7: Why You Can’t Walk Straight (And Other Sleep Deprivation Stories)

Everyone’s Talking About Sleep. Nobody’s Getting It.

You may be thinking, “I thought we were hustling and sleeping when we were dead?” That is so 2012. Now we’re protecting our sleep like our life depends on it. And it kind of does.

I spent my 20s not really caring about sleep, but certainly not getting very much. I remember being an anxious sleeper as a kid – scared of the dark, nightmares – so sleep was never something I looked forward to. It was actually a bit stressful. During college, I slept when I slept and sometimes was tired, but I never thought about sleep.

Then after I moved to New York, I got really depressed and wanted to sleep away entire weekends. This is when I remember actually starting to think about sleep because it’s hard to sleep at night if you lay in bed all day. It was harder to get sleep when I wanted to and I found it to become more and more elusive.

I would say my true insomnia era was my late 20s into my mid-30s. I remember telling my doctors at checkups that I was tired and didn’t sleep well, but it never really progressed into more testing or even medications. I think when they asked if it affected my life, I was like, “Nah, not really.”

Well, now that I sleep between 7 and 8 hours on the regular, let me tell you how it DID affect my life.

The Sleep-Deprived Hot Mess Years

For years, I thought I was clumsy. I tripped and fell a lot – up the subway stairs, over imaginary bumps in the sidewalk. I can’t tell you the amount of kitchen accidents and burns I had on my hands. I had to get mesh metal gloves because I kept cutting myself when I was zesting and using a grater. I broke so many dishes, I had to purchase a new set. Once I knocked an entire stack of bowls out of the cupboard in one shot. It was actually quite impressive.

My hand-eye coordination was terrible. Gym time was a mess – I dropped weights, I pinched my fingers in machines. And I was incredibly reactive, defensive always. I would go from 0 to 60 instantly without any thought about context.

You know that cortisol feeling in your stomach when something gets you going and you can feel it swirling around as you get amped up? That happened to me multiple times a day. I was anxious all the time. I had post-it notes by my bed and sometimes I would wake up with half a stack of notes reminding me to brush my teeth and close the front door. It was ridiculous.

Caffeine and sugar fiend. No impulse control at all when it came to food or caffeine. If it was in front of me, it was going in my belly. I ate constantly – always hungry, always low blood sugar, and needed snacks to keep me going. I could also be really snappy and irritated with basically everyone and everything all the time.

It was not a great point in my life. I worked on a lot of things like blood sugar, stress, and movement, but sleep was one of the last things I was able to address because I didn’t understand how it really worked and I didn’t understand how much of the rest of my life was affected by sleep. I truly had no clue how to fix it.

I didn’t know all those things were results of lack of sleep. Sleep deprivation is actually a form of torture – as in, it’s prohibited by the Geneva Convention. That’s how serious sleep deprivation is.

And many of us are basically torturing ourselves.

The Question You’ll Hate Me For

I’m going to ask you something that I would have rolled my eyes at a decade ago and called myself a few choice four-letter words:

Can you wake up without an alarm?

I’m not talking about sleeping in on the weekend when you’re trying to “catch up” (which we will go over is not something you can actually do). I’m talking about Tuesday morning – you have to go to work, get your kids ready, etc. If you didn’t have an alarm, would you be able to wake up close to when you need to get up?

If you’re currently flipping me the bird, know that I love you and am asking from a place of care, not malice. I just told you I used to be a sleep-deprived monster who couldn’t even walk like a coordinated adult human with two working legs.

I’m asking so you can think about how much sleep you’re getting and if it’s actually affecting your life. I didn’t understand what that question meant years ago, so I said no. Clearly, I was very wrong. But I’m also a little thankful because I think if I had gone down the road of sleep medications, it would have been an even worse journey for me.

Why Not Getting Enough Sleep is So Problematic

Blood Sugar (Because You Knew I Was Going Here)

First, you know I’m going to tie this into my favorite perimenopause topic: blood sugar.

One night of 4 hours of sleep decreases your insulin sensitivity – your ability to manage your blood sugar – by 25%. That’s a really big deal. Three to four nights of getting only 4 hours of sleep can put you in a temporary diabetic state.

This feels like blood sugar crashes all day long, fatigue, low energy, cravings, wanting a nap, not being able to say no to another cup of coffee or a donut.

Does this shed some new light on the loving terms “baby weight” and “dad bod”? Right after you have a baby, you probably spend months sleep deprived. Some people do this for years. Now you’re in perimenopause and sleep is becoming more elusive as the anxiety, stress, and to-do list just keep growing.

That stubborn weight gain? Your body not responding to food and movement like it used to? This is part of the reason for many women.

Memory and Brain Fog

When you sleep, your brain is turning the things that happened during the day into memories. The things that are important get filed away and stored, and the things that aren’t, don’t. When you aren’t sleeping, your brain isn’t able to accomplish this task, so you forget. You get brain fog. Your filing system is a hot mess, so your recall? Not happening. You also can’t pay attention.

Think about all the teenagers now and the women in perimenopause who are being diagnosed with ADHD. Are they ADHD because they actually have ADHD, or are they supremely sleep deprived? I don’t know the answer, but it’s an interesting question. Both populations are notoriously sleep deprived.

Hormone Health

Lack of sleep worsens hot flashes and night sweats. That’s because estrogen, progesterone, and melatonin all play a role in regulating sleep, and low levels of all three are correlated with more frequent sleep disturbances.

Sleep disturbances in one of the SWAN cohort studies were reported by 66% of perimenopausal women as being clinically significant – meaning it was affecting their life in a meaningful way. This means anxious, tired, cranky, irritable, grumpy humans.

Mood is a really big piece of sleep. No one wakes up exhausted from 4 hours of sleep in a winning mood, ready to take on the day with resilience and a smile.

Nancy Drew-ing Your Sleep: The Detective Work

Okay, so now you know what CAN affect sleep. Time to start Nancy Drew-ing YOUR specific situation. Let’s figure out what is actually stealing your sleep.

I want you to think like a detective – we’re looking for patterns and clues here. And here’s the thing: you don’t need to investigate everything at once. I want you to pick ONE of these three areas to focus on this week. Just one. We’re going for curious observation, not another thing on your to-do list.

Clue #1: TIMING – When Are You Doing Things?

This is about your daily schedule and when things are happening relative to your bedtime. Maybe spend a few days keeping a loose diary – nothing fancy, just notes on your phone.

Your detective questions:

• When is your last dose of caffeine?
• When are you eating your last meal or snack? Are you eating within 2-3 hours of bed?
• Does that snack have chocolate? (Because chocolate has caffeine, my friend)
• When are you getting in your workout?

Here’s my story: I used to have lattes at 4 PM. This was TERRIBLE for me. Now I don’t have coffee past 11 AM. I sometimes have decaf if I’m really dragging or green tea at lunch, which has a lot less caffeine than coffee. And my chocolate snack? Every day at lunch now. Once you’ve tasted the well-rested experience, you will not give it up so easily.

If you’re eating really close to bed, most likely it’s not because you need fuel or calories. If you were working all day and didn’t have a chance to eat an evening meal, that’s different – but most people are snacking. And if you aren’t sleeping, that late-night chocolate is something to consider.

If you’re eating food late at night – within 2-3 hours of bedtime – then you may be disrupting your sleep. It’s really hard to digest food and sleep at the same time. It’s extremely inefficient. Dr. Satchin Panda of the Salk Institute talks about the circadian rhythm of our organs, and your digestive system is not meant to be working late into the night.

We’ve all met those people who can have an espresso after dinner and say they go right to sleep. I never know if I should be incredibly jealous of this magical ability or if I should have compassion because they’re so sleep deprived their body can override espresso at 9 PM. Most people can’t metabolize caffeine that fast, so having that much circulating in your body can truly disrupt sleep. You can still feel tired with that caffeine, but your brain may be firing on all cylinders.

Clue #2: SUBSTANCES – What Are You Putting in Your Body?

This is about medications and supplements that might be secretly keeping you wired.

Your detective work:

• Do a quick Google or hop on drugs.com to see if your medication has any stimulating side effects
• Look into your supplements – if you’re taking them at dinner or bedtime, are they supposed to be morning supplements?
• Are you taking any stimulating medications at night?

Example: Wellbutrin is a stimulating medication, and I’ve had women come in taking it in the evening. No good. If you take it at night and sleep like a rock, ignore this. BUT if you’re taking it at night and you’re not sleeping well, consider moving it to morning. Same thing with B vitamins – also very stimulating, and they should be taken at breakfast.

Clue #3: ENVIRONMENT – Where and How Are You Sleeping?

This is about your actual sleep setup and what’s happening around you.

Your detective questions:

• Cool, dark, quiet – which one is the problem?
• Are you waking up hot? You might need cooling sheets, less night clothes, an open window, or a fan on.
• Are lights sneaking in? Do you need blackout curtains or shades? A night mask is an excellent way to keep the light out without having to overhaul everything in your room – very useful for travel too.
• Does your phone make noise and vibrate during the night? Are notifications waking you up?
• Do you give yourself enough sleep opportunity – meaning, have you blocked out a full 8 hours where you can be in bed? It’s not possible to get 8 hours of sleep if you only have a 6-hour sleep opportunity window.

If you’re having a hard time falling asleep OR are waking up in the middle of the night and can’t go back to sleep, pay attention to why. Is your mind racing? Are you worrying? Are you hot? Is there pain? Are you uncomfortable? These clues matter.

Pick ONE area to investigate this week. That’s it. If caffeine timing jumps out to you, start there. If you suspect your medication timing might be the issue, let’s focus on that. If your room is basically a sauna with strobe lights, let’s fix the environment. You’re looking for YOUR sleep thief, not solving every possible sleep problem that exists.

What to Build This Week (Regardless of What You Discovered)

Okay, whether you’re doing some detective work or not, here’s what I want you to START BUILDING this week to set yourself up for better sleep.

Your brain is an insane predictive machine. It’s so good at this because brain power is expensive – your brain uses 25% of your energy and it’s only 2% of your body weight. So it takes a lot of shortcuts, and you have the ability to teach your brain which shortcuts to take.

Create a Nighttime Routine

The first thing you can do is create a nighttime wind-down and bedtime routine. This lets your brain save some energy because you’re telling it exactly what to expect. You want to create a set of events, build a habit that is repeatable every night. Bonus points if you use this while traveling because it will really help with jet lag.

We want to include more senses when possible because that’s really helpful for your brain. For example, incorporating sound or scent can make the routine cue even stronger. Scent is especially powerful when it comes to triggering memories.

Now, it’s not the length of time that matters here – it’s the repeatable part of the routine.

Good practice in general for sleep: No bright lights and phones about 30 minutes before bed. Do something relaxing, not stimulating, leading up to your bedtime wind-down routine. Reading is a great activity, especially with a paper book – probably nothing that’s going to get your heart racing or make your brain turn on. You can also listen to music, do some yoga, take a bath or hot shower – whatever is going to help you wind down.

You don’t need a 30-minute bedtime routine, but let’s set a 30-minute timer as a reminder of when it’s time to start making your way upstairs. An actual phone timer can be really helpful here if you tend to lose track of time or have an endless to-do list that you’re always trying to tackle before bed.

Finish whatever you’re doing, head to your bedroom, and then start the bedtime routine.

The important thing here is that you do the same thing in the same order every single night so it becomes a trigger for your brain. It thinks, “Oh, we’re doing the bedtime routine thing. I predict sleep will happen next.”

You can do whatever you need in whatever order you want. But an example might be: putting on your night clothes, washing your face, brushing your teeth, turning down your bed, spraying lavender scent on your pillow, putting your phone on the charger away from your bed, kissing your pets goodnight and shutting them out of the room, climbing into bed, kissing your partner goodnight, turning on your sound machine, putting on your eye mask, and turning off the lights.

There are so many creative variations of a nighttime routine, but the key here is the same set of activities, same order every single night, so your brain can make the sleep shortcut. This set of activities means sleep comes next.

Even if all you can manage is dim the lights, brush your teeth, and turn out the lights – that’s still a routine. Start with three steps and build from there if you need to.

Create a Location Association

The next thing you can do is create a location association. That’s a fancy way of saying that the only things you do in bed are sleep and sex.

If you’re watching Netflix in bed, talking on the phone in bed, working from bed, reading in bed, scrolling on your phone in bed – your brain has no idea what you’re going to be doing the next time you’re in bed because there are so many possible options. If you only sleep or have sex in bed, your brain is probably not going to confuse those two activities. 😉

Okay, let’s say as much as you would like to keep your bed for sleep and sex only, it’s just not possible. Your roommate is a gargoyle and you can’t hang out in the living room. Perhaps you travel a lot and your company won’t spring for a suite. Or perhaps you live in a New York studio and literally don’t have anywhere else to sit.

Then we alter the location situation: You sit on the bed, but the bed is fully made. Your pillows are propped up on the opposite side that you sleep on. You never lay down when you’re not sleeping. You keep the curtains open, lights on, and you do not keep your bedtime sound machine on. You basically want to make the bed as not sleep-like as possible to try to use the location association for sleep.

You can also enhance the sleep location association by setting the mood, if you will. Turn on a salt lamp or some low red lighting, close the curtains, turn on the sound machine, turn down the covers and put your lavender spray on the pillow, turn down the temperature, and put your phone outside of the bedroom to charge and remove all screens and devices.

Yes, there are actually alarm clocks you can purchase that are not your phone. It is entirely possible to have a phone-less bedroom. They often have backup batteries, so if the power goes out, your alarm will still work.

Your Assignment This Week

Pick ONE detective clue to investigate AND choose ONE action to build – either start a consistent bedtime routine OR clean up your sleep location association. Don’t try to fix everything at once. We’re building foundations here.

Next week, we’re going into all the stuff that requires a little bit more – supplements that can actually help, breathwork techniques, relaxation techniques, and how to know if what you’re dealing with is a lifestyle-based sleep issue or if stress and cortisol are hijacking your sleep.

Because here’s the thing: a lot of what looks like insomnia in perimenopause is actually your stress response running the show. And that requires a different approach.

Until then, coffee in hand. I’ll see you next Wednesday.

Can you do me a favor? If this was helpful, share it with one person who might need to hear it today. Our bodies didn’t come with a user manual, and this perimenopause thing can feel confusing and lonely – but you’re not alone. You’re not crazy and you’re definitely not broken. And maybe someone in your life needs that reminder too.

Let’s spread the word and be kind to each other and ourselves.

The legal bit: I’m a nutritionist, but I’m not your nutritionist. This podcast is for information and education only. No client relationship was formed. Always seek medical advice when necessary.