Fix Your Sleep, Fix Your Pain & Fatigue

Annika Carroll

Rodger, thank you so much for having me. I’m excited.

Rodger Murphree, DC, CNS

I think your background was really interesting because as a sleep coach and you really specialize with women, which fibromyalgia is 80, 90% females. But your background’s also you’re a functional practitioner as well. So you incorporate some neuroplasticity, some brain retraining, which several people here on the summit have. We’ve talked about that. And then for some functional medicine principles that, you know, we all know and love and that combination has really allowed you to be incredibly successful with your clients. But what I want to know is how did you get involved to become head of the sleep bar, a sleep like a boss company? I mean, where do that even come from?

Annika Carroll

You know, it’s a bit strange if you think about I have a background in international business. I used to work in the corporate world at Human Resources and I completely burnt myself out. And I was at a point where it was after our son was born, which was a very traumatic experience. And I went back to work and I gave it all and it was just too much because I ignored myself like nothing else. And then I just couldn’t get up anymore at some point and I basically quit working and started to figure out how to heal myself. And that was somewhat successful. I had a great general doctor who really tried his best, and I had a therapist I went to see which did something. I went to see a naturopathy doctor, which is something, but I wasn’t, it wasn’t all good. And I then had a second burn out because we actually moved from Germany to Canada. And I live in Canada now. My husband’s from here and yeah, so that was a big adventure and that was a bit much. And then every time I was burnt out, I wasn’t sleeping and I did not understand that because I was like, you know, my body is just screaming for a rest and I try to sleep and I can’t. And every morning at one I’m awake til at least four, sometimes five. 

And if it was five, I’d just get up. Like that one hour doesn’t me. And I was just like, I’m never healing if I can’t figure this out. And then I ran into a functional practitioner who, like, looked at me holistically and looked at what was going on inside my body from the gut to the hormones to my minerals, to my heavy metals, my thyroid, everything. And we put a plan together and I started sleeping better. And then I found somebody else who was doing similar work with people who are not sleeping, adding on the whole mindset and neuroplasticity work. And I was like, Yeah, this is what I want to do because there are so many women out there and women more than men, there’s lots of people struggling with sleep that women generally more than men. And if you have an autoimmune condition or anything of that kind, there’s pain involved. Then it’s even harder to get a good night’s sleep.

Rodger Murphree, DC, CNS

So ironically, as a recovering insomniac last night, I did not sleep. A wink made the mistake of getting into bed way too late and knew I had an early morning. And normally this it hadn’t happened in a while. So this is very unusual for me. But I can identify and of course everyone that’s listening to your story is going, yep, yep, that’s me, that’s me. Burnt out now, kid, you know, it’s crazy that you can be so tired and you think I’m exhausted, but you’re so tired you can’t even sleep. And the people have had fibro, so they definitely identify with that. And normally I can take out of necessity. Over the years I developed a supplement called Delta Sleep, which is a combination. We’ll talk about some of the things that you recommend too. 

But gamma me, butyric acid ashwagandha l-theanine sort people you know, valerian root. Some of you may be familiar with some of these things, but normally I can take that when I wake up at 3:00 in the morning and I’ll put me back to sleep within 1015 minutes. I don’t have any it’s not there in my bedside table because I hadn’t had to use it so long. But for fibromyalgia, you know, you can identify with Annika’s saying because this is you. I mean, this is with fibromyalgia. This is where I start to make sure the first thing we do is reestablish that deep restorative sleep. Why is it that a lack of restorative sleep is so detrimental to our health? Why is that?

Annika Carroll

Well, because sleep is the time where we heal, recover and grow. Right? Regulate emotions. People often forget that part, that very important, consolidated memory. It’s really that space when we what we like to call in rest and digest. Right. We have this fight or flight, this where we’re always like on the go, super stressed and we all are like, who isn’t really stressed these days? And if we then don’t sleep, we just push our body to the limit and we don’t give it time to rebuild and restore and we just trigger it more and more. We push more and more stress hormones into the system, and the body can do that for quite a while. But there comes a point where this is just going to tick for everybody and it’s having sleep issues. If they’re pain related, for instance, that might be something different. But if you’re pushing, pushing, pushing at your starting to see sleep issues coming up, like that’s a red flag. That is your body saying, yeah, we’re going in the wrong direction here, please stop and resetting. What’s going on?

Rodger Murphree, DC, CNS

Yeah. So when we’re in that deep delta way sleep that really restore to sleep, our bodies healing itself is generating chemicals that we need to be able to handle stress. And if you’re not getting that deep restorative sleep, you bankrupt your stress coping savings account. So you don’t having these chemicals and then stress becomes more magnified. And then you see that you’re further in depletion of the chemicals neuro transmitters that you need. And it’s this vicious cycle that people get in and they can’t get out of it. 

And I talk about it with my patients. They feel wired and tired. They feel some of them feel really revved up. And with this fight or flight situation and we know with fibromyalgia, the audit part one part of the autonomic nervous system is hyper vigilance. So the sympathetic nervous system is really just over going really overboard. And the parasympathetic, which is, as you said, the rest, which is would you sit rest and digest the calm part? The parasympathetic nervous system is dormant. It’s just it’s not working. And this is brought on, typically, as you mentioned, by stress, right?

Annika Carroll

Yeah. And is it for fibromyalgia? Because how I look at sleep is I look at all the stressors that are there for people so they can come from the outside. Right? Like your boss, your coworkers, your teenage family diet, all these things. Right. And but they can also be internal. Like they could be things that are causing inflammation in your body. Right. And that is something that a lot of people are quite astounded about. When we talk about that. It’s like, you know, one of the body’s anti-inflammatories is cortisol. So the body helps like cortisol helps the body keep that in check or suppress the inflammation. And when you cut yourself in is bleeding and it might get infected or something. And there’s inflammation there and the body raises cortisol to heal that cut. That’s great. But if we have gut issues, for instance, we might have a leaky gut or something’s maybe something people have heard of. And that constantly produces low grade inflammation in the body. And that is a constant release of cortisol and really stresses us out and leads to potentially cortisol being higher throughout the day and then at night, then we want it and then we can have melatonin, our sleeping hormone, come in and help us sleep. 

And then we get a really messed up, what we call the sleep wake cycle, the circadian rhythm. And it’s just sometimes you think it’s just the what’s going on. I’m just too busy. I’m just like, but I can’t calm down. I’m not a meditative type of person. I just can’t do all these things good. My mind’s just on fire. But if it’s actually internal and if it your mind’s already on fire, it’s probably partially internal. Either it has always been or that has caused it to be like that. Then it’s really something to look at holistically, to figure out what are all those things that are actually keeping you up.

Rodger Murphree, DC, CNS

So stress is a big one, but as you just mentioned, inflammation is probably the driver. Yeah. And I just this morning opened up in one of my news feeds here, but it was the medical. I’m trying to think of what the meant Medscape News and and they have a a little study in there that they just released and it talks about how lack of consistent deep restore to sleep now they’re they’re associating that with our two year of sclerosis and and then they go on to say that we know we already know this that a lack of this consistent deep restorative sleep can increase your risk of heart disease, type two diabetes. 

And of course, low immune function and low thyroid function, low metabolism increases your risk of weight gain, irritable bowel brain thaw. Obviously, if you’re not sleeping, you’re going to have less energy. And if you’re not getting deeper source of sleep, it’s generating inflammatory chemicals, sometimes up to 40% higher than what they should be. And that kind of makes ties in with that study. Doesn’t is it tells you that you’re not getting that good sleep, you’re generating a lot of inflammation that then can cause the arteriosclerosis.

Annika Carroll

Yeah. And really, like all the diseases you mentioned, have been linked, right? We don’t know exactly. Is there really a 1% correlation yet? But we know that people who have less restorative sleep tend to sicker at some point in their lives. Yeah, it all ties in. It all makes sense. Yeah. Yeah.

Rodger Murphree, DC, CNS

So we have these different triggers that can just throw off our bodies by a rhythm. And you mentioned a few of those. I mean, heavy metals, you would think that having a heavy metal toxicity or really any toxicity issue, whether that small toxins, heavy metal toxins or some type of pollutant can be driving this poor sleep. But yeah, and I think that’s why knock on wood, I’ve been successful with the most difficult insomniacs, because you and I probably approach it the same way we’re looking at as a functional medicine practitioner, we’re looking at what are the underlying causes that are triggering this this individual not to be able to either fall asleep or not to be able to stay asleep.

Annika Carroll

Absolutely. And I think that is the difference that we often see to a classic doctor that you go to. If you go to your doctor, you complain about insomnia. They’re going to tell you in a lot of cases what I hear from my clients all the time. And I was like that, too. Their behavior with too much stress. Yeah. Thank you very much. I know but they’re just not sleeping is causing significant contributor.

Rodger Murphree, DC, CNS

To do it.

Annika Carroll

Yeah but help me please and then sometimes you get information on cognitive behavioral therapy, sometimes they give you a pamphlet on sleep hygiene that you need to keep your bedroom dark and it needs to be quiet and all those things. And those are all important. But if you have serious sleep issues and they don’t want to go away after a stressor in your life has been removed, it could be that there is a situation that just really causes stress at that moment, but once that’s gone, your sleep should come back. And if that doesn’t happen, then we really need to dig into, like you’re saying, what are the underlying issues here? Yeah.

Rodger Murphree, DC, CNS

So with my patients, some of them are really hardcore insomniacs and many of them just the thought of going, getting in bed and trying to sleep generates a fibro flare where they just they get so revved up and so anxious about it because they’re thinking, oh my gosh, it’s Lemme Clock Midnight 1 a.m.. I’m not going to be able to sleep again. And they get so worked up and again, another vicious cycle they get in where they just are just this had this loop, this negative feedback loop, this is going and going. And again, as a recovering insomniac, I totally understand that I used to dread getting ready for bed. Now I’ve learned good sleep hygiene, tricks and tips that I share with my patients, and then some natural supplementation and and really to lighten the toxic load, I think that’s very important as well. But with every patient of mine, the first place I start is reestablishing this deep restorative sleep. Because without doing that and fibromyalgia, you don’t stand a chance. I don’t care what you do. You’ve got to get that right, because if you’re not, the body can’t repair itself. And you’re I mean, if you’re not sleeping, you’re going to be exhausted. If you’re not sleeping, you’re going to have more pain or inflammation more likely. Have you heard about we’re likely to have low moods and feel anxious. I mean, it’s you’ve got to fix that. You have to. That’s a big warning light. That’s true. You got to look underneath the engine and figure out what’s going on.

Annika Carroll

Absolutely. And I think it’s the other thing is also, if you have a condition already and you’re struggling and you’re trying to get better, you need energy. Right. It’s like it’s already a bigger effort for you than for somebody who doesn’t have this condition to maybe even just move. Right. Just go for a little bit outside, not even talking many steps, but just go outside, get some fresh air, some sunshine, all those good things. And maybe when you feel better, actually do a little more. But for people with and with a condition that might be very hard and if we then get some sleep, we just feel like a million bucks. Yeah. And then we can start doing some of these. Implementing some of these dangers that we need to make a lot better because it becomes a little easier.

Rodger Murphree, DC, CNS

Yeah. So what are some of the steps that people can take to start to right this circadian rhythm, the sleep wake cycle that’s become out of whack? What are some of the important first steps they can take?

Annika Carroll

The 1/1 thing that I have all my clients do is we try to actually reset your sleep wake cycle. And we do that mainly through light therapy. So we need we have cortisol, our awake or stress hormone, we have melatonin that’s a sleepy and they work only through light and dark exposure. So getting natural light in your eyes first thing in the morning when you wake up and then it just has to be 10 minutes. If you can do more, great. If you can’t get outside, if you can on your porch with a cup of water, get 10 minutes of sunlight or natural light so your body knows, oh, it’s morning. I’m resetting my circadian rhythm to our morning. Cortisol needs to come up. Okay. That also sets the timer for 14 to 16 hours. When you start releasing melatonin. So as you’re going to start feeling tired at night again, because that’s what we want, right? We want that healthy circadian rhythm. What’s also super important for that is once the sun’s down, really manage your light situation at home because we’ve all like in this modern world that we live in with technology and largely these lights that everybody has in their ceilings, your shining light straight down your head, your eyes and your brain. Think it’s noon, because that is when the sun in the summer is right up high in the sky and we’re sending signals to our brain that tells it. You know what it is not sleep time, it’s go time now. So that is something I would really start managing. If I have real trouble with sleep, then your lights at home try to avoid overhead lighting in the evenings, like get those side lamps from the side tables that people use to read by then where you’re where the light actually shines right under your eye but doesn’t come from above. And that might sound a little funny, but that’s just biology. 

We don’t want to send the brain any signals that say the sun’s still up because the brain doesn’t know where the lamp is or the sun is, where if you want to watch TV or you want to be on your phone, wear orange, blue light blockers. If you’re struggling with sleep, cut that nasty blue light out. If you’re somebody who has a bit of struggle with sleep here and there, you can maybe be a little more lenient. But if you’re not sleeping, cut that blue light and get natural light in the morning. And if you can during the day a few times and I’m talking 5 minutes, take a break from work here and there, step outside, send a new time signal to your brain and then your circadian rhythm will over a few weeks and will reset itself to a good release of cortisol and a good release of melatonin.

Rodger Murphree, DC, CNS

So those individuals who can’t fall asleep until two or 3:00 in the morning, and they’ve gotten in this pattern for years, sometimes before I ever had the opportunity to work with them. That’s a real challenge. And you know, people would say, oh, we just need to be you need to go to bed by 11. You know, there’s no way. So in this day three is going to, you know, turn that around and a day or two. So there’s steps that have to be taken to make to make that happen.

Annika Carroll

Right where I’m actually I’m working with a client right now. She’s actually she’s older. She’s 70, and she hasn’t slept well in 40 years. And she has exactly that problem. She goes to bed at two or 3:00 and sleeps then because she’s so tired and till like 11, 12, one the next day and her life is totally off track. And you can reset that. You can move your circadian rhythm back. You might never be a person who goes to bed at ten. We don’t know. Because you might. Because night owls and early birds from like a chronotype perspective do exist. But can we move forward from a three day and to I am who I am. Yes, but if you now try to go and say, hey, I’m super motivated, she said, 11:00, let’s go. You’re going to be lying there staring at the bedroom ceiling for hours because your circadian rhythm is still on that other time. So if you have something like that, that is where cognitive behavioral therapy for insomnia is something that might help. And what and what we do with that is that we start shifting your circadian rhythm forward. So let’s say somebody goes to bed at three, we start helping them move the clock back in very small increments. Generally, we work with 15 minutes where we say you can get go about 15 minutes early and if you sleep like that for five days a week, you can shift another 15 minutes. But at the same time, you need to shift your morning wake up back to yeah. 

And you need to be super consistent with that because otherwise that time in bed just gets bigger and you can’t find a new rhythm, right? So that’s something that we need to really shift where we potentially sometimes work with time, release melatonin to help people get fall asleep at night. And it’s a very slow process. And that client that I’m working with now, we’re doing it in five minute increments of 15 minutes from audio up if we go in 5 minutes, which takes a long time, but it works and we don’t know yet how far we can shift, but so far we’ve already shifted from 3 to 1. So that’s really good.

Rodger Murphree, DC, CNS

It’s pretty good.

Annika Carroll

Yeah. Gives her 2 hours during the day and also right to spend with her family and but that is a process that can take time but the body can do it but it just needs do that. And with that, that light exposure is key to manage that morning light and to manage that darkness at night because the body really needs those really sharp signals. So now it’s awake time and now you have to go to sleep.

Rodger Murphree, DC, CNS

So it’s really about trying to balance the whole cortisol melatonin ratio and timing really because you, you know, if you do testing like I do, but you can see a four sample cortisol test and you’ll see that in the morning it when it should be at its highest. And then it it ebbs and flows within a day. It should start to go really low in the evening as the sun goes down and should be at its lowest, you know, ten, 10 p.m. or so of midnight. And then it’ll stay in the Cortazar slowly start to creep up but some individuals, they’re tired all day long and then about eight, 9:00, they get their second wind. They have a little bit of energy. And then they’re trying to do everything they hadn’t been able to do that day because they haven’t felt good. So now they’re doing the laundry and now they’re cleaning up the kitchen. Or maybe they had had any alone time, time, if, you know, they’re a parent and they just need that alone time, but then they miss that window of opportunity to wind down. And now they’re now they’re, you know, 3:00 and finally they can go to sleep. But that pattern that people get into, there’s ways to break that, healthy ways to break that. What are some of your tips? Obviously, the light you know, the light therapy, that’s very, very important. What about going to bed at the same time every night and trying to get up at the same time every morning?

Annika Carroll

The second one. The second one is actually more important.

Rodger Murphree, DC, CNS

Yeah, I was going to say is or. Mm hmm.

Annika Carroll

Yeah. Get up. At the same time, our body needs rhythm. And why are we always so hung over on a monday? Because we Monday to Friday have a reasonable sleep schedule. And then Saturday, Sunday, we deviate from that schedule.

Rodger Murphree, DC, CNS

You know.

Annika Carroll

Try to keep Monday to Sunday within a half an hour of when you wake up.

Rodger Murphree, DC, CNS

Yeah.

Annika Carroll

Because that gives your body even more of signals also. Yeah. Now I’m supposed to get tired. Now I’m supposed to be awake. The body can deal with that a lot better. With women, we are even more complex because we also have a menstrual cycle that goes over to our circadian rhythm where we have hormonal fluctuations that are more intense than men’s. So that makes us even a little more complex lack of sleep. So these rhythms are really, really these routines are really important to us with going to sleep at the same time. That is great. It’s but it’s secondary to getting up at the same time for you. For instance, if we can pick on you as an example because you said I didn’t sleep well last night or I really didn’t sleep, and what happens a lot in those cases, people are like, Oh, you know what, my normal bedtime might be midnight. I’m just saying this now. I don’t have a lot of bed at ten because I’m so tired because I didn’t sleep last night. And that’s a mistake, because if you do that and even though you might sleep because you’re actually exhausted, because you didn’t sleep yesterday and you’re shifting your circadian, you’re starting to play with your circadian rhythm in a way that your body will not like at all. So tonight you might then get a decent sleep tomorrow, so you likely won’t because you’ve deviated from your cycle. So in cases like these, ideally you go to bed maybe half an hour earlier, but you really try to make that stretch from 10 to 1130. And I know it’s going to be not nice, but that’s the way to not shift your circadian rhythm even more because that’s happening. That is what happens a lot. People don’t sleep well, they go to bed early the next day. They still don’t feel great. They caffeinated, then they play with with the caffeine. The caffeine then kind of plays with their cortisol again and their melatonin. And then we get into a vicious cycle of, yeah, no sleep pattern.

Rodger Murphree, DC, CNS

Yeah. So I have patients that tell me, Oh, Dr. Murphy, I wake up at, you know, 3:00 every morning and I can’t go back to sleep. I’m just exhausted, you know what can I do? And then I start to quiz them, question them, and I find out they’re exhausted all day and they’re going to bed at 730 at night. So they’re, you know, they’re getting, you know, quite a bit of sleep. It’s just not in the right timing. And that can really create some problems as well. I mean, obviously, if you’re waking up at 3 a.m. and the rest of the world is not so it makes it hard to interact with your family and, you know, whatever else you want to try to do that. 

And then the other, as you already mentioned, I may have some patients that sleep until noon and then they wonder why they can’t wind down and get in bed at a decent hour. So big part of that is timing. Definitely the timing. Now, you mentioned melatonin, and that’s probably one that people think of right away when they, you know, and everyone is an insomniac or have trouble with their sleep is probably try melatonin with or without success. But that is the sleep hormone. And you would think that that would be all you would need to do is just load up on melatonin but didn’t always work.

Annika Carroll

No. When it doesn’t work for a lot of people, actually. And I know if you were in the biotech or to meet the people who are like in the health service space, they even high dose this stuff now and they all think it’s great. We don’t know anything about that yet. And I’m personally melatonin is not necessarily my goal too. And I only do that when I shift a person’s circadian rhythms. So if I try to get them from 3 a.m. to 1 a.m., I need to make them a little more tired in the beginning. But generally, most of my clients actually have because we measure the melatonin, have decent hour time. And so that is in most cases not the issue. It’s more the cortisol, the stuff that actually raises the stressors that bring the cortisol up and suppress the melatonin is the problem. And yeah, and anxiety and stress and all those things can do that too. Right? So there’s normally I it’s not my goal to because even like if I because it doesn’t work for a lot of people, it gives you hangovers potentially the next morning. People are just not as alert as they want to be for a few hours when they have to go to work. And so that’s not helping. And I kind of try to get to the root and then most of the time it sports itself out or we get grinds to a point where they can actually some people are really anxious sometimes on a Sunday night when it comes Monday morning or something, but then they’re so good they can take their three mg about time, use it Sunday night, sleep the rest of the week they did. They can switch on and off, which to me that’s fine, especially there are people who come off sleeping pills or antidepressants because that’s all we like. We have a lot of that too. Yeah. Yeah. So melatonin is to me like, yeah, for jetlag. Yes. And for shifting circadian rhythms, basically. That’s what I mean.

Rodger Murphree, DC, CNS

Well, in an hour, candidness. I’m a big fan of melatonin because of it being an antioxidant. I mean, I think that’s part of it and it helps with the immune system. And there are some patients, I mean, not the patients I work with all have sleep issues. And some of them are really hard that I will use, you know, ten milligrams, 20 milligrams, which is really high doses. But it’s either that or, you know, stay on Ambien. And, you know, many of the patients with are on sleep medications and they’re still not sleeping. Yeah, we know what sleep medications. 

The studies show that if you’re taking a sleep medication, you increase your risk of death by five fold, no matter what sleep medication you’re taking, no matter what illness, not to scare anybody. I’m just I’m just sharing. Not scared. And so you want to look for a natural option? No one has a sleep drug deficiency. I mean, it’s something else is going on. And a big part of you’ve already mentioned this imbalance between the cortisol and the melatonin. Now, one thing we do see in fibromyalgia across the board is low serotonin, this brain chemical. And it’s in the gut as well. More more in the gut than it is in the brain. 

But the serotonin is is needed to make that melatonin. And when you’re deficient in serotonin, you’re going to have trouble getting enough melatonin produced. But I usually start my patients with five hydroxy tryptophan and and the synergistic vitamins B vitamins, vitamin C, magnesium to get that serotonin level up, which raises their pain threshold. That’s one thing that it does. But then also it spills over into making that melatonin helps for mental clarity. Also mood is the happy hormone helps regulate GI motility. So it can be very helpful for those with IBS, which is about 70% of people have fibro. Do you do you find that there are challenges with individuals and their in their diet, in particular things that they’re eating that are probably contributing to some of their sleep issues?

Annika Carroll

Yes, it is. I think it’s partially what you eat. It’s when you need to set.

Rodger Murphree, DC, CNS

The timing, too. Yeah. As mentioned in.

Annika Carroll

Addition or stability is huge with sleep with women I often see, oh, I didn’t eat all day. I left of coffee and muffins and bagels. And then I had a big dinner. And then you have energy because that’s the first time you gave your energy. Yeah, but the other thing is, if we eat inflammatory foods and I know these are hard for people to give up gluten, dairy, seed oils.

Rodger Murphree, DC, CNS

Sugar.

Annika Carroll

Sugar, all those are and highly inflammatory foods. And if we are struggling, then they’re even more harmful in that situation to us than to somebody who might not have a health condition. They’re still inflammatory, but their bodies just might be able to heal better from them or react less to them. So, yes, absolutely. I kind of I really overhaul people’s diets, which is sometimes hard. I get it because you have to kind of get your family behind it. Otherwise you would be making changes for yourself and no changes for everybody else. And that is hard. And that it’s important to healing and it is so important to sleep.

Rodger Murphree, DC, CNS

So one out just early on, I remember when this case had really tough insomniac and for her, I mean and I and I say this with conviction that if you don’t get the sleep thing figured out, your fibromyalgia symptoms are not going to improve. And 22 years of specializing in fibromyalgia, this is a start here every time because I’ve learned the hard way this you have to get this right. And what I found out with this individual, she would she was exhausted. She’d get in bed at ten. I mean, she was really good about sleep, hygiene, everything she get in bed at ten and every night, every morning she’d wake up at 230 almost on a 230 and could not go back to sleep. But she would wake up in a panic and a panic. And I know you have clients like this. And what it came out to be is that her blood sugar was bottoming out at 2:00 in the morning. And when your blood sugar bottoms out, your cortisol level goes up. So she was getting this spike of cortisol at 2:00 in the morning and she had no choice but to sit up in bed with, you know, the heart palpitation and everything came to you know, we came to find out she just was really sugar intolerant. She could not handle especially close to bedtime where she was eating on the sly. By the way, she didn’t tell me to wear a tan corner, but she said, you know, she’s in a lot of paint. Things have been injuries every night. And sure enough, you know, a few hours later, her blood sugar, which is PWM, and it would wake her up. So I’ve learned to really be a good detective and try to figure this out. Obviously you have.

Annika Carroll

Yeah. And I think you have to, because those things are the little things that people would not think about but those and that is that is even an easy fix. And if she’s still hungry, she can even eat something, just not a kind of Ben and Jerry’s ice cream, but you can have things and a lot of people do better with the snack before bed. If it’s about protein, fat and a little bit of carbohydrates. Right. They do. It gets them over that hump, that 3:00 issue. And sometimes it’s that easy. But often it but often it’s not. But it’s a big contributor for sure.

Rodger Murphree, DC, CNS

Yeah. Now, you mentioned a little bit that four months as we start to kind of wrap up, let’s get some of the kids, some of the highlights. So hormones definitely can play an issue, especially with females. Progesterone is a big one. I think that oftentimes I see them and my patients, they’re estrogen dominant. So you’ve had a endometriosis or you’ve had over incest or some of these other conditions were where you have more estrogen and progesterone that can really throw things off. And progesterone is very calming, very relaxing. But then again, estrogen may be something needs to be balanced, too, because it can be low and it can create hot flashes. So there’s definitely a balance that has to happen there.

Annika Carroll

Absolutely. And we see our sleep changing like even mid to late thirties already progesterone starts declining. Right. And then we get this period in our forties towards menopause, like in perimenopause, we, we kind of our estrogen dominant even though we might even not even have a ton of estrogen, we just have more estrogen and progesterone that can already cause sleep issues. Then get into that rollercoaster of like really get into menopause. Right? And then the hot flushes and the night sweats and all that fun stuff and and then eventually testosterone goes down, too, and low testosterone can also cause sleep issues. So it’s really something where you can often do a lot with very little. And often it’s also this just creating the understanding of what is happening, right? Even if we say we get this anxiety, I find when people understand what’s happening in their body because they’re seeing what’s going on, that already gives a bit of a okay, I understand. Now, what can I do to fix it?

Rodger Murphree, DC, CNS

Yeah. What role does exercise play in good sleep hygiene?

Annika Carroll

That depends on how bad of an insomnia you are. You’re really burnt out. Yes. I want you outside moving. But moving. I mean, you can just walk and you’re totally. That’s all. We’re not going to stress you when you adrenals more because it is not your body can deal with it right now if you’re still okay if your cortisol still high but there is quarters and you can do some exercise and it’s great. Like we need to build up what we call sleep pressure. We think the body needs to get tired and exercise is a great way to support that. And if you can do it, if you’re physically in a state where you can do it at the waist, to me it’s movement and you don’t want to do it too late before bed. A lot of people are like, Oh, I need to hit like my the gyms are open. Like people go to the gym at ten and then fall asleep before 2 a.m.. Of course they can’t because they’ve racked up the cortisol.

Rodger Murphree, DC, CNS

Yeah.

Annika Carroll

At the gym and that needs to come down and that just takes a while to be metabolized, broken down, and then you’ll eventually get tired. So great if you can exercise. It’s a big plus for a good night’s sleep. Just do it ideally up to 3 hours before you want to go to bed.

Rodger Murphree, DC, CNS

And you know, some people hear this, so I’m sure the people watching this, that’s what they hear. You just need to exercise. But with fibromyalgia, they can barely get out of bed sometimes. So when they hear that, I mean, they’re thinking, hey, hey, buddy, you need to walk in my shoes and see what it’s like. But, you know, if you’ve got this adrenal fatigue or your adrenal glands are exhausted and you’re just burned out, you really can’t handle any additional stress. That’s why I’m fibromyalgia. Stress is so magnified, you can’t deal with it. And exercise is really healthy. But it’s a stress, it’s a stressor, it’s a good stress. But you really got to be careful how you start to incorporate that. Some of you, you know, definitely would encourage you to do that. And if you are exercising, continue, do some, but don’t overdo it. I think I see that a lot of times people just push themselves, push themselves and they actually set themselves back on their health journey by doing that.

Annika Carroll

Absolutely. Like these things, when I see this peloton bikes and I used to spin like I’m a huge fan, like when you’re burnt out, when you’re not sleeping well, stay away from these high intensity cardio, hot yoga type stuff like that is all just way too much. And you’re not going to hear that.

Rodger Murphree, DC, CNS

Yeah, yeah, yeah. You got it. You got to really be careful. Engage your energy reserves, what little you have now. But you mentioned getting out, just having nature, going outside, just walking, just stretching means things that you can do, but you just don’t want to. You know, it’s kind of like with fibromyalgia patients sometimes, Oh, I just need a deep massage. I need to work all that out. And then they go and then they can’t get out of bed for four days, you know? So there’s a time and a place, but you got to be careful how you go about doing this. 

Yeah, well, Annika, we’ve covered a lot of topics. I mean, we really hit quite a bit and we haven’t talked much about supplements. And I know as a functional practitioner you incorporate diet and testing and a lot of different things. You’re not a big fan of melatonin. Totally understand that. Are there some supplements that you found that can be helpful with helping people get that circadian rhythm back or let me reset? Or are there some go to supplements that if this person just needs some help to be able to fall asleep or if they wake up in the moonlight, something they can take to go back to sleep. Now, maybe it’s just short term, they kind of reset things. Are there some things that you like?

Annika Carroll

And yeah, one thing that I definitely like is magnesium.

Rodger Murphree, DC, CNS

Yeah.

Annika Carroll

By itself is always a bit of a thing. Magnesium need some cofactors to really work and sell very well. So I would consider something like magnesium B vitamins. They’re a great angle. B vitamins. Not at night though, because you they can wake you up. You want to do that in the morning and you want to. I always like my clients to have split magnesium doses, some in the morning and some at night. Some people are very sensitive and can’t even do that. Even magnesium. If that is something that might work. Some people don’t like it because it dries the skin hours out or magnesium lotions, if that’s something you can stand on, like just the touching even. I don’t know how that might be for your patients if they say even that is uncomfortable for me and those oils, those are great. If you can take an Epsom salt bath, if that’s something they can do, maybe it helps with detoxing. It’s not the magnesium that you ingest is a bit different, but it helps relax and detox and it’s a great start. And L-Theanine works great for people. GABA It works sometimes great for people, not all the time. Those are things you can try and for a lot of people, they, they work. If that’s just a smaller thing or that is exactly that issue, then that can help. But in that case, also a little bit of melatonin might help you.

Rodger Murphree, DC, CNS

Yeah. So I mentioned earlier about this low serotonin. A lot of individuals have fibromyalgia or their recommended antidepressant. And we’ve had numerous conversations on here about that. And no one has an antidepressant deficiency. And these medications don’t make serotonin. They only help you hang on to what serotonin you have. But if you’re already deficient, you’re already run down. I mean, that’s but what you are if you have fibromyalgia, it makes more sense to take things that your body can utilize to make that that serotonin and certainly diet, you know, eating a good healthy diet with protein, protein is where you get these amino acids like tryptophan that turns into fat across the trip fan and then into serotonin. 

But I like l-theanine. Although some people say it’s not strong enough. I like GABA, although some in it don’t absorb it very well. So. So sometimes it doesn’t work very well. But there are some naturals I mentioned the delta sleep thing that I developed. I really like that. My patients, I enjoyed that. But I like your approach in that you’re really trying to dig deep to figure out what can we do to reset the circadian rhythm. It’s not a supplement deficiency, it’s not a melatonin deficiency. It’s something else that’s driving this. And I really like that approach. I really appreciate that. Where can people find out more about you and your work? What’s the best website for them to go to?

Annika Carroll

Website is sleep like a boss dot com.

Rodger Murphree, DC, CNS

I love the name. It’s lovely. I love the name this great a naked. Thank you so much. This has been enjoyable. I really enjoyed getting to spend some time with you and I hope folks really will put a deeper store to sleep. Give it the importance that it needs. I really believe you can get this right. So many of your fibromyalgia symptoms will improve across the board just by getting neck that good, consistent, deep restorative sleep. Thank you so much.

Annika Carroll

Thank you so much. It was fun.