Ep041: Eczema and Sleep--with Christa

deepintosleep.co

Christa

Biegler

with Dr. Yishan Xu

 

TODAY’S GUEST

Christa Biegler is the host of the Less Stressed Life Podcast, author of The Eczema Relief Diet & Cookbook (Apr 20), and the founder of the Eczema Nutritionist, specializing in difficult skin and digestive issues. She lives with her unicycling husband & kids in the Midwest.

WHAT WILL WE LEARN

Timestamp:

  • 3:40' Discussed wet wraps

  • 9:40' environmental stressors

  • 23:30' Stress

  • 33:44' Light Therapy

You can read the blog article summarizing this podcast here: https://www.mindbodygarden.com/en/blog/eczema

RESOURCES

Christa’s podcast episode and new book:

Her websites:

Her social media info:

  • fb.me/christabieglerrd

  • @christabieglerrd

  • linkedin.com/in/christabiegler

Thank You for Listening!

Newsletter and Download Free Sleep Guidence E-Book:

CBT-I Courses:

Podcast Links:


Transcript

yishan xu 0:00 If you have eczema, you may suffer a lot and cannot sleep well. How can you use food and nutrition to really help you? Today? We have Krista a nutritionist. She will share more about this with us. Let's welcome her. Hello, Krista, welcome to deep into sleep. Christia Biegler 0:21 Thank you so much for having me. Talk about this really awesome topic. yishan xu 0:26 Yes. I'm really excited actually to know more about your expertise, your knowledge about eczema? Christia Biegler 0:33 Yeah, well, it's a tricky topic for sure. Because so many people are affected by it. But our treatment options are. They're not very robust yet. So there's a lot of room for more information about it. And again, like I said, it affects a lot of people actually tend to 20% of kids and one to 3% of adults. So I think everyone knows someone with a skin issue even if it's not eczema, an itchy rash or a skin condition. I just feel like everyone know someone who's affected? yishan xu 1:01 Right? Definitely, I would imagine people having this kind of skin conditions, especially eczema, gonna be really suffering at night, they may feel really itchy, they won't scratch the cannot fall asleep easily. Christia Biegler 1:16 It's actually one of the worst side effects for some people because if you cannot sleep as you know, I mean, you are living in that in that realm or speaking it all the time. If you cannot sleep, you cannot really repair right. And so it's sort of a terrible hamster wheel of the itching for some people 18 flares at night. And I think there could be multiple reasons for that. It'd be actually kind of fun to, to riff about why that is because it's not I don't think we have some, we have some guesses about why it is but we can't say 100% for sure. Right? But it does seem to flare for some people at night. And then people are itching and they are they wake up in the night from the itching and that's when things are pretty miserable, right? When you're realizing And if you're a parent and you're already sleep deprived, and you've got kids waking up from itching, that's the worst. And how do you know how to help them? Right? That's the Yeah, that's the really hard part about all. yishan xu 2:12 Yeah. So regarding that, I definitely want to ask you, you mentioned the data regarding the condition among children versus adults. So when we treat that, or when you see patients like this in clinical settings, is there any difference in treating children versus adults? Christia Biegler 2:31 Yeah, well, there definitely is, of course, right. There are little people. And so it kind of depends. The interesting thing about children and I think a lot of people don't help children in their practices, or they don't treat children in their practices. Because it's a very wide span. If you're six months old, it's a lot different or nine or one year old. It's a bit different than when you're even 10. So I like kiddos, five and under because their history has been a little bit shorter, and the parents are usually really in tune. So the thing that I see that makes the biggest difference is how Much desert. How aware is the parent about what is going on? So with kids especially like, there's a, there's a lot of traditional treatments at this time where we recommend wet wraps. And I feel like I see those recommendations more frequent in children and there's products made for children. And we can talk about what a white rap is. I'm talking about it like everyone knows, because I think it's not a conflict people aren't. People don't necessarily know what that means. And I don't know if you see that in any other situation. I know you've you have a lot of you have a lot of professional experience working in a sleek, doing kind of sleep Institute stuff. So I'm not sure if you really saw that. But I guess let me just go over that. So a wet Rafi in a in a child is basically it's a it's a dermatology type recommendation. And there are different eczema, clothing companies not a lot or you can do it with just basically gauze. So essentially what they do is they bury the child and then they put something on the child they put like different mullions or creams or oils or something like that. Usually you don't want to put steroids underneath of a wet wrap, because they think it permeates too deeply and can cause some other negative side effects. I don't know if that's really well known either. So I just want to mention that. So usually you put some creams on, and then they wrap so there's a couple options. Sometimes they'll do a wrap and I've not actually done one, but they have clothing like eczema outfits that you can basically dip or just like an arm sleeve or a hands or whatever different sleeve areas for different parts of the body. So they cover the body with these wet wraps. Or people sometimes do a do it yourself option where they kind of have like a pair of pajamas and dry pajamas, and I don't want to say it incorrectly. So I'm going to be slightly vague on purpose. Because I don't want to tell you like oh yeah, the wet I believe that what goes on the bottom and the dry or actually they do the wet on the top, I believe and then they actually spray it and it just kind of calms the skin and some kids parents will say that they just see like a look of relief on their child's face and then they can sleep. So that's like a nice when I'm addressing eczema. I always tell people so we really convinced Think about dreaming treating it really topically, right. But of course, skin grows from the inside out. So there's some internal messaging going on, that's creating the whole itch thing in the first place, and the waking and the sleep, waking, etc. But since it is still like external to an extent, right, it's on their skin. So it's on the it's on our shield our bodies, our bodies, our bodies armor for ourselves. I always say that you can do interventions from an external and an internal and kind of like a wild card or stress or like pick a different avenue as well. Like, I think you can address it from all angles, and you need to address it from all angles. Because one of the negative negative side effects of not addressing it from all angles, for example, from the external angle is for a lot of people, sometimes it's like an overgrowth of staph bacteria. That's traditionally what we think about in the Muslim world. Anyway, we we often recognize eczema as a bit of a staph aureus overgrowth of staphylococcus, so that's a bacterial overgrowth, and sometimes that can get when people are scratching and they get that bacteria under Their nails, it'll translocate and it'll be people will get it in different places and essentially you get an infection and to tell if it's infected, infected, it's usually looks extremely angry, red raised and sometimes pissy and Uzi and so whenever someone suspects that there might be an infection, they should definitely get that cultured, topically cultured, because if they have an infection, they are not going to get some sleep. And they're not going to be able to improve their eczema from internal or extra like it's just, it's sort of, it's trying to rebuild a house when the house is on fire. You really need to put out that fire or that infection so you can kind of rebuild and rebuild the skin and rebuild rebuild the health from from both the inside and the outside. So there's different ways to talk about it for sure, like the outside and the inside and the dermatologist have like a lot of other options as well for for topical options. I have topical things we use. But yeah, I'm tangent gene. So I forgot your original question. Yeah. yishan xu 6:57 Yeah. But this is great. Sounds like From outside external ways of treating it, definitely we won't use different methods to Sue's the scheme suits the body. Right. So I'm more curious about internal methods, what are some things we can consider to to treat it internally? Christia Biegler 7:18 Yeah, so it kind of depends on the type of eczema so what I like to do is step way back and say, okay, what's going on? So kind of more like an area we can all agree on. So I think different professionals we feel differently about, about how to address eczema and that's really okay because I think it's still really like it's this uncontrolled for me. To me it's it feels like a bit of an epidemic honestly. And I think we don't have a lot of tools so i think i think putting all heads together and having all tools is a great thing. And by the way, there are some other external things like Bad's etc. So we can talk about that later. But from an internal perspective, something we can agree on, is that there's night waking Why is their night waking. So we think that There's some kind of cytokine, like inflammatory domino effect. And what does that mean? cytokines are basically like chemical messengers that communicate messages. And it's a very broad term. And they cytokines are inflammatory cytokines or inflammatory messengers that are happening in our body can increase from a variety of things. So there can be like, think about the things that cause inflammation in our lives. These are things I talk about a lot in practice, because if we don't address the initial inflammatory triggers, we tend to like start over all the time. So this is a good segue. So funny. A lot of people discount this one or like, we don't want to address this one because it's easy, but hard. So it's actually really hard, but it's like it's free. And so people, sometimes we discount like a thing that we can't buy sometimes, right? So actually stress so when I have people that have an improvement in skin conditions, and then they have like an acutely stressful day or a couple of days where they were making Be gone traveling that a fight with someone etc Look, just common things that happen. They'll notice this flare in their skin and sometimes it's late and so it happens a little bit later up to a couple days later and sometimes it's immediate. So our emotions do cause that inflammatory cascade, so I just cannot discount that piece I mentioned that versus stress is one thing. Then there's environmental toxins essentially. So there that can be a lot of things for some people, they'll have contact dermatitis, they'll they'll start reacting from from from many things in their environment. So I have an example sometimes stories help tell stories help illustrate a point right so in my particular eczema story, I probably had some other clues that there was stuff going on. I mean, I really had like kind of on and off eggs, Mr. hairline, eggs and Mark things that kind of popped up in the wintertime. And actually winter is a great, great point too because we don't have in most places that are not temporary like where you live. We have like a dream. drier air, right. And so when we have that dry air and no humidity in the air, we automatically lose some water from the top layer of our skin. So again an external thing. And so sometimes the winter can be kind of just more aggravating or harsh. For some people, the springtime is harder on their eczema and that tells me there's a different root cause Anyway, I'll get back to the environmental toxin piece a little bit or environmental factors or environmental influences. So from my skin issue, I kind of was a kind of many of us just think of it kind of comes and goes, and it seems to go with the season we're like, oh, that's normal or genetic, or we kind of, you know, we just kind of chalk it up is like, this is my normal right until it gets bad enough where it's influencing us. So for for me, I had taken my kids to swimming lessons for a full week and I was in a chlorinated pool for many days and where I live I don't have chlorine in my water. How about a well, because I liver really, really super well so I don't have chlorine in my water. So it's not something I'm getting a lot of exposure to because normally in the shower, you're getting a lot of exposure to chlorine and chlorine is essential. is very similar to bleach. Um, in some, in some places they do people don't like the chlorine smell in the water, so they actually met chlorine and ammonia. So it's called chloramine. And so anyway, for me the and this is funny because it's like there's two ways to look at this. dermatologists will commonly recommend when there's that staph overgrowth, they'll commonly recommend a bleach bath for kiddos and actually it's, I've had some I have some dermatologist I've interviewed on my podcast where they talk about it more like a bleach dunk, which I think is a good point. It's like oh, it's like a quick antimicrobial thing because if again, if you have all this stuff on your skin, and then you go to bed like it, you're just gonna hhh so they'll do like a bleach dunk and then you kind of rinse off. Well a pool is similar in that it's like a giant bleach bath sort of so if skin gets worse, in a pool, it's like one thing and if it gets better, then it might be a little bit more of a staff origin. So I actually saw this, my my baby my six year old he has similar genetics to me. So I will not buy Could bore you with the story. But my point is, is I kind of gave him a bit of a rash. We were working on some some staff overgrowth stuff like he was getting he was having like a really sore throat like kind of recurrently. Anyway, long story short, he would go so mean it would be a little bit better. And that tells me Okay, we've got some topical bacteria. So if it gets better, we've got some maybe topical, something not good going on. And that acts as kind of an anti subject and for me, seven days of the pool really disrupted my skin microbiome and caused a crazy flare for me. So like, I ended up with a hellacious flare on my on my neck and around my eyes, etc. Oh, very exciting. yishan xu 12:40 Just really, yeah, it sounds like it's really individual thing. And like, everyone has different triggers different reasons. And the same environment condition can just make some someone's condition better someone's condition worse, Christia Biegler 12:56 right? But that's important information. So we could think about it like a frustration. But really, it's important, valuable information on how are you going to fix the problem. And this is also why we don't have great resources yet because we're in the past we were kind of treating eczema very like it was one thing and that's the problem. We are saying we're using the term eczema and this is why probably it's so common, but we're really talking about 10 at least 10 different conditions 10 or 12, maybe 15. So we've got some Boric dermatitis that's exam on the scalp or flaky scalp. Even cradle cap could be considered a condition which is really similar. Or maybe like from a dermatologist standpoint, maybe they call it the same thing. There's hand eczema, contact dermatitis, new Mueller eczema, which looks like round circular patches molluscum. There's just so many there's like from you can get nickel allergies, that's a really great another environmental point. Some people will be alerted. That's a really tricky one. And how do you figure that one out? So if someone's getting a spot in a weird place, or if they're getting kind of an irritation, right where the jeans like where people's hands jeans and they have like a little, they have some nickel in that metal, that's where that button is. Sometimes it'll be a recommendation to put tape over that. And if that helps clear up a certain little area, you know that you might be dealing with some nickel issues, which are going to present food and in your environment. So those are some environmental factors. So we've talked about stress, and we talked about environmental factors, and a lot of areas some other places I spend a lot of time our food and, and bacteria fungal issues. So I'm going to talk about food first because a lot of people will notice that they get a flare from food stuff, but and that's like a big topic. But what I want to say there is that food is our friend and not our enemy. But there are some foods that seem to be kind of eczema irritants, so sometimes and my profession is I do dietician, work, and then other things like I help with nutrients, etc. So it's really common for people To say, hey, this dietitian must know what foods work best for eczema. So my point is, is that there are some sets of foods that are somewhat irritating for eczema. But our goal is for that not to be a long term problem, it what typically happens is there is something else going on creating a situation in our body where our body cannot break down those foods properly, use them properly, or it's kind of reacting to something that's things that we don't even see on foods. So like, when you have if you've had food sitting in the fridge for or if you have leftovers for a while, there are a means these are a means that that that build up. So these are just like aging compounds essentially. So those things build up. And for some people, those are triggers. That is really difficult to figure out as a person, right? Like it seems like this now it seems like this. So it's not necessarily the food, it's a matter of your body is not breaking down things in the proper way for a certain reason. Which brings me to the next piece, which is bacterial fungal imbalance. So people, you know, in the research we have, if you go to PubMed, which is our research repository, and you type in intestinal permeability, you'll find like many thousands of papers, last time I checked was well over 10,000 papers talking about intestinal permeability. So that gets a lot of press. I think there's more of an issue with bacteria and fungal etc imbalances. So, what I liken this to, if you have a nice lawn, some weeds, you know, and every nice lawn has some weeds and with, with people with eczema, the common weeds I see are staph and strep overgrowth. And it could be something else too. But there's a there's obviously our our microbiome is as diverse as the Amazon, right? And so there's always this possibility that there can be some weeds Why do we get weeds? Well, sometimes early Expo exposure to medication and we don't really replant the grass, right, we just like killed some grass and killed the weeds and don't really replant the grass. So then weeds grow up grow. We've all experienced that right? Like, you lose a patch of grass and weeds like to grow there. Or diets don't. So like a really diverse, colorful plant diet is what really feeds our microbiome like and makes it this beautiful lawn. And so we just like in the US, we're not super, we're kind of boring. We like to just eat the same things over and over and over, like, right? We really do this, we do the same for proteins over and over and over. Unless you're eating wild game or fish you're eating really, I mean, just think about the proteins you ate last week, like I bet it was for things unless you were eating wild gamer fish, and then with our plant foods, people, we get really comfortable with things right? Because Because thinking about food and cooking sometimes a lot of people don't necessarily enjoy it or they're just looking for something. We you know, we're just creatures of habit, right? So, yishan xu 17:41 yeah, it goes on in the store, we only buy certain things, right, Christia Biegler 17:44 we I know how to use those bell peppers. So I'm just gonna keep using those every week. And the easiest way to diversify, if you're trying to break out of that is and this is a great thing because it's also the cheapest option is to shop seasonally. So right now we're kind of like where you are. probably feel a little More More like spring where I live. I'm looking at fresh snow dripping off the trees this morning. Yeah, so it's a bit different. But like, I still think it's a great time to be indulging in those squashes and winter, winter produce, right? And then as you know, whenever whatever is cheapest, or whatever is a bumper crop next, that's what I should be buying next. Because when it's cheap, it usually means it's plentiful, which means it's in season, right? That's essentially what that means. Like if it's on sale, not always, but that's how you can like quickly diversify or just look for something different or new, or like, try something you haven't tried before. Those are good, simple ideas for trying to take advantage of like improving your microbiome before because, you know, often we don't think about this until it's like, oh, I'm already I already have like too many weeds. So now I maybe need like some help figuring that out. But, you know, just generally, if you're not, if you're not bothered by skin issues, the best thing you can can do is the most diverse diet. So that's kind of the short version of that, but people will often say hey, I see See reactions from the food but really is it the food? Or is that what your body's doing with it when it's already there? Right? Is there some other factor and so that's why I think the bacteria fun like the the the gut imbalances is the easy way to say your immune, there's other immune factors as well, that I'll sometimes look out. But basically I'll look at those. So I think if people aren't addressing stress, environmental factors, like having just like a great a good nourishing diet, because we're also looking at nutrient deficiencies, possibly as well as a cause of cosmetics, and for some people, right, so, or nutrient if you don't have you have nutrient deficiencies, your guards are going to be down, right. So if your guards are down, you're gonna it's easy for things to come in and set up problems. So for example, like vitamin A, it does a lot for repairing the epithelial tissue, but it also really supports your immune system. And if your immune system is you know, slacking, it allows more fungal overgrowth that allows more problems to come in and set up shop. And I've had people or I've had kids, it's been fun to see this, where sometimes when they start to get a cold email A few days beforehand, they'll start to flare and our body knows we're going to go sick before we get sick, which has been really fun. I've been using this ring to kind of track sleep, and just activity etc. It's been sort of a fun little biohacking device. But the recently we were on a long trip and my kids had gotten sick and I was rundown taking care of them. And for a few days before I had anything happened to me, it said, you know, your heart rate didn't drop last night, you know, sometimes that can happen when you're gonna get sick, or you've just overworking it, maybe you should take it easy. So it told me that for several days before it finally took me so anyway, that will happen. So stress, environmental factors, food, but I want to put that in the right context because we don't want to you know, make it the enemy cuz some people started limiting their diets too much and it ends up being not good. We end up with a lot more stem in anger, and then bacterial imbalances. So those are the things I often look at but then also Some, there's more beyond those. But those are like primary ones I feel are affecting a lot of people, I guess. So those are some of the ways I look at it from the inside. yishan xu 21:09 Right? Definitely I really loved the analogies you use and thinking about what we eat and how that impacts us and get to listen to the signals our body actually been sending us possibly days before anything happened to us. And also understand the microbial biology is the bacteria. It's really hard to research topic, even in the sleep area right now, to understand what how our body is dealing with anything we put in our body system, how to deal with it. It's very interesting and complicated. Christia Biegler 21:47 Yeah, it really is. And sometimes we can get a little discouraged. So I was kind of talking earlier you were saying, you know, the causes and effects are so different for different people. But man, that information is so simple. And to to kind of document and understand, like what seems to work not work. And I understand that sometimes it'll feel really frustrating at first because it's like a lot of data, but over time, it starts to make more sense. So my point is what I'm trying to get to here is, with skin issues, sometimes we can get disappointed because it doesn't feel like it's clearing right away. But what I would love to plead you to do is look at other factors that are correlative, or that indicate you're having success. So let me tell you what some of those are, if people are having success and like so with kids mood, because sometimes mood is affected by this stuff. So they're seeing an improvement in mood, sleep and itch, you were on the right track. Like if those things are better, you are doing well, like the skin can turn over and it will it will heal, but it usually will do it at a more delayed place. But if people are sleeping better, that's huge, because one of the reasons they might be sleeping better is they're not up itching. And if you're not up pitching, that means one you're not compromising your skin barrier. So if you continue Scratch, you're like breaking down the skin barrier and making it that you just continue that insult to injury essentially, right? And so if you're not doing that, and you're also getting sleep, so you're actually repairing like this is when your body, we sleep for a third of the day on purpose, you know, I'm Unknown Speaker 23:15 right to repair. Christia Biegler 23:16 So and sometimes people are like, yep, I'll just sleep later. But I mean, really, that's like one of the first things I look at to know that I'm on track. And there's many reasons I look at it, because it also tells me that things in the microbiome are moving in the right direction as well, because as you know, serotonin which is sort of kind of a little bit of a precursor to melatonin, but it's a calming neurotransmitter is made largely in the gut, right? And the microbiome or the affected largely by the microbiome, so I actually love I love talking to people who say, I'm not sleeping well, because I'm like, Oh, yes, there's so many ways to improve that by microbiome and addressing what's going on inside like, it's one of the first things that I want to see improve because I consider it sort of low hanging fruit. If I can't get it improved with microbiome stuff then of course there's there's a lot as you know like there's a million topics you could talk about religiously but man what an important what an important area so I always have people document and I scale those things like a one to 10 like how do I think my sleep my mood my itch where and then my my skin issue every day because then I can start to see trends like oh man two days after this sleep was was affected etc so but I mean you worked in a sleep center so I'd love to know like what you saw Did you ever look at them? Did you was skin itching or eczema, every issue that you saw come through your center? yishan xu 24:38 Yeah, I actually see that when I work in psychiatry department not really well in the sleep department also for sure. But I definitely see like I totally agree if you sleep better, it helps with the different type of skin conditions. But the same time when you have a skin conditions, it interferes with the sleep And a lot of time people complain because they're eating because they have like, they feel it. So at night, they are not able to sleep well. But we always, we always have some way to treat with sleep. And sometimes we use psychological interventions to help to manage the stress to help people acept whatever physical condition is, sleep can still pick up. So yeah, we definitely see mixed conditions. Yeah, Christia Biegler 25:31 that makes sense. So it's, you know, a lot of the research around sleeping exam has done in children because it's such a larger amount of people that are affected I guess, and maybe the parents are just really looking I don't know, you know why it is but at a basic level, there's just more people affected right. So it's easier to get study participants and it's pretty ethical to look at sleep in kids like you know, it's not like you're doing crazy stuff so so in kiddos there's a like one study I found talked about how 60% of those with eczema as a skin condition had disturbances in their sleep, but when they have a flare in their eczema it over 80% of them are have a disturbed sleep. So this is huge. It's like such a big deal. What I found interesting was they talked about circadian rhythms and the skin, which I think is a great topic as well. We could chat about if you wanted to. But another thing that I thought was unique was that they saw a large association of ADHD where Attention Attention Deficit Hyperactivity Disorder and children. They they said it was associated in with eczema, but only in the ones that had sleep problems, which I feel like is not fair, right? Because Because if you're not sleeping, of course, you're going to act out or feel differently or just like not feel good or not feel yourself and when that starts to become your normal, and people are like, oh, now you have this attention problem. Well, gosh, I just like I'm not getting good quality sleep in the first place. So I just thought that was interesting. It's related to children with eczema, but Pretty much just in the ones that have sleep issues. So it's interesting how many comorbid? Or how many, how many things together, right? Yeah, it's so good when you can address things from the inside and fix multiple problems, rather than like, Oh, I'm just addressing the one thing I guess. I mean, that's, that's how I like to think about it. I guess I just like, right, like when you Yeah, like when you water the tree and the tree grows, you know, rather than like cutting off the branch. yishan xu 27:26 Definitely. And I also like your approach, or at least your view of this is you're not only watering the tree, you're putting all kinds of nutritions around the tree, and to also help to make sure the soil is very healthy. So you are really looking at the same issue from multiple angles. And I totally agree it's so important. Christia Biegler 27:47 Yeah, and I mean, the tree thing is a great analogy, because you're not only watering and making sure it's got great nutrients, but it's also got great sunlight. So literally, you're getting an angle from it. You're putting internal interventions in at the base, and then Also looking at the external interventions on the outside, right? Like the environment has to be conducive to heat like to that trees growing and thriving. And I feel like if we start to look at everything kind of that way, we'll improve so many things because, you know, it's not it's, it's not like we're supposed to have these nutrient deficiencies, but or, or XYZ other problem but tends to be it tends to never be one thing, it tends to be kind of a perfect storm, right? Like maybe one thing is, is, is a bigger priority than other things are like you need to focus on one area at a time first, right? And that makes it a lot easier and more strategic sometimes if I try to focus on one area, right, but it's usually multiple things that are yishan xu 28:42 Yeah. So I'm curious when you check out all this initial points where they are, what are some things lead to the problem or triggers? Do you it's your approach more from dietician and nutrition? from food point, like when you inter make the do the intervention? Christia Biegler 29:06 Yeah, so I actually look at all those four points that I was just talking about, I look at stress, because that's a huge like we want to, if we just if I just look at it from only nutrition, even I think nutrition is a really broad topic, then I'm a little short sighted. So then I want to make sure I obviously refer if it's something that I should not be, you know, doing are something I can do. But I can generally work on manipulation of the microbiome, so I can help with like, making the grass look good. Again, you know, which is going to affect the food, you know, so like that really interplays with the food so much that and that's a great question. Like, I started with just food until it wasn't enough and then realize, like, man, we could just expedite this whole process if we would do these two things at the same time. And then also like addressing and looking at how big of stresses is playing a role, how big sleep is general and making sure there's not other environmental pieces, so we try to control try to control all the variables. That's the funny thing about life like, we have some Variables coming in all the time. And so I try to couldn't just like take a really short amount of time to control variables and have an analogy for this. Actually, I always I liken it to like having a broken or sprained ankle, I usually like the food stuff, etc. That's like kind of sitting on the couch, but we don't sit on the couch forever with a brain is broken ankle, we need to like add, wrap, elevate it, healer, etc. So that way you can walk again and then run, you know. So like, I don't think any intervention is kind of a permanent intervention for me, like, I'm looking to work things through phases. And I'm looking for a certain amount of time where things kind of have a return, right? Like how quick should things some there's certain types of eczema that when I hear someone's story, or when I see what it looks like, it's just not as fast to resolve and I just tried to tell people that like you have the same kind of eczema I did. It does not resolve as fast as some of these other ones that are a little bit bright, pink, red, etc. Like some of those will resolve a little bit more quickly. But what often happens was we were kind of discussing before people will get frustrated I'll just kind of keep jumping things. And so we never really like it. I totally get it. Because I've been there like we we just throw things out. Because we're like really desperate in the middle of the night when you're not sleeping, right? You become very desperate. And so it's hard for you to stand back and look at things. But the more we can be like comprehensive control the variables even short time, so we can kind of manipulate things and figure out exactly because usually this is telling you your body is giving you a signal, right? Right. When it's showing up on the outside, it wants to tell you something, right? Like your body would normally want to sleep well, I would normally not want to pitch, etc. But so it's just trying to figure out which signals it's trying to tell you. And then giving it what it needs essentially, right? yishan xu 31:40 Yeah, yeah. Right. So yeah, you're doing a lot of work. And this definitely sounds like cover so many different aspects. And I would imagine it would be challenging but also exciting to work on this topic. Do you also have a team you work closely? To manage all these different factors around it? Christia Biegler 32:04 Well, actually, I would say I would individualize that. Right. So like the team might be, when it's the child, it's going to be the parents and who's other who are some other people that have been in their, in their in their corner. Right. So does the dermatologist need to help with a certain thing? Do we need to bring in someone else? It kind of just depends on the case. Right? Right. As far as like my team, I'm always kind of masterminding or talking to other professionals. I talk to other professionals that work on skin issues, and I talk to other professionals that don't work on skin issues. Because as you could imagine, when you're working on the, you know, when you're, when you're working on watering a tree, it doesn't matter if it's a peach tree or an elm tree. There's a lot of similar like, they're very different, but there's a lot of similarities. So when you talk to other practitioners that use similar methodology to address different conditions, we can share out we can share a lot. So I mean, just to be even simple. When we're looking at eczema, there's a lot of overlap between like psoriasis. There's a lot of overlap between apps Many are just random skin rashes. I mean, I, I still kind of consider I still listen for the same things. So there's some like testing that can be done. But also, I think like the person with the condition with the eczema, their, their experiences, their history that's as or more important, like what they say helps doesn't help is as or more important than any test result, right? Because we can, our test options. were awesome. Our medical options are awesome, but we like we can always improve right and so nothing's perfect. So when we, when we listen to people, we just get a lot farther I guess. So. yishan xu 33:37 Yeah. Yeah. Yeah, definitely. So I'm wondering whether we still have several minutes to talk about a little bit about the scheme circadian rhythm because you mentioned that I'm actually curious about what you how you use that what what you know about it? Christia Biegler 33:52 Yeah. So that's something I've been paying a little bit more attention to and I something I'm learning a little bit more about. So I'm going to back up and talk about circadian rhythm in general. So circadian rhythm is probably no surprise to anyone listening to this episode, but uh, you know, it's your sleep wake cycles, essentially right? And to my knowledge, we have our, our sleep wake cycles are affected by many things. I've literally been looking at how light effects this most recently and how that can help my different clients. So first off, another symptom I like is fatigue, because there's a lot of potential to improve that there's a lot of possible causes of that. And so obviously, fatigue is going to come along with poor sleep too. But yeah, one so I think about fatigue, like a question I'll ask someone is, do they have trouble getting out of bed in the morning, even if they've slept well. So if they do, then I want to start looking at cortisol awakening response, or basically your body's get up and go in the morning. And so if that cortisol awakening response is not very good, I will look at circadian rhythm signaling so like that's a fancy way of saying, Go get some full spectrum light or look at the sun. I recommend people go look at the sun the first 30 minutes of the day because when you Look at full spectrum light are you which some people don't have daylight and so sometimes they have to use light boxes in the morning. But I was like the free option First, there are photoreceptors in both your eyes and on your skin cells, which apparently is a little bit newer on your skin cells, kind of when you when you see light, it's basically telling your body like oh, this is the time it is and it started kind of setting that circadian rhythm. And this gets so affected by I'm sure something you've talked about a lot by the effect of light. And so sometimes we get up and we look directly at our screens in the morning. My knowledge is that that tells our photoreceptors in both our eyes and our skin that is now noon. And so if it's noon, it's a lot easier to feel tired earlier than if it you tell your body is now 6am or 7am or whatever time it is when you want to get up. So I always challenge people like if you're not waking if you don't if you feel if you had even a good night of sleep but you're waking if you're waking up and feeling really like it's hard to get out of bed The first thing I do is go get some full spectrum light or look at the stuff 100 seconds, five days, see what you think. Like, I don't really have anyone who reports negative about this. And then other light experts will say, also get a little bit of light exposure, like around the midday and then in the evening kind of when the sun's going down because it helps kind of reset those circadian rhythms. This is definitely an area for me. I like to learn new things. And I feel stimulated by new things. And so it's an area where I, I still have a lot of things I'd like to learn about circadian rhythm that I don't know a ton about. But I'm like, I've got some books like old school books that I'm like, Oh, I wonder what was popular then and how we are still not addressing this now. But as you know, like, what happens or a thing I hear people say is they'll wake up in the middle of the night, there'll be scratching, and then they'll just go watch TV in the middle of the night, which can affect or interfere with their ability to go back to sleep because now they're taking in that blue light from the screens, and it's interfering with melatonin production. So people are gonna get up and do that. I'd really recommend They use amber glasses and and apparently they have to actually be amber to actually block the light that's affecting the melatonin from the screens for nighttime. So again, something I'm learning more and more about it's supposed to be read glasses in the morning or if you can't see the sun if it's just like a little bit before the sun comes up, I've got like a shortcut on my phone where I make it red screen. So I'm not getting like blue light from it. I'm looking through kind of red filters so I do that in the morning then midday you have computer glasses for just and that's been really good for eyestrain, because if I look at the computer all the time it affects eyes and then night Amber. So anyway, they're like, two, I don't have good analogies yet for for the other circadian rhythm stuff in the skin, but it is in the literature about like eczema, which I think is great. I love that they're talking about all of the all the potential factors, but kind of what I said what is one of the things I hear the most is people get up and then they're kind of disrupting melatonin production by kind of they're essentially like sleep hygiene factors which I get, like, what do you can do in the middle of the night? Sometimes you're like, I understand why that happens, but maybe try to include a little hack, like, maybe try to block that blue light with Amber glasses if possible, because otherwise we're sort of insulting that circadian rhythm even more. So. And when that gets a struggle, a mood is a mess. I mean, it's a lot of things, right. yishan xu 38:26 Ray Ray? Like, is, surprisingly, how closely our sleep and food intake and all the other like our body systems interfere with each other, and interact so closely. Mm hmm. Totally. Totally. Yeah. I like how you read research and apply them in your own work. That's cool. Christia Biegler 38:49 Yeah, it is really good. And actually something I didn't talk about something I'm really interested in right now. I'm working on finding experts interview or maybe I'll do the episode about red light therapy. I don't know if you've done Anything about this, but red light is just really restorative. And really helps cells work better and helps with cellular turnover. So I'm just looking at that, again, I was talking about internal, external and kind of some different ways to look at things. And the thing is the research around red light is amazing. But when will it hit? When will it be mainstream not for a long time, so you have no choice like if you want to be cutting edge you need to go read what's working and then start to apply. Otherwise, I mean, wait 15 years otherwise and eventually like, eventually you'll hear about yishan xu 39:31 Yeah, it's a field that sleep field is slowly developing but the light bright light therapy definitely there are a lot of trials already people are using it with a lot of good success. There are also like you mentioned amber glass at night. There are other type of glass with the little light within the glass. You can turn it on in the morning and just to wear it. I saw the picture of it, but I don't know the name of it. Sometimes in clinical settings, we use it. Christia Biegler 39:58 Oh so it's like a it's You turn on the glasses into a different light filtering setting is that what you what you said there?


www.deepintosleep.co
Dr. Yishan XuComment