The Interconnectedness of Sleep and Mental Health
with Julia Glowinski, MSW, RSW
Intro to Julia Glowinski (01:30)
Do we acquire insomnia or does it affect all ages? (03:36)
Underlying reasons for insomnia (07:14)
Insomnia and mental health (08:45)
Evening routines that improve sleep and relaxation (13:24)
Sleep and emotional traumas (16:13)
How sleep affects our day performance (19:35)
Night owls and morning larks (23:17)
Sleep and newborns and how it affects the family (25:51)
Shifting the perception of sleep in society (33:09)
Resources Mentioned in This Episode
Julia Glowinski is a registered social worker, specializing in sleep. Julia dedicated her social work practice to the area of sleep, as a Certified Infant and Child Sleep Consultant and a Cognitive Behavioural Therapy for Insomnia (CBT-I) clinician.
Lesya Liu 0:00
Hello everyone and welcome to the new episode of You Can Exhale Now podcast. Today I am hosting Julia Glowinski of Glow Sleep in Ontario. And as a registered social worker specializing in sleep, Julia also specializes in sleep issues in conjunction with mental health issues, developmental delays and sleep disorders. So I'm really excited to have this conversation with her today, specifically about the interconnectedness of our mental health and sleep.
Julia, welcome to the show.
Julia Glowinski 1:28
Thank you so much for having me.
Lesya Liu 1:30
Thank you for coming. So why don't you tell us a little bit about yourself and how you decided to become a registered social worker and why do you specialize in sleep?
Julia Glowinski 1:43
Absolutely. So I am, like you said a registered social worker. And my practice is solely sleep based and I have a lot of passion for sleep. I've been doing this for a few years now and I actually started in the mental health field. So I was working on a psychic crisis unit here in Toronto, for youth up to 16. And on the unit, we saw lots of complex mental health and behavioral issues. And there was such a connection with sleep and mental health and because it wasn't overnight, like it was a unit where we really could monitor the kids 24 hours a day, we could see what would happen at bedtime and their struggles to fall asleep. And a lot of it was a result of past trauma, anxiety, depression, and we actually had a sleep lab in the basement so the youth on the unit could actually have a sleep study done overnight while they were on the unit like a mobile unit. And that really sparked my interest in sleep and that connection with mental health and well being and then as a mom, on my second with my second child, I had a lot of difficulty and I was absolutely sleep deprived. Something that I've never experienced before in that manner. And it really took such a toll on me mentally and physically. And I had a very, very difficult time. And I think both of those things together really led me to where I am now, which is I'm a certified infant and toddler sleep consultant. So I work with lots of young families and new babies. And then I also work with youth, and even work with adults doing corporate seminars and doing counseling for things like insomnia, lots of cognitive behavioral therapy for insomnia as well.
Lesya Liu 3:36
That is awesome. So it seems like you know, we always think of insomnia as something that comes with age, we do not necessarily think of it as a problem for us, or children. I know that that's not necessarily the case. But can you speak a little bit about the potential reasons for sleep disturbance, especially at very young ages.
Julia Glowinski 4:03
Yes, that's absolutely true. And insomnia can affect very young children, sometimes and young children, a lot of what we see is sleep apnea, so breathing issues in our sleep. And that can actually cause issues with sleep quality, which can contribute to insomnia. So even when you fix those breathing issues, sometimes you're left with the habits of not being able to sleep or waking up in the night and not being able to fall back asleep. So that can be very common to be left with this insomnia that outlasts the sleep apnea. Even once a child let's say has had a tonsillectomy and has and their breathing issue has resolved they're still left with insomnia. And insomnia can be a result of things like anxiety, a lot of the time that's what is happening, anxiety about falling asleep. having difficulty falling asleep or staying asleep so their sleep onset into anxiety or sleep maintenance anxiety when we actually can fall asleep No problem, but we wake up in the night and can't fall back asleep. So a lot of that is due to a Cohen. Mental health issues where we are experiencing anxiety or depression or intrusive thoughts. That is a very common reason. And sometimes people don't know why, but they just wake up and they're not tired. And that could be due to sleep hygiene, some bad habits we've picked up along the way, watching TV right before bed or being on our phones. So there's all sorts of things that can contribute to poor sleep, which can lead to a diagnosis of insomnia.
Lesya Liu 5:50
And is it true that as we age, the likelihood of having insomnia increases or is it really just due to our lifestyle and our habits that we've created over a lifespan?
Julia Glowinski 6:06
It's a good point you make, it's both so absolutely. As we age, we do have more sleep difficulty. Our night wakings tend to be longer. And we have less deep sleep as we age as well. So it's unfair because as we get older and sometimes we want to sleep that's when we have more difficulty sleeping when we are kids or teenagers. We may not actually want to sleep and we don't sleep. But then when we finally want to, that's when we have more trouble sleeping. And the other thing is yes. So as we age is also due to lifestyle. We don't have someone telling us when to go to bed, and we end up just staying up late. We're working late. And the truth is we have more stress for the most part for most of us. As we age, we're working. We're worrying about things on a financial level. We're worrying about our physical health, maybe our families have Maybe we're responsible for a family now our job. So there's all different things that we're actually worrying about. And that worry really contributes to our achieving optimal sleep.
Lesya Liu 7:14
Mm hmm. Have you noticed a difference in underlying reasons behind different symptoms? Like you've already mentioned, some people are having issues falling asleep, while others fake up in the middle of the night and cannot go back to sleep? Is there possible different reasons for those kinds of different symptoms? Or does it really kind of come down to the same underlying issues?
Julia Glowinski 7:43
It could be the same underlying issue, especially if it's worried thoughts and things and racing minds and things like that. Sometimes it's just when we start processing things, so sometimes when we wake we have trouble. We don't have any trouble falling asleep, but when we wake up, we start panicking. Uh oh gosh, am I going to be able to fall asleep? Or I'm worried about tomorrow? Or did I wake up on time? And or did I miss my alarm, those things can make it difficult for us to fall asleep, back asleep in the night. The other thing is it also could sometimes be an underlying medical issue. So if we're waking up constantly to go to the washroom, while that can be normal, sometimes that happens as we age, and that can cause us to wake up more in the night. And then it could be harder for us to fall back asleep. And it also depends on sometimes medication, we're taking what we're eating throughout the day. So there are some underlying issues for sure, that could be contributing to sleep onset insomnia versus sleep maintenance, insomnia.
Lesya Liu 8:45
Mm hmm. And, you know, you've mentioned the word anxiety multiple times already. So can you speak a little bit about how stress and anxiety affects or sleep, really and how sleep deprivation affects our stress and anxiety. So it's almost like you know, this vicious cycle that people get trapped in. So can you speak a little bit about that and how you can address, like you said, racing mind or panic, panic in thoughts right before you go to sleep, especially if they surround the sleep like not being able to fall asleep. The fear of just laying there for hours on end and racing thoughts.
Julia Glowinski 9:32
Yes, you said exactly what I always said. I always say it's a vicious cycle. And it's so unfair because with most things in life, the harder the more we try or practice something, the easier it gets. And with sleep, if we're changing our lifestyle, and we're using certain strategies, yes, it can get easier, but if we're solely just trying to go to sleep, and we really, really want to, it doesn't always work like that. Because we're putting more pressure on ourselves. So it is a vicious cycle. Unfortunately, when we are more anxious, or when we're more, having depressed thoughts, we are more likely to have difficulty sleeping. Because we're unable to calm down at the end of the day. We're carrying with us everything that happened during the day. If we're not processing what we're going through during the day, if we're not talking it out with someone, or we're not really working through it or journaling or doing something that helps us process it. Sometimes when we lie in bed. That's the first moment we get to actually think about what happened during the day. And we tend to ruminate, and we worry and we have lots of thoughts that come up. Sometimes it's even creativity. A lot of people in the arts tend to be more creative at bedtime and then their mind is flowing and it's really hard to shut off. And that can lead to us not falling asleep. If we're more anxious or more alert at bedtime. And then when we don't get a good night's sleep, the first thing to happen right away is an issue with our mood. So we instantly are going to be less patient, which can affect our relationships and our connection to people, we are going to feel more anxious. Sometimes it's about not getting sleep. And it's as simple as that. And sometimes in general, it's just that general feeling of anxiety or being sad. And that contributes to again that night not being able to fall asleep. And sometimes that anxiety is just a generalized anxiety and sometimes it's specifically sleep anxiety. So worrying about not being able to fall asleep. So it definitely is a cycle, like you said, and some of the things that we can do is if we're lying in bed and unable to fall asleep, one of the main strategies of cognitive behavioral therapy for insomnia which is something that I practice, and it's It's short term therapy. And what it says is something called the half hour half hour rule or the 30:30 rule. And what that is, is that we want to associate our bed with sleep, we don't want to associate our bed with anxiety. So besides the fact that we shouldn't be doing work emails in bed, we shouldn't be spending the entire day watching TV in bed or anything or studying in bed. Besides that, we actually don't want to spend a lot of time trying to fall asleep or being awake in the night in our bed. So if you've been lying in bed for about 20 to 30 minutes, and you can't fall asleep, and I don't want people to be staring at their watch, but if it's been around 20 to 30 minutes, what we want to do is get up, go to a different room. If we can, if not, we just want to get out of bed. Let's say we're in a studio apartment or in a dorm room, go to your desk, go to a different area. Do that. Something for 20 to 30 minutes that's coming for you. And only after that time, once you're drowsy and feel like you can fall asleep again, then you go back to your bed and try again. And you repeat that if necessary. So the idea is we don't want to be lying awake for hours in our bed, and then our bed becomes associated with anxiety instead of being associated with sleep.
Lesya Liu 13:24
Mm hmm. That's an interesting approach. So would you recommend any kind of evening routines that became popular in the last couple of years like journaling or meditation or listening to music? Do any of those really have positive significant effects on how fast we fall asleep and how relaxed we are? Or is it more just a hoax?
Julia Glowinski 13:54
It's absolutely true. But I would say it really depends on you. So what's right for someone may not necessarily work for you, for example, some people really find it calming to do yoga before bed, or to stretch or listen to soft music, do meditation, like you said to journal. Other people, perhaps journaling brings up too much trauma before bed or too much worry, anxiety. So maybe that wouldn't be the best approach. Maybe instead of writing a full out journal, there's also a gratitude journal where you're just writing three things that you're grateful for before bed, if writing a whole entry would feel too overwhelming for you. So yes, all of those things are great. Essential oils and lavender and having camomile tea, all of these things. If they feel calming to you, then they're amazing. And that's what we want to continue but the most important thing is having a consistent routine full of like several rituals before bed. And it can be very simple. It could be washing up and ideally it's in dim light to cue ourselves for sleep or queuing our brains To let our brain know it is now nighttime, so we want that melatonin to be produced, we don't want to expose ourselves to too much bright light or, or obviously, we're usually going to bed when it's still when it's dark out. But if for shift workers, we want to make sure we're not exposing ourselves to daylight right before bed. And we'd want to let's say, wash up, maybe read for 15 minutes. Like I said, maybe a gratitude journal or anything like that. And then we shut off our light. Maybe we do some sort of meditation if you want, but it could be as simple as washing up, Lighting a candle, let's say reading for 10 minutes and going to sleep. The idea is that we want to in the same order to do the same things before bed, because it not only like I said, is going to cue our brain with a melatonin production. But it's also queueing our minds. It's telling us we're trying to separate the day from the night and that's what's really important. So to sum up, I guess it's less important, I would say, of what you're doing, but more important of the way and the routine in which you're doing it. Mm hmm.
Lesya Liu 16:13
And, you know, you've mentioned traumas, and I think this is a big, big topic, you know, in the community right now that not all traumas are created equal, and in a lot of ways, they're all carrying around some kind of trauma, even if we consider it minor or we do not consider it trauma in the first place. But I'm sure there are lots of people who experience sleep issues and sleep disturbances because of trauma. Maybe they don't necessarily have PTSD. But what would you suggest for somebody who thinks that they had traumatic experiences and maybe as a result of that those thoughts are keeping them up at night.
Julia Glowinski 17:00
I would say what's really important is to try and speak with a professional about processing, processing that during the day, because we don't want to take it into the night with us. So that would be really important. Another thing that we can try is, and I don't want to, to make that too, like I don't want to, what's the word and not put emphasis on that because that is very much a really important piece and to really work through that trauma is so important, and there's so many amazing therapists who specialize in trauma when we're trying to fall asleep, and there's something that is affecting us due to trauma. If the trauma is related to the nighttime or bedtime or being in a bed or something like that. Then I would try to shift your sleep environment so that it is as Different as possible, having a little bit of a light on, which I usually wouldn't suggest, but if it was, if there was a traumatic issue around bedtime or something like that, that is something that we want to do. Besides that there are some really great breathing techniques that can be used for trauma, or something to kind of, if we're having flashbacks to bring ourselves out of that, for example, at bedtime, if you're unable to sleep, or you're you're trying to fall asleep, but having trouble, something that can take you out of that is a technique where you think of five things that you can see. So you'd have to have a little bit of a light on four things that you can hear, or four things that you can touch, three things that you can hear two things that you can smell and one thing that you can taste so you kind of try and go through all of your senses and that can bring you out of the moment. Another thing that is really helpful is Like I said, you do have a light on, let's say you've tried to leave the room and take some space in that 3030 rule, you can pick a color. And I love this one, I think it's really effective. And it takes us out of the moment because we're instantly shifting our focus to something else. So let's say you think of red, and you look around the room, and you try to find five things that are red. And if you're still feeling like having those flashbacks, and you're still feeling really anxious, you pick another color, and you go through that color and it instantly shifts your thought to something else. And that can be really effective for trauma.
Lesya Liu 19:35
Mm hmm. That's, that's great advice. So, you know, it's not a secret anymore, that our night and our day is really interconnected. And you know, whether it be sleep at night or not really affects our day to day our cognitive functioning, our physical well being. Can you speak a little bit to the science of why sleep plays such an important in our day's performance?
Julia Glowinski 20:03
Absolutely. So there's so much going on when we sleep. And there's different stages of our sleep. We go through a sleep, we go through multiple sleep cycles when we're sleeping and, and there's important parts of each cycle that we're going through. So while we're sleeping, we are processing our emotions. And that means that every time we think of something, we don't have to necessarily go through it and feel those emotions so strongly every time we think of them during the day, they're being processed overnight. We are also determining while we sleep, what information is being left behind and discarded and what information is being put in long term memory. So in a sense, we're sleeping to remember and we're sleeping to forget. We're also working on boosting our immune system, which is so important, especially now during COVID. But in general, it's so important for our immune system. And that's why when we don't get enough sleep, There are, we're more likely to have a diagnosis of cancer, we're more likely to have a diagnosis of diabetes, we're more likely to be obese, we have a higher there's a higher rate of heart attacks, irregular heartbeat stroke. So there's so many physical health issues related to being sleep deprived and not getting that good sleep. On top of that, we are more likely to be diagnosed with a mental health issue or be in a psychiatric crisis. And, in general, we're also less productive at work. So our decision making skills are poor. We are not as creative. In fact, in Canada alone, we spend $21 billion dollars due to loss of productivity because of sleep deprivation. And I think in the US, it is Believe it could be, it's much higher, it's at least three times as high of how much money is being spent due to loss of productivity. And that's why workplaces are so interested in trying to work to get their employees to sleep better as well. But we are more likely to have a car accident or reaction time is slower. There's more medical errors, over 100,000 medical errors can be attributed to sleep deprivation amongst doctors and nurses. So there's just it impacts every single part of our life. It impacts our relationships as well. And there are so many different processes that are happening overnight. That even helps for example, for athlete athletes are in certain parts. So it would be what's happening is our blood is rushing from our brain to our muscles. So it's replenishing our muscular energy as well. So it's helping us from injury, and it's preventing injury. So there's so many different aspects and different important functions for happening while we sleep, that people don't really take into account when they're deciding to stay up late, and for an extra couple hours and binge watch Netflix or something like that.
Lesya Liu 23:17
Mm hmm. And, you know, kind of tagging on that last part. Is there really such a thing? You know, do people really differ from each other in terms of being night owls versus morning larks? Or is it just, again, just kind of myth that circulates around so do different people really have different sleep needs? And they really require different sleeping habits and schedules, or are we really all the same at the end of the day?
Julia Glowinski 23:49
It's absolutely true. We really do have different circadian rhythms. Everyone's is a little bit different, but there definitely are people who are night owls and others. People who are larks who are mourning people. And a lot of that can be contributed to. Obviously things like shift work when we're working nights versus days, but it also can contribute to having a concussion sometimes. So a concussion can shift your circadian rhythm, which is your internal body clock. And then we'd actually start we'd have something called phase delay where we're going to bed later and waking up later kind of like teenagers. And that's a real thing. Our circadian rhythm shifts in our teenage years, so that we actually are wanting to go to bed later and wake up later. Sometimes a concussion can even cause something called phase advanced where we are Melatonin is produced too early, and we get tired around six or seven or 8pm and we then wake up at 5am or 4am. So both things can happen. But definitely some of us are wired to wake up earlier and some leaders can Try and shift our circadian rhythm though. And that is something that I work with a lot of people on, trying to get people to sleep in later in the morning, especially little kids. And that has a lot to do with light. So making sure that we are not eating when we should be sleeping and making sure we're not being exposed to light when we should be sleeping. And that's something really important for when we're jet lagged as well. Because if we go across the world, and we're in a different time zone, and we suddenly we're in our new time zone, it's 2am. But back home, it's daytime, we want to make sure that even if we're awake and can't sleep, we're keeping ourselves in as much darkness as possible. And we're trying not to eat too much because we're trying to tell our body what is day and what is night.
Lesya Liu 25:51
Mm hm. And so, you know, you said that teenagers, for example, have a little bit of a different circadian rhythm. But I know one of your specific special areas of expertise are kids and infants and like you've already mentioned at the very beginning, you know, new mothers do not get enough sleep. So can you speak a little bit about that on two levels? First of all? What kind of negative effects are happening if the newborn doesn't sleep the way they're supposed to sleep? And how does that affect new mothers? And how can we address those I guess for both mothers and the child? How can you find a new schedule that works for everyone?
Julia Glowinski 26:42
Yes. So I think what's really important to remember for young babies is that, yes, sleep is really important for them. It's so important for them for their development and for their mood and further growth, but we often Don't take into account the effect on the mom. And it's not just that moms are tired or dads sorry, two ads do. It's not just that parents are tired, it's that they're actually sleep deprived. And sleep deprivation is a form of torture. And like we've mentioned so much it plays a huge impact on our mental health. And it can also impact our attachment, our connection with our baby, if we are not doing well, our babies might not be doing well. So it's one of those things I always think it's like putting on your oxygen mask first; we really have to take care of ourselves to make sure we can also take care of our baby. So a lot of the work that I do is working with family is to find what they are comfortable with and getting their little one to sleep and try to meet them where they're at. Some people want to do sleep training, where we're choosing a method to try and help teach a baby to sleep. Some people want to just change certain aspects of the routine or the timing of naps or bedtime, and work from that angle to try and improve sleep. And my job, I think what's unique, I guess, is as a social worker, trying to really see where the family is doing on a level of the well being of the family as a whole how everyone's working together, what is going to make that family less stressed and, and, and grow together overall and get the best sleep possible that they can. And sometimes that involves, it involves always, I guess, taking like doing a full assessment of all the different aspects that could affect sleep because it can have a huge impact on mom or dad's mental health. And I think that that is something that some parents don't realize that it's not just about baby sleeping. We're not doing ourselves any favors by being up the entire night. Worrying about a baby not sleeping Or with a screaming child if we can't function during the day?
Lesya Liu 29:05
Mm hmm. Yeah. And I think a new baby is such a beautiful and important life event in the life of anyone, right? And yet, I think sleep deprivation always has this like, very negative effects on that time of our lives that are supposed to be one of the best. I know it compares moods and it also is like a major predictor of postpartum depression. Can you speak a little bit about the connection between sleep deprivation and the postpartum depression?
Julia Glowinski 29:42
Absolutely. And that is such an important piece. And yeah, so when we're not sleeping, we are more likely to have our mental health fail us. And it is, it definitely is a predictor. It's one of the most important predictors of postpartum Depression. And a lot of people struggle with postpartum depression. There's so many of us who do. And we often don't see that connection. Because when we're in it, it's hard to acknowledge and we feel so lost. And we don't really feel that there's any hope. It's hard to feel that things are going to get better when our baby is up every two hours. And for moms who are up and sometimes moms have help with a partner, or a night nurse or someone in the family who can come and help feed so that they can sleep for moms who are nursing and feel that they really are the only person who's responsible. There. I have clients whose babies are eating literally every hour, overnight for weeks at a time. And those are things that absolutely can contribute to postpartum depression, whether it's a full diagnosis of postpartum depression or it's just What you can call postpartum anxiety or baby blues, it really plays a huge role. And it's so important because it's a very dangerous territory to enter when you don't have the proper support. And it's something that I struggled with, with my second when I was so sleep deprived. And it it's a very real thing and I think that's something that I'm really really passionate about is trying to make that change and and give people hope that this there's a way out there is something that we can try and work on to get baby sleeping because it's not baby doesn't need to be eating every hour. There's something that we can try and, and work on scheduling the environment, how they're falling asleep, when they're falling asleep. When they're eating, there's something that we can do that that we can do to make positive change.
Lesya Liu 31:55
Mm hmm. So it seems that sleep affects all the parts of our lives from mental health, physical health. So is there really a merit in the saying "sleep on it?" You know, when we are faced with tough decisions, or you're unsure on how to proceed in our life the next day. Does it really work to "just sleep on it?"
Julia Glowinski 32:22
What a great question. Yes, it really does. Because we're processing so much when we're asleep. When we sleep, and we're waking up with a clear head, hopefully, we slept well, and a clear mind and we're able to reset ourselves. Tomorrow's a new day, and we hope to wake up and feel that way. And we really are able to process things differently differently. We're taking a break. And again, like I said, we're separating that day, from nighttime, and therefore we're separating one day from the next. It's like a whole new beginning where we can try and reset and I think that's a really Good point. It's a really valid, valid way of looking at things so that we can sleep on it and reset ourselves. Mm hmm.
Lesya Liu 33:09
So I know. Thankfully, the conversation has shifted dramatically in the last couple of years. But it was always like a badge of honor. When people would work late or you would be on call 24 seven, or it was always like a badge of honor that you slept for hours a night and now we're chugging coffee and gallons and stuff like that. So thank god this, this shift has begun. in corporate culture, especially, but can you speak a little bit about how we can continue to make this shift in corporate culture in our interpersonal connections with other people? How can it really Make it as clear as possible that sleep and mental health are so interconnected and that getting a good night's sleep is actually one of the best boosters of productivity and mental clarity and all the good things that come associated with quality sleep at night?
Julia Glowinski 34:22
Yes, and I love that. And I think corporations are really starting to take notice, especially from the productivity piece and the missed work and the illness that can ensue if we're not having enough sleep. And a lot of corporations are putting things in place a lot of forward thinking companies have nap areas which are amazing little nap pods. And there are rules that you have to take vacation like you need your rest. There are rules that emails from Don't get sent out after a certain hour, which I think is fantastic. Because there's so much pressure. If someone's sending an email out late, you feel Oh, gosh, everyone's working. So I need to send it out late too. So I think one of the ways that we can be leaders in this area and really try and create a healthy environment for employees, as businesses would be to try and put those things in place. Now, not everyone is going to be able to have a nap at work or those types of things. Definitely. hours that emails are sent out. I think that if it's something you can always schedule, so if someone wants to work late, they can schedule the emails only sent in the morning to create a better culture that's more interested in health and wellness. A lot of people are doing more initiative. So I speak to a lot of companies and they're inviting new sleep experts in to talk to people about how to get better sleep and I think it's about really trying to make sure that the environment you are creating for employees is about not about trying to get people to pull all nighters and stay up all night and do work, but really working well working hard while they're at work, and then taking time off and taking time to focus on their health.
Lesya Liu 36:26
Mm hmm. I couldn't agree more. Julia, thank you so much for this conversation. I think we've gotten so much great insight into mental health and sleep and the importance of sleep in our day to day performance. So I thank you very much for this episode.
Julia Glowinski 36:45
Thank you so much for having me.
Transcribed by https://otter.ai
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