I’m a New Mom. Will I Ever Sleep Again?

Welcome to the very first episode of So Glad you Asked! We’re kicking off with the #1 most requested topic — sleep — based on input from hundreds of providers and parents we surveyed for this show. You'll hear from Emily, a newly postpartum mom as she shares the real questions that literally keep her up at night: struggling with sleep while juggling both a toddler and newborn at home! We’re also joined by Dr. Jade Wu, a board-certified psychologist & leading sleep expert, who helps us explore common sleep challenges for pregnant and postpartum moms — along with practical, evidenced-based strategies to tackle them. We hope you walk away from today’s conversation with tangible insights and actionable tips that will transform your sleep routine at home. And as always - we’re so glad you asked! 

Recommended Resources: 

• More on Sleep at Dr. Ruta’s Resource Hub
• Learn More about Dr. Jade Wu
• Find your copy of Hello Sleep here

Disclaimer: This podcast is not intended to be a substitute for professional medical care. The views, thoughts, and opinions shared today are the speakers’ own. **Trigger Warning** Postpartum Anxiety, Depression 

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So Glad You Asked with Dr. Ruta Nonacs is brought to you by the MGH Center for Women's Mental Health and the J. Willard and Alice S. Marriott Foundation.

Transcript

Emily

[ 00:00:00 ] Yeah.  As a first-time mom, I think I went into motherhood thinking I had to be perfect, thinking I had to get everything right.  And I liked reading all the books and listened to all the podcasts and did all the things and learned that like, oh, this is a lot harder than I thought it would be.  And right when he was born, he automatically would only sleep for two-hour stints at a time.  So it was a long time of like pretty severe sleep deprivation for me and my husband.  And this time around, me and my husband have been thinking a lot more about sleep and how to prioritize sleep.

Dr. Ruta

[ 00:00:32 ] Welcome to So Glad You Asked, the show where real moms bring us their toughest questions.  I'm Dr. Ruta Nonacs, a perinatal psychiatrist at Mass General Hospital with over 30 years of experience supporting the mental health of moms and helping them navigate the emotional highs and lows and the often unexpected challenges that come with planning a family, pregnancy, and motherhood.

Allie

[ 00:00:54 ] And I'm Allie Hales, a mom of four.  I know what it's like to scour the internet wide awake at 2 a.m.  with a million questions, wondering if what I was experiencing was normal.  That's why we created this show.  It isn't just for Real Moms, it's by Real Moms.  Every episode is a conversation led by you.  Your questions, your experiences, your mental health, front and center.

Dr. Ruta

[ 00:01:17 ] And we don't just listen.  We provide real, evidence-based answers and reliable resources from trusted experts.  Because moms don't just deserve support.  They deserve solutions.

Allie

[ 00:01:29 ] Today we dive into the number one most requested topic after surveying hundreds of providers and parents for our show.  Sleep.  We'll hear from Emily, a mom who shares questions that literally keep her up at night.  Struggling with sleep while juggling both a toddler and newborn at home.  We'll also talk to Dr. Jade Wu, a renowned psychologist and sleep expert, to weigh in on our conversation.  We hope that you walk away from this episode with practical insights and actionable tips that will transform your sleep routine at home.

Dr. Ruta

[ 00:02:02 ] I was just going to start with you, Emily, and sort of the questions you would like us to address as we discuss.

Emily

[ 00:02:09 ] So I have an almost three-year-old, like two-and-a-half years old, like two and a half year old and almost two-month-old.  And I think my main question is how to balance sleep with both of them.  And my trickier one has always been my son, my oldest.  And he's been tricky with sleep since birth.  And now my daughter, who's almost two months, is so far quite a bit better at sleeping.  So again, my main question is how to balance sleep with a toddler and a newborn, especially when the toddler is the trickier one.

Dr. Ruta

[ 00:02:37 ] And before we sort of delve into the sleep stuff, What are you doing about feeding?  Because that's so tied up with sleep in little kids.

Emily

[ 00:02:49 ] 100%.  Right now I'm solely breastfeeding, but I'm also trying to be a lot more gentle with myself this time.  We have formula in the pantry if needed, but just breastfeeding.  I do have to wake up usually about two times a night and breastfeed my daughter.  But again, because it's my second time around, I'm doing a lot more like lay down feeds in bed and not feeling like I have to wake up all the way to feed her.

Dr. Ruta

[ 00:03:10 ] Can you tell us a little bit about sort of how things went with your older child and what you did and what you learned from the experience?  Because it sounds like you're using that knowledge the second time around.

Emily

[ 00:03:23 ] Yeah.  So with my first, my son.  I don't even know where to begin.  There's a lot that happened.  But as a first-time mom, I think I went into motherhood thinking I had to be perfect, thinking I had to get everything right.  And I like read all the books and listened to all the podcasts and did all the things and learned that this is a lot harder than I thought it would be.  And right when he was born, he automatically would only sleep for two hour stints at a time.  And that didn't get better till around like six months of age for him.  So it was a long time of like pretty severe sleep deprivation for me and my husband.  And we tried like all the things.  And he also had a tongue and lip tie.  So we got that corrected.  Sort of like mini trauma for both of us having to stretch out his tongue.  And he breastfed like pretty well from day one.  But because of his tongue and lip tie, he.  Couldn't get enough milk per feed and I think maybe that was one reason why he was waking up so much, and then around when he was maybe like four months old, he got a cold, and I got a cold, and my breast milk production started to plummet, and I thought, 'Oh, my breast milk's done so I liked very quickly stopped breastfeeding him as much as I was before.  And so I had a hormone crash.  And then with that, plus the sleep deprivation, I got pretty severe postpartum depression and anxiety, and then got a lot of help from that.  But I think the biggest trigger for all of that was the sleep deprivation in terms of like my own mood.  This time around, me and my husband have been thinking a lot more about sleep and how to prioritize sleep.  When my son turned four months, we got a sleep coach to try to just help us get more sleep.  And it did help.  And it was basically like a form of cry-it-out with checking in.  But it was torture for me.  And it did help.  But then every time he'd get sick or a tooth would come in, the whole cycle would start again.  And even to this day, he still wakes up like sometimes not at all through the night, but usually like one to three times with like a tantrum or needing a cuddle or needing milk or something like that.  So hopefully that answers that question.

Dr. Ruta

[ 00:05:25 ] I really want to highlight sort of the connection between infant sleep issues, breastfeeding problems, going to anxiety or depression.  They often come together.  And I think both sleep problems and breastfeeding problems are really risk factors for depression and anxiety.  And I wish that we could intervene earlier.  We could support moms because I don't think it necessarily has to go that way.  But I think so much is focused on the baby that we end up not taking care of mom.

Allie

[ 00:05:59 ] Yeah, I would agree.  I can relate on some level.  I went into having my first like, oh, I've got this.  Like I've read all these books.  I've listened to all these things.  Like I have a plan.  Like my first son was born early.  So he was born seven weeks early.  And it just was like a totally different thing than I thought it was going to be.  And I feel like people said, oh, you're going to be tired, but they didn't explain how tired you're actually going to be.  So I felt like I wasn't prepared for how tired I would actually be.  And then just trying to problem solve things when you're so sleep deprived was really hard.

Dr. Ruta

[ 00:06:34 ] And people do sort of act as if there's one way to do it.  And we often try many different things.  And I think it can feel really bad as a mom and you're so exhausted and you don't know where to look for help.  Allie, you had mentioned that you found certain things very helpful in terms of learning what to do for you.

Allie

[ 00:06:57 ] Yeah, so I really liked sleep training.  So I did that with my kids.  It was helpful for me to have some kind of a program to follow, even if it wasn't perfect because kids are kids.  I think, too, the way that I found being able to find sleep was I really could only relax if I knew someone else was responsible for the baby.  Otherwise, I just felt like I was always on.  Like even when I was asleep, you know, I could be woken up at any minute.  So it was hard for me to really relax.  So I guess my question to you is, how are you finding a way to sleep while you're trying to prioritize, you know, your kids' sleep, too?

Emily

[ 00:07:33 ] I think how we're doing it right now is we're sort of dividing and conquering.  It is easier, though, to totally relax and sleep when I know like a family member staying over and taking care of the newborn or we've been lucky enough to be able to hire a postpartum doula this time around and use her occasionally at nighttime.  That's been helpful.  But most nights I've been fully responsible for our newborn girl.  But I am able to sleep better this time, I think, because I have like a better sense of knowing like she'll be OK.  I will know when she wakes up.  And I'm a much lighter sleeper now than I was before being a mom.  And so like if she makes any kind of weird sound or anything, like I'm right there because she's still in the room with us and I'm fast in it.  So I definitely agree, Allie, like knowing someone else is like helping is huge.  And then I think with my daughter, she'll give three to four hour stretches of sleep at night.  Like I feel like it's like a gift to me.  That is such a game changer.  I feel like that's why I don't look super sleep deprived is I'm getting like these chunks.

Allie

[ 00:08:26 ] I know.  Who would have thought that you'd ever been like, I got three hours of sleep in a row.

Dr. Ruta

[ 00:08:30 ] Yeah.  It can be crazy, especially during those first couple of weeks when baby's getting up.  They need to be fed.  They need to be changed.  You go back to sleep and then you start it all over again in 45 minutes or an hour, depending on how the cycle's going.  And I think, you know.  When you have a partner or family living at home, I think it's really important to rely upon those other people who are in the house for you.  And that's something I try to emphasize when I see moms who are expecting a baby, whether it's their first or their second or their fourth.  Because you can't do it all.  I think the other thing that's really changed over the last 20 years is the baby sleeping in the same room, which I think for some people who are light sleepers, it's kind of a nightmare because they hear everything, especially moms.  I think there's just this maternal hypervigilance that takes place.  And so in that case, sometimes what I recommend is that you trade off nights or parts of nights with your partner so that one person is 100% responsible for taking care of the baby and the other person's 100% responsible for sleeping.  So there might be a time when you're not sleeping in the same room.  It'll get better, but you can't both be sleep deprived with this baby that's squawking, rolling over, snorting, all those things.  I think moms have a really hard time kind of sleeping through that.

Allie

[ 00:10:04 ] So for having the baby in the same room, I did the same thing.  Like we lived in a small apartment in the city and our baby was half in our bathroom, half in our room.  Like I could hear everything.  Like even when I was the one that was supposed to be sleeping.  I could still hear everything that was going on.  Eventually we moved the baby like out into the family room.  But at what point do you feel like it's okay to have the baby, you know, not right near you where you're seeing and hearing absolutely everything that's going on?

Dr. Ruta

[ 00:10:35 ] Yeah, it's a great question.  And I think sometimes these pediatric recommendations are kid-friendly, but mom-unfriendly.  And this came out just within the last couple of years where they're saying that kids should sleep in the same room with an adult for one year.  But it was a fairly dramatic change in recommendations because before that, they said in a bassinet in your room for six weeks and then transfer to their own bed.  I think it's important to connect with your pediatrician because there are some things that can be modified because you're deteriorating, and that's not good for the child either.  I think it's really important to have a nonjudgmental pediatrician to talk about these things with, because there's always room to move.  I think certain things like sleeping on the back versus stomach are more important and sleeping, being in the same room is a relatively new recommendation.  As you said, Allie, it's really hard when you have a small space.

Allie

[ 00:11:39 ] Emily, too, I just wanted to ask you what has helped you be able to go back to sleep, even if you know you might get woken up again soon.

Emily

[ 00:11:47 ] It's a good question because the first time it wasn't like that for me.  It took me like a while to go back to sleep because I was like, he's going to wake up again soon.  And this is really hard.  One thing I'm doing is I don't go on my phone.  So, I'd like scroll or listen to a book or whatever, text people back while I was breastfeeding or turn on a light.  And this time, I do none of those things.  And also this time around, I'm on Lexapro because of my previous postpartum depression anxiety.  And I really think that helps with my sleep, to be honest.  And like occasionally I do still struggle.  It's not like it's gone.  Like occasionally I do like lay there after a feed.  But like usually that means I'm anxious about something.  So I try to let myself think like, OK, like clearly something like we had like a big event coming up and I was kind of nervous to be around a lot of people with my newborn.  I just like give myself time to like acknowledge that and be like, OK, like I feel anxious about that.  It's OK to be anxious about that.  And those things have been helping.

Dr. Ruta

[ 00:12:36 ] You brought up the point about phones, and that's something that I've been seeing.  How they interfere with sleep.  And it's really hard, but they really do make an impact.

Emily

[ 00:12:47 ] And like, I'm not perfect.  Like sometimes I'll still go on my phone.  I notice on those nights, I don't sleep as well.  We got like our newborn photos back.  I was like, I want to look at them.  And then I was up for like an hour, you know, so it still happens too.

Dr. Ruta

[ 00:12:59 ] I think just sort of recognizing like, oh yeah, that did make a difference.  And that's important.  I think also what you said about like anxiety, that is a big factor.  You know, sometimes it's just normal anxiety with a little A and sometimes it's anxiety where it really does interfere with your sleep and you can't settle down.  I think between the little A anxiety and the big A anxiety, which might require some more specific treatment, there are a lot of sort of behavioral techniques that we can recommend to people to help them with sleep.  It can be hard to use those techniques when you get too far into the sleeplessness because people start to develop like a sleep phobia where they have to go through all these things and these rituals because if they don't do them, they might not fall asleep or just these like very elaborate ideas about sleep.  And it's just really hard because life is unpredictable and you can't do all those things.  So some of those behavioral techniques kind of help break those cycles.

Allie

[ 00:14:03 ] I have a question.  Emily, first of all, I just want to say how self-aware you are of all of the sleep things, which I think is so impressive.  I really want to ask Ruta too about this little A and big A anxiety.  At what point, you know, Emily, did you realize that you wanted to talk to someone about it?  Dr. Ruta, at what point do you feel like someone should really be addressing this with their physician?

Emily

[ 00:14:26 ] I'm actually a psychologist, which I think made it trickier.  I think when symptoms started to happen, like I noticed myself not being able to sleep when my son slept.  And Dr. Ruta, I know you mentioned like sleep rituals, like me and my husband would be so anxious to go to sleep because we knew how much we'd be up at night, that we would like do different things.  It's a little hard to remember because I was like so sleep deprived at the time, but we would do different things to try to like help him sleep.  When I started to really realize I needed help was I would cry extremely easily.  I was sleeping way less than my husband and my son.  I was super anxious being in a separate room than my son, even though he was totally safe in his crib and doing just fine.  I also didn't want to leave the house, which is kind of weird for me.  And I was way overly anxious.  I always thought something horrible was about to happen, which is not typical for me.  So my anxiety just really got pretty bad.  And then also I just started to be really sad and down.  I tell so many people that I struggled with postpartum depression anxiety because no one had ever told me they had.  I knew it was a thing, but I never actually heard someone say it.  And I'm like amazed how many people I'll say it to.  And they'll say something like, 'You know what?  Like I never labeled it, but I think I really struggled with anxiety or I think I was really down and like maybe a little bit more than just postpartum blues.'  So I think it's actually much more common than people think.  I think people are just really ashamed to talk about it.  But because I'm in the mental health field and because it's happened to me, I really try to talk about it.

Dr. Ruta

[ 00:15:52 ] It's definitely appreciated that you're open to talking about it, because I think there still is a lot of shame about talking about these things.  As human beings, we're not supposed to have these issues, and especially not as moms.  And there's just so little room to have a problem in that realm.  People are saying, 'oh, you look really well rested,'  but you might not feel that way inside.  There's a really big disconnect.  And I think you hit upon many of the questions that I use to distinguish what's a little anxiety expected, given that you have a new baby, you're not sleeping as well as you would like.  That would be, are you not able to sleep when your baby is sleeping?  That's like one of the number one questions.  And then.  The other thing is, how do you feel when you're not with your baby?  How do you feel when someone else is taking care of your baby?  Are you able to relax during that point?  Often it's hard to be away from the baby or to trust other caregivers.  That said, there's a huge overlap between anxiety disorders and normal anxiety, and it can be really, really challenging.  I wish I could say like, oh, you should just talk with your pediatrician or your OB.  I think sometimes they're kind of dismissive about these symptoms and they're good at the reassurance.  But I've found that people benefit the most from other moms.  I think that network, if you can find women who speak openly about these things, that's when you can sort of say, huh, I'm worrying about this way more than I have to worry.

Allie

[ 00:17:30 ] I had another question too.  Emily, you mentioned Lexapro that was helping anxiety.  Dr. Ruta, do you ever prescribe any kind of medication for people who are having a hard time sleeping?

Dr. Ruta

[ 00:17:42 ] I think, again, it's one of those things where every case is different.  I think you go through kind of the list of things that might be causing problems with sleep.  So first of all, is the baby, what are you doing with the baby?  Is this really a sleep problem that requires the attention of a sleep coach?  Then you do the lifestyle things.  There are a lot of types of behavioral interventions that we can use without medication.  But I think certainly if there's depression or anxiety, the sleep isn't going to get better unless you treat the depression or anxiety, which we'd use something like Lexapro.  And it's not really sedating, but it decreases the anxiety.  And the anxiety is what's interfering with the sleep.  So if you improve that, you can take care of the sleep.  So that would be a very common medication.  There are some times where we use other types of medications like Unisom is the sort of over-the-counter medication.  And sometimes that works great if it's just a sleep issue, like with people who are traveling, like if they're in a different bedroom, they have a little harder time falling asleep.  I don't think it's the best long-term situation, but people do use that.  I think also, Emily, what you model in terms of compassion for yourself is really important because it's not tenable.  And if you fall apart, it's not good for your family.  And, you know, that baby needs you.  It doesn't need every ounce of breast milk.  And I think everybody can benefit from being a little bit more gentle to themselves and what they expect of themselves.

Emily

[ 00:19:23 ] Definitely.  And I think especially with my son, my husband and I like searched and searched and searched for the right answer, quote unquote, for his sleep issues.  And we still are.  But I think the answer is that there's no perfect answer.  It's that it's all it's like a moving target.  And we will keep trying different things.  And what's helped the most with our son, honestly, is time-just like his development.  And he'll go through like these up and down phases of really like a couple of really hard months where he's not sleeping well.  And then a couple of great months where he's sleeping really well.  So, yeah, I think every kid is unique and it's there's not one solution.  It's kind of working and finding the right solution for each kid, which is tricky, but also I think very validating.

Allie

[ 00:20:00 ] And I do love; I agree with Ruta just, you know, you even being willing to like have the formula in the pantry if you need it.  Like I just I didn't give myself that grace for my first couple of kids.  And it was so much harder on me.  I remember the first time I fed one of my babies a bottle of formula; I just felt so guilty about it.  But then I also felt so relieved.  And it was really hard to feel both of those things like relieved for me that I could, you know, sleep and take a break.  But then also, you know, feeling guilty about, you know, a different feeding choice.  And I think for you to be in that place is just, I think, going to help a lot of women who are trying to figure out how to balance it, too.

Emily

[ 00:20:40 ] Yeah, it's taken work to get there for sure.  But it also is not like just the duality of parenthood, right?  Like we talked about earlier how like people always say like, oh, this is the happiest time in your life.  And like it has been for me, but it's also been the hardest time in my life.  So it's like always holding both those sides, right?  Like just like what you just said, like feeling so grateful you didn't have to feed for that one feed, but also feeling so guilty.  So maybe normalizing that to like just part of parenthood is holding both extremes at the same time, which is pretty wild.  So thank you.

Dr. Ruta

[ 00:21:10 ] Joining us now is Dr. Jade Wu, a clinical psychologist and leading sleep expert.  Dr. Wu helps us explore common sleep challenges for pregnant and postpartum moms and provides us with practical strategies to tackle them.  I was wondering if you could start by talking about yourself.  You're a psychologist and you're also a behavioral sleep medicine expert, but what does that actually mean when you are in the office and when you're working with new and pregnant moms?  Yeah, sure.

Dr. Wu

[ 00:21:44 ] So I am a licensed clinical psychologist and I specialize in perinatal mental health.  And I separately also am board certified in behavioral sleep medicine, which means I help everybody with their sleep and mental health issues, but especially folks who are pregnant and in their postpartum years.

Allie

[ 00:22:00 ] So I'd love to hear from you, you know, how prioritizing your sleep as a mom is important and why and, you know, maybe the best ways to do that.

Dr. Wu

[ 00:22:11 ] Yes, I love that you brought that up because you're right.  If you Google 'postpartum sleep', usually it's baby sleep books that come up, right?  And there's a million of them and some of them are great.  But mom's sleep, very, very little information.  And here's the thing.  Mom's sleep obviously changes postpartum compared to pre-pregnancy and pre-having kids.  But it doesn't have to be really terrible for a really long time.  And a lot of my patients are coming to me like five years, 10 years, 20 years after their babies are born.  And they're like, well, my sleep got disrupted when I had babies.  And it just never got back to normal.  And obviously now their kids are in college and you can't blame it on that anymore, right?  So I think it's really, really important for us to prioritize mom's sleep from the get-go.  So here's what that looks like.  So number one, really underrated is just to have a really good contrast between day and night.  Some of that you can't help.  You do have to get up at night to tend the baby, feed the baby, and that's okay.  But we want to really make sure we have lots of light exposure during the day and as much sort of compartmentalization as possible between day and night.  So don't spend all 24 hours in the nursery or in a couple of different spots in your house.  You do get dressed in real clothes, comfortable real clothes, you know, during the day.  Turn on all the lights.  Put up all the curtains, get outside.  You know, if the weather allows, spend time on the porch or at a park with your baby rather than indoors all the time.  And at night, really dim the lights and use orangey-colored, like warm-colored lights, because those are the colors of light that do not stimulate your brain as much, that don't trick your brain into thinking it's daytime.  And, you know, when you get up to help the baby, don't turn on the lights or bang around, make lots of noise and, you know, act as if you're like up, try to set yourself up for success that you already laid out all the things you need so that you are walking around and like puttering around the house as little as possible when you're getting up.  So that's one thing is just to create that contrast between day and night.  Another really important thing is we don't want to be taking away from our nighttime sleep by sleeping too much during the day.  Now, I know there's the age-old wisdom of nap when the baby naps.  And to an extent, that's really good advice.  But, you know, with young babies, newborns, and even into the first year, they're napping several times a day, maybe twice a day by the time they are getting to like a year old, right?  So that's a lot of opportunity for you to say, well, okay, the baby's napping, let me just haphazardly nap too.  So then you end up taking up a lot of your or using up a lot of your sleep drive during the day and not saving it for nighttime.  So what I recommend is if you have the opportunity to get one good solid nap during the day for about half an hour to an hour, no more than an hour, great, do that, especially if that's going to be about the same time every day.  That's really good.  Pretend like you live in Greece and you're just doing like a siesta thing, right?  And then, you know, do your consistent nighttime sleep routine instead of napping whenever you kind of catch a moment to nap.  And definitely don't nap for very long or too late in the day because then that will definitely take away from your nighttime sleep.  Okay, here's another thing because a lot of moms say even if I'm not actually getting up to take care of the baby because my partner is doing that, or I've finished feeding the baby, now I'm back in bed, but I'm still wide awake.  My mind starts racing.  The baby's sleeping soundly, my partner is sleeping soundly, but now I'm still awake for a long time.  So that's called hyperarousal.  That's when your body and mind are too revved up.  And that could be due to a number of things.  Part of it is just mom instincts.  You're just like really tuned in to, you know, what's happening with your baby.  You're waking up at the slightest noise.  You know, you're kind of paying attention to a lot of things that's keeping you awake.  Part of that can't be helped.  But also part of it is, are you getting enough time during the day to really process your thoughts and emotions?  Or are you saving that all for nighttime when it's quiet and dark and nobody else is needing you for anything?  So then all the thoughts and all the worries and all the planning and rumination and excitement and all the things that your brain wants to talk to you about during the day, I mean, your thoughts have been waiting very patiently for you this whole time that you've been busy taking care of your babies, planning meals and taking care of the household.  Maybe you're working, you're doing all these things during the day and you're kicking the can down the road.  So then by nighttime, it's a perfect time for your thoughts to come out and play, right?  So set aside time during the day to actually process your thoughts and feelings.  Maybe journal during that time.  Maybe do a to-do list during that time.  Better yet, write a paper that has two columns on it.  One column says things I can control and the other column says things I cannot control.  And use that time during the day to lay out the things you can control.  Great.  So those are on your to-do list.  You don't have to keep holding that in mind.  And to spend time just venting about the things you cannot control.  Get it out of your system.  Allow your brain to process those things so it's not bothering you as much at night.

Allie

[ 00:27:54 ] It's really helpful advice.  I need to start doing that now.  When you have patients that are trying to figure out what are some tips if I am waking up in the middle of the night to feed the baby just to kind of decompress again and go back to sleep.  One person gave me this advice, oh, you have a word, think of a word, and then you have to think of five words that go with each letter of that word, and then you fall asleep.  And it really did not work for me, but I know that there are things like that.  Is there anything that you tell your patients?

Dr. Wu

[ 00:28:24 ] That's a fantastic question.  And so I think what you described there, people are calling cognitive shuffling, and it's really just a fancy way of saying distract yourself by thinking about something else.  It's like the age-old count sheep kind of thing, but a little bit more complex.  So I would say in the middle of the night, there are sort of two ways to go.  One is distraction.  So that's like the cognitive shuffling.  Think of words, think of images, do like an association, word association kind of thing.  Count sheep, count backwards from thousands.  That's definitely fine.  You can do that.  And if that feels like it doesn't work or it's just too much effort and you're just like, oh, I'm so tired.  I don't want to be thinking about words.  Feel free to also listen to an audio book or podcast that's lower key, not anything too exciting.  And what this does is either.  It distracts you enough and kind of puts you in a nice and calm state enough that you fall back asleep or you don't, but you were going to be awake anyways.  But now at least you get to enjoy a nice book or podcast.  So then you're not getting anxious or frustrated because that anxiety and frustration keeps you even more awake, right?  And that also makes you more exhausted for the next day.  So if you're going to be awake anyways, you can listen to something.  So that's distraction.  That's the one way to go.  Another way to go is acceptance.  So this is, or another way of saying it is getting out of your head and into your body.  So instead of trying to push your thoughts out of your mind, or instead of trying to convince yourself to calm down or to like trick yourself into thinking about other stuff, how about we just say, okay, there's thoughts there.  That's okay.  Thank you, brain, for trying to remind me of these important things.  And right now, I think I'm going to pay attention to the body instead.  So then you gently turn your attention to the body.  Maybe you can start at your toes and just wiggle your toes.  Ask your toes, how are you doing?  You know, how are you feeling?  Non-judgmentally notice any sensations there and then move to your feet.  Move to your ankles, you know, go slower than what I'm saying right now.  But, you know, just do a scan of your body and really non-judgmentally notice the sensations there.  And whatever sensations you encounter, even if it's uncomfortable or painful or annoying, just allow them to be there.  Don't judge them as bad, but just say, okay, I notice.  I notice that sensation.  I'm going to allow that to be there and just be curious.  And then move to another part of your body.  And usually when people do that, by the time they haven't gotten even to the top of your head, they've fallen asleep, or if they don't, they've engaged in a mindfulness practice that is good for their mental health overall.  And they're resting.  So, yeah.

Dr. Ruta

[ 00:31:09 ] We're going to keep dipping into your toolbox.  I feel like you just have like so many things.  Thank you.  I'm definitely happy to share any tools from my toolbox.

Allie

[ 00:31:19 ] And that wraps up today's show.  We hope it gives you the clarity, reassurance, and tools you need to take care of your mental health.  Dr. Ruta, what's something you hope our listeners take away from today?  I'm so glad you asked.

Dr. Ruta

[ 00:31:33 ] It's important for us to all remember that although we focus so much on getting babies to sleep, mom's sleep matters just as much.  Disrupted sleep is a reality for most parents, but there are ways to prioritize rest.  Dr. Jade Wu has generously shared valuable insights and practical tips to help improve your sleep routines.  Remember, sleep is absolutely essential to our emotional and physical wellbeing.  When moms prioritize their own rest, they're better equipped to nurture themselves and their families.  Thanks for tuning in.  As a reminder, please note that this podcast is not intended to be a substitute for professional medical care.  The views, thoughts, and opinions shared today are the speaker's own.  Your feedback and questions drive this show, so feel free to send us an email at podcast@womensmentalhealth.org or leave a voicemail at 617-643-9232.

Allie

[ 00:32:34 ] This is So Glad You Asked with Dr. Ruta Nonacs and Allie Hales, brought to you by the MGH Center for Women's Mental Health and the J.  Willard and Alice S.  Marriott Foundation. Additional resources are available at Dr. Ruta's resource hub at womensmentalhealth.org.  Listen and subscribe wherever you get your podcasts.