Low Cortisol

PerformHER | Optimizing sleep for health and performance with Kate Vazquez and Laura Decesaris

 

In this interview, Laurie, Kate and Laura discuss Optimising sleep for health and performance and easy tips so that you can get the best sleep.

This is a transcription of an Instagram live conversation. You can find the full video on Laurie’s IGTV tab on Instagram and on soon on YouTube.

Laurie:

Hello, everyone. I am joining Kate and Laura today. We’re gonna be talking about all things sleep and women performance. I can’t wait to get it on with them. 

How do you feel about the topic of sleep?

Laura:

It’s one of my favorite things. It’s still one of the most common things thatI hear from women. Their sleep is disrupted, especially during their thirties, forties and beyond. It’s definitely always in the top three complaint lists. So a really important topic, because without sleep, nothing else really works the way it should. 

Laurie: 

Exactly, that’s why I am so excited to be talking about this. Kate, Laura and I are all about optimizing health and the topic that we picked today was sleep. It’s one of my favorite topics. Actually I’d say it’s one of my favorite tools for health optimization, because really learning how to dial into sleep has been a game changer for me. 

I first started learning about it as an athlete, because you have to recover, if you wanna get to your goals and sleep was my number one recovery tool. I still have so many tips to share, but like I’m not gonna hog the show here.

Laura:

So Laurie, your area of expertise is blood sugar. And more and more people are waking up to the importance of that hormone for women’s health. Why don’t you start by telling us a little bit more about blood sugar and sleep? Can your blood sugar management be related to your sleep?

Laurie:

Absolutely and vice versa. When you have a poor night’s sleep, it’s going to throw you off for the next day. And I’ve seen this on continuous glucose monitors when I’m monitoring myself or when we monitor clients. Poor sleep changes your hormonal landscape. It’s affecting cortisol. It’s really affecting how well you manage blood sugar. So if you’re somebody, who has blood sugar regulation issues, sleep is always one of the levers that we can adjust to help you better manage blood sugar. 

At the same time, a lot of women are running around thinking that they don’t have a blood sugar issue. They haven’t been diagnosed with diabetes or prediabetes, so they think they don’t need to worry about it. But a lot of women, even if they’re in very good health, have blood sugar issues, that’s causing some of their most frustrating symptoms.

Typically there’s problems with energy, maybe brain fog, focus, motivation or even things such as period problems. So I’d say sleep dialing and sleep is important for blood sugar health. 

At the same time what we can also notice is that if you have poor blood sugar regulation and your blood sugar goes quite high, right before you decide to go to bed, that’s also going to interrupt your sleep. What we’ve also seen on continuous glucose monitors, which is what I use with my clients, is that if your blood sugar was high just before you went to bed and it didn’t have time to come down again, oftentimes that could even wake you up in the middle of the night. We see all sorts of things going on in the evening that have to do with how your blood sugar was looking throughout the day. So actually really dialing in blood sugar throughout the day can help you have a better night’s sleep and be more restful and wake up feeling more energized. 

So I’d say it goes both ways and they are two pretty important things to think about in terms of performance and optimizing health. So that’s my input there and I’ll let you two speak.

Laura:

Yeah. It’s such a big topic to unpack, but so important. I love that you use CGMs too, because that wearable tech can be just so insightful.

Kate:

I actually have one on right now and I’m monitoring my blood glucose. We just had this virtual retreat over the weekend and the course was ending later than I normally go to bed. I was going to bed past my bedtime and my blood sugar was up throughout the next day, because my sleep was impacted. 

It’s so important, because you don’t know until you track it. That’s the importance of getting sleep, is not just so you can feel better and perform better, but it impacts your cells. It impacts your glucose levels. 

Laurie:

And your immune system.

Laura:

It makes me flashback to pulling allnighters in college and thinking that was a good idea. If I knew all this stuff then…

Laurie:

I like what you said Kate and I wanna add to that. Don’t take my word for it, put on a continuous glucose monitor, stay up late and see how it affects your blood sugar the next day.

How about you Laura? When it comes to blood sugar and performance?

Laura:

Oh gosh, that’s a giant topic. We could have multiple series on that alone. I first got into looking into blood sugar a couple of years ago. It’s not necessarily once someone was diagnosed with diabetes, but kind of this weird in between place. It’s where we see patterns of blood sugar going up and down and being very irregular throughout the day and night.

It’s true. You don’t know it until you track it. I’ve seen women who eat a really healthy diet, who are not eating a lot of sugar, but still have really crazy blood sugar. 

A lot of times I think it’s really tied to what’s going on throughout the day. What’s going on with their stress levels? What’s going on with their brain health, maybe brain inflammation? That can all affect blood sugar.

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When it comes to sleep in particular, I feel like a CGM is one of the best things to wear. I know there’s things like Fitbits and Oura rings and stuff like that. But if you’re a woman, who is like waking up at 2, 3 or 4 am all the time, 75% of the time that pairs with CGM readings. You see this crazy blood sugar drop in the middle of the night, because things are irregular and of course your brain is gonna wake you up. You’ve run out of food for it and it still has work to do. 

What kind of sleep pattern do you fall into? I see three major patterns of sleep disruption in women. 1) I can’t fall asleep and I’m tired, but totally wired. 2) I’m waking up in the middle of the night and 3) I sleep all night, but still wake up exhausted. 

Blood sugar can definitely contribute to any of those, but especially waking up in the middle of the night is a really common theme.

Kate:

I completely agree with that as well. Waking up between two to four could be a blood sugar crash. But also, are you stressed? What do your hormones look like in terms of your cortisol? Is the cortisol too high before bedtime? Or is it too low? 

If you’re wired and tired before going to bed, most of the time it’s because cortisol is still too high and cortisol should be dropping at night, which leads to melatonin increasing. Melatonin also helps us to sleep at night. If that’s all not happening, because cortisol levels are still high, our body is not getting the signal to start producing melatonin and wind down to go to sleep. So that’s why a lot of women will have trouble going to bed at night, because they’re just feeling so wired still. 

If you’re sleeping through the night and still waking up tired, after sleeping nine plus hours, that’s usually a sign of low cortisol. Which is another thing that can affect our sleep.

Laura:

Yeah. I’ve been there. I have this theory that like for high performing women, burn out is kind of fun. It’s like touching a hot plate at the restaurant and seeing how close you can get without getting hurt. 

I’m curious Kate, because I know you’re a hormone expert. We’re talking about stress. We’re talking about cortisol. Do you particularly see patterns in relation to women’s hormones at certain parts of their cycle, where they are more prone to this? I feel that if women can kind of know specifically when to queue into that, it can really save them a lot of grief in the long run.

Kate:

Oh yeah, absolutely. First off in the luteal phase, when our progesterone increases that actually raises our body temperature. At night we’re supposed to keep our rooms nice and cool, but then when your body temperature comes up and your room’s not really cooling down it can be difficult. In the summertime I like to sleep with a very thin sheet at night just to keep my body cool, because during the luteal phase with my progesterone peaks, I am hot and it also impacts sleep too. When we have lower body temperature at night, we sleep better. So I always recommend that women during their luteal phase turn on the fans, see if they can turn down the AC a little bit and get that room a little bit cooler, so they sleep better. 

Then there’s hormonal imbalances. A lot of times women have low progesterone levels and when progesterone is peaking, during the luteal phase, it affects our sleep. But when progesterone is too low that can create problems, because progesterone also helps us to sleep at night too. When we have a nice balance of progesterone and ratio of progesterone to estrogen, we’re gonna be sleeping a lot better at night. 

A lot of the hormonal imbalances that I see is low progesterone, which creates that estrogen dominance effect in the body. It’s really important when I look at women and their sleep being impacted. What does their cortisol levels look like? If it’s too high, we definitely wanna address that, because that’s also probably causing lower progesterone levels. I help women work on those two components. That’s a huge piece when it comes to hormones and a lot of women don’t realize that it’s all related, the cortisol, the progesterone and the quality of our sleep.

Laura:

Love that. If you’re wondering what your progesterone is, be sure to get tested. Every woman I talk to, who is in that perimenopause or menopause phase misses their progesterone more than anything else. So optimize it while your body can really pump that out, because it goes so far beyond fertility. It is that calming thing that keeps us sane and happy and we want as much as we can.

Kate: 

Oh yeah, absolutely. When you mentioned that perimenopause to menopause transition, of course progesterone was the first hormone to start declining. That’s when a lot of women tend to have issues with their sleep. Sleep issues can happen before that, anywhere from your twenties to forties, but it’s definitely something to think about as well.

Laura: 

We’re straying a little bit from sleep here, but it’s all relevant to me. What is your favorite go-to for raising progesterone? I personally have started using Organifi’s harmony product. I feel like it optimized my levels so quickly, but I’m always curious what other people’s go-tos are when they start seeing that pattern, other than obviously like addressing stress and lifestyle changes. 

Kate:

Absolutely. I was definitely gonna say, make sure you’re addressing the stress component. Helping women to adapt and calm down the nervous system, because then the body’s gonna go from survival and producing more cortisol to a parasympathetic state, which is that rest digest state. In that state the body’s gonna produce more progesterone, but we need nutrients. 

We need nutrients to help support progesterone. So I always like to check the vitamins, especially B6 and vitamin C. Your adrenals need vitamin C and when we’re stressed, we’re depleting it, but we need vitamin C to produce progesterone as well. So optimizing nutrients, B6 and progesterone. I also love Vitex, a naturall herb to really help support the production of progesterone in our body in the evening. 

I do wanna give a disclaimer, don’t take Vitex without getting tested first, because especially if you have PCOS. A lot of women with PCOS will have high levels of LH, which is luteinizing hormone compared to FSH. It should be a one to one ratio, but most women are two to one or three to one. When they take Vitex, it can increase LH and worsen PCOS. So don’t ever take any herbs or supplements without consulting with a medical practitioner first, to get tested and to make sure it’s okay for you to take these herbs, because even though they are helpful, they can also worsen things. If you are in the clear and you’re good to, I love Vitex.

Evening Primrose is another one of my favorites. Bladderwrack also helps to support progesterone and estrogen metabolism. Be careful if you have thyroid disorders, because it does contain iodine. So those are my few of my favorite ways to really help naturally support progesterone.

Low Cortisol

Laura:

Your big takeaway is: Test, don’t guess.

Kate:

And make sure you’re doing it with a licensed functional medicine practitioner.

Laurie:

Before we go, what other last tips or suggestions or things would you like to say about sleep?

Kate:

I’d love to know. What is your favorite? All of our favorite sleep hacks, because I think everyone wants to know what we should do to really improve our sleep?

Laurie:

My favorite sleep hack is actually just winding down before bed and turning off screens. I put on some blue light blocking glasses and I tried to really engage more in activities that help me bring the stress levels down. 

So anything that could potentially cause stress like checking my email, I try to avoid that in the hours just before bed. All so that I can really calm down and have the best night’s sleep. I also love magnesium.

Laura:

I have a few things that I love. I think finding your own personalized routine is always gonna be key. A lot of women think they’re winding down at night by just scrolling through TikTok or social media, because it doesn’t feel like their brain is as engaged as when they’re working. But your brain is very much still engaged in processing, when you’re scrolling through videos. Really teaching yourself to put that aside a little bit before bed and giving your brain an actual minute to calm down and start promoting that restful sleep is important. 

My sleep routine is phone down and lights down. I have salt lamps that I turn on in the evening just to start getting that more natural light rhythm in. I use a sleep mask and mouth tape, which sounds a little extreme, but like I want things dark and I wanna get that nasal breathing to make sure that I’m sleeping really deep. It’s very simple to train yourself to do that. Anyone can do it and it definitely, lets you get into that deeper sleep level.

Laurie:

I love those tips. 

Kate:

I haven’t done the mouth taping yet. But that’s something that’s talked about a lot and it’s a really cool tip.

I too do a wind down routine before bedtime and I put my phone on, “Do not disturb.” It starts at 6:00 PM, because I go to bed at 7:30. An hour and a half before bed, all electronics are shut off. I shut down my computer and put my phone away. I like to take an epsom salt bath or drink some tea with a camomile. I have a pulse electromagnetic field mat that I like to lay on to really help calm my body and listen to calming music. Whatever your routine is, I always recommend doing at least an hour or an hour and a half before bed. I turn down the lights too, because it’s sending the signals to the brain. But red light really helps to produce melatonin in our bodies as well. 

Have a regular bedtime routine too. A lot of times we’ll go to bed and it’s very sporadic. If you can actually have a regular bedtime routine, where you’re going to bed and waking up around the same time every single day, that really helps to improve your sleep as well. 

One last tip, have a regular bedtime routine and even go to bed 15 or 30 minutes earlier and see what happens with your sleep. It can work wonders

Laurie:

Absolutely.

Laura:

Love that. I wanna add like one quick thing, if you’re a Mom and you can’t do all this, just pick one thing that you can do. Maybe it’s just winding down with the lights or making sure you’re not on the blue lights late at night. Maybe it’s like trying to schedule a quick nap in the middle of the day. Maybe it’s like trying the mouth tape, if you find that you’re constantly waking up with a dry mouth. Pick one thing, you don’t have to do all of these things.

Find out more:

Connect with Laura on Instagram @dr.lauradecesaris and check out her website.

Connect with Kate on Instagram @katevazquez_pa and check out her website.

This information is for educational purposes only and is not intended to diagnose, manage, or treat disease or serious conditions. Always check with your doctor before making any changes. It’s important to consult a well-informed health practitioner for personal advice about your situation before relying on general information we’re all wonderfully unique.

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Laurie Villarreal, FNLP, CHWC, FNS, LMC, CPT, RYT

Hi, I'm Laurie, a functional nutritionist and health coach, athlete, dog-mom, and biohacking adventure-lover. After having struggled for years to find lasting solutions for my own debilitating hormone-related symptoms, I created my online practice to begin helping other active, driven women get the support they need. I now help  women around the world elevate their health, energy, business and life by optimizing their hormones with personalized nutrition and lifestyle tweaks. Together, we discover new tools and strategies that keep you showing up at your best so you can play even bigger in your life and work.