This is the Whole Care Network. Music Helping you tell your story one podcast at a time. Content presented in the following podcast is for information purposes only. Views and opinions expressed in this podcast are solely those of the host and guest and may not represent the views and opinions of the Whole Care Network. Always consult with your physician for any medical advice and always consult with your attorney for any legal advice. And thank you for listening to the Whole Care Network. Music Do you wish you could get a good night's sleep? Uh-huh. Oh, yes we do. In this episode, Nancy and I are talking with the amazing Dr. Glenna Brewster, who is with Emory University's School of Nursing. We're talking with her today about her sleep study and creating good sleep habits, which we can all use. Yes, we can. And we're sharing five tips. Welcome. We are Sue Ryan and Nancy Treister. This podcast brings our years of experience in a variety of family caregiving roles to prepare you to navigate your caregiving journey. We're sharing our personal experiences, not medical advice. And because it's our passion to support you on your journey, we believe no topic is on limits. Let's get started. Music So welcome. Thank you for having me. We appreciate it. Let me introduce Glenna to you because you're going to be very impressed. And then I can't wait for you to hear all about these good sleep habits. These are great habits. Because Sue and I've already learned a lot just having a discussion with Dr. Brewster. So we're really looking forward to sharing these with you. Dr. Glenna Brewster is a nurse scientist, family nurse practitioner, and assistant professor at Emory University School of Nursing. Gracious. That's a lot. It is. I feel very undereducated. She leads the Mind at Rest research team, which develops and tests practical, evidence-based programs to reduce sleep problems and improve health outcomes for people living with memory loss or dementia and their caregivers. So listen up, people. This isn't just about your care receiver. This is about you too. Dr. Brewster's work is recognized nationally and internationally for advancing dementia care and supporting family caregivers through the community partnerships and research. So thank you very much for joining us today. Thank you very much for having me. And please tell us more about your study. Thank you. Sleep problems, especially if you're a caregiver or person living with cognitive impairment, you would recognize that they're significant and you would have a hard time falling asleep. You might have wake up multiple times during the night, or you might notice that as the disease progresses, that there is daytime sleepiness. So sleep disturbances are prevalent both in care partners or caregivers and people living with cognitive impairment. And that is what I wanted to understand and address. As a result, I have developed the Sleep Mate Study. That is a study for both caregivers and people living with cognitive impairment across a trajectory to dementia, where we are wanting to see whether or not this intervention, it's a six week virtual intervention, and you participate together. And I want to see, is it feasible? Is it acceptable? And does it improve your sleep outcomes? And when you participate, we are asking you to wear a watch because we want to see how it is, you know, objectively that you're sleeping. We also want you to record it because we know sometimes how we feel and what we see might not be the same thing. So we want to look at it objectively and subjectively. We're also asking you over a few months to fill out some questionnaires to determine, you know, does the intervention help with how you feel psychologically? Does it help with your quality of life, both for you and the person living with cognitive impairment or dementia? So what I want to tell you is there's more to find out, so stick around. And as we get to the end of the program, you can find out how you qualify for this. Wonderful. And this topic is so valuable and Nancy and I have both learned the need for quality sleep and what not having it is like. And while we've also learned that we're so focused on quality sleep for our care receiver, that we don't necessarily prioritize our own sleep. And as caregivers, our quality of sleep is every bit is important. And actually, you know, sometimes even more important than there. So what you're doing is really, really helpful. And that leads us to the first tip, which is really pretty straightforward is how do you practice good sleep hygiene? What does that mean? So sleep hygiene means developing daily habits that would facilitate and lead to getting good sleep. And good sleep has to do with when you fall asleep, you're able to not necessarily sleep all the way through the night, but at least get some consolidated. And that means getting a few hours of sleep where you can sleep straight. Or if you wake up during the night, you're able to go back to bed and fall back asleep. I don't necessarily say good sleep has to do with when you wake up in the morning and you feel refreshed because you can get good sleep, but not necessarily feel refreshed when you wake up based on the stage of sleep that you're in when you wake up. Interesting. Yes. So we say when you're practicing good sleep, one of the first things I say is do your best to go to sleep around at the same time. So within about 15 minutes before or after. So for example, if you're targeting 9pm to go to sleep, try to get to sleep by 9, but within the 845 to 915 window and then get up at the same time each day. Most of us may have a hard time getting up at the same time each day. So set an alarm if you're going to have a difficulty waking up at the same time. And you mean the weekends too? And I mean the weekends too. Yes. It might be difficult. I know we want to sleep in. But what we want to do is get our bodies into the pattern and the habit of waking up at the same time each day. And you'll find eventually that you might not even necessarily need an alarm because your body gets used to doing that. And then you just wake up at that same time each day without needing the alarm. And so what you're saying then is it's while we want to get to bed at about the same time, it's more important that we wake up at the exact same time every day. Yes. Okay. Interesting. The next thing is we, many of us like to drink coffee, but caffeine can actually impact our sleep. And you know how you respond to coffee and your loved one or the care recipient. So based on what that response looks like, then we recommend if caffeine keeps you up, then having your coffee, you know, and if caffeine keeps you up, then having your last cup of coffee or having your last coffee drink before noon. Be aware though that coffee isn't many things. So caffeine can be in medication, caffeine isn't chocolate. Caffeine is not only, I know I have a hard time with that. So being, being aware of that whenever you're eating anything and being considering whether or not it contains caffeine. Also trying to limit alcohol and having large meals or if you do smoke nicotine or anything like that, that might impact your sleep to two hours within two hours of bedtime. So if you're planning to go to bed by nine, I will say the last time you should have your drink or the last time you should have a large meal would be, you know, like seven o'clock might be the late test. Exercise two is something we encourage you to exercise, but when we're exercising too close to bedtime, it actually makes it a bit harder for us to fall asleep. So if you want to do something, we encourage you to do like, you know, gentle stretches. And then finally, we all like to drink water, I'm sure. So whenever you're drinking any types of fluids, also limiting the amount of fluid you have to within two hours of bedtime. We say try to not have a lot of liquids within two hours of bedtime, because we know for sure that when we do have those liquids, then we're going to, it's going to wake us up to go to use the restroom. And we want to minimize the you getting up during the night to use the restroom. So we say limiting liquids. And if you do feel thirsty, then you can have a sip. Just don't have eight ounces of water. Gotcha. And so when I talk a little bit about this for the care receivers in our episode number 13, when we talk about overnight incontinence and really making sure that, you know, you limit fluids late in the day, but also don't forget to make sure they're getting enough fluids. So hydration is critical or else you'll end up with UTIs and other things. So you need to push through fluids earlier so that you can limit fluids later, but it helps everybody. So tip two is to limit daytime naps. And I'm all about that. Let's limit daytime naps because I found if I take the slightest bit of nap that I can't go better than that. That happens. So we think about naps like snacks. Imagine if you're having a snack and it's close to dinner time. When dinner time gets around, you're not hungry, so you don't want to eat your dinner. So if you see napping like snacks, then when we ready, when we're ready to go to bed, then we're not sleepy. I do recognize though that many people like their nap during the day. So one of the things we say is if you must nap, try to keep it to less than 30 minutes before 3pm. Okay. Good. Yes. I have a quick question. One of the things I used to do is I would just go sit quietly with my eyes shut and I would literally have my phone timer on for either 5 minutes or 10 minutes. Just to, just to, I wasn't intending to go to sleep, but it was just to kind of decompress. Is that okay? Yes, that is okay. I see that like relaxation. So one of the things we also do in the intervention is we give you a short relaxation to do within about 10 minutes. So I see that like, like that where you take 10 minutes during the day and you just have that time to, as it were, get back into yourself. And that's just a pleasant activity, a time to just relax and decompress for a few moments during the day. Another thing to think about is if the person who is living with cognitive changes or memory loss, as the disease progress, we see them sometimes wanting to sleep more during the day. Or sometimes even after the person gets the diagnosis, then all of a sudden they're not doing anything anymore. And guess what? When we are not occupied doing things, what do we do? We tend to sit around and sleep. Meaning throughout the day, the person who is living with cognitive changes or memory loss or dementia would be sleeping and napping a lot. And I say to many of the caregivers I interact with to work with them to find the things that they enjoy doing. The diagnosis doesn't mean that all of a sudden they're no longer able to do anything. So is there something that they enjoy? Is there something that they did before that they could continue to do and let them do it? So for example, my grandmother lived with vascular dementia for a few years. And when she was living with us, she always loved taking care of us when I was growing up. I'm an only child. I'm her only grandchild, so you can imagine. But she liked taking care of us and taking care of the house. So when she lived with us, she would always take the broom and go and sweep and I would say that's fine. It's something that's keeping her occupied and she was in a safe environment. So as long as there is something that you can identify that the person enjoyed doing before, that they can continue to do in a safe environment. They can help prep for meals. They can help do the dishes. They can sort the laundry. They can fold. It might not be how you would want it. It doesn't have to be perfect, but it keeps them engaged. It keeps them engaged. Yes. There does come a time though when it's time to go to bed and you've got some really good guidelines about, okay, we're serious about this now. Let's be intentional when it is time to actually go to bed and sleep for the night. Tip three is make your bedroom like a cave. I love it. I love it. And yes, imagine with me what cave feels like. So it is cool, dark and quiet. Cool is different for each person. So it's relative. Yes, it is. My cool might be 65 degrees, but yours might be 70 or 75. Or 80 if you're so... It's relative, right? It is. Yeah. So therefore working with the care receiver to figure out which temperature is ideal, making sure that it's cool and then setting it there because our body likes cool when we're falling asleep. Yeah. So darkness and dark means turning off the lights. I do recognize and one of the caveats I always say is, especially for the person or you yourself as a caregiver, when you're getting up to use a restroom at night, you need light. So having a plug in with light that's movement activated in one of the lower outlets would help. So when you get up, the light can come on and show you the way to the bathroom. And the other thing is quiet. Quiet can be, you know, there is no sound, but then some people do like sound. So if you do like sound, I would recommend using white noise or brown noise or pink noise, having the fan on, fan with consistent noise, not something that's going to change in frequency. Yes. And sometimes it can cover up the noise that's not consistent. Exactly. Exactly. So you don't want something that's going to change in frequency and variation with the noise. Which we'll talk about that later. We will talk about that later. Yes. My favorite thing about quiet, if I think quiet all the way through is quiet isn't just the noise around you, but quiet is quieting your mind. And tip four is something I never, ever thought of before. And I love it, which is schedule worry time earlier in the day. Where were you a few years ago? Exactly. Because I would have been really, really good. This is a brilliant one. And whether or not you're a caregiver, you worry because life is happening and when life happens, we all have experiences that we're going to think about and process. So it might be something that happened today that I need to process or that I have things that are happening tomorrow that I need to plan out. And guess the best time that we do that or we think about that when the day is done and we go and we lay down in our bed, it's the ideal moment for all these things to come back and flood our minds. You're like, hey, we've got a place to come. Come on. Here we go. We're going to go. They're quiet. We can come in. We can come in now. That's enough time for me. Right. Here I come. There's a community effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort effort you're thinking about it and processing solutions then wake up and get out of the bed and go somewhere else and do it because we don't want your mind to associate being in bed with doing all these other things. If it's a small minor thing that you just need to write down and then turn over and go back to bed then it might be okay to have a small notebook closer to your bedside that you can jot it down and go back to bed but if you're going to be awake and thinking about it be awake outside it's a huge distinction because I know that I would wake up and stay in bed and be thinking through things sometimes for hours working through things or working computer on the bed. Not working for a thing, not working out. Back sleep yeah yeah so that's really a valuable tip. Which is the whole point right of tip five which is actually only do the things in the bedroom that need to be done in the bedroom right make the bedroom the bedroom. So keep your bedroom for the three s's sleep sickness and sex avoid scrolling on the phone especially these days we do that a lot we get in bed and we say oh we're not ready to sleep yet so let me get my phone and see what's going on on Instagram Facebook TikTok there's so many things to keep us awake these days um the television many of us have a tv in our bedrooms and we might have a hard time giving it up but I tell people who participate in my studies just try it for a week and see how it goes and then after that you can reevaluate avoid working avoid reading so anything that's not those three s's avoid doing them in the bed and the goal is to connect your brain with going to bed and going to sleep so you want when you go into bed that this is a cue for me to go to sleep and not a cue for me to do all these other things which are not sleep. That was huge for me because I was not aware of that being a thing I mean when you're talking about the the time that you get up and and having your body associate so you're what you've learned is that your body actually does associate I'm going to bed I'm going to sleep and you teach that to it you mentioned that there was someone in your study who at first was like oh yeah I'm not doing that and then you encourage them to do it for a week which they did and what was the outcome. I think that's one of the if if it's the only thing that they remember it is that and I have asked them to to talk to other participants and that's one of the first thing they mentioned the fact that they initially didn't want to give up the television and they did and how much that actually improved their sleep at the end. Love it. That's awesome. Well you mentioned to us and I thought this was interesting I hadn't really thought about that is you know you go through sleep cycles right and some are lighter sleep but when you're in a lighter sleep cycle the television is actually interrupting your sleep because it's noise and back to noise again. Glenna thank you so much I've learned a lot from this Nancy I think you have as well things we just weren't aware of that can be very very helpful and you're actually doing a study about this so you kind of did the teacher about that in the very beginning please share for us more information about the study. I will be happy to so hopefully you have learned a few tips that you can use to incorporate in both your and the care receivers sleep routine as you move forward and this study as a reminder we're recruiting pairs so both a person who is living with cognitive impairment and that could be subjective where they feel like there is some cognitive changes happening across the trajectory to dementia you don't have to be diagnosed so the person who is receiving the care the care receiver doesn't have to be diagnosed with dementia just have a complaint or an experience of cognitive changes and care givers or care partners so both people participating both having some type of a sleep disturbance or a sleep problem so that could be difficulty falling asleep difficulty staying asleep meaning that you fall asleep and then you wake up and when you wake up you have a hard time falling back to sleep or significant daytime sleepiness or some other type of impairment during the day it's for people who are living within the contiguous us so any of the united states states you are eligible to participate and you do get an auditorium each of you get an auditorium for participating as a thank you for your time and investment in participating in the study and if you have any questions or want to find out more about the study then please reach out to us or telephone number is 404 712 9164 or you can email us at drbrustalab at emory.edu or you can check out our lab's website it's www.mindatrest.org that's such a great name it is a great name such a great name and we'll put all these links in the show notes as well so that if you didn't get a chance to write those down we'll put them in the show notes and we'll also put them in the notes the block there you go so it'll be easy to find yes well we really do appreciate it i want to thank you very much as well and uh and tell you how much we enjoyed and hopefully we'll i'll execute on some of these things myself i hope you can yes thank you very much so let's summarize today we talked with dr glennah bruster about her sleep study we talked about five tips first practice good sleep hygiene second limit daytime naps third i love this one make your bedroom like a cave fourth and i love this one too actually i don't know which one i love the most schedule worry time earlier in the day i wish i'd known that years ago oh so do i and the fifth one is keep your keep the bedroom for the three s's and if you have tips that will help people sleep either as caregivers or for their care receivers please put those tips on our facebook page our instagram page the links are in the show notes as all our podcast reckon pay attention to the podcast number and go to the caregivers journey dot org and you can find the blog with the same number and effectively we've taken notes for you that's what the blog is if you like this podcast please share it with other people that you think it might help please follow us or subscribe to it we really really appreciate it and as we always say we're all on this journey together
