How to Sleep Better by Fixing Blood Sugar and Sleep Disruptors

0:00I just want to give you the space to process it, Michael said. Elena paused. I don't think I want to see anybody else. This is the love story of real hinge couple Elena and Michael, written and read by me, Raven Smith. Listen to the free audiobook now. Sierra has all the best active and outdoor brands for the super athletic stuff, like running gear for cruising up the trail. Woo! And the super athletic-ish stuff, like fishing gear for chilling by the creek. Nice cast. Fitness apparel to push for higher reps. You got this. And golf balls priced so you can afford to lose one. Or a few. Head to Sierra or Sierra.com for the brands you want at the prices that let you do it all.

0:44From athletic to athletic-ish, Sierra's got it. Better sleep means better hormones and better hormones means better sleep. But what do you do when sleep is your problem? Welcome to part two of our sleep series on the Dr. Brighton Show. I'm your host, Dr. Jolene Brighton. And if you've already optimized your hormones and you're still struggling to sleep, it might not just be your estrogen, progesterone, and cortisol that we talked about in episode one, but it probably is still cortisol because that is such a problematic hormone when it comes to sleep. So if you don't know what I'm talking about, you definitely want to catch part one of this series, but we're going to go ahead and dive into three often missed, but also incredibly important reasons that you're not sleeping, especially if you're in perimenopause.

1:34So today's episode, we're going to talk about blood sugar crashes, histamine surges, and what happens when you have ADHD. I'm also going to walk you through how to know if each of these is affecting you and what you can do to get your sleep back on track. Last episode, I gave you tons of tips. this episode going to be a lot of the same. So we are going to strategize and we are going to get your sleep back on track. Now, before we jump in, can I ask you to take a minute to leave me a review? Even if it's just clicking five stars and not writing anything, that still helps support the efforts of me, my team, and this podcast to get out in the world.

2:12And if you've already left a review or you're someone who comments regularly, thank you. I see you. I appreciate you being here so much. Let's get into blood sugar crashes, especially those that we're feeling in like the 2 to 3 a.m. hour. This one gets missed all the time, but it is super common. So blood sugar crashing in the middle of the night, common reason for women to wake up, especially if you have PCOS, maybe even if you're postpartum. We see it all the time in perimenopause and menopause. Remember, perimenopause and menopause, while estrogen is changing, that's not the only hormone changing.

2:48And if you missed my episode on insulin dysregulation, please go listen to that because I go over the exact lab values. So labs you should get done and the values you want to see to make sure that your blood sugar is in fact in check. With blood sugar crashes, you're waking up in the middle of the night because your blood sugar has dropped and your body has to spike cortisol to bring it back up. So stress hormones will come up, tells the liver let's release some of that stored sugar and liberate it so that we have that. And that is why I said like it's probably a cortisol issue because like cortisol seems to be involved in just about everything.

3:26As I had said with perimenopause, and especially if you caught the first part of this series, estrogen drops and insulin resistance can increase, especially if you're under stress or you already have a metabolic condition. In PCOS, we have issues with inflammation, insulin being up, and there's, you know, the estimate is roughly 70 % of those with PCOS have insulin dysregulation. So we can certainly see it in that picture. When we're early postpartum, our estrogen goes down and we can have blood sugar issues, especially if we're breastfeeding, because that's very calorically demanding. We also have stress.

4:06So there's a whole milieu of things going on that can lead to us having sleep problems postpartum, but also having hormonal issues postpartum that should resolve themselves but are still keeping us up in the meantime. And sometimes we're having blood sugar issues because of the way we eat during the day, because of our stress levels, because the way we structured our dinner. So there can be a lot of things going on. We're going to talk specifically about what you can do to start to resolve this, but I would always encourage you, if you don't know why, definitely meet with a provider and figure out what is the root cause driving your symptoms.

4:40So how do you know if this is you? If you're waking up like 2 to 4 a.m., racing heart, slightly shaky, you're feeling hungry, maybe irritable, that's a sign that your blood sugar may be the cause of your night waking. If you feel better after eating or you can't fall asleep unless you snack, that's another sign. And if during the day you find that you're crashing, like especially in the afternoon, you're feeling hangry if you skip meals, maybe you skip a meal and you're getting like really shaky and you don't feel right, like you're having blood sugar issues during the day. If you have them during the day, you're going to have them at night as well and that can keep you up at night.

5:24Let's talk about some solutions. We need to think about food And I'm sure that's not a surprise to you. We want to prioritize balanced meals during the day with every meal having protein, healthy fat, and fiber. And that is because that's going to stabilize our blood sugar and keep us feeling full longer. We want to also avoid high carb meals that don't contain any protein, especially at night. So if you're just eating a bowl of pasta with like some marinara sauce, that's not going to cut it. You're probably going to see dips in your blood sugar. Typically, I'm recommending 20 to 30 grams of fiber during the entire day and 20, 30 grams of protein at each meal.

6:12And I'll just say that if you need guidance on how to structure your meals, you can go to drbrighton.com slash plan. And that is a anti-inflammatory meal plan that is structured so that you get enough protein and you get enough fiber in every meal. And people in the U.S. don't usually have a problem with fat. But when we're thinking about fat, we want to be thinking about avocado, avocado oil, cold water fish sources of fat, also having like nuts and seeds. So there's whole foods that contain fat, and then there's what you can be cooking with, like ghee. Maybe you're using grass-fed butter, olive oil.

6:53We love olive oil. If you caught the gut health episode, I talked a lot about polyphenols. So I definitely recommend checking that out if you want to learn more about why do we love olive oil and polyphenols so much. Now, when it comes to protein, if you are waking up at night, think about your dinner being slow digesting carbs like sweet potato, quinoa, lentils, and then having at least the size of the palm of your hand of protein. Whether you're going to choose tempeh or you're going to choose a steak, make sure that you're getting quality protein. Now, a lot of times when people are having blood sugar issues, they'll be advised to go low-carb, no-carb diets.

7:33For women who are having night waking, that can be problematic. So we still want to have some carbohydrates at night. And we might want to also consider a bedtime snack if you're consistently waking up at night. So maybe you'll try a spoon of almond butter, like a spoonful of that. Maybe having a hard-boiled egg or two. Maybe you make chia seed pudding. If you read Beyond the Pill, you know I have an upgraded golden milk recipe in there where it's turmeric, which we love because it helps with inflammation. Using something like coconut milk, maybe like a whole fat coconut milk. We need fat to absorb it.

8:10Put a little pepper in it. Add collagen. Put a little honey in it. So we're getting amino acids. We're getting some sugar to help us stay asleep through the night. So let me like clarify this a little bit further in case like what I said was maybe a little confusing, especially if the first time you're hearing this. So dinner, we're going to have our protein, at least the size of the palm of our hand, protein. Then we're going to pair that with a slow burning carb. That's going to be things like sweet potatoes, lentils, maybe a brown rice. and then we're also going to have vegetables on top of that.

8:46So adding in the fiber. So maybe you want to do a stir fry. That's a really easy way to combine all of these things. Maybe you want to bake sweet potato, a steak, and then you want to have like some sauteed greens on the side. That's how we want to structure our dinner. Then after dinner, about two hours later or maybe an hour before bed, we're going to have a little snack, hard-boiled egg, that upgraded golden milk, so it can be a beverage if you like. You could do a smoothie that's more of a protein and veggie, fiber-filled veggie forward, not a whole lot of fruit. Because if you do a ton of sugar before bed, we can see that glucose goes up, insulin's like, I got you, and then glucose goes down abruptly and now you're waking up.

9:37We want stability in our blood sugar at night. But we're going to go beyond just structuring our food. It's also important to think about supplements. If you're having trouble sleeping and you're having trouble with your blood sugar regulation, supplements aren't going to solve your problem. They're going to be something that supports your nutrition and lifestyle efforts. So taking something like myelinositol, typically around 2 ,000 milligrams. That can support insulin signaling and it can be especially helpful for women with PCOS. There's a lot of research on that for PCOS. And myoinositol can help you sleep.

10:15If you're familiar with the Dr. Brighton Essentials Myoinositol Plus, it also has chromium in it, which is a mineral that will help with your blood sugar as well. I will put that in the show notes. Like I always say, you can use my products if you want, but no pressure. Now, the other thing that came up in part one was magnesium. Actually, I ended part one of the sleep video talking about magnesium glycinate, how helpful it is for helping you get sleep. So typically with my magnesium plus supplement, I take 300 milligrams every day. Five days before my period, I take 300 milligrams twice a day.

10:53That's because I have endometriosis. And yes, I had excision surgery, but I still have adenomyosis and I don't want to have period pain if I can help it. But with magnesium, it also is going to help with insulin sensitization. So we didn't talk about that in the last video. So yes, it's going to help with our neurotransmitters that help us get good sleep. It helps support the nervous system. It helps support so many things, but it also can be our ally in helping with our blood sugar. And I always love when things are like a two for one, because it's really easy to incorporate those when you know like myo-inositol and magnesium, they can support my blood sugar, they can support my stress response, and they're going to support my sleep.

11:35Like that's a win. Now, if you're having blood sugar issues, we always have to ask like, what is your exercise routine looking like these days? So think back to what your exercises looked like in the last 30 days. And you can just take a moment to be thinking about that. Well, I tell you that balancing your blood sugar isn't just about your weight or your metabolism. It's important for your sleep. And when we talk about exercise, that's also not just about your weight and your metabolism. It's also essential for your sleep and for steady energy, which we love. So if you haven't been walking regularly, I would encourage you to take a 10-minute walk after your meals to improve your blood sugar.

12:22If you watch, and again, I'll link in the show notes, the insulin video, I give you some other exercises very specific to dropping your blood sugar. Well, not like dropping it, but like helping you stabilize your blood sugar quick. So if you thought back to your 30 days of exercise and you're like, hmm, haven't really been getting in walks, great. That's something that we can work on. When you walk matters. So we want to walk 10 minutes for just 10 minutes after we eat. that can help our blood sugar. As you're thinking back the last 30 days, how many days a week are you strength training? If it's not at least two to three days per week, then that's the goal to work towards.

13:02And if you just start with two, fantastic. But we need to be strength training at every age, especially as we enter perimenopause and beyond. We need to be strength training at least two to three days a week. And that is to help build and maintain muscle. Muscle will help you stay sensitive to your insulin. It's going to support better blood sugar. And if we are having sleep problems, the intense exercise, that happens earlier in the day, before 2 p.m. ideally, with gentler exercise happening at the end of the day. I like to weight lift in the morning, and then in the evening, I'll actually do stretching or mobility exercises, usually while my family is winding down or maybe we're watching a TV show.

13:50If we're all just hanging out, I can move my body and increase my flexibility, increase my mobility. And I would encourage you to think about how you can structure your exercise routine in your day so that an intense exercise happens at the top of the day. And then if you're going to move your body, I mean, you can do a 10 minute, you can do a 30 minute walk after you eat dinner. That's perfectly fine. If you want to do stretching, you want to do yoga, as long as it's gentle and it's not pushing you into that sympathetic, that fight or flight that we talked about in part one that can drive your cortisol kind of crazy.

14:29I mean, maybe I shouldn't be saying drive your cortisol crazy because cortisol is doing exactly what it should be doing if you're doing intense exercise. But at night, That's like not the time that we want cortisol to be up. So if you identified yourself with the blood sugar dysregulation, I want to encourage you to employ some of these tips to help you start getting your sleep back on track. Now I want to talk about the second in this episode, the five of the total problems with sleep that we've been talking about in this entire series, and that is histamine surges and hidden inflammation. Now, if you're someone who wakes up, you're itchy, maybe you're anxious, maybe you're feeling congested, maybe you're having flu-like symptoms, or you're hot but you're not sick, there's a good chance that histamine could be the culprit.

15:22So this happens because when estrogen is up, it'll slow histamine breakdown and encourage histamine to be released. And then histamine's like, let's do some more estrogen. progesterone does oppose this whole histamine estrogen cycle but in perimenopause it's dropping in early postpartum it's non-existent and if you identified with the cortisol issues or everything we talked about with low progesterone in part one then you might be having histamine problems i just want to give you the space to process it michael said elena paused i don't think i want to see anybody else. This is the love story of real hinge couple Elena and Michael, written and read by me, Raven Smith.

16:10Listen to the free audiobook now. And the result of an imbalance of estrogen and progesterone during the luteal phase is that histamine can build up, and especially at night when clearance can slow, and then we're finding ourselves waking up. Histamine is not just about allergies, by the way. Histamine also acts as a neurotransmitter and it's a vasodilator, which means that it can wake you up, raise your heart rate, and give you vivid dreams or make you feel restless. So if you're like, that's another sign, like, right? Like I'm having restless sleep and I'm having really vivid dreams. So that's one sign.

16:53Another, like you feel itchy or flushed at night. If you wake up congested, but you're feeling fine during the day, definitely get an air purifier for your room if that's the case. And that can be related to histamine. If you find that antihistamines actually help you sleep, in some people they actually make sleep worse. But if you're having histamine issues and it's helping you sleep, that could be another sign. If you find that you are reactive to red wine, leftovers, fermented foods, you got histamine issues. Like that's definitely a sign of histamine issues. I'll link to the episode I did with Jen Fugo all about histamine and diet because I don't want anyone to be like, I have to just do this like extreme anti-histamine diet because that's the only way I'm going to know if this is my problem and this is the only way I'm going to sleep.

17:43That's not usually our best bet. And in that episode, we talk about the nuance around that. So drbrighton.com will have it in the show notes for you. Now, the other tricky thing about histamine is that when we're having histamine issues, we may actually feel more tired during the day and have trouble sleeping at night. But if you have trouble sleeping at night, you're going to feel more tired during the day. So I mean, that one is not, I would say that's a symptom that fits into the full symptom picture. It's not enough on its own. I will also say that if you are neurodivergent, ADHD, autism is where we have the best research, but certainly any neurodivergent condition may be at risk of histamine issues, or if you have endometriosis or adenomyosis, we know that histamine can be an issue with those as well.

18:26So if you have those conditions, you may also have a histamine problem. And this is the tricky thing. As I talk about all these six causes for why we're not sleeping, odds are you have more than one. It's usually not just one. I wish it was. I should have said that in part one, but here we are. I should also mention that if you have PMDD, histamine can be a driver of PMDD symptoms and that can include trouble sleeping. So that's just another condition to be aware of with this. So how about we talk about some solutions now? I don't necessarily want you to get wild with like changing your diet and going to like an antihistamine diet, but I would recommend you track it.

19:06Is it wine? Is it vinegar? Is it aged cheese? Is it kombucha? Is it leftovers? Is there something that you feel like is making you feel worse? And if you can identify what that is, avoid eating those at night. That's when it's especially important because if you're waking up with symptoms, then that might be what's going on. I would definitely encourage you to meet with a registered dietitian, certified nutrition specialist, someone who is an expert in nutrition to help you navigate this diet aspect, and make sure you're resolving underlying issues, which usually comes down to the gut, which is why we got to do that gut hormone episode in the show notes for you.

19:47But I just want to say you should be able to eat a variety of food that is a normal state of being. And if you can't do that, then we definitely want to get you there. Like we don't want you living a life where you're super restricted. Histamine gets cleared by the DAO enzyme and your gut plays a big role. I mentioned this. So if you think you have gut dysbiosis, that can be making histamine issues worse. What's gut dysbiosis? An imbalance in gut flora. And actually, you can't tell this just based off symptoms. Usually, we have to test things. I also want you to understand what I talked about in the gut hormone episode is that estrogen won't get cleared as effectively.

20:30So estrogen and histamine won't get cleared as effectively if you have an imbalance of your gut flora. You could probably see where we're going with that, right? If we can't clear estrogen and histamine and estrogen perpetuates histamine and histamine perpetuates estrogen, but we're going to have an estrogen and a histamine problem that's driving our sleep. Again, it's not usually just one thing. So typically, whenever we're talking about taking care of your gut, we are talking about fermented foods coming into the mix. But if you have a histamine problem, I just said fermented foods can be a problem.

21:06So instead, we might want to think about a quality probiotic because that's going to support histamine clearance and it's going to support the estrobilum, which is how we clear our estrogen through the gut. And when it comes to probiotics, it's important to have prebiotics as well, but prebiotics that are not going to aggravate you. In our women's probiotic from Dr. Brighton Essentials, we use guar gum. That one, we selected that because it doesn't aggravate SIBO in other ways that prebiotics do. And so we want to be really mindful that we're not doing anything to aggravate the gut and we're really just supporting the gut in that clearance.

21:44Now, other things that can be helpful, vitamin C, magnesium, B6, those support that DAO enzyme that helps with histamine metabolism. So I feel like that's like how many, you know, we should play a game of like taking like a turmeric ginger shot every time I say magnesium in an episode. Although we might get the tummy troubles from that because I do say it a lot. Now, even if it's a histamine problem, we still have to support our circadian rhythm. And histamine, like I said before, it acts as a neurotransmitter as well. and that can be influenced by sleep disruptions. So poor circadian rhythm hygiene of like not exposing yourself to light at the right time of day and having too much light at the wrong time of day.

22:36Go back to part one of this sleep series if you need a reminder on how to tend to your circadian rhythm. But if you've been doing all the right things for sleep and you still feel like I'm wired and itchy, congested, I'm having like flu-like symptoms or I have the period flu or I have PMDD symptoms, then it's not just your hormones we need to look at. It's also histamine. So take inventory and see where you can start today to start optimizing those histamine levels. Now, the last part I want to talk about, so our last issue with sleep is that if you have ADHD, ADHD changes everything when it comes to sleep.

23:18And for many women, perimenopause is the first time that they realize they might be neurodivergent. And it's not just because of the sleep disruptions. It's not because those become so extreme, but it's because changing hormones are influencing neurotransmitters and influencing specifically dopamine, acetylcholine, serotonin. And so that's a really common time. The other time that we see ADHD symptoms become rampant is postpartum, another time when we're low hormones. So I said perimenopause, but I also want to pull in menopause into that because as we start the estrogen decline and then we have subsequently no estrogen being produced from the ovaries anymore, in menopause, we can have worsening ADHD symptoms.

24:06Now, if you're someone who's like under 35, you're nowhere near perimenopause and you notice you have worsening ADHD symptoms that are just before your period, I want you to know that that is the number one time in a woman's cycle that she sees worsening ADHD symptoms. And number two is the first few days of your period. So the thing about ADHD symptoms is like if you have ADHD with concomitant PMDD, that PMDD gets better when your period starts. But until your estrogen rises to a substantial level, that is usually going to happen by day three of your cycle, where you're going to be like, my brain's starting to come back online.

24:52That's what we test estrogen actually on days two, three, or four of your cycle to see how is that follicular phase going. With that, know that symptoms can start to get better a few days into your period. But if you are having worsening ADHD symptoms and worsening sleep issues, that points to an estrogen issue. Now, why is ADHD even being included in our six reasons you might not be sleeping series? Well, ADHD brains have delayed melatonin release. And so an ADHD brain's like natural state, for most people, it's not true for everyone, so ask if it's true for you, is that they're not going to feel tired until way later than other people.

25:40So even if they're exhausted, even if their body is exhausted, their melatonin might not be rising. So with ADHD, melatonin might not rise until like 10 p.m. to like 12 a.m. And the neurotypical brain is more like 8 to 10 p.m. So there's a shift there. And then, you know, as we were talking about perimenopause, if you add that in the mix, then you're dealing with dopamine dysregulation, you're dealing with less GABA stimulation from progesterone, and being more emotionally reactive is usually layered on top of the circadian chaos, as I would like to call it right now, because that's what it can feel like.

26:23Your whole sleep system is thrown off. I also want to note that many ADHD women also experience demand avoidance around bedtime, what some people call revenge bedtime procrastination. If you heard in the last episode, I talked about us being toddlers. ADHD people are just their next level toddlers of like, are you telling me I have to go to bed? If I know I have to go to bed, then I'm not going to go to bed. And it's silly. and we get that like, oh, that's not the best thing for me, but it's just the way our brains work. So number one, if you're listening to this and you are living with someone with ADHD, don't tell them what to do.

27:06Don't tell them like, oh, we should go to bed. It's time to go to bed. They will possibly lash out. Because what happens, let me just say for people who don't know, that triggers the sympathetic nervous system. So now the sympathetic nervous system is like, okay, we're under threat, cortisol is up. They're not going to go to sleep because now their hormones just shifted and also they might be combative because their nervous system feels under threat. Now odds are when we look at the diagnosis rates of ADHD that most women walking around with ADHD don't actually know that they have it. So how do you know if maybe ADHD is at the root of what's going on with your sleep problems?

27:49So you are wide awake at bedtime, even when you're tired, and it's not related to your menstrual cycle. If you avoid going to bed, even though you know it's going to hurt tomorrow, even though you know it's the best thing and the thing that you need, but you're just like, I can't do it, could be related to ADHD. If you've always identified as being a night owl and now it's getting worse, that could be that delayed phase sleep syndrome of ADHD. I want to date with Rawls, Carty says. Rawls? Raka asks. This is the love story of real hinge couple Carty and Raka, written and read by me, Nicola Dynan.