160: Dr. Stasha Gominak, Neurologist & Sleep Medicine Expert: How Low Vitamin D & B Vitamins Are Destroying Your Sleep (And More!)!

Welcome to the Sleep as a Skill podcast. My name is Mollie Eastman. I am the founder of Sleep as a Skill, a company that optimizes sleep through technology, accountability, and behavioral change. As an ex sleep sufferer turned sleep course creator, I am on a mission to transform the way the world thinks about sleep.

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sleep each week. I'll be interviewing world class experts ranging from researchers, doctors, innovators and thought leaders to give actionable tips and strategies that you can implement to become a more skillful sleeper. Ultimately, I believe that living a circadian aligned Style is going to be one of the biggest trends in wellness.

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And I'm committed to keeping you up to date on all the things that you can do today to transform your circadian health and by extension, allowing you to sleep and live better than ever before. 

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Get excited for a truly fascinating episode. I have been obsessed with Dr. Stasha Gominak for quite some time now. So it was a real privilege to sit down and have a conversation with her. We speak on topics around vitamin D, how your levels of vitamin D could be playing a huge role in your sleep results.

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So that was a big portion of today's conversation. It quickly became apparent that we're going to need to have her back on. There's just so much that we need to cover, but we also touched on things like your B vitamins and how that could be playing a role in your sleep results as well. But first, I want to share a little bit about our guest, Dr.

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Stasia Gomenek grew up and attended college in California, moved to Houston for medical school at Baylor College of Medicine, where she received an MD degree in 1983.  Her neurology residency was done at the Harvard affiliated Massachusetts General Hospital in Boston. She practiced neurology in the San Francisco Bay Area from 1991 to 2004,  then moved with her husband to Tyler, Texas.

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Starting in 2004, she began to dedicate more of her practice to the treatment of sleep sleep and sleep disorders. In 2012 and 2016, she published two pivotal articles about the global struggle with worsening sleep and the possible causes and solutions related to vitamin D deficiency and intestinal microbiome.

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In 2016, she retired from her office practice to have more time to teach. She currently divides her time between right sleep coaching sessions for private individuals and teaching other clinicians the right sleep routine. sleep method of sleep repair. I know you're going to be fascinated with this conversation and you're going to want to tune in for our part two when we record that very, very soon.

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Now let's get into the podcast, but first a few words from our very important sponsors. If you're listening to this podcast, you're likely looking to improve your sleep. And one of the first places that many people begin when they talk to me about sleep is they want to know what's the supplement I can take.

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And welcome to the Sleep is a Skill podcast. This is an episode I have been so excited to record, to dive into, and I know you're going to be fascinated by the information that we're about to unveil, if you will. So, Sasha, thank you so much for taking the time to be here. Mollie, I'm thrilled that you invited me.

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I'm happy to be here. Yes, yes, we're both in Texas, basking in the sun over here, and it's going to be a great segue into some of the topics that we're going to touch on, including vitamin D and what that has to do with sleep, as well as the microbiome and the interactions, the complex interactions there.

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But before we get there, Let's begin with how did you find yourself in this arena of specializing in sleep and really devoting your life to helping support people in their journey and improving their sleep? Thank you for that question. It was completely by accident, um, but I am a neurologist and I had about Half of my practice in Tyler, Texas, uh, in daily headache suppers.

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So that population is predominantly women who are otherwise relatively healthy, uh, who have had a couple of kids. and they don't really have a reputation for having a sleep disorder. So at the time, and this was in the mid 2000s, so um, a while ago, almost 20 years ago now, there was no reason to be thinking about sleep.

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I had no specialized training in sleep, but one of my patients asked me for a sleep study and she looked just like you. She was healthy. She otherwise had no reason to have a sleep study, but she had. pretty severe migraines and frequent headaches and the odd thing was I said no because I didn't know of any I didn't see any reason and at the time we were really directing our attention to older overweight males  but she had a sleep study anyway because she insisted and she had sleep apnea.

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And when she put on a CPAP device, her headaches went away. And to me, that was earth shaking, because  I had spent all this time, 20 years, thinking about the biochemistry of headaches, and which medicines work and which didn't. We had just gotten some, some medications in the 90s that had really helped the tryptans.

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But this woman put on this torture device, and her headaches went away in three or four weeks. And I had tried several medicines in her.  To me, that meant  that something was happening while she was in deep sleep. So she did not have drops in oxygen. What we had been sold was drops in oxygen, stress out the brain, and then the brain has all these things that happens to it.

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We get into sympathetic overdrive,  etc. But she had no drops in oxygen. It wasn't about oxygen. Not only that, neurologists know that you take out oxygen to a part of the brain and you get a stroke.  That's not what was happening. So, the pulmonologist who got assigned this because they have the machines, had come up with an explanation.

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And that's what I'm doing too. All of us, human beings, make up a story. And if my story helps you get better,  that story might be worth a lot more. something more than the other story. So if it hasn't, uh, as an improving effect, it's worth more. Anyway, I got into CPAP. I didn't have anything to offer my patients except for these sleep studies.

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So I start sending all these young, healthy women, then teenagers, then kids, then some men for sleep studies. And only a very few of them had sleep apnea. In fact, their records said that they had. no significant apnea. And that was the whole report.  It wasn't until a couple of years in that my pulmonologist told me that they had a pretty uniform abnormality on these studies that hadn't been reported, which was they didn't have enough rapid eye movement sleep.

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Some of them had none. Some of them had less than they should have. So if in a normal person, you should have Eight total hours of sleep. Four of those should be spent when you are paralyzed and deeply asleep. So it's a different set of pathways,  let's say, a different set of chemicals, and that is where we do repairs.

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So deep sleep, This is divided into two parts, slow wave sleep and REM sleep. This becomes confusing for those of us who are a tracker, like you're wearing an aura ring. Yeah. Because the trackers call slow wave sleep, deep sleep, and they call rapid eye movement sleep, REM sleep. To the sleep experts, both of those phases are deep sleep.

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And that refers to the fact that our brainwave patterns are different. We have actually different things that we're doing there. The chemistry is different. At the end of this, it's obvious that the women who can't get into these deeper phases of sleep, they do not stop breathing. There is no drop in oxygen. 

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There's something happening in the brain. It's the brain that is running that. It's not about the airway. So at that point, it seems responsible that I'm responsible. Like,  one, why don't they put this on the report? Two, this is totally neurology. And three, nobody in the literature is talking about sleep and headaches.

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Nobody's describing this abnormality where there's no REM sleep in these other Why is completely normal, healthy women who are doing everything we tell them to do?  No one's writing anything about it. I'm scouring the literature. Lucky by this time I've got, you know, search engines and I can see most of the literature. 

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So I know I'm on a frontier, but I have no idea what to do. So I start giving out a bunch of sleeping pills. I started asking a bunch of questions and this is a pretty consistent finding. And now I'm also doing sleep studies in all the people who have strokes that I see on the weekends when I'm on call.

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So I did literally thousands of sleep studies  and unfortunately there was no answer as to why this was happening. But I started because I didn't have any other choice to read a lot of anatomy articles. So I read about the brainstem. I read about this area where  you get paralyzed. We all get paralyzed while we're sleeping.

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My pulmonologist said, Oh, yeah, sometimes. You know, when he mentioned that my patient group that I was sending to his office was very different than the older overweight males that we were told to send, he said, the other thing that's interesting is they may sometimes have REM related apnea. And at that point I said, why, what's that?

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And he said, well, you know, um, we get the most paralyzed of all in rapid eye movement sleep. But I just. Kind of freaked out over that and just thought about it for a couple of days and how dangerous would that be? And how, how is it that I didn't know about that? And how do we, how is it that we don't die every night when we get paralyzed?

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And the depth of how, what it would be like as an engineer. So this is a very different way to approach sleep. What if I was asked, what would I do to run the nervous system to get me paralyzed  enough that I could repair the moving parts?  But I wouldn't die  and he would say, Oh yeah, we actually paralyzed this part right here in rapid eye movement sleep and I just thought about what that would mean and what would it mean to be perfectly paralyzed and how would the nervous system do that and what's the electricity behind that?

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How's it different than the wires in the wall? This is a way of looking at sleep as an engineer.  That's very different than looking at it from a scientist, where you do experiments and then you see what results come from it.  The people who come onto my website, who, who see this stuff, Who have an engineering mind, it immediately makes sense to them because that's the way I talk about it because that's the way my brain works.

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So, there'd be certain problems you'd have to face and then I would find articles about the firing rate of these cells and make us paralyzed. So, the weird thing was over a period of years because there was no other answer and I was very frustrated by having only CPAP and sleeping pills. Neither one of them is really a full answer.

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Most of my patients now, five years into it. They said, I love my CPAP device. I wear it every night. But you know what? First year I felt great.  Now I feel pretty crappy and I'm back on my medicines again. So I saw that several times. That means it's helping. It's a band aid, but it's not about what the primary disease is in the background.

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So I'm building these ideas and because I have nowhere else to look, because nobody's telling me what to do. So there's an aspect of,  of severe naivete. I don't have training. I'm looking at the articles, looking at it in a different way. And by now I'm thinking about sleep as a single cell. I'm thinking about these cells that are paralyzing this half of my tongue, paralyzing my eyes so I can repair my eyelids so they work normally.

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That's a really peculiar  way to look at this. I love this. No, this is fantastic because I think that's part of the journey for us is to understand how you made these connections coming from your training and now bringing us into this world of how do we now think about this knowing some of this information that you're discovering on the ground and what to then do about this.

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Like this is this phenomenon that's not being kind of shouted from the rooftops and needs to be. Yeah, and the reason why I tell this story is If I just blurt out, here's what you have to do. Right. I'm not satisfied by that. I want to know why. I want to know why did you get here. You know, I didn't know anything about supplements.

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We wind up in a supplement area in a health and wellness area that has a different dogma than what I'm going to talk about.  So the important part to learn is that medicine moves forward sometimes by science, but at other times by clinical observation. And clinical observation at the moment, that means, what do my patients tell me?

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Clinical observation for the last 20 years has been minimized.  And the drug company  clinical trial with one variable, namely the new drug, is being touted as the only true science. That is not true, and in actual fact we did not make this body. Therefore, everything our patients tell us is the, is the real truth.

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If they keep saying this and that and 25 people tell you the same thing in one year, if you don't understand it,  it's still the truth. So there are aspects to that that have to do with my the length of time I've been practicing medicine and the feeling that I know based on the CPAP and these sleeping pills that my patient's headaches got better.

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That means something's happening when their sleep gets better. There was a very clear clinical improvement. My patients on CPAP often had three medicines for blood pressure, two diabetes medicines. They were on this for cholesterol. All of their chemical measurements get better. That means there's a possibility that what we're doing is cleaning up the mess.

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For more information visit www. FEMA. gov Why aren't we concentrating on what if I could make this person into someone who doesn't need to go to the doctor? That's a totally different way of looking at medicine. But when I get to be 55  and I start to sleep badly, I don't want to take these pills that I'm giving out like candy, and I have my own sleep disorder.

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That's another really important thing. If you have not had a sleep problem, you just don't understand why people would want to be talking about this. So the odd thing is, in order to really relate  to not being able to do something that's completely natural, and by the way is absolutely essential for a normal life, You just won't be interested in it.

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I was very interested because my sleep was getting bad. I had restless legs. I had lots of things that were involuntary and this is a neurologist experiencing their own illness. That's very important. Because medicine is really about me giving other people medicines. If I don't have an illness myself, I don't really understand what it's like. 

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So in the background, those are all the things that are happening in my mind. And then I've got an 18 year old gal who comes in for daily headaches. She's just beautiful. She's about to go to Austin to go to college.  She has a sleep study that she's done in between my first visit with her. She comes back and says, you know, my headaches are so much better on this medicine you gave me, but I'm so tired.

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Is there anything you can do for me? And I think, you know, that's not my field. I don't know, but I'm looking at her sleep study and her sleep study has zero deep sleep. She's 18. She sleeps 10 hours. When you ask, how's your sleep? She says, fine. Sure. So 10 hours of recorded sleep. She tries to get into deep sleep.

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You can see that it's, there's a transition where the brain is attempting, but she's waking up to light sleep, not to awake. She doesn't know there's something wrong with her sleep. And that opens this whole question. How would you even know? How would you know that your sleep is abnormal unless you had a sleep study?

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So, by that time, I've learned how to read the sleep studies, and I'm quite aware this is profoundly abnormal, but she won't know it,  and I say, well, I don't really know what to do for your fatigue. Let's do a thyroid and a B12.  I'm just pulling that out of the hat because I'm not interested in supplements.

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So, we do our B12, it's profoundly low. And all I know about B12 is what we've been taught, the dogma at that time, which is that you have to give B12 shots, that it's really an autoimmune disease, where you attack this thing in the stomach that, has this carrier protein. So I send her off to her primary for shots and then I think, gee, I need to read about this.

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So I go out to Google and I Google what's, what are the, what are the symptoms of B12 deficiency? And it says fatigue and daily headache.  And I'm just totally freaked because I have never done a B12 level in a headache patient in my life. And I think, how could I have missed this? I read about headache all the time.

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So I go back into the neurology literature. No, there's nothing about doing a B12 level in a daily headache sufferer. Because the connection between sleep and migraine, which is, completely. They are tied together. Those two are part and parcel of how the brain stem, the bottom part of the brain that manages things when we're unconscious.

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That anatomy is completely bound together, but that's not the way headache literature is written. So I give B12 shots. I don't do them myself. I send them off to the internist. I start doing V12s and all my daily headache sufferers and a few of them start to come back and say, you know, after my V12 shot, I get two good nights of sleep and then 28 bad ones.

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So that's a proof of concept. Then I start reading more about B12. There's lots of B12 literature that connects it to sleep, to fatigue. The reason why they feel fatigued and they feel more energetic is it's related probably to acetylcholine, which we'll talk about either later or in another interview because they feel better right away.

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They feel more alert. They have more energy. I have not been able to find a direct connection between B12 and acetylcholine, but I'm convinced that it's there in the background. The short answer is I start to do B12s. I find out that it really needs to be given daily. We move over to a daily pill. Now I don't have to send them off for shots. 

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And one of my patients who, ironically, was also a sleep disorders expert, a pulmonologist who's running a sleep lab, but is on disability because she's so sick, says to me, my doctor did my D level and she gave me vitamin D and my wrist pain went away.  Mm. At this point, I don't care about vitamin D. I'm not the least bit interested.

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I know it as a bone vitamin, but I've noticed that now that I've started to measure B12s, not everyone who has a sleep disorder on their sleep study and daily headache or some other illness has a B12 deficiency, so it's clearly not the whole story, but for the very first time, as I told you, I'm thinking about the brain in this peculiar way of These sleep switches are made up of individual cells.

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So instead of thinking of it as, Oh, B12 is a supplement that's for weirdos. I'm thinking because that's what I had been brainwashed into. Okay. Medicine doesn't do vitamins. Vitamins are for lesser humans, you know, nutritionists, dietitians, et cetera. There's a class struggle there that's in the background that is really insulting.

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And the cool thing is you and I can be sitting here and you don't have to have any initials after your name. And really, I don't either. And that's the way medicine and that's the way education is moving. That's really an important thing because I'm going to say all sorts of things that's completely  to the side of what medicine is doing, but it is well documented in the scientific literature.

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What I'm saying has really good experimental evidence to hold it up. But the clinical  pathways that your doctor is hearing are different than what I'm going to talk about. So I'm thinking of it as an individual cell. I think, well, I don't know what this B12 does, but now I'm thinking maybe those cells are lacking in something they need.

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So this idea of could sleep disorders be linked to a deficiency state is just not something I would have ever thought of. conceived of, okay? So then I start to add a vitamin D because this gal says my wrist pain went away. There was another thing that I was observing in the background that's also really important, which is if we get paralyzed,  and that's normal, that when I have these studies that show no sleep apnea and reduced amount of REM, We're documenting that the legs of these people are moving.

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We call it periodic limb movements of sleep. So there are two things that the  pulmonologists are trained to read. How many times do they stop breathing? What are their leg movements like?  Well, if you take a few steps, again, like an engineer, why would we need to get paralyzed? Maybe the moving parts need to stop moving so that we can fix them.

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Could that mean That this is why those 32 year old women who are completely normal have ankle pain or hip pain. Or foot pain or back pain. Why do they have a knee that they hurt 20 years ago when they were 12 that comes back again in exactly the same way? So i'm starting to wonder whether or not these other pains that from my point of view I didn't have any pain when I was 32.

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I don't think anybody should have pain when they're 32  That means i'm thinking about pain in the body As a sign, you know, when I'm doing these sleeping pills, I'm not taking away those movements as far as I know. I have restless legs. I have movements on my sleep, uh, study. I take a dopamine medicine, which is big time medicine.

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I'm not going to take that unless I absolutely have to take it. But most of the other medicines don't address those movements. So what I was thinking when she said my wrist pain went away had more to do with, oh, maybe this will help her bones. But I'm still in the background thinking, well, it'd be nice if their pain went away.

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Right. So it's related to sleep in this peculiar way. So then in 2009, I do B12s and D levels in everybody who comes in between August of 2009 and December of 2009 because I have nothing else to offer. And for the first time, I'm thinking, what if there's a deficiency? Say, this would be so cool. We could give back what they need.

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That's as far as I got. And it turns out that maybe a quarter of them have a B12 deficiency, but all of them have a low D. And the peculiar part of that is, it's August through December. That means the only thing I know about D is it's made from the sun. Well, it should be the highest of the whole year then, if you're not taking any supplement.

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So the thing that made the difference was two guys come back in December just before I'm about to go on Christmas vacation and say, you know, I've been wearing my CPAP mask faithfully. You told me it would take my headaches away, but it didn't.  And then the last time I was in here, you told me about that vitamin D.

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You measured my vitamin D. You told me to take vitamin D.  And you know what? I got some of that vitamin D. And in about three weeks, my sleep got better and my headaches went away. And two guys tell me the same thing within one week. And it turns out, in retrospect, their D levels were actually a little higher than most of the women's.

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Because they were both outside workers and they were also wearing CPAP, which really helps.  So that, um, Christmas break, I spent a lot of time on PubMed doing research about vitamin D and sleep. And there were no articles connecting the two at the time. The first article about that was actually published the next, like January of 2010.

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But I dumped into the literature from, written by a guy named Walter Stumpf, who was a, uh, Neurologist and an endocrine chemist, he spent his whole career showing where vitamin D receptors were and writing numerous articles. He has over 300 articles about what does vitamin D really do? Why would there be a hormone, not a vitamin?

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It was never a vitamin. That's a big mistake. That's made for very, improper treatment of our patients and a lot of abnormal and  unrealistic dogma that we have to try to fight against. We have time, we'll talk about that. Yeah. But it's not a vitamin at all. It is something we make. If you title a vitamin something we can't make, this is something we make.

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All animals, all the way back to insects, reptiles, mammals, us, everybody makes D3 on our skin in reaction to sunlight. Sun touching a certain chemical in our case, it's a cholesterol in most animals cases, it's a cholesterol and it changes into this vitamin D that we then absorb and vitamin D is the hibernation hormone.

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It is a hormone. All hormones are made by the body to affect our behavior. They have all sorts of different  effects, like insulin, oddly enough, is a hormone. Insulin has a bigger hormonal pathway.  Estrogen, obviously. Testosterone are hormones. Hormones mean we try to keep that chemical toward a healthy mid range.

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And we go too high, things get out of whack. Go too low things get out of whack  Most lay people have more experience with thyroid hormone replacement because we use replacement a lot for that There are symptoms when your thyroid replacement hormone is a little too much symptoms when it's a little too little  Our body is really designed to keep it in the middle now in the background.

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This is an unusual hormone because It changes many parts of our behavior when it goes low. So there's actually a winter You Low D state, and that's called hibernation. And we get fat, and we want to sleep more.  That is what's supposed to happen when our D goes low in the winter, okay? So let's take an ideal in Texas and say, Okay, we're going to have winter between about November to maybe April.

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So grandpa is Not tilling the soil then and he hasn't planted anything and he's hanging around the house and eating more and not doing as much physical activity. So it's not too surprising that he gains 10 pounds in the winter and then come April and May he starts to go out. Behind the horse. He's still living completely outdoors and starts to till the soil in the past.

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All humans lived outdoors because there wasn't really a way to get food. If you lived indoors,  it is a glaring example of the fact that now you can live indoors. 24 hours a day, and that our biology was not actually formed to tolerate that. That means as we started to go indoors back in the 80s, and this was extremely obvious to me as I'm reading these articles, because I lived before the 80s.

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So I was in medical school in 1979. We did not have courses about, you know, Sleep apnea, fibromyalgia, chronic fatigue, irritable bowel, autism. There are many, many things that have become epidemic since that time that those of us who are older physicians just went,  you know, they haven't really given us a good reason for this.

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I'm not even sure it's a real disease. Okay. Once you get into this literature, they are real diseases. There's no question about that, but the true cause has not been found. So in the midst of our amazing advancement, in genetics where everything now is being sold as though if I know your genome, I can tailor a medicine for you. 

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Well, what if I don't want your medicine? What if I don't get sick in the first place? What if I really don't want to be in a state where you have to do something to recover me in some way? What if we think of it as, you What about all the people who don't need to see the doctor? What about grandpa who never saw a doctor until he was 75?

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Aren't those the people that I want to be like? Right. So in, in the background, there's my actual experience living, then there are all these diseases that have become epidemic that I know weren't.  that common. They were there, but they weren't common and they certainly didn't exist in young people. They were in old people.

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So you have to picture it with me having this. Also, I've got all these friends who, you know, I've known since medical school who have these terrible medical problems and I've been relatively healthy. And every time that happens, I think, well, why is that happening to her? That really shouldn't be happening to her.

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That's not fair. So,  There's my personal experience. There's knowing that we started with sunscreen in the eighties because we didn't have any before. There's recognizing that from the eighties when the dermatologist started to say sunburn is dangerous 80 years later or 40 years later, it's now become ridiculous.

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in that being out in the sun is bad for you. That you shouldn't actually let your child be touched by the sun until they're six months old. That is based on folly. That is based on ignoring every other organ of the body, including your mood, except your skin. So the dermatologist step forward and say, this is about the skin.

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But unfortunately, I'm not standing next to that dermatologist in 1982 when Walter Stumpf has already put together this whole picture and he's already said this is going to be linked to our fertility, it's going to be linked to metabolism including diabetes because there are vitamin D receptors in the pancreatic islet cells that secrete insulin, it's going to be related to our weight gain, it's got to be related to metabolism in multiple ways because it allows us to gain weight you and to use fewer calories per day so we can make it all the way through the winter.

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All of the humans that made it through long term, eight month starvation, where they have very few calories to live through, they lived and created us. That means  there are already a fully formed set of articles that explain what this should be responsible for. The only piece that he left out was sleep,  even though the reason why I got to his articles was that he had actually  already shown that there was a stripe of cells in the brain stem that govern our ability to get paralyzed correctly.

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And he showed there are vitamin D receptors there. So I'm just. Pagent through his articles once I get to vitamin D in the brain and now I've got these articles that say these same places that I've been reading about the anatomy and how do we get paralyzed and what are the cells that do the clock, what are the cells that actually run the clock that tell us to go to sleep at 10 I'm looking at it again from an engineering standpoint and then focusing on the fact there is something wrong with this particular stripe of cells because not only are they stopping breathing, They're kicking their legs.

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That means sometimes they're too paralyzed. Other times they're not paralyzed enough. And I'm seeing this same pattern in an eight year old. A perfect eight year old. Why would this child have two sleep disorders? He doesn't have any tonsils. They were already taken out. So we're looking at this tube that he's breathing through.

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That doesn't explain his leg movements. That doesn't explain why he wakes up with leg pain, crying in the middle of the night.  So I'm seeing this. for two or three years already wondering about these cells. And now these cells have vitamin D receptors. So I actually called Walter Stumpf up and we talk about,  I say, Walter, I can't find any articles about vitamin D and sleep.

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Has anybody written about that? And he said, no, but that makes perfect sense. So the one little piece that was left out was he had really pictured the entire thing. He has articles about DN infertility in the eighties. He has articles that actually predict what's going to happen. So by the time I'm reading it, it's now 2010.

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He started writing this in the eighties. He's predicting things that have become true over this 30 years, but he was writing about them 30 years. ago. That means it was really before the vitamin D deficiency epidemic started. It was right as it was beginning.  So he's a little bit off time. Also, he turns out to be, have a personality type that is a little too arrogant and his colleagues don't listen.

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And this was my first introduction to  these articles were there. I could have had this in my endocrinology course in medical school.  It wasn't accepted by his colleagues. That means I just spent 30 years in medicine watching people die. Once you know about this, you watch the people around you, it's everywhere.

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Yeah. They are leading terrible, painful lives while the literature is filled with the answers for what would make them well. And I've been practicing medicine with this arrogant attitude that is  Kept me until the last five years or so while I'm asking questions about sleep because there's no one helping So i'm asking well, what do you think is wrong?

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Is there anything that helped you? So you have to also get to a different place As a physician  to have your own sleep disorder and asking your patients and working in collaboration To actually see one of the big problems because every time That somebody listens to one of these interviews and goes back and speaks to their physician You're lucky if you get someone who's open minded enough to say, what do you want to talk to me about?

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Because my job as a physician was to know everything and tell you. And if you don't get out of that point of view, you won't be able to learn about D because the medical literature is, is unfortunately telling things that are really absolutely wrong.  So in the background, one, I'm learning about vitamin D, but I'm also now into this supplement area.

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First, my colleagues thought I was crazy because of the sleep. Now I'm talking about vitamins every day and everybody around me just starts to roll their eyes and think I'm a whack job. And that was a really important experience for me, frankly. I'll stop and let you ask any questions. Oh, absolutely. Well, one, thank you so much for kind of walking us through this journey, because to your point, it takes that detective work, because it's not out in the open.

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It still continues to not be out in the open. There's still a lot of questions, and yet you have now been able to dive in in a way that you've created a whole kind of protocol for people to go through. So I know that certainly even in the time allotted for today, there's likely to be more questions for people.

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Okay, so then what does this look like for me? And we wish it was so simple as to say, well, you know, just take this vitamin and what have you. And to your point, not really just a vitamin, but if we're talking about vitamin D, And then it's a connection of course with the bees and there's a lot here. So I do think it's important to interject too for people listening that if they're now saying, all right, I'm interested, what do I do?

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I'm going to absolutely encourage you all to check out Stasha's website. I have been doing the same myself, been just really so impressed with the information that you've put out there and I think it's going to make such a difference for so many people. So we're going to link to that below too so that you can then take the next steps to understand What do we do?

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So do we test for vitamin D? There's certain types of tests that we want to test for. We want to get connected to our B's and our B12s, etc. So you're going to guide us with that with some of your protocols.  And one of the next things that we do with every person that comes on is ask how can we learn by example of what you're doing to facilitate your own sleep right now.

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So we do ask four questions of every guest and it's clear to me if you are available to that we're going to need to have you back on because there's just so much gold here. But our first question that we ask everyone is what does your nightly sleep routine look like right now? And if you can help guide us through that so we can start to learn what can we be doing that Sasha's doing. 

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I am slightly an unfair example because I have to take still a medicine for my restless legs. I am also on, and we can talk about this, about how the mood is connected to these neurotransmitters,  but I'm on a medicine that is known to cause restless legs.  I started on an antidepressant because I was so difficult and confrontative and aggressive, which had always been my not best self throughout my life.

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And so I ended up trying a bunch of different SSRIs and serotonin reuptake inhibitors. So I'm on an SNRI that's. Have been reported to cause restless legs Unfortunately, I've completely tapered off that and was very difficult to do And I got suicidal within a year after stopping it So i'm back on it and I therefore have to take dopamine agent So it's a neurotransmitter that we've actually made a copycat drug That drug when I take it puts me to sleep two hours later, no matter what Okay, I could be talking to you and I'll just say, Mollie, I'm sorry.

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I have to go to sleep now. Okay, I may want to stay up and party, but I'm not able to. So I go to sleep. And if I don't get to sleep, I ache all over. There are several other things that happened to me that are about how this drug works. Sure. So my going to sleep is no problem.  But I wake up in the middle of the night.

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So my usual routine is I'm really sleepy. I fall asleep, you know, like watching something on television or reading a book and I fall asleep easily and I'm happily asleep. And then I usually wake up somewhere about 3. 30. And what I discovered about my vitamin D is that is the signal of my vitamin D being out of range.

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That if I wake up and I'm awake for an hour, that means my D is off. If I wake up at three and I roll over and go back to sleep, it means my D is in range. That's not the whole story, but that's what happens to me at my bedtime. So then I'll let you ask my other questions. Sure. Well, one, thank you for that because I think it's so helpful.

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One of the most frequently asked questions that we get over here is, I'm waking up in the middle of the night. What do I do? So for you, part of your clue for people or what you would potentially offer for people that are so dealing with that is that they might want to then explore their vitamin D levels.

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And then our next question is, what does your morning quote unquote sleep routine look like with the concept or thinking that that can impact your sleep? I'm a little unfair again because I'm retired now and I don't start anything until 11 o'clock. That means I sleep as long as I possibly can and it's not unusual for me to go to bed at 10 and wake up at 8.

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You know, so I, I really have the luxury of not getting up early. I hate getting up early. I think it's really the wrong thing to do. Anyone who gets themself up earlier than 6am is really cheating themselves of a very specific thing that their brain is supposed to be doing then. And it's the only time it does it.

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So you should never really get up at 4am unless you have to. And if you have to do that every morning, you need to change jobs. And that means that women who have babies are at a particular risk for sleep disorders because of that. So I get up late and I, uh, hang around in bed and, uh, read stuff and, uh, get started  kind of slowly. 

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And in terms of what else I do, I'll let you ask the other questions. Sure, yeah, absolutely. So then our third question is, what might we visually see in your space, like on your nightstand or maybe proverbial nightstand if you're traveling or what have you? My aura ring, which I don't take every, I don't wear every night because when I do, I become fixated on the results.

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And I'm just constantly thinking, Oh, I, I don't get enough deep sleep. I have a pretty good REM record, but I don't get enough deep sleep and that's still bothers me. And you know, I'm 68. That means I, I don't want to have any pain and I want to still be able to run. And so I'm. I'm faced with, I think I have a long span of time with an abnormal sleep, and that I'm still taking chemicals that require another chemical, suggesting that my chemistry is not right, so I don't use it every night, and my phone is on my bedside table.

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Now, I don't want to be against the people that say that,  electromagnetic frequency is affecting us because I don't think we know the answer to that. Sure. But I personally don't do anything about having my phone on my bedside and that's really the only thing that's there. Got it. No, I think it's can be an important takeaway that minimalism and for whether it's for EMF purposes or for mental health purposes or what have you, I think that's really noteworthy.

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And our last question would be, to date, so far, because I certainly get the sense that you are a continually improving and curious mind, so I'm sure this will evolve, but to date, what would you say has made the biggest change for your personal management of your sleep? I really think that in the background, when you go to my website, most people take away the supplements, and the supplements are really,  a really important piece because your body is missing certain things.

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Sure. But in the background, it is not just those supplements. Once you get finished with the right sleep program, that usually lasts about a year and a half, there are still things that affect your sleep. So the piece that's most important is recognizing this is a lifestyle. It's a way of looking. So,  As going indoors has been a lifestyle change.

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Yeah. So is concentrating on your sleep and saying this is one of the most important things I do. This is still a path that continues for the rest of your life. Then you notice that if I eat certain things or if I drink alcohol or if I don't exercise outside, my sleep is affected. That means you go back to having a relatively small sleep disorder, but you still keep the idea that not only is diet, exercise, and I would say exercise outdoors and being outdoors, spirituality, And Those things are all about health and wellness and that you can't really skip any of those, those  pillars that build for a better health.

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I think you're going to see over the next 20 years, there's going to be a big movement toward doing much more outside, spending much more time outside. Absolutely. No, I think that's so wise. And to your point, it can be so tempting. I think in our modern society to want the one thing, the one pill, the one, you know, solution.

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And to your point, it's like a garden, you need all of the components. And it is something that we can't just divorce certain elements and think we're going to get great results. So really so wise. And of course, I'm going to share for people how they can follow you and be a part of some of your protocols.

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And before we do that, just wanted to check in. I know these are big topics and we all. only just scratched the surface, but is there anything we left out in this conversation to kind of put a bow on this topic of so far what we touched on of D and B's? What I tell in most interviews when we have enough time and I gave you a lot of background so it took up most of the time is that once you do vitamin D by itself, there are other things bad things that can happen to you because it turns out that D by itself does not return the microbiome to normal.

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And the change in our bacterial population all over our whole body started around the same time that the D started to go low. The last three years has really been pivotal in the science showing up. So before 2020,  There were no articles that substantiated that vitamin D was a necessary growth factor to have a normal microbiome.

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The 1st article was was published in 2020.  that means that I thought the microbiome would come back to normal when the D was. supplemented, but I had two years of supplementing my patients, me supplementing, getting a perfect D level. It took two years to really figure that out. It's very complicated, which is why I do not recommend that anybody listen to a dose recommendation.

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They instead need to read more and understand they're playing with fire. This is biohacking that can really hurt you. It can cause pain. It can do bad things. It's not just hypercalcemia.  So the second piece is you really need to be doing a second piece to give the microbiome what it needs to come back.

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The most important part of this is bringing the microbiome back. When you get a normal microbiome, there are literally hundreds of things that we will end up calling vitamins that are supplied by the bacteria that are in our belly, on our skin, in our nose, in our ears. All these things that we've been just, we've been spent, we've spent a hundred years vilifying bacteria, but they were actually protecting us.

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So the, the change in the GI literature has been very helpful to me. So not only does that change what protects us, but it turns out if you don't have the right bacteria, you don't sleep. That waking up at 3 a. m. It's about a specific chemical and you need the bacteria in there plus the vitamin D to get that chemical to allow you to sleep through the night.

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So it's not simple. It's not one thing. I think that was perfectly reasonable to expect that, you know, medicine is here. Take this sleeping pill. I just thought vitamin D was going to answer everything. And it was a big rude awakening to recognize that every single piece of the body has is linked to hundreds of other things.

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And that means you want to really get your body back to the normal homeostatic middle. And that was really about living outdoors, getting the right microbiome and going back to grandpa at 75 who's not seen a doctor because he feels fine. Exactly. So well said. And for the listener that then says, okay, Stash is making great sense.

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I want to take certain steps. I definitely want to encourage you all to, I mean, I did this myself. I bought Stash's program, dove in, cause she will guide you on one, what types of tests you need to take. Cause it might not just be as simple as just getting any old test. to test for things like vitamin D and B's and what have you.

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So she's going to guide you in that and it's a pretty affordable option too. So I definitely, definitely recommend heading her way. And so what you can do there is she will also let you know of certain ranges that you want to be hitting for your D levels and your B levels and beyond and gets much more layered too.

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So that's not just a cut and dry thing. When you really want to kind of get curious. and understand out of all of the work that she's done with so many people, what are some of the protocols that you can bring in yourself with knowledge, with testing, not just kind of throwing that in, you know, just willy nilly.

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So, Sasha, let us know the best places for people to go, steps for them to take. So, my website is www. dr. gomenak. And if I had a simple recipe on a note card, I would absolutely give it out. You know, I I really didn't. The reason why I have a website is not because I planned to be here, but because it turned out that my patients really got bad things happen to them.

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Autoimmune diseases, and terrible pain, and relapses, and things that had gone away. When I didn't know how to manage this, it's much more complicated than it seems. Most of us are not really ready to just step into a long program. There's a workbook that acts as your personal assistant that takes you through everything that you're doing.

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And it also works as a journal. There's a whole half of the workbook that's a journal because you have to actually observe what your body is telling you. It's very different than usual medicine, which is I have the lab results, I'm the smart one, and I tell you what to do. It's not like that. You really have to be willing to learn and listen to how your body's telling you that this particular thing is too high now and what you should do about it.

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That, it's difficult, but it's worth it. Yeah, absolutely. Well, I so thank you for taking the time and being vulnerable to dive in into a world, to your point, that had been kind of set lower on the bar, as you had noted, around vitamins and supplementation and what we had thought about that and stigmas and to actually help us to extract what steps that we can take to really change lives to change the results that people are getting in this very frustrating topic, just alone of sleep, but it's pitterings into other areas of their lives.

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So, so appreciate you. Thank you for the work you're doing and we'd love to have you back for a part two. But again, just really appreciate the time. I'm willing and. Hoping to come back. Yay, fantastic. Well, I wore my, no one can see this if you're not watching the video, but daily dose of sunshine sweatshirt just for this conversation.

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So yes, we'll have a part two very soon. Thank you so much, Stasha.  You've been listening to the sleep as a skill podcast, the top podcast for people who want to take their sleep skills to the next level. Every Monday I send out the sleep obsessions newsletter, which aims to be one of the most obsessive newsletters on the planet.

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Fun fact, I've never missed a Monday for over. Five years and counting and it contains everything that you need to know in the fascinating world of sleep. Head on over to sleep as a skill. com forward slash newsletter to sign up. 

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