How your palms and feet help you sleep

The AVAs and a list of 19 other sleep considerations.

As always, this is not medical advice, and reading this does not form a client relationship with me- your health is your responsibility.

This newsletter will update week 2 of my intuitive fat-loss phase and a sleep tip that has worked for my clients and myself with insomnia and premature waking. Please feel free to skip to the parts you care about.

Intuitive fat-loss phase end of week two update: as of Monday, 10 October, I averaged 114.9lbs. The scale shows 114.2lbs today, Wednesday, 12 October, which I am surprised by as I am about to start my period. I am surprised because, like most women, my water weight usually increases right beforehand. I also have been consuming more carbohydrates, which can increase total body water from glycogen storage - 1g of glycogen binds 4g of water. However, my focus on consuming adequate protein is arguably a big reason for the limited range in my water weight fluctuations.

Considering Monday to Monday (3 October to 10 October), that is another 1lbs average scale weight loss, so a loss of ~0.86%. Again, I am very pleased with the change because, as I noted in my last newsletter, the 12 guidelines I set for myself are manageable, and I did not have to change my lifestyle much to meet them. The guidelines are in my 26 September (Intuitive Fat Loss) newsletter.

I want to emphasize that I spent ~25 months reversing and at maintenance tracking pretty much every day leading into this phase. As such, I have developed the ability to look at most things I eat to determine how much protein, etc. I am getting from them. I also think the longer period of not being in a fat-loss phase was necessary to make this one so successful. This phase has also made me realize I need to focus more on a muscle building phase after I spend some time at maintenance.

The guidelines that have helped the most so far are -

1. Consuming enough protein that does not cause me to have blood glucose swings.

2. The low volume, pushing to failure for mechanical tension focus that Paul includes in his lifting programs.

3. Being mindful when eating - taking a breath before starting, thoroughly chewing, taking longer to eat in general, and stopping the moment of satiation.

4. Allowing myself to feel some hunger.

Flobility continues to help my parasympathetic to sympathetic tone. This has been helpful to keep stress down, so I am not wasting macros to lactate, etc.- this would decrease the overall amount of ATP I would make from taking them through the full metabolic cycle. Walking has allowed me to keep my NEAT up. I also have found that I am still fidgeting like before. My husband will corroborate this, given my knee bouncing, causing the car to shake when I drive. I find this to be interesting as fidgeting seems to be one of the first things to drop off as a biofeedback marker with a reduction in calories. I will continue monitoring this and see if it drops off during these 6-weeks. Two weeks of 4 sessions of 45min zone 2 cardio was a little intense and impacted my recovery from Flo and lifting. I was incredibly grateful to enter this week with only three sessions. I have been working through the 3-part couch to 40k series on the Nordictrack bike and am in the Iceland part. The rides are beautiful, and I appreciate how the bike changes resistance and incline to "match" what the actual riders are experiencing.

Sleep Tip: Warm up your feet, hands, and, if possible, your face ~30min before sleeping.

Like many, I used to have debilitating insomnia and would wake up early. Some days I could fall back asleep, but then I would wake groggy; not having "energy" until later in the day. If I woke up and stayed awake, usually adrenaline would kick in, and I would be able to function somewhat well throughout the day - especially if it was only a matter of waking up early vs. being unable to fall asleep. However, if this pattern continued, I would eventually crash - the ability to sleep all weekend has saved me many times. Obviously, I could not do that once I became a mom, so I had to figure out how to fix my sleep.

The worst was being unable to fall asleep. Again, like most of my clients with insomnia, my brain was running "a mile a minute," and I could not "lower the noise" enough to sleep. While sleeping is more of a "parasympathetic" state, the ability to fall and stay asleep is energy intensive. I quote parasympathetic because "rest and digest" still require energy, so they are not what I would consider a relaxed state. Also, if one is in an excitotoxic state from - excess glutamate stimulating the NMDA and/ or AMPA "receptors;" excess estrogen using resources for proliferation; excess catecholamines due to overproduction or decreased breakdown; the inability to restore proper Ca+2 oscillations via insufficient ATP, again back to energy, etc.- falling asleep may "be out of ones reach." We often go to food, supplements, and/or drink "stimulators" to get us through the day. However, this can lead to a perpetual cycle of buffering poor sleep with external compounds. As the body builds a tolerance to these things - liver excretion, "receptor down-regulation", etc. - one will need to use an increased amount to achieve the same effect.

Eventually, the body will fall asleep. However, if you have experienced this form of sleep, it is usually not restful or reinvigorating - one wakes up feeling as if one needs another sleep to recover from the night. If one is tracking their sleep data, many will see a reduction in deep and/or REM sleep. Deep sleep, also known as slow-wave sleep (SWS), seems to occur during the early phases of sleep. Many will tout the importance of getting sleep before 12 AM because of this. SWS seems to be what our body uses to integrate new movements and consolidate memories. If I wake up from a deep sleep phase, I am "dead to the world" for a while as my body "starts up" again. REM, or rapid eye movement sleep, seems to be our body's "internal psychologist" - according to Dr. Andrew Huberman, we "unlearn fear and uncouple emotions from traumatic events during this stage." One can see how people can become anxious, paranoid, etc., from insufficient REM sleep.

I look at sleep trackers like calorie, macro, and micro trackers. They can be helpful for a period of time to help you correlate how much REM, SWS, and light sleep you are getting. Then, once you know, more intuitive sleep tracking periods can be helpful. I also think many nocebo themselves sometimes and become dependent on them. Exactly like when people can become too dependent, "orthorexic," etc., when using a food tracker. You may wake up feeling refreshed, recovered, and ready to go about your day, then you look at your sleep score, and it says you did not get as much REM, etc. All that to say, I do not think everyone needs to use a sleep tracker. Of course, adrenaline, etc., can give the appearance that your sleep was better than it was. Yet, over time you will notice other symptoms.

Most things abide by the Pareto principle - 80% of effects or outcomes are due to 20% of causes - also known as the law of the vital few. As such, most waste their time searching and trying the other 80% of causes that give one the remaining 20% effects. I am not judging; I used to jump around lifting protocols, diets, supplements, etc. I did this, especially when I was at my "lowest" health-wise. I will say having recurring rhabdomyolysis, losing the amount of muscle I did, having my GFR crash to the point it did, etc., made me frantic in trying to "save" myself as the "best" doctors in their fields could only offer me - "try not to get sick or too stressed." As an aside, this franticness showed everywhere - from driving fast, almost as if trying to "escape" my body, to how I dealt with external stress, etc. I have not written my health story yet, but I intend to as a newsletter soon.

Sleep is one of the things I would put in the 20% cause category. Given the above, telling someone "get more sleep" is easier said than done. I am especially looking at my fellow moms out there! And in my case, "put your head down and close your eyes" was not sufficient. As such, most of my clients and I have tried most of the common "hacks" -

1. Blue blocking glasses once the sun goes down

2. Sunrise sun gazing

3. Morning, solar noon, and evening sun

4. No caffeine - I do not drink much caffeine since I do not clear it well anyways

5. Red lights/ Organic bees wax candles once the sun goes down

6. Going to sleep within one hour of the sun setting

7. Circadian meal timing - stop eating 3 hours before bed; casein shake before bed; etc.

8. Magnesium - threonate, bisglycinate, etc.

9. L-theanine - a disaster for me; some of my clients do well with this + caffeine

10. Prayer/ meditation.

11. Non-sleep deep rest.

12. Mouth taping - I only mouth breathe when I am sick; this has also helped many of my clients.

13. Proper tongue posture - mewing and inter-oral face pulling. When I was younger, I had an expander for my top palate, complete with the "key" on the floss. My tongue still did not fully rest against my palate. IOFP for ~2 months, along with Flo corrected that. I still have some face asymmetry that I am working to correct.

14. Sleep frequencies/ music

15. Consistent sleep and wake times

16. Baking soda/ K bicarb and bag breathing

17. Progesterone - topical, sublingual, by mouth, and intravaginal for inhibiting adrenaline and cortisol, and increased GABA-A "receptor" agonist allopregnanolone.

18. Zinc - this has helped me and others at first, but it can lower cortisol too much and cause a low cortisol awakening response. The low CAR can show itself if you wake up and your tracker shows you had a "good night's sleep" but you are having difficulty "getting going." An insufficient cortisol response can also be a reason for an adrenaline response to T3. Zn also helps the uptake of serotonin in the brain. I have had non-medication-induced (supplement-induced) serotonin syndrome, so I do not do well with most things that increase serotonin or limit its breakdown. Many started consuming Zn because of "covid" and now have energy issues - even "long-Covid". Also, I am not saying Zn is the only reason you have CFS/ ME - I am intrigued by the IDO1 and itaconate shunt theories (more on these later). I would consider if you have been consuming too much Zn. Like every other micronutrient (known and still unknown), we need zinc. As such, I would ensure you get at least the RDAs daily. And if you have been overconsuming one divalent cation like Zn, Fe, Ca, etc., consider if you need to increase your food/ supplement intake of the others.

19. B vitamins - I caution taking most at night.

I would consider the above list if you do have sleep issues and there are many more things to add to the list. But this is closing in on 2000 words so let me get to the point. My clients and I have found warming your hands and feet and keeping them warm (wool socks and gloves if necessary) to be the best way to deal with insomnia and early wakeups.

Sleep experts will tell you to keep your sleeping space cooler; I do not disagree. However, your hands and feet need to be warm. They can become too warm, so this does become a balancing act. Also, insufficient circulation and things related to insufficient muscle mass, POTs, Raynauds, hypothyroidism, excess estrogen/ other stress hormones, etc., can cause your hands, feet, nose, and glute max to be cold throughout the day. Additionally, the glute max is interesting regarding things like anterior pelvic tilt, sway back posture, glute hypertrophy, etc. If you have any of the above confounding variables, I will again ask, how long have you spent on maintenance and/ or a reverse diet? What is your dieting history like?

Why the palms, feet, and face? These areas have glabrous skin, which means they lack hair. They also have Arterio-Venous Anastamoses (AVAs). AVAs connect the small veins directly to the small arteries. Adrenergic neurons also modulate the AVAs - so those with epinephrine and norepinephrine issues can see why warming these areas can be difficult. Due to their fluid dynamics, heat leaves faster, and there is a greater cool gradient through these areas. The AVAs impact brain and core body temperature via a direct connection to the hypothalamus in the brain. The hypothalamus controls the pituitary and autonomic nervous system and connects our endocrine and nervous systems. Many are now measuring their core body temperatures as a gauge of thyroid health, which is great! But, I would consider, are the AVAs at play as to why your body temperature is lower than ~98.6F?

I used to do this intuitively as a child - I would lay on my stomach and place my hands underneath me while crossing my feet.

A reason this potentially helps with waking early is the energy (glycogen, hormones, etc.) needed to get to sleep is conserved. That way, you have resources available during the cortisol awakening response, liver time, etc

Consider externally warming these body parts before going to sleep and throughout the day if your biofeedback markers are not optimal or you have one of the diagnoses listed above. Foot and hand baths are great, as is getting in a bathtub. Epsom salts and some ascorbic acid (if you have some Cl in your water) can be great additions to both. As always with any supplement, even in the bath, I caution starting a low dose and building slow. While many may be deficient in magnesium and others claim the "Mg burn-rate" that Mg actually has to make it into the cell as most should be intracellular. And with AA, one should consider any oxalate issues and the antioxidant recycling cascade. Also, if one has POTs/ Dysautonomia related issues, please be cautious in how hot you make the water.

I would also consider structure and potential nerve innervation issues. As a last thought, if we "correct" the "Cushings hump," do we correct Cushing's? Likewise, if we do things to restore heat and circulation to the hands, feet, and face, thereby increasing the brain and core body temperature, do we correct Raynauds, hypothyroidism, etc.?

Please comment below if you have done this before and its impacts (positive or negative) on your sleep. If you have not, give it a try, and let us know!

Please let me know what questions you have below. I also do individual coaching and give people the tools necessary to go through these phases - biofeedback optimization/ reverse dieting, maintenance, and fat loss - and structure. Also, supplementation considerations, specific health issues, etc. If what I am sharing interests you, please contact me!