A chat with leading sleep guru Kathryn Pinkham (let's all improve our sleep in 2026!)

0:00Kathryn Pinkham:This show is sponsored by Primadine, a clean, natural and science-based spermidine supplement that's been a long-time staple in my own longevity stack. Because studies suggest that through autophagy, spermidine increases healthspan and upregulates a range of health markers, from memory and cognitive function to heart health, hormone balance, fertility and even hair growth. Plus, you can be assured that all ingredients undergo rigorous third-party testing. Buy Primadine now at OxfordHealthSpam.com and use the discount code DrSophie, that's D-R-Sophie for 20 % off. This show is sponsored by Microbes, an award-winning liquid probiotic that's now a staple for me, because Microbes, with a Z on the end, is different.

0:47Kathryn Pinkham:For one thing, they source directly from the soil on their Wiltshire farm, meaning more diversity, with at least 15 strains of good bacteria in every single shot. It's brewed so it can survive in the stomach and a remarkable 92 % of customers say it makes a difference. Plus they offer micro-friendly cleaning, gardening and even microbes for dogs. Buy now at microbes.co.uk and use the discount code SOPHIE20 for 20 % off. Hi, I'm Sophie and this is Age Well with Dr. Sophie Schotter, a space devoted to all things health, wellness and longevity. because for me, aging well is about looking and feeling like the best possible version of ourselves inside as well as out.

1:31Kathryn Pinkham:So together with my producer Fee, I'll be deep diving into the latest research, sifting fact from fiction. I'll also be talking to all kinds of trusted experts tapping into their knowledge, along with bringing you conversations from a range of interesting women and men finding out how they age well. So this is my show. Welcome along. And as always, thank you so much for listening.

2:01Kathryn Pinkham:Catherine, you're one of the UK's leading insomnia specialists. We know you have a master's in counselling and you worked as a psychological practitioner in the NHS and you now run the insomnia clinic full-time. We do want to get into your approach and methodology but before we do, I'm mindful that a lot of people listening might have very serious sleep issues and feel that they've tried everything and probably also bought everything. You mentioned on your website that insomnia is totally curable and your website has some very touching reviews, which we'll link into in the show notes. So to set a really inspiring and empowering tone, before we get into how you work, would you mind sharing a particularly powerful client story or more than one if you feel guided to?

2:45Dr Sophie Shotter:Thank you. Yeah, lovely to meet you. So Absolutely. I started my passion for sleep whilst I was working in the NHS. So I worked in the NHS for a number of years in the psychological services. And as part of that, we worked with people who had poor sleep, but it was often seen as a secondary condition. So if somebody had a mental health or a physical health issue, then sleep was sort of seen as a symptom of that. And if we fixed the primary problem, then the sleep would improve, which actually wasn't the case for a lot of people. They were saying, but actually my sleep is the biggest thing now.

3:16Dr Sophie Shotter:So when I left the NHS and I decided to just focus on working with people who slept poorly, I set up on my own. I arranged my first one-to-one session. And actually the first person who came in was actually, to this day, one of the worst cases of insomnia that I'd ever seen. She really wasn't getting any sleep at all. She was going to bed every night, hours and hours in bed awake, would eventually get out of bed at six, seven o 'clock and have an hour or so downstairs. And as I was sitting there doing this assessment, I was thinking, oh my gosh, my imposter syndrome is out of control. She's not going to get better.

3:46Dr Sophie Shotter:Anyway, I gave her the changes. She went away. And when she came back two weeks later, she was sleeping. And it had this, she came back a different person. She looked different. Her mood was better. Her anxiety was better. And it gave me such confidence. So I always think about that particular patient because had it have not gone so well, I'm not sure that I would have had the confidence to continue with it because at the time I was young and I'd just set up on my own. So I always remember that story because it showed that actually however bad it was and however how long somebody had a poor sleep problem they can still improve it because what matters is not what triggers the issue but what we do to keep it going and that's where we're focusing the treatment so that that was a story that I always remember because I was very grateful for how bad her sleep was and how much better it got.

4:28Dr Sophie Shotter:What a challenge for your first one as well crikey so let's move on to how you work so your approach is rooted in cognitive behavioral therapy for insomnia or CBTI as the acronym which focuses on identifying and changing the habits and thought processes associated with insomnia. Can you tell us more? Yes, of course. So CBT for insomnia, CBTI, is really the gold standard approach for treating insomnia. It's recommended by the NHS. It's also recommended in America. Sorry, the idea behind it is actually very simple. When people are struggling with sleep, they often end up developing habits and thought patterns that actually keep the problem going.

5:07Dr Sophie Shotter:So rather than just treating the symptoms, CBT for insomnia is looking at why somebody isn't sleeping, what's keeping them awake, and most importantly, what is keeping that cycle going. So an example of that would be a lot of the time, if we aren't sleeping very well, we would go to bed earlier in an attempt to catch up on sleep. How that usually looks is that we go to bed earlier, we lie in bed for hours awake, we get into the habit of clock watching, we start to worry, we ruminate in bed. And so actually those things then become the problem. So the initial trigger for why we didn't sleep doesn't matter as much as my new connection that I have with my bed.

5:44Dr Sophie Shotter:So when we think a lot about sleep, I'm very vigilant to not sleeping and we're doing things to try and fix it. It creates a pressure around sleep and the brain starts to link bed with being awake and feeling stressed. So CBT for insomnia breaks that pattern. So we look at resetting your natural sleep drive. so using sleep scheduling to help you to fall asleep quicker stay asleep longer wait less by increasing that natural sleep drive we also work on thoughts around sleep so our mindset towards sleep is really important if we think like a bad sleeper we are a bad sleeper if we have a lot of anxiety and vigilance then your body has to respond with your threat response if it thinks you're in danger it has to trigger your adrenaline so we look at those sort of unhelpful thought processes and how we can change how we respond.

6:32Dr Sophie Shotter:We do look at routines and things that people are doing wrong, but the majority of the work is around resetting our mind and resetting our body clock rather than just sort of looking at external factors that triggered it. Instead, we're looking at what's keeping it going.

6:46Kathryn Pinkham:I'm really interested in this idea of the power of morning light and daylight and how inputs of light and dark reset our circadian rhythm. And I think there's also now evidence here on how being out of balance can impact not only our sleep but also our mental health. What can you tell us about this and how we all tick a little differently? We'd also love your thoughts on things like blue light blocking glasses in the evening.

7:11Dr Sophie Shotter:Yeah so there's definitely no harm in things like morning light and certainly getting outside more when we wake up and getting that daylight and fresh air can play a really positive role in our sleep health because light is one of the strongest signals for our circadian rhythm. So basically our internal body clock. So when people, especially after a poor night, I would always advise someone to get up, get some daylight as soon as you can to sort of trigger your body into starting to create that natural sleep drive. So bright light in the morning helps tell the brain that it's daytime, it boosts the alertness, it helps set that sort of timer to start building up the drive.

7:45Dr Sophie Shotter:And it is good for our mood. So the SADD clocks have got some really good research to show that actually they can really improve somebody's mood. So if you're sleeping poorly, that can impact your mood. If you have low mood, that can impact your sleep. So something like a light clock in the morning can certainly help our mental health. When somebody has a persistent sleep problem, so they are persistently not able to fall asleep or they're waking up at three o 'clock in the morning and can't get back to sleep, then things like blue light glasses or daylight is not enough to fix the problem on its own.

8:16Dr Sophie Shotter:And that's because chronic insomnia isn't just about light exposure, It's a learned pattern where the brain has started to associate bed with being awake. It's feeling stressed or alert when we should be asleep. So in other words, our body clock is now out of sync. And the bigger issue is that the sleep system is now disrupted and the worry and the hyper arousal are keeping us awake. So CBT for insomnia is targeting those deeper patterns, which is why it's so effective. So things like blue light, blocking glasses, if you find them relaxing, then there's absolutely no harm in those. limiting screen time in the evening can certainly help in terms of what our brain is looking like before we go to bed.

8:52Dr Sophie Shotter:So there's no harm in those things. But if you have an established consistent sleep issue, it may be that those things aren't enough to solve the problem on their own. So it's okay, we just need to incorporate them into a CBT for insomnia routine as well. It's also interesting that you don't advise clients to cut down or even cut out caffeine, because I know that caffeine has had a huge impact on my sleep, particularly postmenopausal, which is why I've now ditched it. It does make a difference. And I think you feel the same about alcohol. And again, for me, I know that I'm pretty much teetotal now, but alcohol previously has caused very disrupted sleep.

9:26Dr Sophie Shotter:So can you explain the thinking behind this and more generally your thoughts around sleep hygiene? Absolutely. And it's really important. I just want to clarify that I'm definitely not advocating that people drink alcohol or caffeine, certainly not close to bedtime, I would always advise people to reduce these things and certainly avoid them later in the day. When it comes to caffeine, I think the point that I wanted to make was that caffeine is not the enemy for most people. And for a lot of people, that morning coffee can give people the boost that helps them to get going after a bad night. So if someone is taking on a sleep program, they are going to bed later, they're waking up earlier, they're doing all the things that they need to do to improve the foundations of their sleep and actually a coffee in the morning really helps them with that then there's no problem of course if we all live sort of perfectly healthy lives and we reduced all these things that aren't good for us then it would be great if we could give up alcohol and caffeine entirely but i guess i'm talking to the people who are it's not realistic for them at this time or it's not what they want to do so moderate caffeine earlier in the day is fine for the majority of people i would agree with you that it does seem to be that once we for women particularly when they go through perimenopause and menopause, alcohol, caffeine, certain foods do have much more of an impact than they used to.

10:40Dr Sophie Shotter:So for those people, it may be that actually it's come to a point where they should be giving up because their sleep is going to be much more impacted as is their mood. And similar with alcohol, I'm not suggesting that people should drink with, like I say, healthier, happier if we didn't. But if you are choosing to have alcohol, it's more about balance rather than the guilt or fear that we can sometimes feel around enjoying ourselves. So So alcohol, there's no way around it. It does affect the quality of our sleep. And it's certainly better not to fall asleep under the influence of alcohol because you will feel very tired, but your sleep will be non-restorative.

11:11Dr Sophie Shotter:But in terms of realistic advice, perfection isn't sustainable for everyone. So if you enjoy a drink, then instead look at minimizing the impact. Don't do it too often. Accept that the sleep won't be as good, but it's only one night. It's not the end of the world. Don't panic about it. Don't fixate on how you can fix it the next night. just get back into your normal routine. That's really my broader point around sleep hygiene, that things like caffeine, alcohol, screen time, perfect routines, these can all support good sleep, but they don't fix a consistent sleep issue because it's driven by a deeper cycle of hyperarousal and behaviors around sleep.

11:47Dr Sophie Shotter:So we don't focus on rigid rules because actually these work against us. Somebody with perfect sleep hygiene will tend to sleep worse because they are too focused. They go to bed hoping it will work and then that vigilance around sleep in itself is enough to keep us awake. So healthy habits matter for sure, but they're not the whole story. And I think it's important to get that balance between not fearing things that might mean that you get a bad sleep.

12:10Kathryn Pinkham:Can we move on to supplements? Because this is a huge and increasingly growing space when it comes to sleep quality. The main ones that are talked about are magnesium and also often CBD. I think both of these can be really fantastic for a lot of people and I know Fee's had success here as well. We're also big fans of a supplement called New Cheeto Time Plus which boosts NAD plus levels and a lot of people who I know anecdotally say that this has really been a missing link to improving their sleep. We could also dig into things like apigenin and L-theanin but where do you stand on all of this and the wider conversation around supplements?

12:51Dr Sophie Shotter:I think for some people if they have a deficiency then supplements can definitely help support better sleep but the fear of sort of repeating myself I think they rarely work as a standalone cure for a persistent sleep issue so the people I'm working with they haven't just got a bit of an issue around sleep quality they are generally waking up in the middle of night aren't able to get back to sleep or taking too long to fall asleep waking up too early so if they have a long-standing sleep problem, their body clock is out of sync and their anxiety around sleep is high, this is really unlikely to be resolved by the supplement.

13:23Dr Sophie Shotter:So that's not to say they don't have a place because if we are deficient in something like magnesium, then addressing that can certainly make the person feel better overall and it can help them cope with the poor sleep better. But when it comes to a pattern around anxiety, we must also make sure we're targeting that. So when people come to me and they're taking a lot of supplements, we'll often sort of pull that back to start with, get them started on the CBT for insomnia program. I always recommend getting a blood test to see what you're deficient in and then we incorporate it into the program rather than relying on them as a single solution.

13:53Dr Sophie Shotter:That tends to be how I find that supplements work best. What are your thoughts on sleep trackers and generally tracking your sleep? If you are anxious about your sleep, I would say avoid them completely. Sleep trackers are, There is a difference in how accurate they are, and I'm not into the science massively behind them, so I don't know which ones are better than others. But I know that they can create issues if they're looking at how much we move in the night. You could have somebody who sleeps very poorly but lies still, and it looks like they've had a good sleep. So in terms of accuracy, it's not the same as having a proper sleep study.

14:25Dr Sophie Shotter:If you are anxious about it, all it will do is create more anxiety. For me, there is a huge gap with sleep trackers that all they are doing for somebody who worries about sleep or somebody with insomnia is they highlight the issue, they tell you how bad it is going to be for you, but then they don't give any evidence-based treatment around how to fix it. So an example of this is if someone had a bad night's sleep, the advice that the tracker might give is around go to bed early tonight, you had a bad sleep. This is actually the worst possible advice we would give to somebody who can't fall asleep.

14:57Dr Sophie Shotter:Going to bed earlier means your sleep drive is not high enough. Your momentum to fall asleep and stay asleep is just not there. And now you're going to go to bed early. You're going to spend more time lying in bed, associating your bed with anxiety, with wakefulness, meaning that this will become a longer term problem. So it's the worst advice. So tracking in itself is okay. If you are somebody who just enjoys the data and is somebody who maybe doesn't prioritize their sleep and it helps you to prioritize it, then it's brilliant. if you are prioritizing it but you can't do it all it's going to do is create more anxiety and until they catch up with the with providing proper evidence-based information to treat the problem rather than just sleep hygiene for someone who doesn't sleep well it's just going to make the

15:39Kathryn Pinkham:problem worse yeah that's certainly something i've observed as well and even down to people who actually rely more on what the sleep tracker tells them about how well they've slept than how they actually feel. I think that's another problem at all. So for me, I find it great because I can sleep really well and it makes me more accountable about sleep. But for people like you described, I completely agree it can be quite an issue.

16:04Dr Sophie Shotter:It would be interesting to almost do a study where we gave people a false positive. We told them they slept really well and let's see how they then approach the day and how they approach tomorrow night's sleep because you're right, you wake up, realise that the tracker tells you slept badly and suddenly you feel tired when maybe. Exactly.

16:19Kathryn Pinkham:Yeah. And also the other way around, I've had days where I feel like I've been hit by a train for whatever reason. And my tracker tells me I should be feeling brilliant. Actually, I'm going to trust how I feel.

16:34Dr Sophie Shotter:Yeah.

16:35Kathryn Pinkham:We were looking at some of your thoughts on the biggest myths out there around sleep. And the two that caught our eye from your website were you don't need eight hours of sleep and you don't need to go to bed at the same time every night. What's the latest data on these two and what does your experience tell you?

16:51Dr Sophie Shotter:When it comes to the eight hours of sleep, I think the angle that I prefer to come from is that sleep knees are really individual. So some people feel okay on less, some people do need more. And the danger that we have of aiming for a number of hours is that, again, it adds this pressure. So if you can get seven hours of really good quality sleep, but you try and get eight hours and then you end up damaging the quality of your sleep because you are becoming more stressed about it, that's worse for you than the seven hours of quality. So I really encourage people who are struggling to focus on quality over quantity, especially women who might be going through menopause and are struggling with their sleep.

17:26Dr Sophie Shotter:Quality matters more. So don't go to bed early. Don't lie in the morning. Don't stay in bed when you're not able to sleep because that poor quality sleep is going to leave you more exhausted because of the anxiety that comes with it. When it comes to bed timing, often I'll hear people say that I go to bed at 10 every night. I just don't sleep well. So in fact, what's happening here is if you're not actually tired until midnight, then going to bed at 10 is not going to help you. So the consistency in the bedtime is important, but it needs to be the right bedtime. So in fact, going to bed later, when you're really tired, when you've had a chance to enjoy your evening, maybe spend some time with your partner, maybe get a few things done for tomorrow, watch a bit of telly, read a bit of your book, is more important than rushing to bed at a certain time if you're not feeling sleepy.

18:08Dr Sophie Shotter:and this leads to better sleep quality. So if one night you're just not tired at your usual bedtime, then it's okay to stay up a little bit later. If you've had a stressful day and you've got something on your mind, then that time might be better spent de-stressing a little bit instead of rushing to bed. The key really is more around your wake-up time. That's the one that I would prefer people keep consistent because this helps to anchor your sleep drive. So the evidence backs this up. Studies show that regular wake times are more important than rigid bedtimes. So in practice, is listen to your body around bedtime.

18:38Dr Sophie Shotter:As I say, if you know your stress, you're probably not going to fall asleep. So work on the stress rather than the sleep, but keep that morning alarm consistent because once you've woken up early, you're building that sleep drive. So I think the big takeaway is, of course, if you can get eight quality hours, amazing. If you can't, don't punish yourself for that. Do what works for you to get the quality that you need. And then you can always look at extending it from that point, but let's look at the quality before the quantity. And if it's, let's say 2 a.m. and someone is tossing and turning in bed, what do you advise they do?

19:10Dr Sophie Shotter:And also, random question, have you seen that insta-sleep hack to do with moving the eyes that they look up and down and all around both directions, but you keep your eyes closed while you do this? There's apparently some science behind this, but anyway, people swear by it, other people say it doesn't work. But do any of these hacks work in your experience? And are there any 2am tossing and turning hacks that you could tell anyone listening in? So there are no hacks when it comes to sleep because the idea of a hack would imply that we are somehow forcing it to happen. So we can't force sleep, but what we can do is set up the foundations for good sleep with our habits, with our mindsets and the way that we approach sleep, and then let your body do what it needs to do naturally.

19:51So if you find

19:52Dr Sophie Shotter:yourself awake at 2am, this is because your body clock has shifted. So if you've woken up at 2am for the last two weeks, then actually your body clock is now adjusted and it thinks that you want to wake up at two. You'll wake up, you check the time. By checking the time, we are then continuing to set that alarm clock, that internal alarm clock. Then your mind kicks in with the hypervigilance. Am I awake? How long have I been awake for? Am I going to get back to sleep? How am I going to cope tomorrow? And these thoughts create that anxiety, which is what's then keeping you awake. So the way to manage that 2 a.m.

20:22Dr Sophie Shotter:awakening is not just about what you do in that moment, but it's about what we do during the day. So during the daytime, it's easy to ignore the things that are on our mind. It's easy to ignore our worries about sleep or anything else, finances, health, relationships. We can ignore them because we're busy. We can get on our phones and distract ourselves, tell ourselves it's not that bad. Instead, what I would encourage everyone to do is start to really take notice and listen to what's on your mind rather than trying to push it away or make it change. And the best way to do this is to write it down.

20:49Dr Sophie Shotter:So sit down with a pen and paper, quiet moment, and just ask yourself, okay, what is really going on? Listen to your worst case scenario. So what if I don't sleep well tonight? Ask yourself, so what if I don't sleep well tonight? What's going to happen? What is my worst case scenario? The reason it's important to address your worst case scenario is because if I can really hear the worst case scenario, decide if it's realistic, maybe even make a plan in case it happens, then that way my mind is feeling hurt. So it doesn't need to try so hard to get my attention at two o 'clock in the morning. Then when you do wake up in the middle of the night, you can reassure yourself, I looked at the things that I'm worried about.