleep for yourself too.

[00:19:37] Sarah: Try to on the whole. Yeah, definitely.

[00:19:40] Sue: Given that the world seems to be only getting busier, we are in that always on environment. We have technology, probably our phones glued to our sides for most of the time. Given that environment, what can we do to recognize that whilst also recognizing the impact it has on us as human beings when we don’t get good quality.

[00:20:01] Sarah: Yeah, I think a lot of that is generation said, teenagers these days, they’ve never not known the internet. There is so much to process. If you’re at work, even working from home, you’re on calls, virtual calls, there’s information coming from our phones. The technology has enabled us to be innovative in so many ways, but it also has disabled us to switch off, to have our downtime to have a nap or get to bed at a decent time on a regular basis. And that exposure to light prevents is the sleep robber light, is the sleep robber, because it prevents some melatonin levels rising. So that exposure. To data on your phone, the tv in the bedrooms, the laptops in the bedrooms, all of that is diminishing our ability to get good sleep as well as the self responsibility.

So we have to take the responsibility to acknowledge if we wanna get good sleep health, we need to get to bed at X amount of time. That works for us. For most part of the week, not to be a fun sponge, especially after the last couple of years. We need to socialize, we need to go out, we need to see people.

It’s very important, but it’s having that, that balance. And I don’t like to use the term work life balance because that suggests a conflict between the two. It’s a collective, it’s a pot of energy, and your sleep will impact on your ability to use your energy in the places it needs to be used. So yeah. Gone off on a bit of a tangent, a little bit of rant about it there, but definitely the technology is good and it has its place, but we have to take responsibility in how we use the technology in relation to our sleep health.

[00:21:36] Sue: What your comments are conjure up in my mind, Sarah, is we have role models for many things in our world. What I’m wondering if we do have or are missing are role models who talk up and demonstrate the value of having sufficient sleep. What would you say to them?

[00:21:55] Sarah: Yeah, I think in my previous working environment, definitely there were athletes that totally understood the value of sleep and the younger developing athletes coming through, they would talk about, well, I was making sure I get good sleep and all that.

Occasionally you will hear athletes talk about that in the media, but they tend to be from niche sports. I think probably in somebody like Andy Murray may have mentioned it in the past and stuff, but you won’t necessarily get like the big sports, like the football or the rugby talking. Their sleep as a significant part of their recovery and preparation for performance.

And again, you probably wouldn’t get that in the media in terms of celebrities doing that either, you know, so, so somebody that young people would look up to. So yeah, I think you’re right. I’ve never really considered that outside of the sporting environment before. But no, I don’t think there is necessarily leading examples of good sleepers.

In terms of role models, there’s certainly people out there from an academic point of view, but they’re not necessarily the people that generations that are gonna listen to, for example.

[00:22:58] Sue: So maybe there’s an opportunity there somewhere to tell the stories and share the role model messages of people who are seeing the value of good sleep.

[00:23:04] Sarah: Yeah, I think you’re right.

[00:23:06] Sue: If you were to leave a listener with a top tip or some pieces of advice, what are, of all the things you’ve shared with us today would be the number one to focus on.

[00:23:14] Sarah: I think consider their sleep. So if they’re having a problem with their sleep, consider, maybe it’s something really obvious.

They live somewhere noisy or the street lights, or maybe they’re doing shift work and they need some input there and have a dialogue about. So that they perhaps have a dialogue with their GP if that’s not necessary, or they have a dialogue with their partner if they’re working shift work and it’s waking each other up, all that kind of thing.

It’s like consider your strategy to get to sleep and to achieve good sleep health, because that’s the first port of call, regardless of what the problem is. If you don’t consider it and stop and think about it and think what’s going on here, you can’t make that change in the first. So it’s really valuing it as a factor in one’s life. Yeah, prioritizing it.

[00:23:56] Sue: So if people want to find out more about you and the work that you do, how might they go about doing that, sarah?

[00:24:01] Sarah: Various ways. I’ve got my website, which is gilchrist performance.co.uk. Also on LinkedIn, Sarah Gilchrist on LinkedIn. There’s some information on there. There’s some articles, there’s some sketch notes.

And then also on Instagram, there’s Gilchrist performance or Gilchrist. P E R F on Instagram, and that’s where we advertise it. Its presentations or sketch notes that I’ve put out and things like that.

[00:24:25] Sue: Fantastic. Well, we’ll make sure we put links to all of those things on the website so people can follow. I think what I’m taking away from our conversation today is getting a different sense of the importance that sleep plays in our lives and the small actions that each of us can take that will make a difference to that, that will help us to get a better quality of sleep. Stop and think about it.

[00:24:47] Sarah: Yeah, exactly. Exactly. Small baby steps. That and considering it. Yeah, definitely.

[00:24:52] Sue: So thank you so much for your time. It’s been really informative to learn so much more about sleep today. Thank you, Sarah.

[00:24:58] Sarah: You’re welcome. Thanks, Sue.

[00:25:00] Sue: Well, thanks to Sarah for her insightful advice on how to get a better night’s sleep. Remember, you can keep connected with us on social media, on LinkedIn, Twitter, Facebook and Instagram. Just search for access to inspiration next week. My guest is Nic Parmaksizian global CEO of Design It, who will be talking about how to create an environment that encourages innovation. I hope you can join us then.

Sound Editor: Matias de Ezcurra (he/him)

Producer: Sue Stockdale (she/her)