Journey to the Sunnyside

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Speaker: [00:00:00] Hey, welcome back to Journey to the Sunnyside. Yesterday, Phil Kali and I talked about how alcohol affects your medications. And today we're tackling another big issue, how alcohol might be ruining your sleep. If you've ever had a few drinks and thought it was helping your sleep, only to wake up tired, this episode's for you.

Phil is back to explain how alcohol disrupts your sleep cycles and how you can make some simple changes to get better rest. So let's get into it with Phil Kali, the owner and pharmacist at Cache Valley Pharmacy.

All right, Phil, why is alcohol wrecking our sleep? From a pharmacist's perspective. What is alcohol doing to the body that disrupts sleep?

Speaker 2: So I want you to imagine the neurons inside your head and you've got gas pedals and you got you've got brake pedals And thing that pushes down the brake pedal is gaba.

Gaba is how we we settle down our whole brain When we drink we continually hit [00:01:00] the brake pedal We don't really do much with the gas because the gas keeps going because of that The cell starts to build a whole bunch of new brake pedals So, it takes more and more GABA for you to fall asleep, for you to settle down, which means you start drinking more and more.

When you look from a sleep cycle, now when you used to fall asleep easy, because your brain would produce GABA and it would slow everything down, now there's so many GABA receptors that your body doesn't produce enough to fall asleep on its own, so now that's when people say, I always need that one drink before I go to sleep, it's actually telling me as a pharmacist, you've up regulated the number of GABA receptors you have in your brain.

Speaker: So are there two things going on? Because I think a lot of people will say, I can't fall asleep without having a drink or a bottle or whatever it is. And then also people will say, you know, Oh, I wake up at 3am, chest pounding, anxiety. Are those two separate things or related?

Speaker 2: So there's a teeter totter relationship between GABA and glutamate.

[00:02:00] And so when GABA is high, glutamate goes low, and they go back and forth. And it's a little more tricky than teeter totter, but it'll take a lot longer to explain. So there's a rebound effect when you've hit enough GABA that the glutamate tries to come back around. And when the glutamate comes back around, once the GABA starts to clear out, the crowds leave the concert.

Now, all of a sudden, everything gets louder and noisier with the glutamate. So when that crowd's there, you don't see all that noise, but once it's gone, that glutamate takes over and that anxiety is a rebound effect from the GABA going away and the glutamate getting to take back over.

Speaker: Let's get into the problem solving side of this.

What can we do about minimizing the disruption caused by alcohol with sleep?

Speaker 2: So, it all has to do with how well you process your alcohol and how you come away from your alcohol. There's, there's a huge failure rate for cold turkey. Okay. Like, it's really, really hard on people, and that's because your brain has become so accustomed to having it around.

However, a slowing to a moderation and then coming [00:03:00] off is a much better way to do it from a pharmaceutical standpoint. Alcoholics and omnivores would disagree with me, and I'm all on board with the psychology component is out of my league. It's not what I do. But from a standpoint of a pharmacist, if you come off cold, that's the reason why we usually give you medications to come off of it.

So we'll give you things like lorazepam. We had a thing that we called the VA cocktail. And it's because inside the VA, there are so many people with post traumatic stress, and they're trying to compensate with things that they drink heavily. And when they come in, there's a group of medications we give to them so they don't have seizure issues and things like that when they drink too much.

You have to take that huge example and shorten it to what you're doing. If you're used to drinking three glasses and you go to zero glasses, it's going to be a rough go. You're much better to go moderation to come off of it with a good plan. On Tuesday, I'm only drinking two. On the 14th, I'm drinking one.

And then that way your brain has time to downregulate it and it's a softer landing rather than an abrupt.

Speaker: So one of the surprising things that I [00:04:00] underwent early on in my journey was that I didn't realize that we all know that sleep is disrupted when you drink, but what I didn't realize is that sleep is disrupted for several days or even longer after you drink.

What can we do about that?

Speaker 2: So there are ways that you can compensate for that. And it's absolutely true. In fact, it also does disrupt the type of sleep you're getting to, which is something people don't. It's hard for you to get really deep into sleep because you've got that glutamate agave receptor going on.

And so you've got this thing where you're sleeping, but you don't feel rested in the morning. To reestablish sleep, you need almost an overhaul on your whole lifestyle. So yes, you're going to slow down your drinking. So it's less, but you're also going to realize that if I'm going to do this, I know that I want to be asleep and sleep through the night.

So I have to do my drinking at six in the afternoon or something. So it's by the time I go to bed at midnight, I'm on that next stage. Any glasses I have, you want to look at. Maybe there's supplements out there that can help you sleep because there are supplements that [00:05:00] directly do work on the GABA receptor, but I'd be careful with taking GABA because that's what we're trying to reduce anyway.

I would look at more of the magnesiums and things like that, although they're not nearly as strong. It'll be a healthier landing when you look at it at three month mark.

Speaker: So for me, you know, I was a nightly drinker with wine and for other people, they might not have gotten to that stage. So it might have been much more difficult for me.

But is there a cutoff time that you would recommend as far as alcohol? If you're having drinks a certain evening, how much time should we give ourselves?

Speaker 2: I'd have to like grab your liver and pull it out and see how many enzymes you have in there because there are some people who process glutamate just fine, they process GABA just fine, and there's not a thing, not a problem there.

What I would say is, if you start registering how long your, a lot of people say, I drink too much, if I wait two hours, I start feeling better. That's your time frame. So a lot of people will know themselves better than I could ever tell them, but a lot of people know that I drink. At this [00:06:00] time. And I know by this time I'll start feeling better.

Start realizing that's your half life and try to put at least a half life and a half between the time that you want to go to sleep, if you don't want to be dependent on that alcohol to help you hit the GABA to go to sleep.

Speaker: So let's say you get a crappy night's sleep. Are there some things that we can do the next day that would address maybe not initially the GABA, but things that could kind of get us back to homeostasis the following day?

Well,

Speaker 2: we all know that dehydration. Is a huge part of what's going on there because you are dehydrated. So i'm going to say what everybody else says you want to have hydration That contains sodium potassium and the b vitamins, especially if you can get the b vitamins inside of phospholated form Which is different than a lot of the other types.

It's a it's a little different Um, those are huge to get that hydration. It's not just drinking water. Water by itself is fine, but you won't rehydrate appropriately because your body now has more aldehydes and processing [00:07:00] aldehydes is a difficult task for that body. So you need to make sure it's giving all the tools you possibly can.

There is also N acetylcysteine, which will, could help you as well to help you get over those hangover effects in the morning. That's the reason why hangover remedies often have. A lot of electrolytes, a little bit of N acetyl cysteine, and a lot of B vitamins. Almost all of them look the same with fancier packaging.

Speaker: So I'm going to go off the script a little bit and address other things that we could potentially be taking. Is there something that you like for, let's say, liver recovery or anything like that?

Speaker 2: The only problem I always have with liver recovery stuff is that I really want to push somebody who's concerned with their liver.

You've got to quit hurting that liver. So, the idea that you can fix, it's like those, the, the drinks you have to slow down the, the alcoholism. The problem you have with liver is there are things like dandelion root, there's the N acetyl cysteine, there's, there's a few, milk thistle can help. There are those things that do help the liver.

But when you insult the liver [00:08:00] over and over again, and I'm not talking about very moderate drinking, I'm talking about the guys that you find on the side of the street or even heavy drinking at home. That kind of like really, really heavy drinking. That liver, those supplements could become harmful instead of helpful.

So you've got to quit insulting that, that liver, or first assaulting that liver, and then second, you start looking at milk thistle, dandelion root, and acetylcysteine are the first ones that I kind of lean on. Because they have the most studies that have been accomplished with them.

Speaker: So you're saying like if I work out I can't just go eat a big mac every single time?

Speaker 2: Well you should eat it before and then you'll never work out again because you'll throw it up. So that's kind of, yes, that's exactly what I'm saying. Like that's, I always thought of this race that somebody should do where you run. You run a lap and eat a donut and see how many laps you can do before you, everybody quits.

Cause I don't think the race would last very long and you'd realize how bad that I love a donut, but I know it's bad for me. Cause I can't run for like two days after I ate a donut. It makes me so sick.

Speaker: Yeah, I do love a donut too. [00:09:00] I love them. So

Speaker 2: don't put them in front of me, but I, the second it's done, I'm like, Oh, that was a mistake.

So.

Speaker: Well, you put out a lot of videos around sleep, and so I just kind of want to give you a little bit of liberty here, but, and that is, basically, what would be your top tips for sleep? You know, not even just related to alcohol, but something that you would just, if somebody asked you, what's the regimen I should follow, what would you say?

Speaker 2: You gotta figure out whether you're on the back end of the problem or the front end. So first you have to ask yourself, am I not getting drowsy, am I not getting sleepy? Or am I having a problem because I do get sleepy, but then I rebound back up. So that's when people say my brain, my brain just keeps racing because each of those needs to be treated a little bit different.

If you're having a problem, just falling to sleep. That's when like low doses of melatonin are very effective for people. But if you're a person who is hired and you're just angry, cause you can't fall asleep, cause you're so exhausted, but you still won't sleep. Now you have to start talking about [00:10:00] how do I make it so my, all of my neurotransmitters on the front end, so the ones that make your brain move, all that, on that front end of the, like I'm busy, how you slow those down.

And so now we're going to start looking about how can you clear out norepinephrine, how can we process the whole metabolism of any of the catecholamines that we have. So my general advice is, is there's a lot of sleep aids out there. I always tell people start with some magnesium because everybody needs magnesium and maybe it'll work for you.

And then you start looking at some of those other things. If you're constantly taking an antihistamine like NyQuil or, or anything in that family, because that's doxalamine, what you've done is you're removing that histamine, which is one of the things that wake you up, but you're still not solving the issue of why it is that you're not, you're so excited when you're trying to go to sleep, even though your body says it's time to go down.

Speaker: Magnesium has been a lifesaver for me for sleep and comboing it with B six and I've done some l-theanine. I struggle with [00:11:00] sleep to stay asleep, but I, it really was a game changer for me.

Speaker 2: Well, I love it 'cause who, like, what's, what's the harm, right? You take the amino acid of L-theanine and you take magnesium.

What do you got to lose? You know what I. It's just such a good combination, and if you're wrong, well, you can use more of the amino acid, and you can use more magnesium. So, unlike a lot of other substances, you're like, well, I don't know how well it works, but I know that adding that to the mix couldn't hurt anything.

Speaker: I read that it basically can make you live longer, so that also made me want to take it.

Speaker 2: Absolutely. Magnesium is used in everything, and we deplete magnesium constantly. That's the reason why, when studies show Americans without magnesium, it's not consumption, it's just the utilization of it. We use almost all the magnesium we possibly could get a hold of.

So even people who take it probably could use more in most cases.

Speaker: Well, this one fascinates me because sleep is something that I've struggled with over the years. And it's not falling asleep, but waking up at three or four in the morning. And it gets really, really frustrating. [00:12:00] One, I've. I'll just throw it out there.

One that I've tried recently, I've tried a lot of them and I avoid the ones that I think that are going to be like habit forming or potentially, you know, just strong, crazy things that you hear about people sleepwalking and all this. So I, I did try doxepin, which seemed to work in really low doses. What, what's your opinion on that?

Speaker 2: So doxepin, from a standpoint of a pharmacist, is a messy drug because it hits a lot of different receptors. From an insomnia standpoint, it actually makes a lot of sense, because when you take doxepin, instead of just hitting one mechanism, you're hitting three different mechanisms of trying to help stop that.

So you're, you've got a problem where you're waking up, so that means you've got something in your head that's saying, I need to wake up earlier. So that's, that's glutamate, that's histamine. There's something about you waking and that wakefulness, because, because the doxepin at a low dose, it's, it's not going to be habit forming, but it's also probably not going to fix whatever it is underlying.

And most people who take it can [00:13:00] take it long periods of time. There's a little bit of drowsiness in the morning, so you get a little hangover effect that some people don't like. And so you have to be careful of that hangover effect in the morning, but usually you stay so low and it's just that little bit to keep you asleep that it's probably better than a lot of the other substances you can take.

Doxepin at higher doses can interact with like antidepressants and things like that. And I, I believe most people who drink heavily are masking an anxiety or depressive state and that they've learned how to cope with it. Um, sometimes that's. Looked at as like ADHD, whatever it is, there's something their brain is coping with.

And so I like some of these messier drugs for sleep for people that have liked alcohol in the past, because it allows for whatever their brain is searching for, to be able to be calm a little bit without having that constant need to get more.

Speaker: It did seem to work. I'm Of the mind, I try to keep most things natural as possible, unless I absolutely need it.[00:14:00]

Speaker 2: Well, and that'd be if we were perfect and none of us had any issues, we all would stay 100 percent natural too. And so, I'm a big proponent of natural with, nor, with, uh, average medicine. Not, and, and that, the reason is, is that, like I said, if, if we were all perfect and didn't have any issues, then, sure, we could just take just the nutraceuticals and we'd be fine.

But the truth is, every one of us has. Genetic mutations and things that are different about us and accepting those and, and finding that equilibrium between, you know, Western medicine and natural is really important. Cause that's part of accepting yourself. So, you know, I don't sleep either and I've tried almost all sleep meds.

And what I've come around to is that any one of them could be a solution or a problem depending on how I utilize it. And sometimes I just don't get sleep. And sometimes I get good sleep and sometimes I take something and sometimes I don't. And I just start realizing that the flaws inside myself are okay.

As long as [00:15:00] I keep them in balance and equilibrium.

Speaker: Now you said it right there, balance right there. So I'll finish up this episode. I know I already said that we were coming to the close, but I want to ask you, somebody who's going to moderate. What can they, what steps can they take to minimize the interruption from sleep and alcohol?

Speaker 2: Uh, you've got to get your education done, and I mean education about yourself. Like, get really honest of how many, how much alcohol you're taking. Take it from a scientific approach. I'm consuming this much alcohol, which means I need to be able to figure out how to get off that much, and I've been on it for this period of time.

And start looking at it from a very logical approach of how can I get to where I'm going. Um, there's an emotional basis anytime we've decided to make a lifestyle change and an emotional basis makes us beautiful And it makes us so we'll make these abrupt changes and it makes it so we have a hard time with it So what you've got to do is tell yourself I need realistic goals I need to give myself positive feedback when I make a realistic goal.

And I [00:16:00] need to take that path over long periods of time, finding new ways to give myself that hope of little by little, I can become what I want. So I don't feel like a failure along the little steps. So although that doesn't answer just the sleep, you have to get realistic goals Place. So you feel like you have those successes and those are best found by you really taking a hard look of what you're doing and where you want to be.

Speaker: Yes. All right. Perfect ending. Thanks Bill. That's it for today's episode of journey to the sunny side. Big thanks to Phil Kali for helping us understand how alcohol affects our sleep and energy levels. If you're ready to take the next step in your mindful drinking journey, head on over to sunny side. co and take our three minute quiz for personalized insights and remember to follow us on Instagram.

At join sunny side for more daily tips and resources. Plus you can enroll in our free masterclass. Just check out the link in our bio on Instagram. If you've enjoyed today's episode, make sure to hit that subscribe button so you don't miss out on any future episodes. And until [00:17:00] next time, keep moving forward on your mindful drinking journey.