Andrea: it's your hidden superpower. sleep is your, most, , , performance enhancer. And I came to realize that people really needed a whole lot more attention on their sleep because that's the juggernaut for everything else to fall into place in your life.
Chrissie: How about if we were just wholehearted and tended to the creature of our body that needs to sleep when it's tired and do meaningful work when it's rested?
Andrea: sleep is a learned behavior and you have all the tools ready within you to help teach your brain to get to sleep and stay asleep. The brain is just, it's like any other muscle in the body. You have to train it.
Chrissie: You're listening to Solving for Joy. I'm your host, Dr. Chrissie Ott.
Hello, and welcome to today's episode of Solving for Joy. I am so excited to bring you Dr. Andrea Matsumura, who is my special guest today. Andrea is a board certified internist and sleep medicine specialist with over 25 years experience. Uh, she is about to launch a website, Sleep Goddess MD, and is dedicated to promoting holistic sleep health. She has been a featured guest on numerous podcasts, has founded the menopause collective here in Portland, Oregon, with a number of other esteemed physicians. And we are going to get to talk about what sleep has to do with solving for joy, which of course can be many things. Welcome Andrea. I'm so glad you're here.
Andrea: Thank you so much, Chrissie for having me. I'm really excited about being on your podcast because who doesn't want to solve for joy?
Chrissie: Everybody wants to solve for joy.
Andrea: And who doesn't want to get good sleep?
Chrissie: Absolutely. me in for good sleep. For sure. I love sleep. I am a sleep enthusiast, for sure. Um, I'm just feeling happy thinking about how well I was sleeping before I woke up this morning. Um, how did you get into sleep medicine?
Andrea: Well, you know, so I was practicing internal medicine inpatient, then I went to outpatient, and here I was dealing with all of these chronic medical conditions and sometimes it's really difficult to help people manage optimally all of these medical conditions like diabetes, heart arrhythmias, weight, uh, depression, anxiety. And I started to realize that, you know, a lot of people would tell me how they weren't getting really great sleep. They'd say, Oh, you know, by the way, I know we spent all this time talking about my diabetes, but I'm also not getting a whole lot of sleep. And so my knee jerk and tendency, Just like I would say most of us in the primary care world is to say, Well, you know, I am, uh, I need to solve this and we have run out of time. So let's think about a sleep aid. And so that was the first kind of knee jerk for me, at least. And I came to realize that people really needed a whole lot more attention on their sleep because that's the juggernaut for everything else to fall into place in your life. So if you're having a difficult time managing your diabetes, your depression, your weight, regardless of whatever you're trying to manage, I realize that if you're not getting quality sleep, then all of that is going to be that much more difficult to accomplish.
And so that led me down the path of going back to school, a middle aged woman going back to school to, uh, complete my fellowship in sleep medicine. And then it kind of just naturally, I started seeing a lot of women who were having trouble sleeping and were not feeling their best. And I kind of fell into it like that.
Chrissie: That's the second person today who I have met who went back to complete a fellowship well into their career. So I just want to give you a high five for following that creative impulse. It's a bold one to do. And there are many voices and, uh, momentums that would counter that.
Andrea: Well, thank you, because it was a pretty big surprise for my husband when I told him, Hey, I'm gonna quit my job and go back to school. But it all worked out at the end.
Chrissie: I bet it was. So what you said about how sleep is the juggernaut, it really does touch everything else. In my world caring for medically complex children, poor sleep influences, you know, how severe their spastic quadriplegia and cerebral palsy are. It influences how many seizures they are likely to have. We know that it influences our immune system, our pro social behavior, our memory, um, our diurnal rhythms from, you know, uh, our hypothalamic pituitary adrenal axis, and our, um, everything downstream from that. So if one can solve for sleep, you really are solving a lot of health and joy equations at the same time. And likewise, the inverse of that is if you have trouble sleeping, you've got trouble in a variety of areas um, directly related to that.
Andrea: Yeah, definitely. You know, over the years, I've been now, uh, practicing as a sleep medicine specialist for, uh, almost 10 years. And, What I have realized is that there is a little bit of a method to help people regain their power of sleep. And the first thing I usually ask people is what their circadian rhythm is. And that's different specifically if you're you know, if you're a child, that's a whole different conversation, but as an adult, we pretty much land in one of three types of circadian rhythms. And you're either an early bird, you're a night owl, or you kind of fit into the United States societal norm, which is going to bed around 10 and waking up at around 6.
But there are some people who really cannot stay up past nine o'clock. They're the people who you say, Hey, let's go eat at this great restaurant, and the reservations are at 830, and there's like, nope, sorry, I'm out. Or there are people who are, you know, that are night owls, who do their best work in the evening, who have a really difficult time and struggle in the morning and then finally feel like they hit their stride in the afternoon. And those are the night owls. So I find that once you can dial in what your natural circadian rhythm is, which by the way, we have clock genes that are housed in the hypothalamus of our brain. So it's not like they're, there's some external setting of your circadian rhythm, but for the most part, you're born with, with how your, how every cell in your body that runs on, which runs on a circadian rhythm, how it's going to be optimally set.
And the reason why I focus on that as the cornerstone for then how we dial in your optimal sleep is because there's, there's so much external noise and, uh, Social media right now around needing to be an early bird, and that is, that's just not true if that's not what your circadian rhythm is. And on the upwards of 20 percent of the population of the world is a night owl.
So, if you think about, uh, you know, societies like Italy, France, Spain, they really are more of a night owl society. The United States is kind of more on the earlier side. So that's one of the focuses and speaking, you know, talking about, uh, zapping people's joy is being inundated in your social feed about how you're doing all the wrong things to get right sleep or to capitalize on your day. And so, you know, that, that's the cornerstone for me when I talk to people about their sleep.
Chrissie: Awareness of our own chronotype. Um, so important. And I think about that should of like, you know, a, a semi subconscious message that we should be early birds. And it reminds me of, you know, the puritanical work ethic that we have. Oops, inherited, um, in this country and capitalizing on our day is similarly kind of all about achievement, right? So how about if we were just whole? How about if we were just wholehearted and tended to the creature of our body that needs to sleep when it's tired and do meaningful work when it's rested?
Andrea: There's lots of data out there that shows that when people, stop trying to burn the candle at both ends, so to speak, and short themselves, uh, on sleep, which is again, along the lines of that achievement style, you know, the, What is being fed to us in society that we have to do more with less and that we're lauded if we didn't get any sleep that there's actually data that shows that it messes with memory consolidation executive functioning your reaction time and You know people don't realize that when they get more sleep they do the same amount of work in less time because they're rested.
Chrissie: Such an important takeaway that you actually have the capacity to do the same amount of work in less time because you're more rested. Yeah, that is amazing. Um, you know, I saw your reel in the last week or so about, uh, orthosomnia, and I'm excited for you to talk about that with us and part of, you know, it's the sleep version of orthorexia, which is when people become unhealthily consumed, no pun intended, um, with eating only healthy foods, right? They have a bunch of rules and it's very like perfectionistic at its core. Um, we can hijack our goals around sleep in a very similar way where we get driven, uh, by perfectionistic tendencies. I can certainly identify with some of that, but I'd love to hear what you value in sharing about this concept.
Andrea: Yeah, absolutely. So, orthosomnia is this notion, this belief that you have to absolutely get perfect, a perfect amount of sleep, or else you're not getting good sleep at all. And so then people become fixated on the time, the, uh, stages, uh, many people have wearables these days that tell you exactly what stage and for what percentage of time you were in each stage of sleep, uh, and how much sleep you actually got and whether or not you should be feeling good or not. And I find that people will tend to hang on to those concepts before they ask themselves in the morning how they feel. And And so then they get kind of lost in the data, if you will, and so thus the concept of orthosomnia, uh, rears its, rears its head.
And what I, what I often will tell people is, you know, before you wake up and pick up any kind of device or look at anything, first ask yourself, how do you feel? How do you feel? Because you could have gotten great sleep, slept six hours, but then you pick up a device and it tells you you only got two hours of great sleep, and then you're gonna, it, it changes your view then for how you're going to interact with the world that day. And talk about zapping your joy. Talk about, you know, reducing the amount of joy you could have possibly had in your day, all because we are reliant on something that is telling us how we should be feeling.
Chrissie: Yes. Confession time. I'm wearing two wearables right now. Um, As well of a ring and a watch. I've really mostly pay attention to the ring about sleep and I may not check it for days on end, but sometimes I check it first thing in the morning. Um, and my takeaway, it's, it's actually my second sleep wearable. I used to use one that was under the sheet that would measure my breathing and movement.
Andrea: That's called a nearable.
Chrissie: Oh, I didn't know that word. Okay. Nearable. I love it. And sometimes I would just laugh at myself and go, like, okay, I just used this device to tell me what I already knew, which is like, last night's sleep was amazing. Or, last night's sleep was just so so. Or, I worked a night shift and then I slept in the day and my body does not prefer that sleep, hello. Right.
Andrea: Right. So, you mentioned having something, uh, on your mattress that you were sleeping on. Those are called nearables. So anything that is not actually on your body is called a nearable. So people might have a device on their phone that's recording their sleep that's next to them. Right. Yeah. Those are all nearables. Anything that's on your body, I have two as well, my watch and this ring, uh, those are called wearables and, uh, Newsflash, the best wearable that's out there is only recording your sleep at 75 percent accuracy.
Chrissie: Good to know. Good to know. I have actually wondered what a sleep doc would say about these rings being a poor man's sleep study. Um, would you, would they say that this was, uh, You know, effective information for screening sleep apnea,
Andrea: it's, it's screening. It's a great screening tool to tell you something's not right, but it is not a diagnostic tool. And that's an important distinction, the word diagnostic. So to become a diagnostic tool, you do actually have to jump through a whole lot of hoops to have to be FDA approved. It's not FDA cleared, it's FDA approved and however flawed the FDA may be, there is a system in place to ensure that diagnostic tools are being used to help aid in the diagnosis of a condition.
Like getting an MRI, or a CAT scan, or, you know, doing an echocardiogram. These, these are diagnostic tools just like a sleep study is a diagnostic tool. So wearable devices are not diagnostic tools.
Chrissie: That tracks.
Andrea: I , yes, I, I think though, I, and a reason why I'm saying this is because I've had many a patient come to me and say, why can't I just use my whatever blank watch instead of doing a sleep study? It's already telling me how I sleep. And so I have to explain, explain to people that those are not diagnostic tools, they're just a slight window into allowing you to look at patterns in your body to see whether or not there's something that you actually then need to follow up on with your physician.
Chrissie: It's kind of like comparing an MRI to a photograph.
Andrea: Yes, great analogy. Yes, absolutely.
Chrissie: Maybe not even an x ray, maybe a photograph. And tell me how is it different for women with sleep difficulties? Um, I understand that you have observed that women present differently than men. What do you see?
Andrea: Yeah, absolutely. So, uh, so first of all, you know, this may have already been discussed in one of your other podcasts, but women weren't even included in studies until 1993. So women were not included in any sleep data until 1993. So there is that piece. The other piece is Yeah. The other piece is that, you know, all the data or all the criteria around, uh, let's, let's, uh, talk about sleep apnea, for instance, because that's very common and it's at the forefront of a lot of people's minds when they think about a sleep specialist or sleeping. And all of the data that is being used, including some of the screening tools, uh, they're gender biased. So, women do not typically present with loud snoring or, the, uh, apnea, the witnessed apnea, um, they don't, uh, typically have a partner that's attuned to hearing abnormalities in someone's sleep, so, uh, especially if they have a male partner, so, there is data around that.
So women tend to present more with fragmented sleep, morning headaches, general malaise, like I just don't feel good. I don't know if I'm depressed because I'm not getting good sleep or I'm not getting good sleep because I'm depressed, which is it? Um, so that's really how women tend to present. Certainly women do have some snoring. Certainly some women do have apnea, but by and large, most women don't. And actually on the upwards of, you know, up to a quarter of women have potential sleep issues and up to 90 percent of those women do not know that they have sleep apnea.
So, and I don't know how many times I've heard in my own practice, thank you for helping me try, finally figure this out. It's been a decade since I finally, you know, since I've been talking about my issues. So it's just not that dots are not being connected, that women might actually have sleep apnea and why it's so important is because sleep apnea is a risk factor for heart attacks and strokes.
Chrissie: That is a massive number. So of the 25 percent of women who are likely affected by sleep apnea, 90 percent are unaware. It brings to mind the stories of multiple female physician friends of my own who have been late to diagnosis of their sleep apnea. Um, there are many reasons for that, but hearing over and over again, when they actually got their sleep apnea treated, um, found the right CPAP, et cetera, they felt like they had wings, you know, they felt like they were in a Red Bull commercial. Like they're like, this is what other people feel like every day. I'm a superhero. I could do anything with this level of energy that I got from just a few nights of solid uninterrupted supported sleep.
Andrea: Yeah, absolutely. And not to go down too far the rabbit hole, but almost all insurance companies, uh, only cover a home study to start with and more women have false negative home studies than men do. So one of my take home, uh, points is if you are being evaluated for sleep apnea, And you get a home sleep study, and you have a negative home study, and you still feel like you have a lot of symptoms, you really should move forward with an in the sleep center sleep study. Because home studies tend to have a higher rate of false negatives in women.
And the other piece is that CPAP isn't the only way to treat sleep apnea. There are oral appliances called mandibular advancement devices. And you know, I don't know how many times I have said this, but masks for CPAP, there's a whole lot of different kinds out there. They don't all have to be the big Darth Vader kind. There's little ones that go under the nose. Some are over the nose. Some are over the nose and mouth. But the bottom line is they're all made and developed for men's faces. So they can just make them look purple or pink, but they're really developed for men's faces. So there's a little bit of a barrier for, uh, women using CPAP at times. However, I would say. You know, I try to demystify using CPAP, which stands for Continuous Positive Airway Pressure. It's really just a way for me to provide people with compressed room air. That's all that it is. Um, however, if you have mild sleep apnea, or simple moderate sleep apnea, you could very well use an oral appliance, and that could get rid of all of your sleep apnea.
So there's other options out there for women because the majority of women will have mild sleep apnea that is severe during REM sleep. So that's very unique to women. So, and again, I'm going to harp on, you know, insurance. Insurance companies don't typically cover mild sleep apnea unless you have another chronic medical condition like high blood pressure or diabetes. And that's what the majority of women have because they typically don't have sleep apnea in the other sleep stages, but then it's really severe during REM sleep. And it's probably hormonally mediated. Uh, there is some data out there that does show that it is hormonally mediated. Okay. But there's not any definitive data out there quite yet.
Chrissie: I am fascinated. I am so fascinated by this. Are there any pro tips for, uh, folks who would like to get a sleep study, um, covered, especially since we are at the beginning of a new year and, uh, people have deductibles to think about and things like that. I mean, I think that sleep study availability is often a rate limiting step for acquiring the diagnostic data. But what are some good practices for folks to know who are ready to have their sleep formally evaluated?
Andrea: You know, start now, uh, at the beginning of the year if you can, because it is a lengthy process. So, uh, a couple of things. Sleep is sleepy. There's not enough sleep docs out there. There are just not enough sleep clinicians out there. There aren't enough sleep centers out there, because it hinges on people who are working in sleep centers overnight. And with the pandemic that happened already four years ago, that workforce really, uh, took a hit. So we don't have enough sleep technicians to help, um, staff sleep centers. So, it all kind of has this domino effect.
So, what I would say is, focus on, uh, being evaluated early in the year, because if you're sleep, if, more likely than not, you're going to have a home study, unless you have a, chronic medical conditions. So just a little word about sleep studies. It's not about what, what do I want to do as the patient. It's more about, What are your, what is your clinical picture and what is the indication for a home study versus an in the sleep center sleep study?
So I have a lot of people who might come in and say, well, my, you know, my PCP told me that I could just get a home study, but they have all of these other medical conditions and they really need to do an in the sleep center sleep study. Um, So, there's, there's that piece, but the, the, the long and the short of it is that get started early, get the home study, because that's what the majority of folks are going to be getting, and if that's negative and you still have a lot of symptoms. Really push for, or have that collaborative conversation rather with your doctor around doing a second test, which would be an in the sleep center, sleep study.
Chrissie: Advocate for yourself. If you need to. Yeah. Yeah. Um, I just appreciated for the first time, the irony of needing sleep technicians to sacrifice their sleep and become shift workers in order to diagnose sleep disorders.
Andrea: Yeah, we, you know what AI, AI is in everything now with medicine and it's making, it's making, there's some inroads around developing, uh, and leveraging AI technology to help, uh, expand sleep services. Uh, but at the, again, at the end of the day, you do need a person to interpret sleep studies. It's not, it still has a long way to go before we can substitute, um, which is a good thing because you want somebody who understands your entire clinical picture interpreting your study.
Chrissie: Thoughtful. A thoughtful human at the other end who's thinking about everything together. Yeah, so interesting that women with mild sleep apnea might have severe during REM sleep. I'm just like really enjoying geeking out about sleep.
Andrea: I know and that's not every woman, but it's just that There is a higher tendency of women to have mild sleep apnea overall, but severe during REM sleep. Some women, it doesn't really matter, but that tends to be the picture. And then I guess what's frustrating for me is that insurance companies have, you know, have a lot of more barriers, if you will, to, uh, cover Uh, treatment of sleep apnea and the setting of mild sleep apnea. And there are also more barriers to obtain in the sleep center sleep testing. So
Chrissie: Andrea, will you say more about how some of that is hormonally mediated? I'm sure that many of our listeners will be curious. I'm certainly curious, um, as we just recently had our podcast with our colleague, Dr. Aoife Oā€™Sullivan Tell us more about the hormonal mediation.
Andrea: Sure. So, so in a premenopausal woman, that is where the tendency to have more of the REM related sleep apnea might occur, uh, because it is potentially hormonally mediated. Uh, there may be, there may be a role that progesterone plays and, uh, you know, how our airway is supported while we're sleeping. Since when we breathe during the day, our frontal lobe is in charge of breathing. But when we go to sleep, our hindbrain or our brainstem is in charge of our breathing. So very different mechanism and how we breathe.
And then how do hormones play a role in that? Well, they can support the airway a little bit differently. And so then when you're in perimenopause or postmenopausal, I don't like to use the word postmenopausal anymore, you're just menopausal, right, because you're in a new stage of life that is a new forever stage, uh, then, then, you know, you have a change in those hormones and your sleep apnea may also change. Uh, and maybe it gets worse, uh, because, because of a variety of factors, or maybe you then acquire sleep apnea. And at that point it may not be the hormones that are mediating or changing the level of sleep apnea you have, uh, there's a lot of other factors. So, uh, women who are in that stage of life tend to have weight distribution changed, which might, uh, increase their risk for, uh, changing the severity of their sleep apnea.
And, and then, you know, at the, the most important thing is that when you are in the menopausal state, then your risk, your cardiovascular risk is the same, especially if you're not on any type of hormone therapy. If you're on hormone therapy, again, you know, more up to date phrasing is not, uh, hormone replacement, because we can never replace what is lost. It's more about hormone therapy. So, you know, I'd say that it really depends on what stage of life you're in, how your hormones may be affecting the severity of your sleep apnea.
So, in addition, uh, I, I do want to clarify that hormones may play a role in the severity of your sleep apnea, depending on the stage of sleep that you're in, but they, they aren't the cause of sleep apnea. So that's a really, that's a really important clarification I would like to make, that they play a role. But they aren't the reason why you have sleep apnea, so we don't want to treat sleep apnea with hormone therapy. Uh, we want, we want to really focus on all of the different etiologies or, or reasons why you might have sleep apnea. And hormones are, uh, Kind of part of the big picture when it comes to being a woman, but they aren't the reason why you have sleep apnea. So that's really important. However, hormones help in a lot of other different ways. Uh, so there's that whole piece,
Chrissie: that whole piece, uh, that ginormous piece over there. Um, I saw a Instagram, again, um, you know, ad for a, a newer to me, at least it was novel to me, a type of mask that used, uh, magnets to secure. Is there anything to, um, like know about that? Is that, is there danger there? Is it just an interesting new way things are going?
Andrea: Yeah, I mean some, there's been a couple of those types of masks that have been produced that have magnets and, uh, they're not, you just have to be cautious if you have any kind of electrical device. So if you have a pacemaker or some other, you know, maybe a TENS unit, I don't know how these devices really interact. Um, there's also, you know, there's all kinds
Chrissie: A vagal nerve stimulator.
Andrea: Yeah, the hypoglossal nerve or vagal it's hypoglossal. Yes, or a vagal nerve stimulator, but there's other devices that are being marketed now to treat sleep apnea called the hypoglossal nerve stimulator or It's called, you know, one of them is called inspire. They they really do not work as well as good old air compressed air or an oral appliance. So they have amazing marketing, but they're not, they're not something that I would say is your first line of treatment. Um, so there's that.
Chrissie: So interesting. And I know that, you know, your, your practice is far from limited to sleep apnea, but it is such a common issue. And I appreciate diving into a little bit. Um, you know, I'd love to tie your work in sleep medicine and supporting women in menopause back to your concepts of joy, um, how this work informs your solving for joy equation and kind of what, what variables you may have found, uh, that you once thought were constants and, and how that's gone for you as a human.
Andrea: Yeah. Uh, so you know what? What I love the most about the work that I do is how I help, uh, people, mostly women, really understand that their sleep is I always say it's like your, it's your hidden superpower. It's your, most, , , performance enhancer. Uh, there are all these things that I say to folks, but as you said, sleep apnea is very common. Uh, and, uh, It is often talked about when we talk about sleep, but the other thing that affects women's sleep a lot is insomnia. So women disproportionately will have insomnia over men. And, uh, it tends to, uh, really come to a head during the perimenopausal or menopausal, uh, state.
And so, um, where I, where I, I guess get the most joy out of working with, uh, my female patients around sleep is having them understand that, um, sleep is a learned behavior and that you are, I, I am their biggest cheerleader because you have all the tools are ready within you to help teach your brain to get to sleep and stay asleep. The brain is just. It's like any other muscle in the body. You have to train it. And when you're talking about insomnia or not getting good sleep for whatever reason, because Uh, socially, uh, it's, women are expected just to not get good sleep for several reasons that we could talk about for hours, but the reality is that you can actually teach yourself how to get to sleep and stay asleep. And the joy that that brings, the empowerment that that brings to people, to women, that they can actually reclaim their sleep is really powerful for me. And that's what I. That's what I get the most joy out of.
Chrissie: I love that. It reminds me of, you know, the adage that when we put, when we put money in the hands of women, the entire community benefits. I think this is also a form of wealth, right? So when we put sleep in the hands of women who really need it, everyone also benefits. The ripples are many.
Andrea: A hundred percent, a hundred percent, because when we think, so think about like our little kids, you know, we have to teach them how to sleep and we do that with all, all of these external cues that we provide them with these cues that teach them that it's time to eat, it's time to wake up, it's time to fall asleep, and then we forget as adults that we still need those same types of cues. Right? We, when we're hungry, we don't just go, go, go, go, go, go, go, and then open up the refrigerator and then start shoveling food in our mouth. We don't typically do that. So it's the same with sleep. You shouldn't be going, going, going, going, going, and then boom, just fall into your bed. Your, our bodies just don't work that way.
So I mean, one of the things I say to folks is this is not a couch to 5k learning. This is a couch to marathon. It takes time. And. You know, most people are coming to me with years of not getting good sleep. So on the, on the flip side, spending three to six months to set the rest of your life up for success is not a bad trade off.
Chrissie: It is not, and it will increase your joy. 100%. Yes. Where will people find you who want to, um, request a sleep evaluation with you?
Andrea: Yeah, so I am in the midst of, uh, launching my own website that will offer, uh, consultations, for groups, for corporations, for individuals, in addition for other clinicians, practitioners who want to learn about sleep, uh, it's, uh, called Sleep Goddess Md and that is going to be, uh, launching here in, in the next month of January, January, February of 2025.
In addition, I'm on Instagram as Sleep Goddess md and I'm providing tidbits all of the time. Currently, I'm the, uh, medical director for all of the primary care services at Cascadia Health. And, people can, um, find me there. And then lastly I co founded uh, group called, uh, the Portland Menopause Collective with three other physicians. And we are having a conference in Portland, uh, called, uh, Hot Flashes and Cool Solutions, all about menopause health, and that's going to be at the Sheraton Airport on March 15th.
Chrissie: Awesome and who is the audience for that conference?
Andrea: So the audience is really for anyone who is interested in understanding, uh, how menopause plays a role in, uh, changing women's lives. So we did do, uh, an event, late in 2024 and we did have a few, uh, men, uh, come who were interested. So it's, it's really for anybody who either works with people who are going through menopause, or if you're going through menopause yourself, or if you know someone who is close to you that is going through menopause, it's really open to all of those folks.
Chrissie: Awesome. And where will they find the information about the conference?
Andrea: So, it's on Eventbrite right now, um, and, uh, it's Portland Menopause Collective, uh, and again, the conference name is Hot Flashes and Cool Solutions, uh, also on, uh, my Instagram page is a link to, the Eventbrite, and, uh, Portland Menopause Collective has its own Instagram page. So
Chrissie: we will link to that in the show notes. This is so good. I could talk to you for about two more hours about sleep. Um, I'd like to get your take on so many different things that maybe we'll have a follow up conversation sometime, Andrea, but thank you for being with me. Yeah, we have a lot more to discuss. I can see for sure.
Andrea: Well, thank you for having me, Chrissie.
Chrissie: Yes. My pleasure. Thank you all for listening today. Thanks for being part of the solving for joy podcast audience. And if you haven't rated or reviewed the podcast, I would so value, if you would take the time to consider that as it helps us get more eyeballs and reach more people and, uh, when we reach more people, there's more solving for joy. So thank you all for being here. Thank you, Dr. Matsumura, especially for being here. Uh, and I will see you guys next week.
I want to take a quick moment to acknowledge our incredible team. This podcast is produced by the amazing Kelsey Vaughn, post production and more handled by Alyssa Wilkes, and my steadfast friend and director of operations, Denise Crain. Our theme music is by Denys Kyshchuk cover photography by the talented Shelby Brakken and a special appreciation to my loyal champion and number one fan, Suzanne Sanchez. Thanks again for tuning in everyone. May we continue caring for ourselves, caring for others, and may we continue solving for joy. Take care. We'll see you next time.
