WEBVTT - Introducing Burning Questions 0:00:07.754 --> 0:00:10.914 You're listening to a Mamma Mia podcast. 0:00:20.914 --> 0:00:23.654 Welcome to Burning Questions. I'm Kath Mahoney. 0:00:23.834 --> 0:00:26.954 And I'm Dr Ginny Mansberg. We have spent a lot 0:00:26.994 --> 0:00:29.354 of time talking about women's health on the Mamma Mia 0:00:29.394 --> 0:00:33.733 podcast well, but now Kath and I are entering a 0:00:33.973 --> 0:00:38.074 new era with a podcast dedicated entirely to to your 0:00:38.193 --> 0:00:39.293 burning health questions. 0:00:39.773 --> 0:00:43.424 Indeed, because if you grew up with Dolly Doctor, chances 0:00:43.523 --> 0:00:45.903 are you've spent much of your adult life searching for 0:00:45.943 --> 0:00:49.714 health advice you can actually trust. Whether it's for yourself, 0:00:50.074 --> 0:00:53.454 your partner, your kids or your ageing parents, there's always 0:00:53.494 --> 0:00:56.383 something you want to know. And that is where my 0:00:56.464 --> 0:00:57.424 dear friend, Dr. 0:00:57.464 --> 0:00:58.184 Ginny, comes in. 0:00:58.204 --> 0:01:01.764 Because I'm not a doctor, apparently. But I'll be asking 0:01:02.004 --> 0:01:04.784 all the questions you've sent us while Ginny is here 0:01:04.824 --> 0:01:05.904 to help make sense of it all. 0:01:05.924 --> 0:01:06.484 Aren't you, Ginny? 0:01:06.814 --> 0:01:07.234 I am a doctor. 0:01:07.244 --> 0:01:08.423 Because you are a doctor, aren't you? I am. I'm 0:01:08.454 --> 0:01:10.314 actually a real one. I went through uni. You literally 0:01:10.334 --> 0:01:10.953 did go through uni. 0:01:11.014 --> 0:01:14.874 Unlike Bruna Papandrea, who someone lost her medical degree. 0:01:15.274 --> 0:01:17.214 And her lawyer's degree. Exactly. 0:01:17.354 --> 0:01:19.254 It doesn't seem right to me. But anyway, I am 0:01:19.294 --> 0:01:22.634 a doctor. But a reminder that I am not your doctor. 0:01:23.134 --> 0:01:25.214 So please make sure to reach out to your own 0:01:25.254 --> 0:01:28.294 GP on burning questions every week. I'm going to answer 0:01:28.414 --> 0:01:32.434 your real life questions. No question is too embarrassing, too 0:01:32.494 --> 0:01:35.074 niche or too weird. We love niche and weird. 0:01:35.214 --> 0:01:37.054 Love niche and weird. That's how I roll in the 0:01:37.094 --> 0:01:39.804 bedroom as well. So, Kath, what have we got on 0:01:39.834 --> 0:01:43.464 today's show? Right. We're kicking off by fact checking some 0:01:43.524 --> 0:01:45.203 of the wildest. 0:01:44.844 --> 0:01:48.744 Wellness claims doing the rounds. What's real? And what's just 0:01:48.824 --> 0:01:51.774 internet nonsense designed to sell you something? I feel like 0:01:51.834 --> 0:01:53.254 I've bought a lot of these things, Ginny. 0:01:53.854 --> 0:01:57.834 Then we're getting into genuinely useful advice about sleep. Before 0:01:57.874 --> 0:02:00.194 finishing with how to ask your doctor for what you 0:02:00.234 --> 0:02:03.194 need and feel more confident in the consultation room. 0:02:04.034 --> 0:02:11.084 So let's get into it. Okay, here is our first segment. 0:02:11.444 --> 0:02:12.323 Is this true? 0:02:12.883 --> 0:02:17.914 Turmeric can help with inflammation and or peri-symptoms. This is 0:02:17.974 --> 0:02:20.594 on TikTok and a lot of the wellness gurus are 0:02:20.614 --> 0:02:21.274 talking about it. 0:02:21.834 --> 0:02:25.774 It's not entirely bunkum, but it's not entirely true either. 0:02:25.804 --> 0:02:27.704 I think that's what is so much online. 0:02:27.724 --> 0:02:29.823 Like they'll take a kernel of truth. So if you 0:02:29.884 --> 0:02:34.663 take studies of turmeric, especially the active property in it, 0:02:34.764 --> 0:02:37.184 which is curcumin, so you can kind of buy one 0:02:37.244 --> 0:02:37.703 or the other. 0:02:37.724 --> 0:02:38.584 So turmeric is. 0:02:38.544 --> 0:02:40.624 The orange thing and a spice thing that I would 0:02:40.864 --> 0:02:41.964 have bought and never used. 0:02:42.044 --> 0:02:44.484 Is that right? And I bought and used it a lot. 0:02:44.744 --> 0:02:45.544 Great with a lentil. 0:02:46.074 --> 0:02:48.454 But if you actually take the turmeric, the active part 0:02:48.494 --> 0:02:51.474 of it is called curcumin. And it has been studied 0:02:51.614 --> 0:02:55.044 in petri dishes and a couple of animal studies. And 0:02:55.064 --> 0:02:58.584 it does look like taking curcumin, if you take somebody's 0:02:58.684 --> 0:03:02.964 blood before and after, there are certain inflammatory chemicals that 0:03:03.004 --> 0:03:07.414 we can identify in your blood that do seem to drop. 0:03:08.234 --> 0:03:10.194 But so what? Because what we don't have is the 0:03:10.254 --> 0:03:13.814 next bit. Do you therefore have less inflammation or less 0:03:13.854 --> 0:03:16.934 depression or Fewer PERI symptoms have never been. 0:03:16.834 --> 0:03:17.494 Studied for that. 0:03:17.534 --> 0:03:20.024 So we don't actually have the evidence that just because 0:03:20.044 --> 0:03:25.404 you're dropping the biomarkers, you actually reduce inflammation in your body. 0:03:25.844 --> 0:03:28.864 Does that mean that there is absolutely no point in 0:03:28.924 --> 0:03:32.984 taking turmeric or curcumin? No, it means we've got absolutely 0:03:33.024 --> 0:03:34.544 no idea whether it's going to help you or not. 0:03:34.744 --> 0:03:36.244 I have got patients who swear. 0:03:36.004 --> 0:03:36.624 By this stuff. 0:03:37.124 --> 0:03:39.424 And if they're happy to pay for it and they 0:03:39.544 --> 0:03:42.864 understand that it may or may not be working according 0:03:42.904 --> 0:03:44.904 to the studies, I reckon all power to you. But 0:03:45.364 --> 0:03:46.904 If you're the sort of person who goes, listen, until 0:03:46.944 --> 0:03:48.384 I know that for sure it's going to work, I'm 0:03:48.404 --> 0:03:49.904 not going to use it, then this is not one 0:03:49.924 --> 0:03:51.204 for you because we are not there yet. 0:03:51.344 --> 0:03:53.744 Because people have it in drinks and all sorts, don't they? 0:03:53.784 --> 0:03:56.224 There was a real fad a few years back where 0:03:56.264 --> 0:03:58.724 I worked with a guy on Radio Whipper and he 0:03:58.744 --> 0:04:00.084 just put turmeric on everything. 0:04:00.484 --> 0:04:03.524 Have you ever had a turmeric latte? No. Is that 0:04:03.544 --> 0:04:06.574 like a pumpkin latte? Is it like a Halloween situation? 0:04:06.644 --> 0:04:10.364 I think it's basically a sugary coffee-flavoured drink. But it's 0:04:10.424 --> 0:04:13.534 also turmeric-flavoured. But all the sugar makes it very, very palatable. 0:04:13.594 --> 0:04:16.264 I quite like it. And I do like the taste 0:04:16.344 --> 0:04:19.144 of turmeric, seriously, with lentils, particularly if you. 0:04:19.063 --> 0:04:20.344 Add black pepper, which by the. 0:04:20.303 --> 0:04:23.484 Way, it looks like that further, that combination further reduces 0:04:23.524 --> 0:04:27.294 your inflammatory markers in your body. But I would not 0:04:27.354 --> 0:04:31.353 take a turmeric tablet myself. I'm not that interested because 0:04:31.474 --> 0:04:33.654 I like something with like gold. 0:04:33.734 --> 0:04:35.454 You want some fats, lady. 0:04:35.693 --> 0:04:38.094 I want someone to have done the study in humans 0:04:38.553 --> 0:04:41.573 and like taken people and given half of them turmeric 0:04:41.613 --> 0:04:44.384 and half of them not and see whether they're osteoarthritis 0:04:44.443 --> 0:04:47.363 improves and they've got better walking speeds on a test 0:04:47.383 --> 0:04:49.884 that is completely objective. The thing is, it's pretty hard 0:04:49.943 --> 0:04:54.263 to do a test on turmeric. Number one, because how 0:04:54.284 --> 0:04:54.584 would you. 0:04:54.524 --> 0:04:55.203 Get a placebo? 0:04:55.263 --> 0:04:58.324 Because the turmeric has got such a distinctive smell. And 0:04:58.383 --> 0:04:59.913 number two, who's going to pay for it? Because this 0:04:59.943 --> 0:05:03.013 stuff is not proprietary. So you can be a company 0:05:03.073 --> 0:05:06.313 who sells turmeric and spend $ 100, 000, $ 150, 000 on a trial. 0:05:06.393 --> 0:05:08.953 It's not even going to be a big one for 0:05:08.974 --> 0:05:09.613 that amount of money. 0:05:10.573 --> 0:05:13.283 All right, next question, Ginny. This one is part myth 0:05:13.424 --> 0:05:16.444 and part question. I've heard a glass of red wine 0:05:16.484 --> 0:05:19.243 each night can aid sleep or even be good for 0:05:19.294 --> 0:05:20.833 you because of antioxidants. 0:05:21.474 --> 0:05:21.694 Hmm. 0:05:22.024 --> 0:05:24.823 There's a little bit of truth in that in as 0:05:24.883 --> 0:05:27.623 much as a lot of people, I certainly am a sleepy, 0:05:27.943 --> 0:05:30.644 if I drink alcohol, I feel very, very tired, but 0:05:30.664 --> 0:05:33.474 I'm unlikely to get through the night without waking up. 0:05:33.534 --> 0:05:35.133 So it puts you to sleep, but it doesn't. 0:05:35.053 --> 0:05:36.113 Keep you there. 0:05:36.214 --> 0:05:39.214 Most people have a worse night's sleep after alcohol, particularly 0:05:39.234 --> 0:05:40.873 if you have a lot and you've got like some 0:05:40.933 --> 0:05:43.374 reflux or you feel uncomfortable or that kind of thing. 0:05:43.953 --> 0:05:46.553 And it's definitely not good to keep you asleep all night. 0:05:46.933 --> 0:05:52.174 There are some compounds involved. inside, particularly the skins of 0:05:52.534 --> 0:05:57.914 especially red grapes that do have some anti-inflammatory properties. So 0:05:57.933 --> 0:05:59.794 they are our old friend Flavanol. 0:06:00.053 --> 0:06:01.914 Oh, Flav. Flav is back. 0:06:02.294 --> 0:06:05.873 For anyone who can't remember, Kath's waiter in Athens was 0:06:05.924 --> 0:06:06.484 called Flavanol. 0:06:06.503 --> 0:06:08.104 Yes, I'm sure he was. I'm sure he was. He 0:06:08.683 --> 0:06:11.924 definitely wasn't a red grape. Definitely didn't look like that. 0:06:11.984 --> 0:06:13.544 He was quite hot from memory. He was hot, yeah. 0:06:14.224 --> 0:06:17.784 So Flav is back and this time it's one called Resveratrol, 0:06:17.844 --> 0:06:19.933 which is one of those things that you're going to 0:06:19.953 --> 0:06:24.433 see in supplements, in skincare. Can't cross the skin barrier, 0:06:24.453 --> 0:06:26.594 by the way. It's too big a molecule. But it 0:06:26.974 --> 0:06:31.493 does actually, particularly in a petri dish, have some anti-inflammatory properties. 0:06:32.034 --> 0:06:35.534 And certainly some studies of that, you know the Mediterranean diet? 0:06:35.573 --> 0:06:38.334 Yes. Yeah. So that's the diet that's had by. 0:06:38.474 --> 0:06:41.373 Different communities that live around the Mediterranean Sea. A lot 0:06:41.404 --> 0:06:43.464 of them do have a glass of red wine every night. 0:06:43.484 --> 0:06:46.753 So it was sort of included in some Mediterranean diets. 0:06:47.284 --> 0:06:49.743 The thing is, it's kind of fallen out of favor 0:06:49.803 --> 0:06:51.623 a little bit because when you look at the data 0:06:51.643 --> 0:06:54.303 and you tease apart the food and the customs of 0:06:54.344 --> 0:06:56.384 the Mediterranean diet from the wine itself, it doesn't look 0:06:56.424 --> 0:07:02.823 like the wine is adding anything. In Australia, the guidelines 0:07:03.424 --> 0:07:07.363 are 10 standard drinks for both men and women. I'm 0:07:07.383 --> 0:07:09.024 pretty sure- Not a night? 0:07:09.063 --> 0:07:10.824 Well, a week. Okay. 0:07:10.844 --> 0:07:10.984 Sorry. 0:07:11.004 --> 0:07:11.283 Sorry. 0:07:11.994 --> 0:07:14.184 So you can't have one night then. 0:07:14.384 --> 0:07:16.464 Well, you could get up to one a night. You're 0:07:16.504 --> 0:07:20.184 meant to have two alcohol-free days a week within that 10. 0:07:20.184 --> 0:07:20.604 Okay. 0:07:20.844 --> 0:07:23.414 And just a reminder of two things. When it comes 0:07:23.474 --> 0:07:26.754 to red wine, a standard drink is 100 mils. That 0:07:26.814 --> 0:07:28.754 is not what you get at a pub or a restaurant. 0:07:28.794 --> 0:07:32.224 They generally give you 150 to 180 mils. So 100 0:07:32.224 --> 0:07:34.084 mils is when you go to the waiter. That's a 0:07:34.104 --> 0:07:37.654 bit of a stingy pour. That is actually– The standard drink. 0:07:37.754 --> 0:07:39.934 But you might not be technically pouring if you're at 0:07:39.974 --> 0:07:40.714 home alone. 0:07:40.994 --> 0:07:43.773 Well, if you have a bottle of wine, just to 0:07:43.814 --> 0:07:47.114 do some quick maths on this, a bottle is 750 mils. 0:07:47.674 --> 0:07:49.514 So work out how long it takes you to finish 0:07:49.534 --> 0:07:52.134 a bottle of wine. Because if you and your husband 0:07:52.254 --> 0:07:54.353 are polishing off a bottle of wine in a night, 0:07:54.934 --> 0:07:59.014 you're basically having three and three quarters standard drinks in 0:07:59.074 --> 0:07:59.434 a night. 0:08:00.014 --> 0:08:01.114 Like that's a lot. 0:08:01.194 --> 0:08:03.974 And the National Health and Medical Research Council says that 0:08:04.034 --> 0:08:06.674 four standard drinks in a single day is a binge. 0:08:07.393 --> 0:08:10.694 and associated with all sorts of bad health outcomes. So 0:08:10.714 --> 0:08:13.154 you don't want to be doing that. Even if you 0:08:13.294 --> 0:08:15.634 went through a bottle of wine on your own in, 0:08:15.674 --> 0:08:19.944 let's say, three nights, you're still, don't forget it's 750 0:08:19.944 --> 0:08:23.224 mils divided by three is 250 mils. That's two and 0:08:23.244 --> 0:08:25.964 a half standard drinks a day. It's again, more than 0:08:26.164 --> 0:08:27.424 what we would recommend. 0:08:28.084 --> 0:08:29.184 So that's just the first thing. 0:08:29.604 --> 0:08:33.544 The second thing to remember is that I think drinking 0:08:33.564 --> 0:08:36.564 can really sneak up on you and what can start 0:08:36.724 --> 0:08:40.664 as one cheeky pour can end up at a really 0:08:40.724 --> 0:08:42.184 big problem very, very quickly. 0:08:42.224 --> 0:08:44.984 So I would say if you are the sort of person. 0:08:44.784 --> 0:08:48.984 Who can have 100 mils of wine a night, five 0:08:49.024 --> 0:08:51.624 nights a week. So if you're just having one standard drink, 0:08:51.714 --> 0:08:55.154 five nights a week, I think you're probably okay. But 0:08:55.194 --> 0:08:57.314 if you're having more than that, it might be worth 0:08:57.354 --> 0:08:59.094 now keeping a diary and actually working out. 0:08:59.134 --> 0:09:01.934 Do you have a problem? Maybe not worth the antioxidants. 0:09:02.634 --> 0:09:05.234 After this break, we're going to get some real helpful 0:09:05.274 --> 0:09:08.834 advice on sleep, my favorite thing in the world. 0:09:09.534 --> 0:09:12.344 And why are we not getting as much as we need? 0:09:12.644 --> 0:09:13.364 We'll be right back. 0:09:21.284 --> 0:09:25.564 My sleep's so bad, I can't function at work. I 0:09:25.604 --> 0:09:30.103 need solutions that work fast. I'm not depressed. I'm just 0:09:30.164 --> 0:09:35.274 not sleeping at all. Between the night sweats, the 3 a.m. wake-ups, 0:09:35.394 --> 0:09:38.034 and the racing heart that comes out of nowhere, I 0:09:38.074 --> 0:09:41.334 may be getting three or four broken hours a night. 0:09:41.834 --> 0:09:45.254 I've been running on fumes for months. I've tried melatonin. 0:09:45.414 --> 0:09:46.963 I've tried meditation apps. 0:09:47.654 --> 0:09:48.214 Thank you so much. 0:09:57.144 --> 0:10:00.824 But here's what's keeping me up now. I have a 0:10:00.864 --> 0:10:04.614 performance review in three weeks and I can't think straight. 0:10:05.034 --> 0:10:08.894 I'm snippy with my team. I look exhausted because I 0:10:09.174 --> 0:10:12.494 am exhausted. For those of you who've been through this, 0:10:12.974 --> 0:10:18.244 what actually worked? I am desperate and honestly, I'm a 0:10:18.254 --> 0:10:18.944 little scared. 0:10:19.984 --> 0:10:23.144 That's horrible, isn't it, to listen to? I really feel 0:10:23.204 --> 0:10:25.504 for our listener. That is horrendous. 0:10:25.944 --> 0:10:28.204 I just think there's a bit to unpack here because 0:10:28.384 --> 0:10:30.184 I always think that there are things that you can 0:10:30.244 --> 0:10:33.864 control and things you can't control. So having a performance 0:10:33.924 --> 0:10:36.904 review in three weeks is going to happen and we 0:10:36.924 --> 0:10:40.804 can't control that. But oh my goodness, perimenopause, you totally 0:10:40.844 --> 0:10:43.984 can control. Number two, you need to. 0:10:44.024 --> 0:10:45.904 Get checked out. Like I don't get. 0:10:45.824 --> 0:10:48.184 Where the doctor's coming from saying that your racing heart 0:10:48.224 --> 0:10:49.944 does not need any further investigation. 0:10:50.404 --> 0:10:52.004 I would be going back and just going, hang on, 0:10:52.664 --> 0:10:54.004 Do I need to go to a cardiologist? 0:10:54.024 --> 0:10:56.504 Like, is there something actually happening with my heart that 0:10:56.544 --> 0:10:59.713 we might need to fix? Where I think we have 0:10:59.744 --> 0:11:02.234 a major issue is that three and a half to 0:11:02.364 --> 0:11:06.554 four hours of sleep in total per night very quickly 0:11:07.074 --> 0:11:12.214 becomes catastrophic for your brain. Increased risk of workplace accidents, 0:11:12.254 --> 0:11:15.614 particularly if you work like with machinery, falling off a ladder, 0:11:15.634 --> 0:11:17.994 like that kind of thing can really happen. You're going 0:11:18.014 --> 0:11:20.394 to make major mistakes at work. You're already finding that 0:11:20.494 --> 0:11:24.394 is happening. Driving is really, really dangerous for you. Like 0:11:24.464 --> 0:11:27.304 it's having a blood alcohol of some enormous level when 0:11:27.324 --> 0:11:27.904 you're getting. 0:11:27.784 --> 0:11:29.884 To this lower sleep. So it is fairly urgent. 0:11:30.464 --> 0:11:33.764 If you were sitting in my surgery, and just a reminder, 0:11:33.804 --> 0:11:35.544 I'm not your doctor. You've got to go talk about 0:11:35.584 --> 0:11:37.864 this with your doctor who knows you really well. But 0:11:38.244 --> 0:11:40.704 I would be unpacking things. I'd be making sure that 0:11:40.744 --> 0:11:43.144 I'm ruling out, let's say, a thyroid condition that's giving 0:11:43.194 --> 0:11:46.914 you palpitations or heart disease or even sleep apnea or 0:11:46.954 --> 0:11:49.814 something like that that's actually physically wrecking your sleep. 0:11:50.284 --> 0:11:51.004 I think there's. 0:11:50.944 --> 0:11:54.344 Probably an element of perimenopause there just because of the 0:11:54.384 --> 0:11:57.203 hot flushes coming on with the palpitations. We know 42% 0:11:57.204 --> 0:12:00.714 of women in peri do get palpitations. And then if 0:12:00.744 --> 0:12:02.644 it is peri, which by the way, there's no. 0:12:02.594 --> 0:12:03.354 Blood test for that. 0:12:03.394 --> 0:12:05.094 We just got to listen to you and take a really, 0:12:05.114 --> 0:12:07.694 really detailed history before we can call it. 0:12:08.614 --> 0:12:12.114 If it is that, we have treatment. We have hormonal. 0:12:11.734 --> 0:12:13.954 Treatments that we can give you that are going to 0:12:14.114 --> 0:12:15.314 pretty much. 0:12:15.554 --> 0:12:19.194 Do a lot to help you super, super, super quickly. 0:12:20.084 --> 0:12:23.044 I think short-term, when I'm looking at a patient like 0:12:23.064 --> 0:12:25.384 this where it's catastrophic and we need to put some 0:12:25.424 --> 0:12:27.884 sleep back into the sleep bank that has now been 0:12:27.924 --> 0:12:30.444 run so far into overdraft that we have some issues, 0:12:31.044 --> 0:12:34.344 I would even consider a short-term sleeping medication, even just 0:12:34.404 --> 0:12:36.764 on the weekends, just to catch up while we're trying 0:12:36.804 --> 0:12:39.244 to implement the new strategies. Because by the time you 0:12:39.264 --> 0:12:41.384 get into the doctor, they've ruled everything else out. They've 0:12:41.404 --> 0:12:44.164 done the thyroid test. Your performance review is now in 0:12:44.184 --> 0:12:46.404 the rearview mirror and you might now have lost your role. 0:12:46.484 --> 0:12:48.364 So this is now catastrophic and we need to sort 0:12:48.384 --> 0:12:51.264 you out. I would probably give you a short-term sleeping 0:12:51.304 --> 0:12:53.644 pill just for the weekends, just for Friday, Saturday night, 0:12:54.344 --> 0:12:56.224 just in case you feel a bit hungover the next morning, 0:12:56.404 --> 0:12:59.284 just to make sure you are okay and can function again. 0:12:59.924 --> 0:13:02.384 And I would take everything off your plate that does 0:13:02.464 --> 0:13:04.224 not need to be there while we're trying to get 0:13:04.264 --> 0:13:08.114 through this medical emergency kind of situation. And then I'd 0:13:08.134 --> 0:13:11.434 also be treating your, if we do work out that 0:13:11.474 --> 0:13:14.254 it's peri, I'd be treating that really, really quickly because 0:13:14.274 --> 0:13:16.014 you're going to feel less anxious. By the time you 0:13:16.034 --> 0:13:18.514 get to that performance review, we're going to have taken 0:13:18.554 --> 0:13:21.784 this down from a nine out of 10 catastrophe to 0:13:21.804 --> 0:13:23.404 at least a five out of 10. It's not going 0:13:23.434 --> 0:13:25.874 to cure everything, but we can certainly bring it down 0:13:25.894 --> 0:13:27.834 a notch. Kath, have you ever got this bad? 0:13:28.234 --> 0:13:30.114 Yeah, I have a few times. I mean, and I'm 0:13:30.674 --> 0:13:33.374 awful without my sleep. All the wheels fall off. 0:13:33.874 --> 0:13:36.174 I don't want to exercise in the morning. I'm snappy 0:13:36.194 --> 0:13:38.514 with my son. You're brain foggy. 0:13:38.534 --> 0:13:39.473 You're anxious. 0:13:39.494 --> 0:13:41.814 You're drinking the coffee in the morning to try and 0:13:41.854 --> 0:13:44.414 wake up. Then you're drinking too much coffee, which is 0:13:44.474 --> 0:13:45.834 impacting your nighttime. 0:13:46.434 --> 0:13:47.254 It's horrendous. 0:13:47.734 --> 0:13:50.754 So I really feel for our listener because you just 0:13:50.774 --> 0:13:51.744 can't achieve anything. 0:13:52.244 --> 0:13:55.364 I am so grateful that she wrote in. If this 0:13:55.404 --> 0:13:58.144 feels any better, I probably see one of you every 0:13:58.184 --> 0:14:01.044 day in my surgery, like at least one person like this. 0:14:01.744 --> 0:14:05.544 And often my patients have got elderly sick parents, a 0:14:05.604 --> 0:14:08.223 child who might be neurodivergent, who's still in their bed three, 0:14:08.264 --> 0:14:10.824 four times a night, and we can't do anything. 0:14:12.254 --> 0:14:13.694 It can be really difficult. 0:14:13.814 --> 0:14:15.864 And I wanted to thank you for sharing and bringing 0:14:15.884 --> 0:14:19.344 this to Unleashed, to Burning Questions, because there's so many 0:14:19.384 --> 0:14:22.804 people who can relate to this. And it's a great, great, 0:14:22.904 --> 0:14:23.904 great question to ask. 0:14:23.944 --> 0:14:24.344 Thank you. 0:14:24.544 --> 0:14:27.574 Ginny, so if everything else has been ruled out, what 0:14:27.644 --> 0:14:29.534 could the sleep situation be down to? 0:14:29.854 --> 0:14:32.054 Assuming that there was no hormonal cause, because I think 0:14:32.094 --> 0:14:35.814 there's clearly something hormonal going on for our listener. If 0:14:35.854 --> 0:14:40.344 you are a lifelong sleeper, terrible sleeper, then the best 0:14:40.384 --> 0:14:42.844 thing that we know by far is something called cognitive 0:14:42.904 --> 0:14:44.524 behavioral therapy for insomnia. 0:14:44.984 --> 0:14:48.064 We've spoken about it before on Well. I refer a 0:14:48.104 --> 0:14:50.344 lot of people to- So tell me about it again 0:14:50.404 --> 0:14:53.284 for the listeners, because I'm perimenopausal, I've forgotten. 0:14:53.844 --> 0:14:58.264 So cognitive behavioral therapy is one of the core tools 0:14:58.304 --> 0:15:01.764 that psychologists use to reframe your thinking about things. And 0:15:01.784 --> 0:15:04.384 it says that a lot of the ways you feel 0:15:04.524 --> 0:15:06.334 are led by the way you think about things. And 0:15:06.364 --> 0:15:10.274 some of your negative thoughts are actually leading your brain 0:15:10.314 --> 0:15:12.634 astray and giving you feelings that you feel like you 0:15:12.654 --> 0:15:13.234 can't control. 0:15:13.494 --> 0:15:14.974 So it puts you back in the driver's seat a 0:15:15.014 --> 0:15:15.314 little bit. 0:15:15.354 --> 0:15:19.494 And there's an adapted form of cognitive behavioral therapy specifically 0:15:19.534 --> 0:15:22.574 for insomnia. And it gives you all the sleep hygiene, 0:15:22.894 --> 0:15:26.694 addresses all of your negative beliefs about sleep and how 0:15:26.734 --> 0:15:28.634 it affects you and what kind of sleeper you are. 0:15:29.114 --> 0:15:31.274 But this is not for somebody who's in a catastrophic 0:15:31.314 --> 0:15:32.794 situation that's been going on for a. 0:15:36.814 --> 0:15:37.354 All their life. 0:15:37.454 --> 0:15:39.894 I see these people all the time and it's not 0:15:39.934 --> 0:15:42.014 a sprint, it's a marathon. You are a turtle in 0:15:42.054 --> 0:15:44.474 that situation rather than a hare. And so you are 0:15:44.534 --> 0:15:48.534 actually going to be doing courses. I prescribe a lot 0:15:48.554 --> 0:15:52.134 of online CBTI, which is free. I can send you 0:15:52.174 --> 0:15:55.154 a program for free, but that might take months to 0:15:55.234 --> 0:15:58.594 actually implement that. And I don't think it's appropriate for 0:15:58.754 --> 0:16:01.754 our listener. I think she's in a catastrophic situation where 0:16:01.774 --> 0:16:03.734 she needs some urgent medical help. 0:16:03.754 --> 0:16:03.894 ASAP. 0:16:04.114 --> 0:16:06.774 Now, Do I pull out sleeping pills for most people? 0:16:07.334 --> 0:16:09.794 Very, very, very rare. But I look at this. 0:16:09.794 --> 0:16:13.914 Poor woman whose life is literally falling apart around her 0:16:13.954 --> 0:16:17.294 because of her sleep. And you would not be human 0:16:17.354 --> 0:16:18.894 if you did not think, I've got a tool in 0:16:18.934 --> 0:16:21.874 my tool belt that can help you. I think she 0:16:21.914 --> 0:16:25.554 just needs some help. And for that kind of person... 0:16:25.814 --> 0:16:27.874 I am going to help her if I can. And 0:16:28.334 --> 0:16:30.634 we will deal with the rest of it in time. 0:16:30.834 --> 0:16:34.654 But I'm certainly never going to, for this patient, go, right, 0:16:34.694 --> 0:16:37.194 let's put you into a CBT-I course and let's hope. 0:16:37.174 --> 0:16:38.574 In three months. Just take things slow. 0:16:38.594 --> 0:16:38.674 Yeah. 0:16:38.714 --> 0:16:41.514 So let's see what happens in three months time. She 0:16:41.534 --> 0:16:44.914 might've had a car accident by then and have broken 0:16:44.934 --> 0:16:47.174 a bone. So like, no, we need to help her. 0:16:47.654 --> 0:16:50.534 So when we look at temporary fixes, whether they're a 0:16:51.224 --> 0:16:54.964 over-the-counter remedies like doxylamine, which is a kind of an 0:16:55.024 --> 0:16:58.224 antihistamine that has sedation as a side effect, or a 0:16:58.664 --> 0:17:01.984 prescribed sleeping pill that works on certain parts of your 0:17:02.004 --> 0:17:05.123 brain and helps you sleep. They put a little bit 0:17:05.144 --> 0:17:08.583 of petrol into a tank that's run completely dry. Why 0:17:09.023 --> 0:17:12.974 doctors don't love them permanently is for a couple of reasons. 0:17:13.574 --> 0:17:16.134 Number one, it's not addressing the long-term issue. If you 0:17:16.154 --> 0:17:18.904 have a long-term sleeping issue, you would be better off 0:17:18.984 --> 0:17:21.084 with cognitive behavioral therapy for insomnia. 0:17:21.104 --> 0:17:22.674 So it's not addressing the underlying issue. 0:17:23.174 --> 0:17:25.414 The second thing is in the case of the prescribed 0:17:25.634 --> 0:17:29.394 sleeping pills that are called benzodiazepines, they are addictive. And 0:17:29.494 --> 0:17:31.813 what I mean by addictive then is not I'm addicted 0:17:31.834 --> 0:17:34.134 to my phone, but it actually needs to have two 0:17:34.214 --> 0:17:34.744 parts to it. 0:17:35.114 --> 0:17:35.614 Tolerance. 0:17:36.054 --> 0:17:38.654 So what worked yesterday no longer works today. I need 0:17:38.974 --> 0:17:41.094 two pills. I used to be fine on one pill. 0:17:41.144 --> 0:17:41.734 Now I need two. 0:17:42.274 --> 0:17:44.054 And then dependence. You have a night off from it 0:17:44.154 --> 0:17:45.984 and you don't sleep a wink. You just stare at 0:17:45.994 --> 0:17:48.284 the ceiling all night. So we just do not want 0:17:48.304 --> 0:17:50.803 to get you into an addictive situation. 0:17:51.124 --> 0:17:52.124 They are short-term. 0:17:52.164 --> 0:17:55.404 And the third thing is they actually don't allow you 0:17:55.544 --> 0:17:59.584 a proper sleep cycle with REM sleep, non-REM sleep, deep sleep, 0:17:59.644 --> 0:18:02.344 light sleep. And that circadian rhythm where you have a 0:18:02.414 --> 0:18:06.334 normal sleep cycle is very essential to good brain functioning. 0:18:06.694 --> 0:18:10.344 So long-term, to avoid brain-related issues... We don't want any 0:18:10.384 --> 0:18:13.164 pills that are going to disrupt your natural circadian rhythms. 0:18:13.524 --> 0:18:16.544 We would much rather you get into a situation where 0:18:16.584 --> 0:18:19.494 you can help yourself to sleep. That's where CBTI is brilliant. 0:18:20.034 --> 0:18:22.014 But it's just not what we need right now. 0:18:22.494 --> 0:18:24.854 What about melatonin? I have a lot of friends who 0:18:25.074 --> 0:18:27.354 use it. When you're overseas, it's very easy to get 0:18:27.414 --> 0:18:30.154 over the counter. Where does that fit into this? And 0:18:30.634 --> 0:18:31.984 could it possibly help the listener? 0:18:32.754 --> 0:18:33.404 It may. 0:18:33.584 --> 0:18:36.464 And some people find it super, super, super helpful. And 0:18:36.524 --> 0:18:37.624 some people find it useless. 0:18:37.644 --> 0:18:38.164 So we know. 0:18:38.794 --> 0:18:42.854