In short
Menopause-focused sleep “reset” built around circadian alignment, sleep depth, and recovery behaviors (movement, meal timing, light, stress/threat framing), plus how to use wearables without anxiety and what to do about sleep meds/supplements.
Guests
Dr. Kristen Holmes, Vice President of Performance Science at WHOOP; studies physiological data tied to performance and health. Dr. Mary Claire Haver, OB-GYN, certified menopause practitioner, adjunct professor at UTMB; hosts Unpaused.
Key claims
Small behavior changes compound (e.g., minutes of deeper sleep). In a WHOOP/McKinsey study of 79 high-performing people, every 45 minutes of sleep debt predicted a 5–10% next-day drop in executive function. Poor boss sleep reduced direct reports’ psychological safety. During perimenopause/menopause, sleep disruption worsens muscle loss and metabolic risk; higher fitness generally correlates with fewer symptoms (with caveat about overtraining stress). Long-term benzodiazepines (e.g., Ambien/weaning off) are not a long-term strategy; alcohol and marijuana can worsen sleep architecture.
Notable examples
Weaning off Ambien while starting circadian habits and training; “challenge vs threat” framing improves sleep architecture; wearables as a “bad boyfriend” if they drive anxiety/orthosomnia; home signals include regular menstrual cycle and morning erections.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VOUnderstanding Circadian Rhythms and Sleep
0:00 to 1:26
Learn how aligning your circadian rhythms can improve overall health.
“There is so much science around setting your circadian rhythm and the cascade effect that that has across every cell in your body.”
Understanding Circadian Rhythms and Sleep
3:48 to 4:33
Learn how aligning your circadian rhythms can improve overall health.
“Did you know that your oral health is directly connected to your overall health, especially as you navigate the different stages of womanhood?”
Understanding Circadian Rhythms and Sleep
4:42 to 5:44
Learn how aligning your circadian rhythms can improve overall health.
“In business, there's no room for guesswork.”
Understanding Circadian Rhythms and Sleep
5:51 to 7:06
Learn how aligning your circadian rhythms can improve overall health.
“The first few weeks back at school set the tone for the entire year, but with new teachers, schedules, and expectations, it can feel like a lot.”
Impact of Sleep on Executive Function
7:18 to 12:50
Explore how sleep affects executive function and psychological safety.
“And we looked at basically just their sleep over the course of six months.”
Maintaining Health Through Lifestyle Changes
12:50 to 14:01
Learn about the importance of fitness and lifestyle during menopause.
“There's just no question about it, right?”
Maximizing Training Capacity for Women
14:01 to 16:44
Learn how to prioritize strength training and high-intensity workouts for better health.
“So that's kind of the first order of business.”
The Sacrifices of Women’s Health
16:45 to 18:36
Understand the societal pressures on women and the importance of prioritizing self-care.
“Our physical health, our mental health, our taking care of ourselves becomes very low on that totem pole.”
Personal Journey to Health Prioritization
18:37 to 20:31
Hear a personal story about the importance of prioritizing sleep and health after a life-changing experience.
“And, you know, it's just a local coffee shop.”
Understanding Sleep's Impact on Health
20:32 to 22:58
Explore the connection between sleep quality and overall health and its importance for women.
“Yeah, you got to deal with the immediate.”
Show all 26 chapters
Understanding Sleep's Impact on Health
26:28 to 28:00
Explore the connection between sleep quality and overall health and its importance for women.
“It's trending on social media, celebrities are opening up about their symptoms, and conversations that used to happen in whispers are finally out in the open.”
Willpower vs. Infrastructure
28:14 to 31:15
Discussion on the importance of creating supportive life patterns over relying on willpower.
“You talk a lot about, you know, willpower versus infrastructure.”
The Impact of Connection on Well-being
31:15 to 32:39
Exploration of how connection and alignment with values affect psychological and physiological health.
“It starts to manifest physiologically where now all of a sudden, it's not just up here, it's actually making you sick.”
Understanding Wearables
32:39 to 36:25
Insights on how wearables can aid in health monitoring and the importance of using them wisely.
“And what should a woman, if she's curious, if she's not wearing one right now, what should she look for in a wearable?”
Self-Assessment and Health Signals
36:25 to 39:27
Discussion on self-assessment techniques and health signals to monitor overall well-being.
“I will say that a lot of the metrics and the algorithms are really tuned to yourself.”
Self-Assessment and Health Signals
40:37 to 41:46
Discussion on self-assessment techniques and health signals to monitor overall well-being.
“August is National Dog Poop Month, which yes, is apparently a real thing.”
Self-Assessment and Health Signals
41:50 to 42:01
Discussion on self-assessment techniques and health signals to monitor overall well-being.
“It's super easy and risk-free with their obsession guarantee.”
Self-Assessment and Health Signals
43:53 to 45:04
Discussion on self-assessment techniques and health signals to monitor overall well-being.
“Have you noticed that what worked for your skin five or ten years ago just doesn't anymore?”
Self-Assessment and Health Signals
45:10 to 45:22
Discussion on self-assessment techniques and health signals to monitor overall well-being.
“and enter code unpaused to get 20 % off.”
The Impact of Marijuana on Sleep
45:22 to 48:56
Explore the effects of marijuana and other substances on sleep quality.
“A person who has high self-efficacy, they feel like they have the skills and resources to do what's asked of them, generally speaking, not anxious.”
Reframing Threat into Challenge
48:56 to 52:57
Understand how to shift your perception from feeling threatened to challenged to improve sleep.
“So, you know, and this is something that I thought about in my environment as a coach all the time, right?”
Practical Sleep Strategies
52:57 to 56:00
Learn actionable strategies for improving sleep quality through routines and habits.
“So we usually do this for social content before we wrap up.”
Understanding Chronotypes and Sleep Preferences
56:00 to 57:56
Explore the concept of chronotypes and how they affect sleep patterns.
“I think there's some hope in that, you know, like you just have to preserve your sleep.”
The Role of Napping and Yoga Nidra
57:56 to 58:49
Learn about effective napping strategies and the benefits of yoga nidra for sleep.
“You want to do everything you can, though, to preserve your biological sleep, your nighttime sleep.”
Recovering from Sleep Debt and Key Changes
58:49 to 1:02:13
Discover how to recover from chronic sleep debt and implement simple changes for better sleep.
“So well below the average, which would be probably around 60 for that age group, me and age 43.”
Wrap-Up and Key Takeaways
1:02:13 to 1:02:41
Summarize the insights shared about sleep and recovery strategies.
“kind of fade to eat, obviously put lots of good fuel in your body, but more think about the timing as a place to start as an entry point.”
Transcript
Automatic transcript. May contain errors.0:00There is so much science around setting your circadian rhythm and the cascade effect that that has across every cell in your body. It will impact circadian patterned things like insulin, for example. So you get your circadian rhythms aligned. You start eating during the daylight. Your insulin starts working more effectively, right? More appropriately. Now, all of a sudden, you have less inflammation. You start sleeping a little bit better. So maybe it means like 10 more minutes in deeper stages of sleep, 8 more minutes in deeper stages of sleep. that will have a compound effect. So it's just understanding that, you know, all these little behaviors, maybe it's you're getting two more minutes of deep sleep here, three more minutes here.
0:39Now, all of a sudden, you've got 20 more minutes of deep sleep. It's going to have incredible impact, right? You know, now maybe you're doing 15 minutes of like brisk walking and with some weights, you know, and that maybe you get two more minutes from that, right? So while some of these little behaviors maybe elicit a small effect, But when you add them up, they really start to compound. And this is where you start to feel less under threat. And your body, and not just in your mind, you got to kind of talk yourself into a better future for a little bit, but your body actually starts to change.
1:21Dr. Mary Claire Haver:The views and opinions expressed on Unpaused are those of the talent and guests alone. and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment. In part one of my conversation with Dr. Kristen Holmes, Vice President of Performance Science at WHOOP, we talked about something I wish I'd understood much earlier in my career. Good sleep is more than just getting eight hours. It's about timing, regularity, light exposure, circadian alignment, and what all of those things are doing to nearly every system in your body.
2:02Dr. Mary Claire Haver:Kristen has spent years studying what physiological data can tell us about human performance and health. And in this episode, we go even deeper as she shares research showing that for every 45 minutes of sleep depth, executive function can drop 5 to 10 % the next day. And when the leaders slept poorly, the people who worked for them actually reported feeling less psychologically safe. How you sleep can change how you think, how you work, and how you show up for the people you love. We also get practical about what women can do with this information. We talk about maintaining muscle as we age, what Kristen would prioritize if you only have 30 minutes a day to exercise, and why movement, meal timing, and morning light can have a powerful cumulative effect.
2:53Dr. Mary Claire Haver:We'll talk about wearables, alcohol, marijuana, magnesium, melatonin, naps, caffeine, weighted blankets, cold plunges, and even sleeping separately from your partner. We discuss why women need infrastructure, not willpower, to take care of themselves and what it means to build a life that supports the woman you want to be decades from now. because the goal is to have energy, strength, and health to keep showing up for the life and the people you care about for as long as possible. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner and adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch.
3:36Dr. Mary Claire Haver:Welcome to Unpaused, where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
3:48Did you know that your oral health is directly connected to your overall health, especially as you navigate the different stages of womanhood? Whether you're going through puberty, planning a family, or navigating menopause, your body goes through constant changes, and your oral health changes right along with it. We hear a lot about tracking our hormones for our general health, but did you know those same hormones can affect your gums, teeth, and saliva? It's true. Oral health is whole body health, which is why preventative dental care is such a vital part of your wellness routine. Don't wait for symptoms to appear.
4:22Many oral health issues begin quietly, so regular visits help you detect changes early. Your dentist is a crucial partner in your health journey, often the one you didn't know you needed. To learn more about the connection between oral health and overall wellness, visit smilegeneration.com slash unpaused. That's smilegeneration.com slash unpaused to learn more about the mouth-body connection and find a trusted provider near you.
4:50Dr. Mary Claire Haver:In business, there's no room for guesswork. Every shipment matters. Every deadline counts. When you're trying to keep operations running smoothly, the last thing you need is uncertainty. That's why reliability is at the core of USPS Ground Advantage. From the moment your package is first scanned in, it moves through a secure nationwide network, aiding in a timely and accurate delivery. You get near real-time tracking so you can keep up with your shipments. And with affordable, upfront pricing, there are no hidden fees or surprise surcharges to throw off your cost sheets. It all adds up to predictable deliveries you can depend on.
5:34Dr. Mary Claire Haver:because knowing your logistics are handled lets you focus on everything else, your customers, your team, and the future you're building. Visit usps.com forward slash ground advantage to start shipping with confidence. USPS Ground Advantage. We mean business. The first few weeks back at school set the tone for the entire year, but with new teachers, schedules, and expectations, it can feel like a lot. If you're looking to help your child start strong and stay confident, I've been using IXL to make that transition so much easier. IXL is an award-winning online learning platform that helps kids truly understand what they're learning, whether they're building math confidence, strengthening reading and writing skills, or reviewing science concepts.
6:23From pre-K through 12th grade, it adapts to each child's level and pace, making it easy to spot and close learning gaps in just a few minutes a day before those gaps can snowball. Plus, it's trusted nationwide. One in four students in the U.S. are learning with IXL, and it's used in 96 of the top 100 school districts in the U.S. It's an easy, cost-effective way to get kids back into a learning routine and walking into class feeling ready and reassured. Make an impact on your child's learning. Get IXL now. Listeners can get an exclusive 20 % off an IXL membership when they sign up today at IXLlearning.com slash audio.
7:06Visit IXLlearning.com slash audio to get the most effective learning program out there at the best price.
7:17Dr. Mary Claire Haver:you've said that for every 45 minutes of sleep debt there's a five to ten percent decline in executive function yeah the next day yeah talk about that okay yeah so this is with a study we did with mckinsey we had 79 individuals half women uh and you know the other half are men So these are really hard-charging folks. And we looked at basically just their sleep over the course of six months. And three times a week, they were kind of getting a struper and end back. So we were able to objectively measure their executive function. And we saw with every 45 minutes of sleep debt, they had a 5 % to 10 % decrease in executive function next day.
8:00So 45 minutes seemed to be the sweet spot. We actually built in this study. So in the second year, we added psychological safety measures. And wonderful scientist out of Harvard, Dr. Amy Edmondson, we used her measures, and she actually joined us on this study. And so what we did in this study is actually we looked at the direct reports. And what we saw is that the psychological safety of the direct reports was associated with the quality of sleep of the boss, essentially. So the more 45 minutes seemed to be the sweet spot, but for every 45 minutes, the less psychologically safe their direct reports felt.
8:40Dr. Mary Claire Haver:It's basically a direct report, like you're reporting to your boss. So if your boss slept well, you felt more safe. I know. Which is not, and what I love about this study is that you can think about how that transfers just to like the regular, just how you're operating in the world, right? Like if you're at the counter at CVS, right? And you're sleep dead. Or gosh, did you come home to your kids? Oh, God. After a full day of work? When I was working in chronic sleep debt, I was a terrible mother. They deserve better. I've apologized. I found a new way to make money and support them financially.
9:18Dr. Mary Claire Haver:And it's worked out better. But what I don't want is our shift workers and people still in those positions to feel like this is hopeless. I know. It's not hopeless. And we are doing. But I have to say, I knew none of this. So I wasn't doing all the things to protect. You weren't working out as much. And I didn't understand the importance of exercise to my sleep. Literally. like i was 120 pounds so i was fine yeah like my whole vision of what medicine taught me healthy was was my shape my size and so like i'm healthy you're skinny so i'm good yeah i'm good and i had no idea i was chipping away at my bone muscle cardiovascular referral tuberous dementia rest all of it relationships yeah and relationships so yeah we need to to protect our biological sleep and i and i think a lot of it starts again before we even enter you know before we even have that first symptom of perimenopause, right?
10:10We need to really, I think, you know, I have a daughter. I know you have, you have daughters as well. My daughter's 17 and you know, we're, we are, I'm actively talking about sleep with my kids, you know, just I'm like, Hey, it's like you it's sleep is a kind of a, in modern life. Unfortunately, it's a skill. It doesn't just happen for us. We get pulled from these primal thresholds of nature.
10:29Dr. Mary Claire Haver:Okay. Wait, I love you. Let's, let's go back. good sleep is a skill it is unfortunately we i would love to be able to say oh yeah we'll just sleep but access to food access to light like we we just 24 7 it's it's modern life is literally sets us about to fail it does but i never i my patients feel like they're doing something wrong they don't realize that the worlds that we build we haven't adapted to sleep they do they do and we have to be just intentional and fight against fight back against that and it gets much harder in perimenopause it's so much hard because everything else is collapsing around us it's like this one more thing right so building some of that those habits before you get to perimenopause is very very protective and the other thing that we see in data is that you know and this you know this is kind of hard to say um but it's this is very clear in the data higher fit individuals have better amplitude lower reported symptoms of perimenopause and menopause i mean yeah lower known that for a long time okay yeah yeah lower fit not to say that if you i have triathletes who are absolutely hung upside down with perimenopause so completely yes in general the more fit you are the less overall symptomatic you are.
11:50And I will say there is a overtraining element too that will have, you know, you can be, you know, I have to say too fit, but you can be training in such a way where you're putting incredible stress in the system, a system that is already stressed during perimenopause. So I think, you know, not that we have to stop doing triathlons, but you can probably get away with training less potentially, right? And have almost better performance outcomes, right? Thinking more intentionally about recovery and preserving sleep and thinking about the circadian piece. it's complicated right unfortunately modern life has made this really complicated and this is why your book and i can't wait for my daughter to read it you know she's obviously only 17 but i'm like you need this you need to have this in your brain to understand how to think about your choices right because because these the cumulative lifestyle exposure is going to impact i think the severity of how you move through this this transition and i you know i and i i'm about five to seven years away from having that data to be able to like be able to say that definitively right but i think how you live in your 20s matters yeah for this next phase of your life
12:56Dr. Mary Claire Haver:talk about growth hormone and timing of sleep and muscle and we see age-related muscle loss so if a woman is not purposefully doing things to preserve her muscle mass the aging process and we think adding menopause on top of it you know perimenopause and menopause does kind of accelerate this loss. Where does sleep play into all of this? Sleep impacts our capacity to train. Okay. There's just no question about it, right? So a lot of the conversation online, well, just lift. Well, you know what? I'm too damn tired, right? So I think - Yeah, speak to her because she's really mad right now. I think it's obviously getting our sleep right and getting the behaviors during the day that are going to facilitate the best possible sleep where we're releasing all the things that are restorative that are happening during sleep, like the release of human growth hormone, for example, and all the other genes that are turning on and off during the night.
13:55We need to try to create conditions during the day that enable that to happen. So that's kind of the first order of business. And then when you do that, you then have more capacity to train. You can train more intensely. You can train for longer, right? And you have the ability to then, you know, improve the quality of your muscle tissue. And I think there's, you know, there's a really important metabolic component to that, right? When we have poor muscle quality or we don't have enough muscle tissue, that glucose just ends up going into the bloodstream, right? And that's when all the problems happen.
14:31So, you know, we want to preserve a muscle as much as possible. Again, you know,
14:36Dr. Mary Claire Haver:it's never too late right so if a woman had 30 minutes a day that she could you know this is what my patients tell me like i've got 30 minutes what should i be doing yep i think a portion of that lift so maybe lift for 20 minutes try to hit you know three or four body parts does she have can she do 30 minutes every day yeah okay yeah i do a combination of lifting and i would do some high intensity work. So I would do 30 seconds on 30 seconds off five or six times a minute on minute off. If you're high intensity, meaning like, so you want to go up high, yeah, 80 to 90 % of your maximum heart rate.
15:12So you're really out of breath. Like you're really pushing yourself. You can do, you know, some days I'm like, you know, I just, I don't really feel like I'm not really feeling it. I do 15 seconds on 45 seconds off times eight or something, you know, but I really try to three times a week, get my heart rate up as high as it can go. So I would say prioritize that. We know that, again, thinking about this principle of amplitude, that is a great way to increase that amplitude. And then obviously lifting weights for the other 25 minutes, right? And what I just described will take four or five minutes, right, to do that high intensity work four or five times.
15:47And then maybe on a day where, you know, maybe you do that three times a week, and then another day you go for a really nice long zone two, right? And maybe that's, If your modality is a swim, it could be a swim for some people. It could be a bike. You know, it could even be on the rower. You know, whatever your medium is that you really enjoy that you can consistently do, do it. But that would be my take. You know, don't overthink it. And I would say if you have resources, you know, it's great to get a trainer just to learn how to do the basics, right? And it doesn't, you don't have to have loads of variety.
16:19That doesn't really matter. You just want to, you know, work the big muscle groups, right? And then once you build that efficacy and the skills in the gym, then you can maybe start to be a little more creative.
16:31Dr. Mary Claire Haver:What I'm trying to talk to my daughters about is we're socializing women in this country that you can have it all. You can work and you can be a mom and you can do all these things. But that comes out of sacrifice to ourselves. Our physical health, our mental health, our taking care of ourselves becomes very low on that totem pole. because, you know, I saw this cute video the other day where men are like, my hands are full and they have a cup in each hand and women will put the cups all under each arm and pick up a bag and sling something over their shoulder. Oh my God, that's so true. And if you don't prioritize these things, if you don't build your life where you are first and you are prioritizing these amplitudes, so your nutrition, when you're eating, how you're eating, the quality of your exercise, your nutrition, your sleep, your stress reduction.
17:21Dr. Mary Claire Haver:And then when we start layering on all these other things, you are going to break. And if no other message gets to my kids, it is you have to preserve these things and build that before you start adding. And those stay a priority. Yeah. And I mean, they're seeing a beautiful example in you. Well, I didn't do it very well for a long time. Yeah. I know. I had kind of the same moment. Fortunately, it was like 17 years ago, But, you know, I fell asleep at the wheel with my babies in the car. Yeah. Okay. My grandma had just entered hospice. My mom had, she died of sorts of deliberate when she was, you know, in her 40s.
17:57And so it's just me to kind of take care of my grandma. She had a few months to live. I just gave birth to my daughter. I had an 18-month-old son. And I was going back and forth. And this is, again, you know, not asking for help. And this was me, you know, just thinking I could do it all. You know, I could have my babies in the car and I could drive up to my grandma in Massachusetts. I was living in Jersey at the time. And yeah, I literally collapsed. And that was kind of the moment that really did change my life. You know, I was like, I can't keep up this pace. Like, what do I think I'm doing?
18:29You know, and I literally almost killed my family, you know. And so that's when I started prioritizing sleep. And I started, you know, because I worked in a culture where, you know, the president of the university wore a t-shirt, jokingly, sleep is for the week, you know, but that was literally the reality on the campus of Rizzi University. And I love Princeton. And, you know, it's just a local coffee shop. They make these shirts. But sleep was a sign of weakness if you slept, right? I mean, that was just, you know, and my athletes fought that as well. And so I became this annoying human on campus where I was just like the sleep evangelizer.
19:05Like I was just like, and this is what got me off on this path of like researching sleep and circadian rhythms is I started to see, I'm like, holy shit, this is a huge advantage. So I started doubling down and I had a very successful team at Princeton. And a lot of it was because we slept. Like we just, we didn't get injured. And it's going to go back to this point about doing it all. When it comes to just the people around you, like I realized that, you know, once I started sleeping, once I started taking care of myself, I was absolutely a better mom, but I was a better coach. I was a better role model.
19:36I felt just so much better about my life. I had the energy to train. And when I think about what I endured as a kid, there wasn't a day in my life that I didn't worry about my mom. She was depressed her whole entire life. She was a non-functional alcoholic. And there wasn't a day that went by that I didn't pray that she was healthy. and I was like, I'm going down a path where my kids are gonna have to take care of it. They're gonna have to worry about me. So when I zoom out and think about this, I'm like, I want them to know a healthy, thriving mama, and I deserve that and they deserve that. And so when they see me taking care of myself, they know it's because I love them and I wanna show up for them every single day for as long as possible.
20:20And I don't want them to have to take care of me when I'm 60 years old, right? Like I want to be in my 80s where I'm playing with my grandkids.
20:27Dr. Mary Claire Haver:That is when my patients come to clinic, once we put out the fire and menopause, right? And get them. Yeah, you got to deal with the immediate. Like the immediate, you know, and they're functional. Then the next conversation, and this is the thing I love best about taking care of this population, is they're like, okay, I'm taking care of my mom or my grandmother or my aunts or I'm watching this. And this is my own story. Same. My mother, my grandmother, they mentioned frailty. So both of them. And I just thought this was inevitable for me. And I did not learn until maybe the last five years that there are so many behaviors that I can change the trajectory.
21:04Dr. Mary Claire Haver:We don't have the APOE gene we checked, right? So there's no genetic component to this other than it happened to both of them. And that sleep is part of this. They just changed the cardiovascular risk factor scoring system and sleep is a part of it. So is gynecologic history for the first time in the world. you know but this cultural like rewarding of busyness rewarding of hustle culture i grew up in medicine i mean like you sleep when you die yeah is was the thing and like we're killing ourselves yeah but the women in my clinic are saying i want to be a benefactor and not a burden oh i love that that's so good i do not want to burden my children with my care for as short a time as possible like same yeah you know that's my why and that has become my why yeah i love that So I run the cancer gauntlet, which also is big in my family, but so far so good.
21:54Dr. Mary Claire Haver:Same. I'm going to outlive all three of my brothers who died this year. Sorry. So I am determined that it's called my nursing home prevention program. I love that. I know. It's exactly critical to that. It is. Scraining alignment, sleep is just the foundation. What do you say to the woman who's been handed a bottle of Ambien from her doctor, well-meaning physician who doesn't know anything about this because this is not taught in medical school oh god it's so hard because i know when people are just like so desperate to feel like they're sleeping i mean is it okay for a few days i would say do all these other things get your circadian rhythm as aligned as humanly possible move during the day very very important right because your movement during the day is also correlated with the depth of your sleep right like we see people who are sedentary just don't sleep as well they actually sleep longer but less quality right and lots of lots of folks in our data set so we know that movement during the day is very very important for every single age and is correlated with quality of sleep so i would say to that woman, we need to get these behaviors, these circadian behaviors firing on all cylinders.
23:14That's the start. And maybe in parallel, but I would start to wean, see if we can wean off the Ambien. And again, I'm not a medical doctor, just to be very clear. They do have to wean because
23:25Dr. Mary Claire Haver:it's addictive. Totally, right. So yeah, they'll have withdrawal symptoms. Completely. So I think doubling down on these circadian behaviors, picking, I think the time we should be eating, I think like working out is so empowering and I would say if that woman who's taking Ambien isn't working out like let's start training okay you know I just feel like that changes your outlook we know that it has it impacts serotonin impacts your mood right like you get this little high after you work out and you feel like you're you feel more in control right of your life and the trajectory of your health so yeah I mean I would really try to encourage that woman, just even if it's 20 minutes a day, 10 minutes a day, five minutes a day, just start moving intentionally and make that promise yourself and just keep it every day.
24:13And then weaning off the Ambien. Okay. That's not a, that is not a long-term strategy.
24:17Dr. Mary Claire Haver:Yeah. And I think long-term benzodiazepine use is linked to dementia. It is. It is. Yeah.
Read the full transcript
24:27Dr. Mary Claire Haver:This episode of Unpaused with Dr. Mary Claire Haver is brought to you by Alloy Health. One question I hear all the time is, why hasn't my skin changed so much? And if you've been wondering the same thing, you're not alone. As estrogen declines during menopause, we lose collagen more rapidly. That can leave our skin feeling thinner, drier, and less elastic. So if your skincare routine isn't working like it used to, it's not because you're doing anything wrong. Your skin needs have changed. That's one of the reasons I'm excited about M4 Skin Care from Alloy. It's the first head-to-toe skincare line powered by Estriol, a gentle form of estrogen that's been clinically shown to help rebuild collagen and restore skin elasticity.
25:13Dr. Mary Claire Haver:In the clinical studies, the M4 face cream helped 88 % of users improve skin elasticity and 95 % of users reported smoother-feeling skin with the M4 body treatment. I also appreciate how easy Alloy makes the process. You fill out a quick online intake, get evaluated by a menopause specialized doctor, and your prescription strength skin care ships free to your door. It's also HSA and FSA eligible. The more we understand what's driving these changes, the better we can support our skin with solutions designed for menopause, not just another moisturizer hoping to do the job. Try M4 Skin Care from Alloy and see results in as little as eight weeks.
25:58Dr. Mary Claire Haver:Head to myalloy.com and use the code MCH20 to get$20 off your first order. Your menopause specialized doctor will tailor your skin care to your needs, plus you get$0 unlimited messaging with your doctor. Head to myalloy.com and use the code MCH20 to get$20 off your first order. This podcast is sponsored by MidiHealth. Have you noticed the conversation around menopause is suddenly everywhere? It's trending on social media, celebrities are opening up about their symptoms, and conversations that used to happen in whispers are finally out in the open. And honestly, it's about time. For decades, women were dismissed, ignored, or told their symptoms were just part of aging.
26:50Dr. Mary Claire Haver:And while I'm glad the conversation is happening, here's the truth. Menopause care isn't a trend. It's long overdue medical care that women have always deserved. If you've been listening to me, you know this isn't new territory for me. This is my life's work, helping women navigate perimenopause and menopause with real science. That's why I want to tell you about MidiHealth. Midi is a virtual menopause clinic staffed by clinicians who listen, who take your symptoms seriously, and never utter the words, it's all in your head. Like me, MIDI focuses on your health span, not just your lifespan. That means taking a comprehensive look at your metabolic health, bone density, cardiovascular risk, and cognitive function, because all of it matters.
27:37Dr. Mary Claire Haver:MIDI delivers the kind of proactive, evidence-based care I've always believed women deserve. And the best part? Women in all 50 states can access personalized care, and it's almost always covered by insurance. So yes, I'm glad menopause is finally getting attention. But don't settle for noise. Get care from clinicians who are in this with you for the long haul. Book your virtual visit today at joinmidi.com. That's joinmidi.com.
28:14Dr. Mary Claire Haver:You talk a lot about, you know, willpower versus infrastructure. So what does that mean? So we need things to be automatic, right? Or we don't do them. So you need to create muscle memory and patterns in your life that you anticipate and expect and feel good to you. mm-hmm so i think when it comes to you know willpower i say it's it's alignment not willpower right and it's figuring out you know who do i actually want to be in the world you know i want to be a mom you know who can be present with my kids you know and show up with energy for the work that i love to do right and so when i think about this idea of joy energy and peace those are the things that I deeply value, how do I back into that?
29:02How do I need to live my day? And that's infrastructure. It's not willpower. It's alignment, not willpower, right? It's practicing being the person I say I want to be. And then when you start proving that to be true, you create a beautiful flywheel, you know, but you have to name it. You have to say it. Who do I actually want to be in the world? What are the things that I really value? If you value peace, but you're raging all day, how is that aligned? And so it's thinking, okay, how do I have to design my life in order to live these values that I say are important to me? I think it takes just a little bit of introspection to figure out how do I want to show up?
29:46And what does that mean about my life? What does that mean about the people I surround myself with? And it's kind of you have to sit down and like audit things more intentionally.
29:55Dr. Mary Claire Haver:I find that our menopausal patients do that like they're realizing this, right? They never thought about this in their thirties. The forties is just this chaos. And then when they kind of come through and they get to that stable and after, you know, perimenopause, they are like, Oh, I don't need this person in my life. Like I need to focus on this. I'm like, suddenly they realize they need to circle the wagon because they're not going to be okay yeah do you do you find this in the data as well there is really good data around our core psychological needs we have as human beings one is purpose one is autonomy self-efficacy and control i'm sorry in connection and connection is a core psychological need and when we are connected to people places and things that don't support our values we start to feel a lot of internal dissonance and i think what you're talking about is an inflection point into life where you are like I know who I am I know what I want like all that is starting to become clear and your capacity for bullshit decreases yeah it's just I think the real big moment filling that need a menopausal superpower you know I mean like it is it is like I think we need to kind of lean into it and and it's because like you you recognize like the time is fine you know we don't have you know we're not gonna be on this time is finite yeah it is and for me like perimenopause I lost two brothers in the middle of my perimenopause you know so then this whole like i may not live as long as i think i'm going to you know like if i don't make different choices than they did or yeah and one was cancer one was hiv and hepatitis so bob died of liver failure and like you know like i have a couple brothers left but like it's it's i'm gonna outlive them so i get it you know combined with watching how the women in my family age yeah you know it's not selfish you know it's um it's being around people who bring out the best in you you know and and allow you to live your values i think there's probably nothing more important than that um and we know that's associated with longer healthier life right so i think sometimes that that can can create a hard conversation but what's harder is living with that dissonance yeah you know and because that dissonance doesn't just manifest psychologically it manifests physiologically as well when you don't feel like you have control over the people, places, and things in your life, that all of a sudden, your autonomic nervous system, low HRV, higher resting heart rate, you become more inflamed.
32:25It starts to manifest physiologically where now all of a sudden, it's not just up here, it's actually making you sick. So people matter. And getting that right really matters.
32:39Dr. Mary Claire Haver:So let's talk about wearables. And what should a woman, if she's curious, if she's not wearing one right now, what should she look for in a wearable? Yeah. I mean, I think accuracy really matters. No, they don't need to be perfect, but I think establishing a baseline is really valuable, you know, because then you kind of know, oh, if there's a big deviation, maybe something is going on and I can talk to my primary care physician. And I think I would say medical doctors, primary care physicians are becoming way more, they have wearables themselves. So yeah, so exactly. So we're, I think we're all kind of like, ah, all right, the science is good.
33:11The data is good. It's accurate enough. So now let's all kind of embrace this idea of being a little more data centric, using it as just an extra layer of support to be able to have a clearer conversation. Right.
33:26Dr. Mary Claire Haver:And that's where I mean, I've heard it called a bad boyfriend. You know, it can be a bad boyfriend. So like what are the pitfalls of a wearable pitfalls? I would say obsessing over the data and kind of overtaking your life. There's no, generally speaking, no reason why your data today should tell you not to train. Now, four or five days of data where your heart rate is 17 % above your baseline, then okay, that's an indicator that you're just not adapting well to something. It could be a combination of factors, but that's when you want to step back and audit. All right, what's going on here? I think where it goes wrong is like you're using it to kind of manage your day or it's giving you anxiety around your sleep.
34:11Those are real, they can happen, right? But I think going into it with the perspective of, all right, I'm just going to learn about my body, right? I'm curious about my body. And this is a great way to understand what inputs support me, what inputs don't support me. And I think it's the individual and now i'm talking about all the positives and not the pitfalls but um i think we all have very unique physiology right and that's and all these are calibrated to you right so you get this like n of one experiment and you can see the impact of of altitude right and how
34:49Dr. Mary Claire Haver:that changes my respiratory right home in colorado at 9 000 feet okay so your respiratory rate goes crazy right and my hrv tanks temporarily you know so what about the person who seems to be their mental health is negatively affected by a tracker and they are kind of consumed by it. Yeah. I mean, that's taking a break is obviously the path. It should just be a tool to your point. It's a tool in the toolkit. It's just to help you learn your body. But if it's becoming, I think we call it this orthosomnia, orthorexia, right? There's some sort of equivalent for a tracker, I'm sure. Or they're tracking.
35:28Or they're tracking. Yeah, yeah. Anything in your life that is negatively impacting or creating anxiety. Anxiety. Step back.
35:37Dr. Mary Claire Haver:My daughter's, one of my daughter's best friends operates at a really high level. You know, she's pre-med and runs triathlons and just, you know, she had to take her smartwatch off. Yeah, yeah. Because it was leading to more anxiety and she can't manage, she wasn't able to manage. Exactly. And there's a lot of folks like that, you know, and that happened to me with a glucose monitor. I can't do it. I was actually like eating less. Like I lost a lot of weight when I was wearing a glucose monitor. So yeah, I didn't help me. Yeah. So I definitely, I think that's a really important question and it's one you can only answer for yourself, you know, and it's, and I would say, you know, it's healthy.
36:15Just, just take a break every now and again, you know, you don't need to be wearing it all the time, you know, to take it off for a couple of weeks and come back to it. And I think anything that is, is is is creating anxiety is is you know is worth pausing and what about competition my husband and
36:31Dr. Mary Claire Haver:i um oh yeah we'll get up in the morning and like pull up our phones and what'd you get what'd you get oh yeah i according to uh the ring i am a better sleeper than him okay but according to our mattresses he's probably a better sleeper so it's just funny it's just like a joke between us it doesn't touch our relationship but yeah funny i mean i think as long as it's um light-hearted and it's just fun. Yeah, there's no harm in that. I will say that a lot of the metrics and the algorithms are really tuned to yourself. So comparing doesn't make a lot of sense. I think on our platform, a lot of folks compare strain, which is strain is basically a function of how fit you are.
37:14So if you're really fit and let's say you're super, super fit, you run a mile, and you get a strain of 14 running that mile. I am really unfit and I run that mile. I might get an 18 strain, right? So your fitness, how efficient your heart works will impact your strain. So a lot of the algorithm, like, so you can't, we can't, people can't compare a strain, for example, but we have also all the time people online are like comparing their strain. I'm like, no, no, no, no, no, it's not how it works. But yeah, same with HRV, it's another one. you cannot compare your HRV with anyone else. So I think as a rule, it's great just to use it for yourself and not really use it in a competitive scenario.
37:57But if it can help you think about, all right, let's see who can have the least amount of sleep-wake variability, that would be a good competition.
38:05Dr. Mary Claire Haver:So what if you can't afford the trackers or don't have access? What are things that you can measure at home that would be markers of how you're doing? I love that. I talk about this in the book as well. I mean, your menstrual cycle, morning wood, an amazing signal. A morning erection. Yeah, morning erection. Yeah, sorry. Yeah, that was very non-technical. Most of our listeners are women, so they're like, what? I'm really sorry. That was very non-technical. So morning erection is healthy. Morning erection is very healthy, yeah. So those two are the best signals. So a regular menstrual cycle and, yeah, morning erection are really good signals that things are generally probably really doing well.
38:42What about a resting heart rate? Yeah, resting heart rate. And you can just take that, you know, one minute pulse here on the wrist. And how you feel when you wake up, right? Absolutely. Your energy level during the day. You know, do you feel like you need stimulants to carry you through the day? Can you fall asleep and stay asleep? Another great signal, right? If you're struggling to fall asleep, if you're struggling to stay asleep, obviously that's when you're like, okay, something probably isn't right. Do you have energy to work out? You know, are you able to complete your workouts in a way that feels good to you?
39:10So yeah, I mean, those are a few signals that you can just kind of pay attention to. But I think energy levels is just a big one. And your mood, do I feel generally, it's okay to be in a bad mood. That's a normal part of the human experience. So it's not like you have to be positive all the time and happy all the time. But mood is another great thing to monitor. Mood, energy level, yeah. And then just some of these physiological signals can be super helpful. Yeah, if you feel like your heart is racing when it shouldn't be, that's a sign that you're probably sympathetic dominant, your autonomic nervous system.
39:46So even though you don't have heart variability, but if you find yourself unable to control your state, kind of wind down when you want to wind down, wind up when you want to wind up, that's a sign that you might be off. Your autonomic nervous system might be not functioning properly.
40:03Dr. Mary Claire Haver:I think the biggest thing I've learned from this is the impact of alcohol. Yeah. You know, I come from a very big culture of alcohol as being part of socializing culture and whatever. And like, I just didn't realize how much it was affecting my sleep. It's wild. And I tell my people now, you know, if I do choose to drink and I do drink occasionally, I am potentially choosing not to sleep. Yes. You know. And that's why I just stopped drinking altogether, you know, is, yeah, just, it's like the cost of it is just not, it's just not worth it. it.
40:37Dr. Mary Claire Haver:August is National Dog Poop Month, which yes, is apparently a real thing. And while that might sound a little ridiculous, if you're a dog owner, you know your dog's digestion can actually tell you a lot about their overall health. That's one of the reasons my daughter started feeding her dog Rex, Ollie's Fresh Dog Food. Their human-grade recipes are made with high-quality, gut-friendly ingredients gently cooked to preserve nutrients and developed by chefs alongside veterinary nutritionists. Everything is delivered right to your door and portioned specifically for your dog. My daughter has noticed a real difference since Rex made the switch.
41:16Dr. Mary Claire Haver:He's as excited as ever for mealtime and his digestion has been much more consistent with healthier firmer stools, a good sign that his food is agreeing with him. Plus, the OLLI app gives you free on-demand vet support for any weird tummy troubles, along with a personalized well-being score to help you stay on top of your dog's health. OLLI makes it easy to feel confident you're giving your dog the nutrition they deserve. This summer, treat your pup to better food and perfect poops. Head to ollie.com slash unpaused and tell them all about your dog, use the code UNPAWSED to get 70 % off your welcome kit when you subscribe today.
41:56Dr. Mary Claire Haver:It's super easy and risk-free with their obsession guarantee. That's O-L-L-I-E dot com slash UNPAWSED and enter code UNPAWSED to get 70 % off your first box. Ollie, feed the obsession. Managing a teenager's growing independence can be exciting, but it often comes with new responsibilities, especially when it comes to money. As teens start making more purchases on their own, parents want visibility and peace of mind without having to constantly check in. For all the parents out there, we know you're already trying to keep a million different things under control. Cash App is here to help make sure your teens money and their spending isn't adding to that craziness.
42:40It is
42:41Dr. Mary Claire Haver:designed to meet teens right where they are with intuitive educational tools. With an eligible parental sponsorship, your teen gets access to a personalized Cash App card to match their style, plus tools to help them build real-world financial habits in a safe space. Best of all, there are zero monthly fees or hidden charges. New Cash App customers can earn$10 if they use the code FAMILY10 in their profile at signup and send$5 to a friend within 14 days. Terms apply. Cash App is a financial services platform, not a bank. Banking services provided by Cash App's bank partner, prepaid debit cards issued by Sutton Bank, member FDIC, Cash App Visa debit flex cards issued by Sutton Bank, member FDIC, and the Bancorp Bank, N.A., pursuant to a license from Visa USA, Inc.
43:34Dr. Mary Claire Haver:See terms and conditions for the Sutton prepaid card, Sutton debit flex card, and Bancorp debit flex card. Savings provided by Cash App, a Block Incorporated brand. Visit cash.app forward slash legal forward slash podcast for full disclosures. Let's talk about makeup for a second. Have you noticed that what worked for your skin five or ten years ago just doesn't anymore? Foundation settles into places you didn't even know existed. Blush seems to disappear by lunchtime. And somehow your makeup leaves you looking more tired instead of more refreshed. Here's the thing. Your skin has changed. So your makeup should change too.
44:17Dr. Mary Claire Haver:That's where OG comes in. OG is a certified organic beauty brand that combines luxury makeup with skin care inspired ingredients. Their crystal contour collection is made with nearly 90 % skin loving ingredients like green coffee oil, elderberry extract, and cold-pressed jojoba. It's also NSF certified organic, meaning it's formulated without synthetic fragrances or unnecessary additives. You don't need a drawer full of products or a complicated routine. Just three easy-to-use sticks that work together to add warmth, color, and glow, leaving you with makeup that feels light, looks natural, and moves with your skin throughout the day.
45:00Dr. Mary Claire Haver:If you're ready to raise your beauty standards, OG's got you covered. Go to og.com slash unpaused and use code unpaused for 20 % off. That's O-G-E-E dot com slash unpaused and enter code unpaused to get 20 % off.
45:22Dr. Mary Claire Haver:Just curious, what about the effects of other drugs on sleep recreational like marijuana yeah so we have a paper actually in review right now on tobacco and marijuana so a lot of women are using marijuana medicinally yeah off label no there's no label well again in some states yeah for the treatment of their menopause especially sleep disruption yeah and and i i would say it does impact sleep architecture negatively okay yeah so you're not going to get into the depth of sleep that you would typically you know it's one of those things again like gosh i just you know i just wish there's other thing you know i i think a magnesium theonate like there's maybe other well let's think we'll talk about supplements so what so say okay she doesn't want to go to the dispensary and get her marijuana to help sleep yeah you know and she's you know hrt is on the table off the table whatever what supplements actually help and why magnesium is is not soporific but um like it's not gonna make you sleepy but what does it do it does reduce anxiety okay you know which i think for people who are struggling falling asleep who might be using marijuana it's usually to address the anxiety okay now i'd want to back up and be like let's address the anxiety you know and there's obviously lots of reasons an individual can feel anxious but it's generally speaking tied to our feelings of control you know i kind of mentioned the core psychological needs we have a person who has lots of purpose in their life generally is not anxious.
46:52A person who has high self-efficacy, they feel like they have the skills and resources to do what's asked of them, generally speaking, not anxious. An individual who feels like they are in control and have agency over their health and their schedule, generally not anxious. Positive connections, generally not anxious. So I went through this kind of framework, these four core psychological needs that we have. When those are in place, generally we're not anxious right so look there first like what what which one of these is not happening in my life what can i do in my current circumstance what are the things that i can move around or change that can help me design a life where i am building in these core for psychological needs so cognitive behavioral therapy like talk therapy i mean therapy is really great right to help manage anxiety.
47:46So I would say let's back up and really try to think about how can we build more meaning into our life? What are some little things that we can do? And working with a therapist can be really helpful. And we see one of the studies that we published in Emotion last year looked at challenge versus threat. And this is another, I think, important point for women who are struggling to sleep. It might be related to your feelings of threat during the day. And when our body is doing wazoo shit, we feel under attack. We feel threatened, right? We feel, and what this threat taps is feeling like you have the skills and resources to manage your day.
48:27So if you're under threat and that is not framing your life as challenging, we actually see it impair sleep quality. There was nothing really changing in markers of blood pressure, cardiovascular indices. Like none of that really changed. If you're praising your day as threatening or challenging, the only thing that changes your sleep architecture. So it's like a double whammy for women who are like, what the fuck is happening with my body? Challenge versus threat. Yeah. It's, I know. What is the difference? So, you know, and this is something that I thought about in my environment as a coach all the time, right?
49:00I'm trying to get my athletes in a, in a challenging state so they can produce appropriate levels of energy for the task, right? So mental, physical, emotional, spiritual, right? We want to be in a situation where we are able to modulate all of that in a way that allows us to perform. Positive adaptation. Right, right. Adapt positively to whatever it is that we're doing. When we are under threat, all of that is off, right? And we could just be, let's say we're just not prepared for a presentation we have to give in front of 100 people. And you can just, the anxiety that comes with that, right?
49:35Like we feel like we perceive the day as threatening. um if i am you know there are so many times as a parent where i'm like i don't have the skills and resources like to do to be an effective parent right now you know like i mean you'd imagine anyone who has teenagers goes through that at some point where you're just like okay i need i need some help here and so that can manifest in sleep right so there's a gazillion things that you can appraise as threatening but i think the the skill here is how do i shift from threat to challenge. That's the reframe, right? We need to reframe in some, and it might be getting, building skills and resources, right?
50:14My body feels under attack right now. What do I need? And this is the crux of your work is helping women feel more in control by educating them, right?
50:23Dr. Mary Claire Haver:And so perimenopause for a significant percentage of women, their whole world becomes a threat. It's a literal and figurative state of threat. And the only thing different in their world is their hormones. Right. And that is making them feel like the world is threatening. And so that has to be contributing to sleep because we see it in the data. Yeah. We see it in the data. When you appraise the day as threatening, you have lower quality sleep. So women need to know this, understand that, okay, this is actually what's happening. I'm under threat hormonally, right? Which is then making me perceive the day and perceive the tasks as more threatening, right?
51:02So you have to actively reframe. You have to just slow down and get yourself under control and make a plan. And what would that plan be?
51:11Dr. Mary Claire Haver:Because everyone's taking notes right now. I mean, it's just different for everyone. It just depends on what's going on, right? I mean, it could be, all right, I know that a few of the things that are going to help me feel more in control is actually to create the circadian alignment. Okay. Where am I going to start? I'm going to start with waking up every single day at the same time and viewing morning sunlight. and I'm going to make that plan. How much of a percentage of a change will that make? Like, what are we talking about? Okay, so it's meaningful enough that I'm talking about it. So I can't give you a percentage.
51:43There's a lot of individual variability, but there is so much science around setting your circadian rhythm and the cascade effect that that has across every cell in your body. It will impact circadian patterned, things like insulin, for example. So you get your circadian rhythms aligned, you start eating during the daylight, Right. You your insulin starts working like more effectively. Right. More appropriately. Now, all of a sudden you have less inflammation. You start sleeping a little bit better. So maybe it means like 10 more minutes in deeper stages of sleep, eight more minutes in deeper stages of sleep that will have a compound effect.
52:17So it's just understanding that, you know, all these little behaviors, maybe it's you're getting two more minutes of deep sleep here, three more minutes here. Now, all of a sudden, you've got 20 more minutes of deep sleep is going to have incredible impact. Right. Now maybe you're doing 15 minutes of brisk walking with some weights, and maybe you get two more minutes from that. So while some of these little behaviors maybe elicit a small effect, but when you add them up, they really start to compound. And this is where you start to feel less under threat. And not just in your mind, you've got to kind of talk yourself into a better future for a little bit, but your body actually starts to change.
52:57Dr. Mary Claire Haver:So we usually do this for social content before we wrap up. Okay. Hyper hope. Okay. I'm going to call out some stuff. It's like rapid fire. Got it. Got it. Okay. Hyper hope. And you can say like one sentence if you feel like compelled. Okay. Got it. Got it. All right. I'll try to be succinct and brief. All right. Here we go. Hyper hope. Okay. Sleep timing regularity matters more than sleep duration for most people. Hope. And there are good studies to back this up. Okay. Yeah. Melatonin supplements. When traveling. Okay. Go into that a little bit more. Again, I'm not a physician, so I say this with just a lot of caveats in that melatonin over-the-counter is usually at super physiological levels.
53:41You've probably heard this, right? Yeah, so Andrea talks about this as well, and she really breaks it down. And if you're going to go on melatonin, and you are a woman in midlife trying to get your sleep in order, work with a professional. like and don't just go over the counter and get melatonin like you want all of this like because they have interaction effects you know if you're estrogen, predestinone, melatonin and you know like you just want you want to be able to understand what's working what isn't working so if you're just doing all sorts of random stuff to your body you can't you don't know what is actually working what isn't and so I think working with a provider is so so important or going to a clinic like you have like you know it's just like we can't wing it and I remember at the health the conversation i i started i was like we we can't afford doing it like we have to be more intentional and that is just the cross that we bear okay but yeah what magnesium glycinate or you know magnesium for sleep hope okay mouth taping so i have just some data and like we haven't published any of these data but math taping during the day hope because it gets you breathing through your, like, you know, I, I, I read about this in my book, I just integrity, lung integrity and breathing mechanics are so, so important for, for sleep, for anxiety, for feeling in control when we have inefficient breathing patterns that impacts us at a systemic level.
55:05So we want to try to get breathing, right? Mouth taping can actually start to help you retrain and getting you breathing through your nose, or maybe help you identify, wow, my breathing patterns really do aren't great and I need to get some help. Okay. Yeah. Cold plunge before bed? Hype. Okay. Cold plunge at all? Hope. Okay. For women who really love it.
55:25Dr. Mary Claire Haver:Okay. And I hate being cold. There's no way. You'd have to like lower me with a chain. I know. I really, I like cold plunging, but yeah. Weighted blankets? Hope. Big hope. Okay. Love it. Where do you buy a good weighted blanket? What are you looking for? That is actually a great question. You know, I don't use one, but I definitely am like a, you know, I'm definitely fully covered up when I sleep. But that's a good question. Okay. There's a little business opportunity for us right here. So red light therapy for circadian alignment. Hype. Hype. Okay. Sleep divorce separating beds or rooms from your partner.
56:02I think there's some hope in that, you know, like you just have to preserve your sleep. So if your partner's like snoring and waking you up and that's just tough.
56:11Dr. Mary Claire Haver:What about, and we didn't talk too much about this. What if you have different chronotypes meeting? You wake up and go to bed at this. Oh my God, we didn't talk about chronotypes. I have like kind of strong opinions on this. It's so tough because once you push paths, as we talked about earlier, once, so we all have these natural endogenous preferences for when we feel naturally sleepy. And as I said earlier, you know, based on Kenneth Wright's work from University of Colorado is I think one of the better experiments that they did where they took just a group of morning types and evening types, threw them on a mountain, no artificial light, and they all fell asleep three and a half hours after the sun went down within 30 minutes of each other.
56:50So in lots of the tribes that don't have electricity that are in existence today, they don't even have a word for insomnia. Okay. And they all are falling asleep within 30 minutes. So you think the kind of types are artificial? Maybe. Well, I think modern life and just even growing up in homes where there's really inconsistent lighting behavior and eating behavior. And I think we have a lot of – that's one of the reasons why we're pretty unhealthy, right? So, yeah. So I think a lot of it is preference. Now, there are – there's absolutely – we know from the data there are evening types and morning types.
57:25But I think the variability that we think about it as a society is, I think, not true. It's not five hours, right? It's maybe an hour and a half or so. So when I was married, my partner was definitely a night owl. I'm definitely more of a morning type. And I just went to bed and he was really kind and wonderful. I didn't really hear him when he came into bed. So it worked out. But yeah, I mean, I think you have to honor your preference, I suppose. Yeah. And just knowing that, yeah, you need to sleep.
57:55Dr. Mary Claire Haver:Napping to offset nighttime sleep debt? Absolutely. But try to get it in. You want to do everything you can, though, to preserve your biological sleep, your nighttime sleep. So making sure your nap doesn't interfere with that is really important. So when's the best time to nap? So prior to probably 1.30 p.m. Oh, wow. Yeah. Prior to 2 p.m., I would say. And just aim for like a 20 to 30-minute nap. for frontline healthcare who struggle napping yoga nidra is has really been shown to almost mimic deep sleep in terms of its its its restorativeness and oftentimes people who struggle napping yoga nidra is a great gateway to that and it basically just is a mind body scan there's lots of like scripts online that you can just follow you just work through your body and it's really relaxing very recovery promoting anxiety reducing and can help you kind of enter into the next phase of the day with more alertness wow okay coffee after two in the afternoon no okay don't do it no is it true that you can recover fully from years of chronic sleep debt i want to say yes but at that cumulative exposure takes a hit does take it it does take a hit the 270 um acute care surgeon studies a good example of just this chronic exposure and their baseline, the average HRV is below 30 for that group, right?
59:15At 43 years old. So well below the average, which would be probably around 60 for that age group, me and age 43. So there's an exposure that I think is hard to recover from. Now, can you get back on track? Absolutely. Can you fully regain or kind of nix out that cumulative exposure of sleep debt probably not and then the theory that circadian disruption
59:42Dr. Mary Claire Haver:is the root of most chronic disease in my estimation based on what i understand literature yes okay if a woman listening right now can only do two things two changes starting today to have better more restorative more you know better sleep and recovery what would that be Get your light diet in order. Okay. I just can't emphasize that enough because that is going to create conditions that allow you to fall asleep at a regular time and stay asleep. Light is the most powerful modulator of our circadian system. And then again, what would that look like? Setting your alarm for a time that you can wake up reliably and do this experiment for yourself for a month or so.
1:00:30set that time wake up and get outside okay and if again sun isn't up bathe yourself in artificial light again get that glass of water get your body moving again trying to create okay it's time to be awake right getting that that cortisol awakening response should be kind of rising again the cortisol melatonin follow this amplitude so we want nice big rise in cortisol obviously it's as the day goes on, but we want that to match what our body is meant to do, right? So all these little things kind of help facilitate this kind of circadian robustness, right? That we know is so correlated with health and human functioning and sleep.
1:01:11So yeah, that is the place to start. Set that alarm, wake up, view morning light, get yourself outside, take some deep breaths, um you know just breathe in the day make a plan yeah and then once the sun goes down dim light really important right set the stage for sleep uh you don't have to overthink it but when you feel sleepy go to bed okay very important don't push past that pressure for sleep go to bed and if you do this for three weeks or so you'll start to get yourself into a rhythm and you should find yourself waking up less and you should find yourself dropping into these deeper stages of sleep.
1:01:48You should find yourself waking up more refreshed with more capacity to live your values with the oil and energy, joy and peace.
1:01:56Dr. Mary Claire Haver:So that was like, that was the second one. I would say the second one, again, low barrier to entry is time restricted eating. Start with 12 hours on where you're consolidating all your calories, bias your calories, morning princess, queen popper. So buy a bulk of your calories in the morning and at lunch, start to, you know, kind of fade to eat, obviously put lots of good fuel in your body, but more think about the timing as a place to start as an entry point. So 12 on or 11 on whatever feels good to you with the idea that your last calorie is a few hours before you intend to sleep. Okay. So that time restricted eating is what we call it.
1:02:3312 hours on 12 hours off.
1:02:34Dr. Mary Claire Haver:Amazing. Yeah. Well, Dr. Holmes, thank you so much for joining us on Unpaused. Thanks for having me. We loved it. Awesome. Dr. Holmes's new book, Aligned, the data-driven guide to performance, recovery, and human potential is available now wherever you buy your books. You can also find her on Instagram at Dr. Kristen Holmes and on LinkedIn at Dr. Kristen Holmes, PhD. I would love to hear from you about this topic and anything else that's on your mind. You can find me on Instagram at Dr. Mary Claire and get honest, accurate information on health, fitness, and navigating midlife at thepawslife.com.
1:03:14Dr. Mary Claire Haver:My new book, The New Perimenopause, is available now everywhere you buy books and through our website. You can also find full episodes on YouTube. Unpaused is presented by Odyssey in collaboration with Pod People.
1:03:32Dr. Mary Claire Haver:This is the sound of captivity. This is the sound of rescue. And this is the sound of freedom. Give Armenia's captive bears a second chance by supporting International Animal Rescue. Call 508-826-1083 or search The Great Bear Rescue to learn more.
From the publisher
In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Kristen Holmes, Vice President of Performance Science at Whoop and author of the new book Aligned, moving from the science of circadian rhythm into a practical recovery plan a woman can start using tonight.
Dr. Holmes lays out a realistic strength and cardio prescription for women who only have thirty minutes a day, and explains how sleep governs the release of growth hormone and the capacity to build and preserve muscle as we age. She introduces the idea of alignment over willpower, framing consistent habits as infrastructure built around what someone actually values rather than a matter of discipline, and connects that back to the four core psychological needs, purpose, autonomy, self efficacy, and connection, that predict anxiety and sleep quality.
The conversation turns to wearables, including what to look for in a tracker, the pitfalls of obsessing over data, and simple, no cost markers like a regular menstrual cycle, resting heart rate, energy, and mood that anyone can track without one. Dr. Holmes and Dr. Haver also cover how alcohol and marijuana affect sleep architecture, when a sedative can help short term versus when it becomes a long term problem, and which supplements, like magnesium, actually have data behind them for sleep and anxiety.
The episode closes with a rapid fire round on melatonin, mouth taping, cold plunging, weighted blankets, red light therapy, chronotypes, and napping, followed by the two changes Dr. Holmes would tell a woman to make first if she wants better sleep and recovery starting tonight.
Guest links:
Dr. Kristen Holmes (Instagram)
Dr. Kristen Holmes, PhD (LinkedIn)
The Line with Dr. Kristen Holmes (Apple Podcasts)
Books
“The New Perimenopause,” by Dr. Mary Claire Haver
“The New Menopause," by Dr. Mary Claire Haver
“Aligned: The Data-driven Guide to Performance, Recovery, and Human Potential,”
by Kristen Holmes
