Ep. 9: Healthy Sleep Habits - It's a Third of Your Life

Brian: Welcome to the Living the Healthy Life Podcast, where we bring you the latest on health and wellness from the experts here at Lee Health. Discover what's happening at Lee Health and take away tips and inspiration to reach your ideal state of health.

Hello and welcome everyone. My name is Brian Hubbard. I am the manager for marketing and brand management at Lee Health. With me as always is our co-host Carrie Bloemers. Carrie is a registered dietician as well as the director of education and navigation at the Healthy Life Center of Lee Health Coconut Point. Hello and welcome, Carrie.

Carrie: Hello everyone. Hello Brian.

Brian: Brian. So thanks to everyone out there joining us again today. This is going to be one of my favorite topics. We're delighted to have with us today our special guest, Dr. Jose Colon, adult and pediatric sleep medicine specialist at Lee Health. He's here to talk a little bit about the importance of getting enough sleep, proper sleep hygiene, anything we feel like talking about today with this huge important issue. So Dr. Colon, welcome. Thanks for being with us.

Dr. Colon: Hey, thank you very much for having me. And hello, Southwest Florida.

Brian: All right. Excellent. Let's jump right in. Because it says... I always say this is one of the most important topics that we've discussed. It's very important to me, to really everyone. I feel like we could do an entire series just on sleep. Not only the usual things about how much or not enough, but how much of our modern lifestyle and the general stress of anxiety of modern life affects us. There's lots of remedies. There's lots of clinical treatments available, so there's a lot there. So Dr. Colon, let's just start with a general summary. Easy question for our listeners. Why is sleep so important? And tell us a little bit about what sleep medicine is.

Dr. Colon: Yeah. So sleep is a third of your life and it's very important. And if it wasn't made to be important, it would've been one of the biggest evolutionary blunders that the caveman would have gone through.

Brian: That's true.

Dr. Colon: Every night he needs to sleep and hide from these saber-toothed tigers, so it was made to be important.

Carrie: I'm still hung up on a third of my life.

Dr. Colon: A third of your life, yeah.

Brian: Isn't that amazing? You can't even fathom the number.

Dr. Colon: Yeah, so it's obviously important that a third of your life goes through it. And every night we go into sleep and our brain goes into different stages and cycles. And by the way, you can't spell brain without Brian.

Brian: I love that. I love that. You'd be surprised how many people still misspell my name in that very way.

Carrie: I'm sure I've been one of them.

Dr. Colon: But yeah, so every 90 minutes we cycle into different stages of sleep, of rapid eye movement, REM, where we dream. We're collecting memories. And in between that we also have sleep that's not REM and that's what it's called, non-REM sleep.

Brian: Makes sense.

Dr. Colon: The first half of the night is the deep sleep, where in kids a growth hormone is being secreted and toxins are being washed away in our glymphatic system. And that's even actually where you make an immune response. If you get, whether it's a flu vaccine or whatever, you're not suddenly immune to it. You go to sleep and in sleep you elicit that immune response. So sleep is actually the first line in your immunity. So there's so many reasons that sleep is important there.

Brian: It's amazing.

Carrie: Powerful.

Brian: Absolutely. So sleep medicine, then. What do you and your team, what is your primary role? How does all that work?

Dr. Colon: So one of the things that we do is that we identify different sleep disorders. So I do sleep medicine. What does someone in oncology do? They treat different types of cancers and they find out what type it is and give specific treatments towards that. Same thing with GI doctors, gastrointestinal disease. They need to identify what type of GI disorder they have, whether it's irritable bowel or inflammatory bowel or ulcers.

And it's funny because that's what I do, is that I identify what the sleep disorder is. And I say that's funny because many times people say, "I can't sleep," or, "I have difficulty with sleep," like it's one word. But someone may have obstructive sleep apnea, or restless legs, or period limb movement disorders. Their sleep/wake cycles or circadian cycles can be off. There's insomnia, of which is very comorbid and associated with other disorders. So there's a lot of different types of sleep disorders. And that's what we do, is we identify what the sleep disorder is and we can give guidance in regards to sometimes medication management. Other times there's medical management in the sense of different types of therapies, whether it's psychological therapy or mindfulness-based stress reduction, identifying and making individualized treatments based on that.

Brian: It's such a fascinating field. Do you mind if I ask you how you got into the field? What sort of sparked your passion for this calling?

Dr. Colon: We only have an hour, so I'm not going to start back in kindergarten, but I will start in med school, that I originally went to med school to be a general pediatrician. My father was a general pediatrician and he never told me to go into it or forced me. I grew up watching him enjoy what he did and I enjoyed watching what he did. I went to medical school to be a general pediatrician. And my first rotations, clinical rotations, I found it difficult to give anticipatory guidance, parenting advice when I wasn't a parent. I couldn't do it.

Carrie: Yeah. That would be funny.

Dr. Colon: So as much as I loved working with kids, I couldn't be a pediatrician at the time because of that. I took my neurology selective really early, actually to get it out of the way with. And oh my god, I fell in love with it. And a series of accidental opportunities, I learned that if I do child neurology, I get pediatrics in and then I also have to do neurology. So I went to medical school at USF in Tampa. They did not have pediatric neurology training over there. So once again, series of accidental opportunities took me to Vanderbilt where I did my child neurology over there. And at Vanderbilt, the Department of Sleep Medicine was through the Department of Neurology. So the second that I got there, I started to get inklings of it. And inklings turned into interest, and then interest, I submerged into it. Originally I came over here and started the child neurology practice, but I also had the sleep medicine training. And I started doing both, and then learned that I couldn't do both at the same time because it's two different professions.

Brian: It's a lot.

Carrie: Because you wanted to have time to sleep at night?

Dr. Colon: Sleep is important, sleep is important. And I broke out and now just do full-time sleep medicine in both adults and children. So how did I get into it? It's a series of just accidental opportunities in my life that-

Brian: Make sense.

Dr. Colon: You put some seeds in there and you water them and it's grown.

Brian: That makes sense. It seems how it happens for a lot of us. That's good.

Carrie: And so we're hearing, and we know, and even for us, again, it's just that great reminder, sleep is so important. So one of the things we really wanted to pick your brain about today were some of those basic lifestyle factors that apply to all of Southwest Florida who we're talking to to lead to that good quality, restful sleep and potentially, I don't know, but can we prevent some of these sleep disorders from happening through our behavior?

Dr. Colon: Behavioral approaches towards better sleep, we've all read to use your room for sleep and to have a regular bedtime, to have a regular routine. Cooler temperatures, ideally around anywhere between 68 to 70 degrees.

Brian: I love that because I crank. At night I crank that thing down, so that's good.

Carrie: The energy bill is all going up.

Dr. Colon: We have thermostat wars at my house.

Brian: Oh for sure.

Dr. Colon: Where I like it. I actually like it around 70 or below. My wife, she likes it at 74, which for me, I'm burning up.

Brian: Oh, that's sweltering.

Dr. Colon: Yeah, for me it is. So we're constantly going back and forth.

Carrie: So you get better quality sleep at a lower temperature?

Dr. Colon: 68 to 70 is what the research shows, yeah.

Brian: Wow. Okay. That's a handy tip. Well, I won. I can take that home with me and say, "Hey, look."

Dr. Colon: So these are all tips that we've all read about, but I personally believe that that explanations are better than instructions.

Carrie: Absolutely.

Dr. Colon: So I'm going to ask you a couple questions, Carrie.

Brian: Uh-oh. Here we go. I like it.

Dr. Colon: And none of these questions are going to be hard. Okay? All right?

Carrie: Okay, got it. I'm ready.

Dr. Colon: Do you drive?

Carrie: Yes.

Dr. Colon: Okay. When you drive, are you trying to fall asleep or are you trying to stay awake?

Carrie: I'm not focused on either, but I guess I want to stay awake.

Dr. Colon: Okay. I told you they weren't hard questions.

Carrie: Okay.

Dr. Colon: All right. When you drive, do you sometimes listen to the radio?

Carrie: Absolutely.

Dr. Colon: Okay. Can you see how people learn to associate that radio with alertness to the point that let's say they're tired and they're driving, what do they do? They turn the radio on. That make sense?

Carrie: It does.

Dr. Colon: All right. Let's just say that you were in your bed and you were not asleep. Can you see how it'd be a bad idea to listen to that same radio station?

Carrie: Yes.

Dr. Colon: Classical conditioning. So you ring a bell and then you give a dog food. Pavlov's dog, that dog learns to associate that bell with food.

Carrie: And they drool.

Dr. Colon: Yeah. Yeah. And it's not because you feed them the bell, because that's animal cruelty.

Brian: Right. No feeding them metal.

Dr. Colon: They learn to associate that. I'll give that explanation to my teenagers and young adults and then I ask them, listen, do you get on your cell phone? Do you check social media? Do you get onto your email because it is boring to do that or because it is mentally engaging?

Carrie: Right. Stimulating.

Dr. Colon: That ding, that light stimulates your brain. Again, explanations are more important than instructions. You want to minimize the amount of alerting activity that you do. You want to have a routine that you associate with rest. You want to take out things that... Work, schoolwork, homework, taxes, out of your room, out of your bed so that you associate your bed with rest and not work. The word dormitory, dorm, dormir in Spanish is sleep. And you used to go to the university. You'd be out in the day and then you went to your dorm just to sleep. And at one point they had a bunch of beds in one room.

Carrie: Right. Literally just to sleep.

Dr. Colon: Somewhere down the line dorm turned into party house. But original Latin roots, dorm-

Brian: Oh, that makes sneeze a lot.

Dr. Colon: ... is a place where you sleep. And you want your bed to be your dorm of sleep, not party house.

Carrie: It makes sense.

Brian: So in the same respect, binging TV shows, whatever, a lot of TV. Talking about cell phones and social media, but it may be the same as true for TVs. You don't want to just go into, all right, it's time to wind down. Let's go watch three hours of the latest Netflix show. You don't want to do things like that in your bed necessarily?

Dr. Colon: So I'm going to say equal parts yes and no. And you're going to be like, huh, no? So yes, you're right. Ideally you shouldn't watch TV in bed. Ideally you should cut down all electronics before you go to bed. Then why the no part? Because everyone does it anyways.

Brian: This is true, very true.

Dr. Colon: But let me give you some guidance. Let me give Southwest Florida, Lee Health, everyone some guidance on this. I'll tell you that to wind down, I will sometimes lay down on the couch with either my son or my daughter and we'll watch a show. And very specifically, it's nothing that we ever watch in the daytime.

Brian: Okay. I like that.

Dr. Colon: The origins of this, I realized when I was in med school, at the time I had a TV in my room and I never watched Star Trek growing up. However, when I was in med school, Star Trek, not The Next Generation...

Brian: The after that, right? The Next Generation was great.

Dr. Colon: That was good. That was good.

Brian: That was good.

Dr. Colon: But Enterprise.

Brian: Enterprise, yes.

Dr. Colon: No.

Brian: No?

Dr. Colon: Voyager. Voyager.

Brian: Okay. I'm with you now.

Dr. Colon: Yeah, with Chakotay and Kathryn Janeway. So at the time, that was on every night at 10:00 and I had this regimen where I'd wake up, I'd run, I'd go to class, I'd study all until the very end and then I'd hit a little bit more of the gym. And then when I'd come back I was like ragged tired. And I would put on Voyager at the time. I'd never watched it before and I'd fall asleep like a lullaby. So when my kids were younger, I picked it up. I said, "Hey, let's watch Voyager." It was on Netflix. So we saw episode one and we'd only watch one episode. They'd never seen it before, but that was our bedtime story. After that was done, we watched Once Upon a Time. It was on Netflix. And again it was like a bedtime story.

Now I'm going to tell you something. Carrie, you know me.

Carrie: I do.

Dr. Colon: I love football.

Carrie: Absolutely.

Dr. Colon: I love football as much as I loathe Monday Night Football.

Carrie: I was going to say, you're going somewhere. Yep.

Dr. Colon: So I can watch any game, but when I watch it at night, my brain is wired afterwards.

Carrie: Right. Stimulated.

Dr. Colon: And I have difficulty sleeping afterwards because my brain is still wired.

Carrie: A lot of these association patterns happen.

Dr. Colon: Exactly, exactly.

Carrie: That we're conditioning ourselves. So it's about still the routine, right?

Dr. Colon: All of that, all of that. So Brian, when you asked the question should you avoid the TV, yes we should, but we don't always. And my point of view, if you're watching something calming with your family, that is pretty equivalent to that of having the campfire.

Brian: Cozy, yeah.

Carrie: So can I ask-

Dr. Colon: You just did.

Carrie: ... because I'm curious, what about the type of light, right? They say the screens all emit that blue light.

Dr. Colon: So you want to reduce the amount of light that you possibly can. Now, you-

Carrie: Okay, so watch TV in the dark?

Dr. Colon: That's what I do.

Carrie: Okay, you heard it here.

Dr. Colon: I turn off the lights in the kitchen.

Carrie: Any overhead.

Dr. Colon: I have a light so I don't kick my shins on in a different room. And then I walk my daughter up afterwards. So now the other reality is you're talking about lights. Yes, we need to avoid screens as much as we can, but our teenagers don't have textbooks all the time. They have Chromebooks. So there are settings that you could put on phones, but there's also blue blocker glasses that you can get. You could just Google blue block glasses and there's a bunch of different types from very expensive fashionable ones to very cheap basic ones. So I would say, look, if you're in that real-life scenario that you have to do some kind of homework or research or stuff like that, do what you can to have appropriate settings and blue block glasses.

Brian: That's great.

Carrie: And how about, because we're on the topic of light, we live a lot of our lives indoors now. So some things I've read about even sleep quality is that we need exposure to the outdoor elements, the actual sun. Is that any part of your recommendations?

Dr. Colon: You're smart, you've done your research. So I'll take that a step further. People want to go to sleep, and they try to start with sleep at night. But the best way to improve your sleep is start with your wake time, to have a consistent wake time and to have consistent morning light.

Brian: I like it.

Dr. Colon: There are programs or whatever, different things that I can calculate what time to give you artificial light. Hey look, we live in Florida. Wake up, go outside. We have it at a point that wake up at a regular time when the light is out and get your morning light. If you're able to get some morning exercise or walk around the block, excellent. But yes, we do need the light, and in particular in the morning in order to regulate our sleep drive at night. If people start with trying to go to sleep when they're not tired, guess what's going to happen? They're not going to fall asleep. And then what happens? Then they get frustrated.

Brian: Then they get up, then they eat, then they do all these things.

Dr. Colon: Oh yeah, yeah. That's called insomnomnomnomnia.

Brian: And that can't help.

Carrie: I love it.

Brian: Because the next thing that I had on my list was does the food we eat affect, and it seems like an obvious probably so, yes. But does the food we eat affect our quality of sleep?

Dr. Colon: So food that we eat can affect quality of sleep. Things with caffeine are going to keep you up. Things that have high sugar may sedate you at first, but then when the sugar rebounds and you get your epinephrine, it affects the second half of the night of sleep. Things that are high-histamine, wine, cheese, certain chocolates, if you're prone to congestion, it can affect congestion. Now something that many people don't know is eating the right foods at the wrong time can be just as bad sometimes as eating the wrong foods.

Brian: How do you feel about that? You're a dietician.

Carrie: Hey, I'm eager to learn. Tell me more.

Dr. Colon: The really late night eatings, start-

Carrie: Like you're saying a big salad with lots of fiber that will impact our digestion maybe?

Dr. Colon: No, anything that you eat after you're supposed to be in bed asleep really gets metabolized into fat.

Carrie: Yes. Okay, I'm with you there.

Brian: So maybe is there a cutoff? Let's say you go to bed at 11:00, so you shouldn't eat for two hours before? Three, four hours before, something like that?

Dr. Colon: And that would be ideal. Yeah, ideal. And ideally it's nice to have 12 hours between your dinner and your breakfast. And if you're eating breakfast at 6:00 AM and you want 12 hours, then it should be 6:00 PM that you last eat.

Carrie: No, that's a great point. A lot of folks have asked about that intermittent fasting and that's I think one of the baseline recommendations. It's hey, we don't even have a normal overnight fast anymore. Before you dive into that, let's just look at 12 hours overnight. Can you even hit 10 hours? Many people are at six or eight when they think about it.

Dr. Colon: And something fascinating happens when you hit that 12th hour is that your mitochondria start to regenerate and rejuvenate. So yeah, if you could hit that 12 hours, great. If you could hit more, I mean with intermittent fasting, what they're recommending is if you have like an eight-hour window during the daytime that you eat. So that is eating early and not having breakfast till later.

Brian: Interesting. So let me jump into this because you talked about waking up at the same time every day. Okay, so this is a two-part question. What about naps? Can we talk about how good and/or bad and what the ideal nap length is? Because some people take a nice little 15, 20-minute power nap, they may call it, and they feel great. Some people might catch up on the weekends and do... I'm speaking from experience honestly. Might have a nice one hour or two hour kind of nap. Does that indicate that A, I'm not getting enough sleep? Is this sort of catching up on sleep? Is that good and bad? There's a lot of questions in there, but you kind of see where I'm going.

Dr. Colon: So that is some parts equal physiologic as it is cultural. There are some cultures that have a little bit shorter sleep time at night. Up later, but then they have a larger siesta in the daytime.

Brian: True.

Dr. Colon: So culturally, that is a way of life and a way of health. That's not the way that we do it over here.

Brian: Yes. This is true.

Dr. Colon: Kids do not get dismissed in the middle of the day and get to go home and take a siesta. That's not the way that it works here.

Brian: Very true.

Dr. Colon: So in the US what I would say is naps are ideal at 20 minutes. And my answer used to be 20 to 40 minutes, but the research is pretty clear that the more that you nap towards 40 minutes, and especially if you get into an hour, you get into a deep sleep, into the deeper sleep. And then when you wake up and you have sleep inertia, well guess what? That deep sleep kind of washes away your desire to get the sleep regular at night.

So I'm going to give you a parallel example over here. We're going to get off the subject and then get back on it. Okay?

Brian: Okay. I'm ready.

Dr. Colon: I do not give my children candy before dinner because then they're not going to have the appetite for their nutritious dinner.

Brian: I love these examples. They're great.

Dr. Colon: So a long nap or a late nap is sleep candy, and it makes it so that you don't have your sleep drive or your sleep appetite at night. So keeping it at 20 minutes is ideal. And I'm going to give you another pretty cool pointer, and Lee Health, you're going to love this. Caffeine and naps at the same time. Oh yeah. So let me explain. How long should your nap be? I just told you guys.

Brian: 20 minutes.

Carrie: 20 minutes.

Dr. Colon: All right. Well, it takes 20 minutes to absorb caffeine. So you take your caffeine at the same time that you nap, and then when you wake up you have the benefit of the nap and the benefit of the caffeine.

Brian: I'm going to try this on Saturday. This is a thing.

Dr. Colon: Now, I didn't make this up. This was actually studied in industrial medicine and in industrial journals. And they found that 20-minute naps gives cognitive benefit, that caffeine gives cognitive benefit at work. And that when you did the combination of this, that it was-

Carrie: Exponential.

Dr. Colon: Yeah, even exponential.

Brian: Wow.

Carrie: Very cool.

Brian: Never heard of that.

Dr. Colon: So I will commonly, lunchtime. And let me say caffeine of 200 milligrams or below.

Brian: Below.

Dr. Colon: Above 200 milligrams, you start to get jittery. You piss off your anxiety receptors. So I will commonly be at work and I have the first part of my day, it's lunchtime. Look, do I have a bed at my work? Well, that's cheating. I have a sleep lab, but I still don't use it. I still don't use it.

Brian: It's not yours, per se.

Dr. Colon: I go to my car and crank up the air. I have a green tea shot from Whole Foods that's 100 milligrams of caffeine. I'll put my calm meditation on for 20 minutes. I'll put sunglasses on.

Carrie: Block out the light.

Dr. Colon: Yep. And there are times that I may fall asleep. Most of the times I don't fall asleep, but I still am having that rest.

Brian: You're relaxing.

Dr. Colon: I'm still hitting that parasympathetic response.

Brian: It's a good tip.

Carrie: And that hits somewhere we want it to go. You mentioned the meditation, meditation app. So can you speak a little to that, to the benefits or really why is that incorporated in your routine?

Dr. Colon: Meditation is very helpful for sleep. And it's equal parts for relaxation, but even more for something else, non-judgment. But let's talk about the relaxation part first. So when you breathe in, your heart rate is variable, and when you breathe out, your heart slows down. And if you're taking a moment and you're following your breathing patterns and you're doing, let's say, an awareness of breath, you're slowing your respiratory rate down and that slows your heart rate down. Well guess what happens in sleep? Your heart rate slows down. So you're eliciting that relaxation response, that parasympathetic response. So you can potentially meditate yourself to sleep. So that is something that you can do. However, the large studies in meditation, it's not about meditating yourself to sleep because they do the meditation during the daytime. What happens is when you practice a regular practice of mindfulness-based stress reduction, part of mindfulness is non-judgment. What's the definition of mindfulness? Paying attention to something on purpose-

Carrie: Awareness.

Dr. Colon: ... without judgment. And that's the thing, is that the studies show that people who practice mindfulness develop more compassion, but also have more non-judgment. And that's one of the things that people with difficulty sleeping or insomnia have, is a lot of self-judgment. Like why am I not asleep? How come I can't sleep? What's wrong with me?

Brian: What's wrong with me?

Dr. Colon: That's a lot of judgment.

Carrie: Yeah. And we were talking a little bit before about our society, the way life roles, stress, anxiety, the fast pace. So is that where you'd say a tool like meditation and mindfulness, that awareness, bringing that in, that's why we would use a tool like that?

Dr. Colon: Yeah, absolutely. You hit the nail on the head there. Yeah, it's important.

Brian: It's a stressful world. It's a stressful modern life. We're a stressed-out country. We're a sleep-deprived country. I've read that. Is that in fact true? I'm assuming it's probably close to being true.

Dr. Colon: It is.

Brian: So talking about stress and anxiety, I think we have to mention we live in a post-hurricane world. We've all been through it. A lot of people out there obviously have much more trauma than others, but we've all felt the effects of it. We've had COVID. We've had two years of pandemic life. We've had work-life balance, people working from home. There's a lot of stress. There's political things, there's world events. Have you seen this kind of stress response increase over, I don't know, the last few... Well first of all, increase since the hurricane happened? Are you seeing there's an upward trend in stress and anxiety? Is it affecting sleep more? Are you getting those kinds of complaints or are we way off with that kind of thing?

Dr. Colon: Yes.

Brian: There you go. A man of few words.

Dr. Colon: So explanations versus just answers. In difficulty sleeping, insomnia, there's a 3P model that everyone has some predisposing factors towards in insomnia. It's family, stresses, whatever. And then there's precipitating factors that occur. Threats to our life, and threats to our life are not necessarily getting eaten by a lion. That would be a threat.

Carrie: It would be.

Dr. Colon: But you know what? A change in job is a threat. Marital issues are a threat. Kids' tantrums are a threat. Hurricane Ian was a threat. The pandemic shutdown was one of the biggest threats that I've come across in how we live life. And the data for the pandemic is very robust because it happened to the entire US and it was for a long period of time. And the numbers of insomnia complaints really went up. And if you look at Google search for insomnia during the pandemic, it went up. And when you compared that to that of sleep apnea and narcolepsy, it stayed the same.

So yes, stress does lead to difficulty sleeping. And then 30 to 40% of people can have insomnia, but 90% of the population at one time has had an adjustment insomnia. So a life-altering situation occurs and we have some insomnia. Now the key is, I mentioned that there's a 3P model and I mentioned that we have predisposing factors, and then we have precipitating factors. And what we want to avoid are the perpetuating factors, that once this threat has left you, it's been a year on the job now, you moved on and you either reconcile or you have a new family now, but the insomnia is still there. And the perpetuating factors are feelings about insomnia. Sometimes people can't sleep because something's bothering them. What's bothering them is that they're not asleep. The harder that we try to sleep, the worse that it gets.

I can't stand the thought of being in bed and not sleeping so I'm going to turn on the TV. I can't turn on the TV and not have a muffin so I have a muffin. I can't not have a muffin without a table, so I put a table. That table goes great with my laptop.

Carrie: A cycle.

Dr. Colon: So there's a set of perpetuating factors that continue to make us associate that we cannot sleep. And that that's the key thing, is understanding that the storm passed and life situations are going to pass as well, and do what we can to elicit relaxation responses. And I can't tell people don't worry about sleep, but I have to tell them the opposite. The more that you worry about it, the more it's going to negatively affect your sleep.

Brian: That makes a lot of sense.

Carrie: Wow. And Brian and I were making eye contact when you're going through that list, like I'm in bed, but I can't fall asleep. And then you're mad.

Dr. Colon: Well, and you're mad that-

Carrie: We've been there.

Dr. Colon: And you're like, I got to get up at 7:00 to go to this thing.

Carrie: I need my good, quality sleep.

Dr. Colon: I got to get six hours at least. And then you get mad.

Carrie: So you're saying one of the keys there is to try and break that perpetuating cycle.

Dr. Colon: Yes.

Carrie: And to be able to move forward to get back to our relaxation techniques and-

Dr. Colon: Yeah. Break the perpetuating factors. Don't fall into the trap of bringing daytime things into your bed, which it commonly happens. You said, "Oh, I need to wake up at 7:00." The fact that you're saying that means that you're looking at the clock. Stop looking at the clock. Put your alarm clock on and turn it away.

Carrie: Turn it around?

Dr. Colon: Yeah. You know you put it on at night.

Brian: One of the great things about having your alarm on your phone now is that you could do that easier. Back in the day you would have it on your night side end of the table that you could see it all the time.

Carrie: Yeah. Definitely don't need one.

Brian: That's pretty good. So that brings me to my next point. We can go on, and this has really been a fascinating. You guys mentioned stress, obviously we were talking about that. What I am curious about, you both have family life. Carrie, you have three boys, which is pretty amazing. Dr. Colon, you have two children, is that correct?

Dr. Colon: Yeah.

Brian: So you both are living the modern life. You have home obligations, you have work obligations, you have this. You're very busy, active, all those things. Dr. Colon, how do you practice all these things in your own home? Your children are... I'm assuming they're learning these things from you and how you're navigating all that. And then Carrie, I'd be curious to know how you're balancing the work, sleep, life balance with three youngsters running around. That's a lot of stuff there. Who wants to start on that one?

Dr. Colon: Well, attitudes, habits, lifestyle are learned. I don't eat food that I don't want my kids to eat, to be eating.

Carrie: Modeling behaviors, Mm-hmm.

Dr. Colon: I commonly will hear, "I try to give a kid this, but they eat that instead." All right. They eat what's in the house.

Brian: Good point.

Dr. Colon: So we try to have a family meal and make it as nutritious. We have Sunday run day, that every Sunday morning they know we're going to go for a run. We'll give the exception if Jada had a big Saturday dance competition, or Manuel had a Saturday football game, he's going to be sore the next day. We make him do it Monday morning instead. This weekend we're doing a Disney run. And I am going to run the 10K with Jada. She's 10, and I'm going to be King Triton and she's going to be Ariel.

Brian: Love it.

Dr. Colon: And then my wife and son, he's almost 14. They're going to run a half marathon. So we enroll in a couple 5Ks per year just as family fun.

Carrie: So you're doing it together and fun. So you're modeling and engaging with your family together.

Dr. Colon: Yeah. How do you do it?

Carrie: Oh, man. Well, so mine are a little younger still, and I think part of it for us is environmental. So we're getting them outside at these ages as much as possible so there's not the temptation of screens and other devices. We have historically had a pretty big routine with family walks almost every evening. And that looks a little different now for various reasons, but it's still about it's outside, they're moving, the garage is there, they want to get on their bikes. And then they see dad going for runs on the weekends, so we got to probably throw the kids out there, the oldest out there with him about this point.

But when it comes to meals, similarly, we're eating what they're eating. I always say there's rules. The parents, we get to decide what and when for meals and children can decide if they eat and how much. We don't want to interrupt their food cues either, but it is that parent providing those healthy choices. And there's a lot of competition out there for their taste buds these days so I don't also pressure too much. We know exposure with foods is a big thing and 20 times or more sometimes. And that they can just consistently see it and that's when it'll be an acceptable, okay thing. And they'll try and kind of build those things from there. But we do smoothies to make it fun for food, but a variety of different things too.

Brian: That's really interesting. So it's kind of like what you said, the more that you practice the behavior, the good sleep habits, the good food habits, the more the children learn that that's how the household is run or whatever it may be. And they learn that that's how their life is.

Dr. Colon: Yeah, yeah.

Brian: It's interesting. Thank you both for sharing that, by the way.

Dr. Colon: And also include them in the kitchen as much as we can. So if we're prepping stuff, we ask them. It is burdensome sometimes to after a long day do everything on your own while they're screwing around doing other things. "Hey, get over here." Now Carrie, you mentioned smoothies. Now here's a cool parenting tip to everyone in Lee County. Smoothies, great for breakfast. Great for breakfast. You put phytonutrients, fruits, your greens in there. It tastes good. The younger they are make it thicker because it takes them a while on that straw. And if they're sucking on that straw, they can't talk. And if they can't talk, they can't fight.

Carrie: And then they can't throw a tantrum either, right?

Brian: I like where this is going. Very, very helpful tip there. This has been amazing. We don't want to keep you too long here. We appreciate all your time. We know you're very busy. I would say real quick before we kind of wrap it up with some... I want everybody to know that they can go to leehealth.org. They can search for more on sleep medicine, learn all about the sleep lab, the locations, the treatments available, the locations, whatever it might be. But Dr. Colon, I want to give you the last thought. Is there anything that you want to touch on that we haven't touched on or anything you want to emphasize at this point?

Dr. Colon: No. We mentioned the main things, as you know. The more you worry about sleep, the less that you get. The actual importance of it, hitting up at the sunrise. And if you feel like there's non-refreshing sleep, then there may be one of several sleep disorders that may need to be evaluated.

Brian: And at the sleep lab with your team of experts, that's what you guys do.

Dr. Colon: So our sleep disorder center, we do an initial consultation first. And then if we do need a sleep study, yes, then we do it at the sleep lab. But our sleep disorder center is outpatient clinics and we have overnight laboratories for when they're needed.

Brian: Excellent. And you can find those locations. Does a patient need a referral for those kinds of services?

Dr. Colon: So that's all insurance-dependent. There's some insurances that do not require referrals. There's some that do. You could always try to call and schedule an appointment. Many insurances don't require them, but if they do, then that's their insurance's rule, not ours.

Brian: Good point. Like I said, go to lee health.org, search for sleep medicine. You'll find locations, phone numbers, more information, treatments, common sleep disorders with some descriptions and other things of that nature. Dr. Colon, this has been fantastic. We appreciate your time. We'd love to have you back because we know there are many specifics that we could really kind of dive into, go down the rabbit hole. So we would love that if you're open to that. Carrie, any last words for the group?

Carrie: No. Thank you for joining us, Dr. Colon. Pleasure as always. And I know I wrote down some tips and I'm sure others have lots of takeaways as well.

Brian: We hope you'll tune back in for upcoming episodes, everyone. We'll be interviewing experts around Lee Health so you can learn more about what we do and how we strive every day to fulfill our mission to the community to provide the best care close to home.