Welcome And Meet Dr. Harris

SPEAKER_00 0:44

Hello, hello everyone. We are officially live. Welcome to another episode of Beauty of Breathing. Let's go live on Instagram, real quick. Oh, and there she goes. Capri is making her appearance. Well, today we're excited to welcome Dr. Shelby Harris, one of the nation's leading experts in behavioral sleep medicine. She's a board-certified behavioral sleep medicine specialist, licensed clinical psychologist, and clinical associate professor at Albert Einstein College of Medicine. Dr. Harris specializes in evidence-based non-medication treatments for insomnia, sleep apnea, circadium rhythm disorders, and other sleep challenges. She's also the author of two books on sleep health and a nationally recognized speaker and media expert dedicated to helping people achieve healthier, more restorative sleep. Dr. Harris, welcome to the Beauty of Breathing.

SPEAKER_01 1:45

Thank you. Thanks so much for having me. I'm looking forward to talking.

SPEAKER_00 1:48

So our topic today is behavioral treatment of insomnia. Dr. Harris, you've spent your career helping people sleep better. What first drew you to sleep medicine and what continues to fascinate you about it?

SPEAKER_01 2:03

So I was first drawn to sleep because I was a sleepwalker as a kid. Um, pretty bad sleepwalker a lot of times. And then I, when I was, when I had just graduated from college, I took a year off between college and graduate school, and I was put on a research study that looked at treating insomnia and people who are in early recovery for alcohol um dependence. And we found that I was going into rehabs at the time, and we found that in the study, if you treated their sleep issues, their insomnia early on in recovery, it actually helped to reduce relapse rates. So a lot of people go back to alcohol, they found because they weren't sleeping. And so we really targeted the sleep as part of the treatment. And I just thought to myself, this was like 25 more than 25 years ago. It's like, why are we not talking about sleep in other areas at that point? And so it made me, when I went to graduate school, I was looking for graduate school specifically that had some sleep training in it. There weren't many, there still aren't. And that's kind of what just continued it from here on in, because when someone is sleeping better, you just see how many areas in their lives it really impacts for the better, that it's just it's like the most rewarding.

SPEAKER_00 3:14

Right. I always tell my patients that uh we talk about nutrition all the time and we talk about working out all the time, but not necessarily sleep. And I feel like sleep is more important than the other two, because if you have a horrible night of sleep, you're less likely to work out and you're less likely to be healthy the next day.

SPEAKER_01 3:33

Yes, I will often describe it, I've done this for a long time. Like people talk about the pillars of health, like nutrition, nutrition, exercise, they put sleep there, mental health. Excuse me, losing my voice all of a sudden. I always think about sleep as being the bedrock, actually. It's the thing that the pill other pillars are built into. Because if you don't have a good solid foundation, the other stuff is going to be shakier. So I love that.

SPEAKER_00 4:00

Another thing that one of my mentors says is you um that your day does not start when you wake up, your day starts before you go to bed. Because again, if you have a horrible night of sleep, it's going to affect the rest of your day.

SPEAKER_02 4:15

Yes. Sure.

SPEAKER_00 4:17

Paying extra attention and doing everything that we can to allow us to have good quality sleep is so important. Everyone says, though, that they're exhausted as they why do you think we're sleeping worse than ever?

SPEAKER_01 4:33

Um so there's so many reasons. So, one, I think the biggest thing is stress. And also just we the with the phones in our lives, we it's not just like it's not just having a blue light in our face. That's not my my biggest issue. It's that we don't turn off as a result. So we have more stress, and then work is no more like a nine to five kind of thing because of the phones. We're constantly on. We're we never get a moment to turn off. And because we're busier than ever, people are just sandwiched with helping

Why We Sleep Worse Now

SPEAKER_01 5:06

with their families, their work, a million things at once that sometimes it just they bring it to bed with them, but they're stressed and they're just not sleeping well. And then other times we have so much to do that people aren't making time for sleep. So it can be also an issue with getting enough sleep or having trouble with sleep when you actually try to. So we see a lot of both going on.

SPEAKER_00 5:27

But at what point does I'm just a bad sleeper becomes an actual sleep disorder?

SPEAKER_01 5:32

Um, usually it depends what high what we're talking about. Like, is it do you have insomnia, sleep apnea? But usually after if you've been trying to practice good sleep hygiene, right? So you're limiting caffeine, limiting alcohol, all this stuff that people talk about all the time. If you've been doing that for about a month and you're having three or more nights of poor sleep, then you should definitely get that evaluated.

SPEAKER_00 5:55

What is the biggest nickel misconception people have about insomnia?

SPEAKER_01 6:00

Um there's a bunch. So the there's I'll go with two. One is that it's trouble falling asleep. A lot of people think

When Poor Sleep Becomes Insomnia

SPEAKER_01 6:08

it's just I can't turn my brain off and go to sleep. It's trouble falling asleep, staying asleep, or waking earlier than you want, or a combination. The other thing is that medication is the only way to treat it. Um and it's not. So it's actually not even the first-line treatment for many people.

SPEAKER_00 6:24

So, what is a first-line treatment for many people?

SPEAKER_01 6:27

So I love um cognitive behavior therapy for insomnia is really it's the gold standard by most of the big name societies. So, American Academy of Sleeps Medicine, um, the menopause society, I mean, their guidelines are for CBT. So, it's really when you're teaching working with someone for insomnia treatment, it's very short term. I typically say four to eight sessions. I kind of give a range. Um, but it's generally very short-term treatment. And once someone learns the techniques and the tools to be able to improve their sleep, it is longer lasting. So if you have a, I mean, to expect

CBT-I Over Medication

SPEAKER_01 7:05

someone to never have poor sleep again, I think is unrealistic. But if you ever have an episode of poor sleep, you know what to do to get yourself back on track. Um, whereas with medication, for many people, when you stop the medication, you haven't learned other techniques and skills. And we don't want, if we don't have to, we don't want someone on medication long term if we have other treatments that have a lower side effect profile long term.

SPEAKER_00 7:28

You've said that trying to um trying harder to sleep often backfires. Why does forcing sleep actually make inside insomnia worse?

SPEAKER_01 7:38

Well, effort, I say it all the time, like effort, sleep collapses when you put it on demand, right? So when when I one of the things I like to ask most of my patients um with insomniers, I was like, what are before you ever had insomnia? Some people have had it most of their adult life, and I can't remember a time before having insomnia. But I'll say, like, before you had insomnia or your significant other, what do they do to fall asleep at night or to fall back asleep? And they're like, I know, I want to know the secret. I said, Well, ask them what they do. Nine times out of ten, people say they don't do anything. They don't do anything. The more that you think about it and try to make sleep happen, you're tensing your body, you're making your brain get more frustrated, anxiety, frustration happens, and that's all stuff that goes in the exact opposite direction of what you need to have happen for sleep. So it's it's almost like you have to unlearn trying to sleep. We want to have you essentially let go of it and then sleep will happen on its own.

SPEAKER_00 8:35

So can insomnia actually happen in the brain and in the body?

SPEAKER_01 8:41

In the brain, how?

SPEAKER_00 8:42

Like from a like psychological standpoint, you mean, or from you just waking up not being able to go to sleep, but you mentioned like your body tenses up. Can people be creating that?

SPEAKER_01 8:55

Yes, yes, they can. So if you're you're waking up and then it leads to frustration, or you're like, oh, it's 2 a.m. again, naturally we'll get tense a lot. If the thought is, oh, here we go, I'm I'm annoyed, like that kind of thought. Yeah, the tension just doesn't help.

SPEAKER_00 9:12

Can you explain to us the cycle um of insomnia that keeps people stuck for ears? Because this it's one of the things that seems to keep people, you know, and they just can't find relief. Insomnia seems to be one of the worst ones that we hear people complain about.

SPEAKER_01 9:28

So there's a model by um uh Art Spielman, who um passed away a number of years ago now, but he came up with this model for um insomnia. Essentially, there's three-factor, four-factor, it depends who you talk with about it. But essentially, it's when you start out having insomnia, something happens that causes it. Some people can't figure out what the actual thing is that made it happen, but it could be um biologic, like a menopause, for example, my area specialty, right? So menopause, perimenopause might make it happen. But then what happens is even though there was an initial stressor, physical, mental, whatever it might have been, then we start doing things to try and compensate for the fact that we're not sleeping. So you might be going to bed earlier, you might be sleeping in in the morning, you might start having sleep effort, right? I have to sleep. Why am I not sleeping? Uh, then compensating during the day. So caffeine, um, taking more naps if you're able to or trying to nap. So all those things that now have started to develop after a few weeks or a month of not sleeping well, those are the things that usually are continuing that insomnia to happen long term. So even though you might have had something that might have started it, there might be other things that are perpetuating it and maintaining it. And that's the stuff where CBT for insomnia actually really works. So it's the things that are continuing going for decades on hand for some people.

SPEAKER_00 10:54

I've been hearing of some apps with uh that do CBT now. How have those been effective?

SPEAKER_01 11:01

Yeah, they're great. It varies. Um, so like there's the CBTI coach app by the the um the VA, some of my colleagues worked on. Um, they're great. They're not for everyone though. So I think the apps are really wonderful for people who have um either they're struggling with getting access to care, just seeing someone like myself, or they're just um not necessarily early on. They're really good if you have early onset insomnia, um, but you're not using lots of medications. You don't have lots of like sleep apnea or other sleep disorders or a lot of complications. They're pretty

Apps Plus Anxiety And Sleep

SPEAKER_01 11:35

good for that. Those are the patients that I don't usually see in my practice. I see the more complicated cases. So the apps are usually a good first place to start, though. We have a lot of good data suggesting that they're really useful. And I've seen it help a lot of people.

SPEAKER_00 11:47

Amazing. How do anxiety and sleep feed into one another?

SPEAKER_01 11:53

Um chicken and the egg, right? So you might be anxious at night and then you wake up. What I hear all the time is like, oh, I woke up at three in the morning and then I started rehashing all the things that have done wrong in my life or that are annoying to me that I have to do. Um, but then you don't sleep as well because you're up rehashing it all. And then when you don't sleep as well, guess what? Your threshold to be able to tolerate daytime stressors reduces. So then you have more stressors and you're you're just kind of feeling things more. You might have more trouble doing the things you need to do during the day. And then guess what? You carry that to bed with you, and then it just becomes a cycle.

SPEAKER_00 12:26

Cycle. Um, most of our listeners are interested in airway. So for airway focused providers, what is one thing you wish that they better understood about insomnia?

SPEAKER_01 12:39

Um, that it is that's a great question for airway focused providers. I think that it's not just necessarily always like one thing that that I think every patient's different. And I work with a lot of patients over the years that are um that have comorbid insomnia and sleep apnea all the time. Um so we're working from an airway perspective to work on helping with their breathing at night while also working on insomnia, right? So maybe there might be something that's causing them to have awakenings, but sometimes then the

Insomnia With Sleep Apnea

SPEAKER_01 13:12

insomnia might take over, whether it's their mind being active. So I think sometimes combining the treatments can be really useful for a lot of people.

SPEAKER_00 13:20

Um, not everyone, so not everyone who has um who can sleep has insomnia, and not everyone with insomnia has an airway problem.

SPEAKER_01 13:30

Exactly. Thank you. Yes.

SPEAKER_00 13:31

So why is that distinction so important?

SPEAKER_01 13:36

Um because I think when it comes to thinking about how you're gonna work with the patient, you have to have an understanding of kind of what are some of the contributing factors. So there are a lot of people who are out there who will say, Oh, I treat insomnia, but they don't even ask, like they don't know to even evaluate for an airway issue or apnea or whatever else might be going on. Um, because sometimes you do have to treat both areas if it has to happen. Or you have to know, like I've had patients come to me many times that clearly don't have insomnia. They have something going on with breathing at night. And so then I have to know, okay, I don't think it's sleep restriction or any of that stuff is going to work. So I have to know when to send them. So you kind of have to know what some of the contributing factors might be to have them evaluated better.

SPEAKER_00 14:20

And do a lot of people have OSA uh obstructive sleep apnea also have insomnia? Is that common to happen together?

SPEAKER_01 14:26

It's very common. I would say more often than not in my practice, people have both, believe it or not.

SPEAKER_00 14:32

Is that comisa? Is that what they're called?

SPEAKER_01 14:34

Comisa, yep, comorbid, co-occurring insomnia and sleep apnea. And it's it's in the rates of in sleep apnea increase dramatically in women when they start to hit perimenopause and menopause. And I specialize in that age range. So I see so many women that come to my practice, they definitely have insomnia, but I'm pretty sure that they have some level of sleep apnea going on that I then have to get them evaluated, and they're thin, they're fit, they're 45. You would never like most people would assume. Like I've had many of my patients say, Oh, you don't have apnea, you're young and you're fit. And then it's like, nope, you'd be surprised.

SPEAKER_00 15:12

So that is a huge misconception with obstructive sleep apnea. You know, uh, we were taught to think that most people with sleep apnea are overweight males, but I think that people think that because they were the first ones that were actually studied whenever we started looking at sleep apnea. But we do see so many patients or children or young fit women who still are presenting with the symptoms. Uh, I'm gonna go just a little bit into OSA. Um are the symptoms between the old, overweight male and the young fit female, are those symptoms that they present with a little bit differently? Is that where we're missing them?

SPEAKER_01 15:54

That's where we're missing it. So women tend to report the symptoms differently. They'll often they don't usually say, I'm sleepy, or they're not falling asleep. Like you would look at like an Epworth sleepiness scale. So that's the kind of scale that we look at for how sleepy someone is, which is it's debatable about using it all the time. But we'll look at that and like they'll they won't be falling asleep all the time. And sometimes they don't have time to fall asleep, right? I've just been my day. So women will often report more that I'm feeling very tired, I'm drained, I have no energy. Um, and we know that sometimes with sleep apnea, we can see higher rates of people having some more anxiety, more depression. So they might report that. So they just get misdiagnosed a lot of times as, oh, you're just you're in perimenopause, or oh, that's part of natural getting older is to be tired, but they're they're not reporting that I'm sleepy, or even with women, they're oftentimes not um snoring loud, short, like loud um choking, gasping. It can be much more subtle in some of them. So it just goes under the radar.

SPEAKER_00 17:05

Um, so going from this, you mentioned menopause or perimenopause. If somebody's going through that, um, what are some of the symptoms that could be red flags? Oh, maybe I am uh also developing is it's normal uh more common for people to develop a new sleep symptom uh whenever they are going through those hormonal changes?

SPEAKER_01 17:27

Yeah. So I do always ask like, do you snore? Do you have any pauses in your breathing? Do you breathe through your mouth at night? Um, do you wake up with headaches in the morning? I see that a lot too. Um, any restless leg issues, if any of that's going on. But I do ask, like, how often are you waking up at night? How often are you using the bathroom, right,

Women Menopause And Missed Apnea

SPEAKER_01 17:46

at night? Do you have heartburn or any sort of reflex at night? Like more of those kind of symptoms I'll see in patients. Do you feel like your sleep is unrefreshing? Do you feel like it's just not restorative? Is your sleep really broken throughout the night? Those kind of questions make me start thinking that there might be insomnia, but there might be other things going on as well.

SPEAKER_00 18:04

Perfect. What is your um opinion on sleep trackers? Do you usually ask these patients to track their sleep at home? Are the people kind of freaking out, looking at too many numbers? Can they actually make sleep worse for some people?

SPEAKER_01 18:17

Yeah. So in my population, I always make that kind of note. Um, the trackers, nine times out of ten, are making people more anxious about their sleep. And they actually are not. I always say, like, is it changing anything for you other than making you more anxious? Do you ever find that you're learning something from it to actually change how you're sleeping? You already are limiting alcohol, you're limiting your caffeine, you're consistent with your timing. What new are you getting it from? What new information? I said, Well, it just tells me how much it slept is like you know this internally, you don't need the exact number. Um, so I usually

Trackers And Bad Sleep Trends

SPEAKER_01 18:46

encourage almost all of my patients not to use them. Now, that being said, there are people out there. I have friends who don't have sleep problems. I I'm I'm a runner. I have a lot of friends who are runners and athletes who like to use them, the different types of trackers, to just kind of get some sense about their sleep, the regulatory, how much making sure they're getting enough sleep. And if they're not obsessing about it and they don't have a sleep disorder that's worsened, then it's fine. Use it. It gives you a little bit of insight. But most people with insomnia, it's highlighting what they already know, which is not helpful.

SPEAKER_00 19:16

Exactly. Okay. I have a ring, but I I actually ended up taking it off because it's never charged. Seriously, like the charge lasts for three days and I'm worrying it for three weeks. And I'm first of all, I'm not checking, you know, that I shouldn't make it.

SPEAKER_01 19:33

Yeah, that's a very different. Like if you're not obsessed, sometimes you're forgetting to charge it, that does or something. Um it's but I I think that a lot of times the trackers are just getting in the hands of the wrong people. So I I I always say to like a patient, it's like, if it you already make sleep a priority, do you need something to tell you to make it more of a priority? No. Right.

SPEAKER_00 19:55

And just one more thing for me to remember to one charge and to another one track and look at it. It tells me when I'm about to get my period, which that's interesting.

SPEAKER_01 20:04

Yeah, like I think there's actually really good use for it. Like we've had patients be diagnosed, um, so they'll use it. I mean, it doesn't diagnose sleep apnea, but you they'll see, like, um, they'll see their oxygen have DSATs at night, like they'll notice some of that stuff, and they think that it can be really helpful as like a tool. But for the average insomnia patient who's like, I just need it to tell me what stages of sleep, I'm like, that's not even always the most accurate. Accurate. Like, how are you gonna force yourself to get into more REM sleep? Like, you can't just will it to happen. We need to do other things.

SPEAKER_00 20:36

That's true. Um, since we're both on Instagram, social media is full of sleep advice. What is the one sleep trend or tip that makes you cringe?

SPEAKER_01 20:52

Well, the worst one that I've ever seen. I've talked about it here and there, is the um the NyQuil chicken. That was a few years ago. It was like there's I can't remember it was the people that do chicken breasts in NyQuil, like heating up NyQuil and cooking chicken in it, and they would be like, hashtag sleepy chicken, because I don't know, the chicken would make you sleepy, and then you add NyQuil. I thought it was turkey that makes you sleepy. Well, it's a combo of the turkey plus all the stuffing and the potatoes, not just the turkey. But it's it's that was probably like the most agreeable.

SPEAKER_00 21:27

Never heard of that.

SPEAKER_01 21:28

Yeah, don't please don't don't don't use NyQuil if you have routine insomnia. Like, that's not good either. But also don't cook a chicken breast. Chicken in it. That was so weird. Never heard of it. It was all over the place for like a month. So bizarre.

SPEAKER_00 21:43

I find that Americans really like to abuse regular medication. Like in Brazil, um, halls, you know, the the cough drop is candy. It's sold as candy, it's not sold as cough drops. And over here, I remember watching on TV that some uh teenagers were buying a bunch of cough drops, you know, and eating all the time. I'm like, I grew up eating that stuff all the time. But they're always trying to stick something, find something. Oh my goodness, it's crazy. To learn how to be present and be happy and party all the time without the pressure. Um, so women's sleep. You speak extensively about women's sleep. Uh, what do you wish more women understood about how hormones affect sleep? We touched on that a little bit, especially during perimenopause and menopause.

SPEAKER_01 22:34

Yeah, I think um one thing to notice is that sleep is is one of the things that can be an early. Sign. Like I've had plenty of women in their very early 40s that would never think that they were going into perimenopause where their insomnia was a sign that things were starting to change and that changes in estrogen and progesterone, those are big changes that happen that can really impact your sleep. And then when it comes to like just accepting that this is how it is, no, I mean, yes, it there is a natural process to it that changes, but it doesn't mean you have to suffer. And we have many different ways to address whether it's hot flashes, night sweats, working up with a busy brain, whether it's CBT, whether it's hormone therapy for some people. And we also have non-hormonal treatments. There's a lot of options out there. Hormone therapy also isn't indicated for everyone. And it doesn't help everyone as much as some of the messaging online is. But it's that you shouldn't just accept that it's what's going to happen and that you have to like put up with it. We have lots of treatments.

SPEAKER_00 23:40

I do have a question, personal question. Why do so many people wake up around 3 a.m.?

SPEAKER_01 23:46

I know it's funny. It used to always be, I used to get the question, it was always 2 a.m. Like, why do I always wake up two? And then all of a sudden, like over the past two years, it becomes 3 a.m., which I thought was interesting. Um, a lot of times it's it's it's what if people are going to bed around the same time, you finish a certain number of sleep cycles by 3 a.m. And a lot of times people are noticing their look at the clock and they finished a sleep cycle and you naturally have a quick awakening. People have trained themselves a lot of time. But it can also be due to um hormonal changes in the middle of the night, having to get up and use the bathroom. Like you've already, it depends on the person and what time they go to bed, but you've already been sleeping ideally four or five hours at that point. So it's like you're probably having some changes temperature-wise, hormonally, and then maybe a natural awakening where you look at the clock and have trained yourself.

SPEAKER_00 24:36

Um, is there one free sleep intervention that's more effective than people realize?

SPEAKER_01 24:44

Um, getting up at around the same time most days. So it doesn't have to be exactly like, for example, 7 a.m. It could be 7, 7:30, but like 7 a.m., 8:30, 7, 9, like that's not great. But getting up at the same time is actually really useful.

SPEAKER_00 24:58

Oh, this is gonna go great into uh, which I'm gonna change the subject from insomnia again. My kids are starting school tomorrow. Wow, okay. I know we're in the south. School starts tomorrow. How what is the fastest way that we can get them back to their sleep schedule?

SPEAKER_01 25:16

I mean, I think if it starts tomorrow,

Consistent Wake Time And School Reset

SPEAKER_01 25:17

it's just kind of hold on. Maybe like aim for like a half hour earlier. And then I usually recommend like because this is what most people like you can do the gradual advancing. I it's so rare that I find people that actually do that. Um, you can do all that, but it's get kind of just go to bed a little earlier tonight, kind of wind down earlier. And then the other big tip that I give is that so today is so tomorrow will be Wednesday. Try the first weekend afterwards. They might be a little sleep deprived because of all the shifted schedules and just excitement. Um, keep the weekend a little lighter so that you know, like people will like over-schedule the weekends right when school starts. I would I usually have people just keep it lighter and that can make it all transition.

SPEAKER_00 26:01

Perfect. Should I let them sleep in on the weekend? How old are they? 12 and six.

SPEAKER_01 26:07

Ah, I mean an hour, but not too much more than that. I wouldn't do too much more. The 12-year-old might start naturally shifting. Uh-huh. But yeah, if you could keep them, especially now, like around the same timing, that would help, but maybe an hour later, not much more.

SPEAKER_00 26:26

All right. Well, I have a couple rapid-fire myths or facts.

unknown 26:33

Sure.

SPEAKER_00 26:34

All right. So number one, everyone needs eight hours of sleep. Myth.

SPEAKER_01 26:39

It's a range, seven to nine for most people.

SPEAKER_00 26:42

Melatonin is a sleeping pill.

SPEAKER_01 26:46

Uh myth, it's more of a sleep shifter. So we use it for certain things, but not always on some insomnia for most people.

SPEAKER_00 26:55

Sleeping in on the weekends catches you up on lost sleep.

SPEAKER_01 27:00

Well, you've myth and fact. If you've only missed out on like an hour or two during the week, yeah, you can make that up. But most people are missing

Myth Busting And Closing Advice

SPEAKER_01 27:07

out a lot more over week after week that you're not going to be able to make it up on the weekend.

SPEAKER_00 27:13

Mouth tape is the answer for everyone.

SPEAKER_01 27:17

Myth.

SPEAKER_00 27:18

Myth, myth, myth. Sleep trackers improve sleep.

SPEAKER_01 27:24

Depending upon the person, but for people with sleep disorders, typically it's a myth right now.

SPEAKER_00 27:30

Um, no, this is a question. One sleep habit, everyone should stop.

SPEAKER_01 27:36

Um I mean, the most basic one is like using alcohol to help yourself go to sleep.

SPEAKER_00 27:43

Perfect. All right. And one sleep habit, everyone should start.

SPEAKER_01 27:48

Keeping a more consistent within an hour kind of wake time most days.

SPEAKER_00 27:52

Perfect. Well, if every healthcare provider listening today changed one thing about how they talk to their patients about sleep, what would you want it to be?

SPEAKER_01 28:02

Um, that it's not one size fits all, and that um patients are good, they understand their own, they're the best experts on themselves. So if they feel that a change has happened and their energy levels, their quality of sleep at night, send them for an evaluation from an MD, a sleep MD.

SPEAKER_00 28:21

That is wonderful, Dr. Harris. This has been such a wonderful um conversation with you. How can people find you?

SPEAKER_01 28:29

So you find me on Instagram at sleep shelby. You can also go to my website, um, like dr shelbyharris, dr shelbyharris.com. And you can find me in my books and everything there or on my Instagram.

SPEAKER_00 28:40

And before we go, do you have one last message that you hope every listener remembers after today's conversation?

SPEAKER_01 28:47

Um, that if you feel like something's off, talk to your provider. And if they're just brushing it away and saying, eh, it's nothing, get a second opinion.

SPEAKER_00 28:56

Perfect. Well, thank you so much. And for everybody listening, if you are a professional wanting to learn more, make sure that you join our Thursday Night Lives, which are Airway Circles, uh, online study club for airway professionals. Uh, every Thursday, 8 p.m. Eastern Standard Time. This week we have Dr. Karen Parker Davidson talking about nasal care uh in focus, evidence based products, pitfalls, and promises. It was such a great conversation. So join us on Thursday. Otherwise, make sure to follow us, Beauty of Breathing, on your favorite podcast platform. And thank you so much, Dr. Harris. That was wonderful. Have a wonderful day. You too. Take care. I'll see you later. Thank you. Bye.