Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
to build their own research program, whether or not they have a mentor.
As clinicians, we spend a decade or more as trainees learning to take care of patients.
When we finally start our careers, we want to build research programs, but then we find
that our years of clinical training did not adequately prepare us to lead our research
program.
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
However, clinicians hold the keys to the greatest research breakthroughs.
For this reason, the Clinician Researcher podcast exists to give academic clinicians
the tools to build their own research program, whether or not they have a mentor.
Now introducing your host, Treacy Unwomenat.
Welcome to the Clinician Researcher podcast.
I'm your host, Toyosi Onwuemene, and it is such a pleasure to be talking with you today.
I'm particularly excited to announce my special guest today, Dr. Funke Afolabi Brown.
She's a sleep expert, and I have to tell you, I'm a physician.
I've been doing this a long time, and I don't know too many sleep experts.
She's actually a board certified sleep medicine doctor, and she's here to help us understand
how sleep is critical to our advancement in academia.
Dr. Funke, welcome to the show.
Thank you so much for having me, Dr. Toyosi.
I'm excited to be here.
So tell us your journey to becoming a sleep doctor, and what does it even mean?
Why should we care that you do the kind of work that you do?
So you know, my own journey to this, you know, just like with most of us and the work we
do, hopefully, really comes from a place of some of the experiences.
We've had some of our stories.
So I started off like most of us in medicine, extremely sleep deprived, burning the candles
on both ends and feeling like sleep was expendable, like sleep was an inconvenience.
And that was whether that was intentionally unintentionally, just really what the narrative
was.
So I didn't know better.
And so after medical school, and then residency and having kids during residency and doing
the same during fellowship, I really hit a wall where I was exhausted all the time.
I was not performing at the best of my ability, and I knew it.
And it was impacting my relationships.
And so then I had to really shift because I knew, I know that I am here to accomplish
so much.
And I knew that that version of me, that tired version of me was really not going to get
to where I wanted to get to.
And so I started making changes really around just resting my body, learning to embrace
rest as a tool for recovery.
And then from there, I just kind of started to run with it because I realized how much
it changed my ability to set boundaries.
Because if I set boundaries to guard my bedtime, to guard my rest, then it helped me prioritize
better.
It helped me figure out what was really important to me.
And it helped me learn to say no and say yes to the things that really truly were aligned
with my values.
And so I went on, continued my training, did some more.
I did a pulmonary fellowship and then also went ahead and did a sleep medicine fellowship,
really coming in initially just to learn about sleep disorders like sleep apnea and all the
other things, but then really literally stumbled upon sleep health as just a critical aspect
of our wellness and our overall well-being.
And then in moving forward, I was seeing patients in my clinic and kept hearing the same theme,
exhausted, deprived moms like I was bringing their children in.
And I saw that I really had an opportunity where not only could I change the lives of
these children by helping them sleep better, but I could actually intervene in some of
the issues that the women were experiencing that was getting in their way of getting restful
sleep.
And so that's how Restful Sleep MD was born.
A beautiful story.
Thank you for sharing.
One of the things that I want to point out is that you are a sleep coach and you particularly
help women and you help children as well.
And so I think it's interesting just thinking of sleep.
You used two terms earlier that I feel like I want to come back to right away and you
talked about sleep ability and forget the second term, was it sleep capacity?
Sleep opportunity.
Sleep opportunity and sleep capacity.
So I want you to speak because here we are as clinicians.
We're taking call.
Sometimes we're up at night.
So sleep is a challenge for us on the basis of the work that we do.
And then when we're not on call, try to get back into a cycle where we can sleep restfully.
It's difficult.
What do you recommend for clinicians who are, who actively are taking call and having sleep
disrupted really as part of their jobs?
Yeah, that's a great question and something that I encounter commonly.
So I think it's really important to step back and say where the issue is.
So the two terms along those lines, that is sleep deprivation and insomnia.
And our sleep deprivation really talks about either intentional or behavioral choices that
we are making, which is getting in our way of sleep in the sense of, like you said, or
environmental choices.
So you have a schedule that does not allow you getting enough sleep.
You were working shifts.
You have a child who's not sleeping.
And so because of that, you're not able to get a sleep you're supposed to.
You're binge watching that we click on social media.
And so because of that, you don't have adequate sleep opportunity.
So as a result of that, you experience sleep deprivation, which is really getting less
than the recommended hours of sleep over a long period of time.
Right.
And then with insomnia, there's actually sleep opportunity, meaning that you've intentionally
put everything down and said, I'm going to sleep now.
And you're having the difficulties falling asleep, staying asleep, or you're waking up
earlier than your desired week of time.
And it's causing daytime impairment.
Both of them cause daytime impairment, but the causes are different.
And I would say many times in, you know, clinicians, in people in academic medicine, professionals,
sometimes they struggle with both of them.
Many times they just really are sleep deprived.
And so I think it's important to first figure out where am I on this spectrum?
Is it fully because of my schedule, my work schedule?
What does my sleep look like on the days that I am off?
Do I have a hard time sleeping then?
Or am I just able to sleep and just take extra hours?
So I think that's the first step, because that's how we can tell if it's just a matter
of sleep deprivation or insufficient sleep.
Then we've got to have you set boundaries.
We've got to have you advocate for yourself to say, okay, I need to figure this thing
out.
If I'm going home from my shift, I'm not going to the grocery store.
I'm going to go home and get the sleep I need, right?
So your approach is a little bit different.
If you have insomnia where you're like, okay, finally, yes, I am intentional.
I'm about to get to sleep and my mind starts to race.
I have this increased cognitive arousal where I just really can't seem to settle down and
quiet my mind.
And because of that, it's keeping me up.
Or, you know, I have a sleep disorder.
I have restless legs syndrome or sleep apnea or something of that sort.
Then we need to build a treatment plan that's going to address that.
So it's very important to kind of start off with where is the problem?
Is it an ability kind of problem or capacity kind of problem?
Or is it an opportunity sort of issue?
And then you can take it from there.
These are really, really insightful thoughts and thank you for sharing them.
You know, one thing you said earlier was the importance of like the sleep, being able to
master your sleep, you talk about it helping you set boundaries.
Can you talk about the benefits?
I mean, I feel as if as clinicians, we understand the importance of sleep, but then we are kind
of burning the candle at both ends and we feel like sleep is what's expendable.
But can you really speak to, especially for us, academic clinicians, thinking about what
are the benefits of sleep that we should strongly be thinking about?
Yeah.
So, you know, I would start off with sleep not just being something we do at the end
of the day.
Sleep is actually a superpower.
It's a tool that we can use to our advantage because one of the benefits of sleep includes
improved cognition and executive decision making and creativity.
And every single one of those things you're going to need to succeed in academia, succeed
in life.
So whether it's writing a new grant, coming up with a research question or parenting,
you need all those tools.
Emotional intelligence, there's studies that have shown that when team leaders are sleep
deprived, meaning that they're not prioritizing sleep or they're not sleeping well, their
team members are less effective.
Imagine that.
So it not only impacts your own work performance as an individual, it can impact the team you're
leading because they're not getting the motivated leader that they were hoping for.
They're not getting the creative leader they were hoping for, the emotionally intelligent
leader.
So I would say that's a big one.
Another thing that sleep really is important for is rest and restoration.
So several of our hormone regulation occurs during sleep.
Both hormone, insulin, all those things that are needed for just our regular bodily function.
And so with poor sleep comes impaired metabolism, higher risk of various diseases, heart disease,
metabolic diseases like diabetes, obesity, hypertension, strokes, all those things can.
And then there's now, I mean, there've been studies that are seeing that our brains have
a system called the glymphatic system, which offers a cleansing action that removes waste
products from the surface of our brains.
And one of those includes beta amyloid, which has been found to be a culprit when we have
development of Alzheimer's.
And so that those memory lapses, that foggy feeling you're constantly struggling with,
some of that is probably related to poor sleep.
And so, and in our mood, right, depression, anxiety, emotion regulation occurs during
sleep.
And so when we lose the ability to get good sleep, we're going to find ourselves, you
know, more ill-tempered.
If you already have that tendency to be more anxious, things are just a lot more exaggerated,
so there is a bidirectional relationship, but that association definitely exists.
And in our immune system, imagine that there've been studies now where they looked at people
who had sleep deprivation and people who had sufficient sleep.
I don't know when that IRB was approved, but they injected them with, I think it was either
rhino virus, and they looked at who got sick, and it was those who were sleep deprived compared
to those that were not.
So that common cold to COVID, to everything else going on, you're definitely more susceptible
when you don't sleep well.
So if you're calling in sick and feeling sick all the time, guess what suffers?
Your work, your productivity, your performance.
So it does affect, I would say, every aspect of our lives.
So I think that's why I say sleep is a superpower.
Wow.
At the end of that, I'm thinking, oh my gosh, not sleeping is a disorder.
I mean, it's real.
It's a problem.
And so now I'm thinking, huh, there's a need for intervention.
So what do you do?
Like you've been, I mean, burning the camera at both ends, pushing sleep away to make things
work.
It's become a way of life, unfortunately.
And hey, for many of us, we're functioning well.
We feel like we're at the top of our game, even though we know we're sleep deprived.
What's the first step?
How do we take the first step towards wholeness?
Yeah, no way.
And you're right.
And that's why that narrative has to change.
I like what Arianna Hoefnit said.
She said exhaustion is not a badge of honor.
It's a sign of chaos.
So while we feel like we are doing well at the top of our game, I think we really have
to come back to that mindset.
Like are we really at the top of our game?
What does that look like?
What's going on in our minds?
What's going on in our energy level?
Are we, is there room for growth or improvement?
What if we were better rested?
Imagine the speed by which we could be turning out those papers or coming up with those creative
ideas or our capacity to actually do more.
And that's voluntarily, right?
So I think it's really important to come and, you know, almost like have a come to Jesus
moment and say, really, what is, what is, what, where am I?
How good do I really feel?
Am I, am I patient enough as I would like to or am I anxious?
Right?
Like I think it's really important to come to that truth and understand that.
And then the next step is starting with setting boundaries.
Like it's not just something that's going to happen.
You're not just suddenly going to decide you're going to sleep well.
If you've been someone who's been doing all the things, you're going to be comfortable.
You're going to have to come to terms with the fact that you may need to cut back, cut
back on all your obligations because you do want to create sleep opportunity.
The recommendations are to get seven to nine hours of sleep every night as much as possible.
And so where are you going to find that if you've been someone who's been filling your
day with activities and living only four hours for sleep at night, you're going to have to
get creative.
And I would say when getting creative, you can start where you are.
If you've been sleeping four hours and it may not be easy to just double up and find
an extra four hours if you filled your day at night with all kinds of things.
So you may start slow and say, okay, you know what, by 30 minutes, I'm going to increase
it by 30 minutes, right?
I'm going to set, again, can set those small goals.
I'm going to increase my total sleep time by 30 minutes by going to bed 30 minutes earlier.
And then you slowly increase that maybe by week or so you hit your goal and pay close
attention to your body because you're going to start to experience change in terms of
your energy, your mood, your appetite, your metabolism, motivation.
You're going to start to see that.
So let that be like a feedback loop to say, oh, wow, this stuff works.
And then, you know, you build from there.
And you know, and then of course, I think it's really important that we, one of the
things I talk about in certain boundaries is you got to see your sleep.
Like, you know, you're going to see a multidisciplinary team.
You're not just not going to show up for them.
You're going to show up.
You're not just going to say, oh, sorry, I have to run some errands for a friend who
told me to take them to the grocery store.
No, you're going to say, Hey friend, I need to go to the clinic where I'm going to see
this multiple specialists.
And so I'm not going to be able to meet up with you.
I'm going to meet up with them.
And that's what happens when we sleep every night.
You're literally seeing your therapist, your psychiatrist, your neurologist, your endocrinologist,
your nutritionist, you're seeing all those experts every night when you go to sleep.
So you have to be very intentional about it, but then build up slowly, depending on where
you are.
And then finally, once you've created that opportunity, you got to look back and see
is there, is there ability issues in that sense?
Your body can generate sleep.
Sometimes you just don't know, but if you have insomnia, if you feel like you're getting
enough sleep and you're waking up still exhausted, then that might be the time to say, okay,
I've got to get checked out to figure out what is going on.
Thank you.
Thank you so much.
That was just really, really practical advice.
Now I want to take it a step further because you also coach families in terms of children's
sleep and for, for many of my, my listeners and primarily mothers, you know, they are
struggling with sleep, but their children are too.
And their children not being able to sleep impacts their ability to sleep.
What advice do you have for parents who are struggling with their children's sleep?
Yeah.
So insomnia in children actually forms close to 40% of sleep disorders in children.
So at some point or the other, children will have some kind of, we'll call them behavioral
sleep issues.
And actually what I say, it's not like they have bad behavior, but then their habits that
they get into that prevents them from being able to sleep appropriately.
And so that might be, you know, a child that needs the parents to be in bed with them to
fall asleep or a child that comes out and asks multiple requests at bedtime or a child
that's, you know, has bedtimes years or a child that's tossing and turning and has nightmares
or sleep terrors or things like that at bedtime.
So it's really important.
I would say to first pay attention to what is going on with my child's sleep.
And then you could build from this.
So I think generally what I give families to even start as a foundation is an acronym
that I use called create restful sleep habits.
So it's C-R-E-H-C-E.
And you know, of course you could Google sleep hygiene and then you get this whole laundry
list of stuff that you don't know where to start from.
But I think this is a good place to start apart from setting that intention and you
say, okay, where do I start?
So start with this.
Create stands for C stands for consistency.
So just make it a date with your sleep every night and your kids too.
Because our circadian rhythm is hardwired.
And so when we fall asleep at different times, it really causes a lot of dysregulation.
And our circadian rhythms control so many other functions in our body apart from our
sleep-wake cycle.
It controls our hormone health, our metabolism, our lung health.
There's so many things that are tied to our GI system.
There's so many things that are tied to our circadian rhythm.
So you want to try to be as regular as possible.
And that includes the weekend.
And so you want to avoid excessive sleeping on the weekends and things like that.
And then our stands for routine.
So having a nice, calming bedtime routine.
Our bedtime routines are not just for our kids.
They are helpful for us as parents as well.
And that wind down routine and nothing too crazy, just things that help us kind of slow
down.
Especially if as a family, we've all been running all day, it's going to be hard for
us to just hit the brakes suddenly.
So really ease into it.
Because what that does is it cues your brain to say it's time for sleep.
And then E stands for the environment.
So what kind of environment are you sleeping in?
You want to check in.
Is there light coming in?
Because light coming into your room, either from the hallway or from outside, can disrupt
your sleep because it then will make it hard for the melatonin, which is a sleep hormone
to be fully produced for us to sleep well.
And then you want to have a room that's cool because that would also promote good sleep.
Then A usually stands for, I say, assign the bed for sleep and sleep fully in bed.
So the bed should not be a place where you are worried, where you're checking on your
emails, where you're eating or watching TV.
The bed is supposed to be for sleep.
And what that does is it strengthens the association between our brain and our bed.
So when you get into bed, it's like bed, sleep, bed, sleep.
It's not bed, maybe sleep, bed, maybe dinner time.
So you really want to strengthen that association.
T stands for technology.
And we know that a whole podcast of its own because the technology has really, really
eroded our sleep systems.
The content we're consuming on our devices is very agitating to our nervous system and
so can cause increased arousal, which makes it hard for us to wind down.
And also, of course, the blue light that the devices exude suppresses melatonin production.
And melatonin is a hormone of darkness.
So in the presence of blue light, it tricks our brains to think it's day time and then
it makes it hard for us to sleep.
And then finally, E is kind of look, take a look, do an audit.
What are the things that I'm eating or consuming that could be getting in my way of good sleep?
So am I eating heavy meals?
You want to eliminate that.
Am I taking caffeine too close to bedtime?
That's a stimulant.
So you want to avoid that.
Am I drinking alcohol before bedtime?
That's also sleep disruptor.
You want to avoid that.
So start with that.
It's all evidence-based.
You could grab a copy of this.
This is like a cheat sheet I have on my website, which is restfulsleepapmd.com.
And then if you're wondering, where do I start?
I always say that that's a good place to start.
And then you work on it one at a time with your family as well.
Wow.
This is really, really good stuff.
And to be honest, it feels like really the tip of the iceberg.
It sounds like there's so much opportunity to improve our sleep habits and alter the sleep
habits of our families as well.
So if people are thinking, wow, I really need to get better sleep, and you're a sleep coach,
where can they find you?
How can they access resources that you produce?
Yeah.
So again, my website is a good place to start.
You can go to restfulsleepapmd.com.
And on there, there are blogs.
And the blogs focus on just really practical tips around sleep.
So like you said, we just scratched the surface here.
Practical tips for sleep for your children, for you as a mom, as well as just information
about my coaching program.
So you've done this.
You've done this all.
You've read the books.
You've tried all kinds of methods and you're still exhausted or your child is not sleeping.
Then I would encourage you to take it a step further.
Let's talk through why, because again, there's so many reasons why we don't sleep.
Sometimes it's our minds that get in the way.
Sometimes it's our bodies that get in the way, so we can kind of figure this out.
I can hold you accountable to prioritizing your sleep, because sometimes it's a boundary
issue.
So we kind of delve into that.
And then from there, we can get your energy restored back by working through the lens
of sleep.
And so whether it's your child that's the sleep disruptor and maybe not necessarily
sleep apnea, we can help you the child sleep better so that you as a mom can sleep better
and you could be the most productive version of you.
Super awesome.
Thank you.
I feel as if whenever the conversation around sleep happens, it's like for all the other
people, but for the clinicians, yeah, this is just sleep as part of the job or not sleeping
as part of the job.
And to be honest, I think there is a lot of, it can be a lot of pathology and academia
and not sleeping is part of that pathology.
In the sense that it's part of the board, everybody's doing it, but if we're going to
live healthily, then we've got to make different decisions.
So this really does speak to that.
And I thank you.
I thank you for being part of the sleep revolution.
Thank you so much for having me.
This has been fun.
Yeah.
So if there's one more thing that we haven't talked about that you feel like someone out
there needs to hear, what is happening?
I would say, I mean, I say this, it sounds cheesy, but it's not.
And what I say is prioritize sleep to radiate your inner brilliance.
And the reason why I say that is you are a gift to your world.
You're not just in here by accident.
You're a light that's not meant to hide, but sometimes the exhaustion and the chronic sleep
deprivation really masks the ability of our world to see that light shine.
So choose sleep and everything else will fall into place.
So choose sleep.
I think that's what I will say.
And start small.
Start from where you are.
No matter how much you feel like your sleep system is broken, it is not broken.
You could fix it.
You could make a decision today to prioritize sleep and then you could take it from there.
I love it.
Prioritize sleep.
Everybody, you heard Dr. Funcaf Salabi-Brown.
Sleep is important.
And don't think that because you're a clinician, you are exempt from all the challenges that
happen with not sleeping, metabolic syndrome, diabetes, hypertension, heart disease, so
many challenges that come.
And we are in this for the long haul.
We are not here to burn out and just burn out of our academic careers.
And so definitely take sleep seriously.
Dr. Funcaf has a whole series of resources.
So please reach out.
I will put her information in the show notes so that you have access to that as well.
Dr. Aronk, it's been a pleasure to have you on the show.
Thank you for being here.
Thank you for having me.
All right, everyone.
I am so happy to have brought you this episode.
I expect that we're going to be healthier people because of it.
And I look forward to bringing you the next episode.
See you next time.
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