Ep. 514 Exhausted But Can’t Sleep? The Best Fixes for Insomnia, Sleep Apnea & Night-Time Anxiety with Dr. Andrea Matsumura

I am delighted to connect with Dr. Andrea Matsumura today. Dr. Matsumura, affectionately known as the Sleep Goddess, is a board-certified sleep medicine physician, menopause expert, speaker, and the founder of the Dream Sleep Method.  In our conversation today, we explore how different life stages impact our sleep quality. We discuss the effects of wearable technology, orthosomnia, and sleep stages, and explain why sleep quality is more important than its quantity. Dr. Matsumura highlights the red flags for sleep, breaks down how sleep deprivation affects our health, and examines specific sleep issues, including sleep-disordered breathing, Upper Airway Resistance Syndrome, chronic insomnia, and the challenges of shift work. She explains why sleep apnea is seen more commonly in menopause, and how it occurs in 67% of menopausal women, yet most fail to realize that they have it. We also tackle the risks of untreated sleep apnea and the sleep syndrome of menopause, sharing ways to address sleep issues with appliances, technology, medications, cognitive behavioral therapy, and ACT therapy, and pointing out those that have proven to be ineffective.  This conversation with Dr. Matsumura is truly invaluable, and I look forward to reconnecting once her new book is published. IN THIS EPISODE, YOU WILL LEARN: How hormone changes in menopause impact airway function and sleep quality. Why sleep apnea in women often goes undiagnosed  How fragmented sleep affects brain function and mood Why even mild sleep apnea can have significant health consequences How different hormones influence specific stages of sleep. How hormone therapy can improve sleep quality without curing sleep apnea The value of oral devices and positional strategies for supporting breathing at night How CPAP therapy can transform sleep and improve cardiovascular health The benefits of cognitive behavioral therapy for addressing insomnia  Why prescription medications and supplements seldom solve long-term sleep problems Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Andrea Matsumura On her website Instagram Pre-order Dr. Andrea’s book, The New Perimenopause.

I am thrilled to reconnect with my dear friend, Dr. Stephanie Estima, today. In this episode, we dive into questions from listeners once more, exploring topics that range from navigating the challenges of perimenopause and parenting to shifting perspectives on fasting, nutrition, and changes in hunger and thirst cues, especially during perimenopause and menopause. We also examine how dairy may become an inflammatory food item in midlife, the benefits of hormesis, hormone therapy, and so much more. Our conversation today is honest and warm, so it is like sitting down with two close friends. Both Stephanie and I look forward to sharing many more of these Q&A sessions with you in the future. IN THIS EPISODE, YOU WILL LEARN: Some advice for mothers navigating perimenopause  How to adjust your fasting in midlife What perimenopause and menopause mean for satiety and hydration signals, and how to adapt Why some women find dairy problematic in midlife, and how to experiment with reducing it How hormesis builds resilience, and how stressors, like exercise, fasting, and cold/heat exposure, can improve metabolic and overall health What you need to consider with hormones like DHEA and pregnenolone How women with MTHFR can support methylation and detox pathways The benefits of combining strength training, Zone 2 cardio, and occasional HIIT for fitness in midlife Why you should embrace your callouses as badges of honor instead of trying to remove them The value of micro-dosing with peptides and GLP-1s Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Stephanie Estima On Instagram On her weekly podcast, Better! With Dr. Stephanie

I am honored to connect with Esther Blum today! She is the bestselling author of "Cavewomen Don’t Get Fat," "Eat, Drink, and Be Gorgeous," and most recently, "See Ya Later, Ovulator!". Esther currently maintains a busy virtual practice where she helps women balance hormones, lose stubborn body fat, and treat the root cause of health struggles.  Today we speak about medical gaslighting, how weight gain does not have to be a part of aging, andropause and menopause, and the Women’s Health Initiative. We dive into physical changes and significant symptoms during perimenopause and menopause, the role of the pelvic floor, deciphering what the dreaded “menopot” is, what does not work, and advocacy in terms of testing and hormones. We also address constipation, weight loss resistance, and how our tolerance for alcohol changes as we age, especially when using bioidenticals or hormone replacement therapy.  IN THIS EPISODE YOU WILL LEARN: How women can redefine their experience and continue having an active sex life after menopause. How to surrender, lean in, and take the pressure off yourself while going through perimenopause and menopause. Why is there so much misinformation and medical gaslighting in our society? Why Esther wrote See Ya Later, Ovulator! Some common symptoms of perimenopause. Risks women may face after a hysterectomy. Changes that happen in the vaginal canal and pelvic floor during menopause. The significant and profound impact of the decline of sex hormones. How to avoid weight gain in menopause. What can menopausal women do to prevent fatty liver and digestive problems? Lab tests women should be asking their health providers for. Why should perimenopausal women avoid alcohol?  Some simple ways to address constipation. Connect with Cynthia Thurlow Follow on ⁠Twitter⁠, ⁠Instagram⁠ & ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Connect with Esther Blum On her ⁠website⁠ On ⁠Facebook⁠, ⁠Instagram⁠, ⁠LinkedIn⁠ Get your ⁠free copy of Esther’s Happy Hormone Cocktail⁠ Esther’s Books ⁠Esther’s book, See Ya Later, Ovulator!⁠, by Esther Blum ⁠Cavewomen Don’t Get Fat⁠, by Esther Blum ⁠Eat, Drink, and Be Happy⁠, by Esther Blum

I have received many requests for a masterclass on the gut microbiome, so I am excited to share one with you today. In our masterclass today, I discuss the microgenderome, explaining how the gut microbiome changes throughout our lives, during puberty, pregnancy, and perimenopause. I cover the key shifts in the microbiome that occur, especially as estrogen and progesterone fluctuate. I unpack the symptoms women experience that indicate their microbiome may be non-optimized, offering practical solutions, including lifestyle strategies, hormones, peptides, and targeted supplements. My goal is to do a solo episode every month. Please let me know which aspect you enjoyed the most, and what you would like to hear more about in my future monthly solo episodes. IN THIS EPISODE, YOU WILL LEARN: Why protein is critical in midlife, and how much of it you need to consume An easy way to incorporate the many different plant varieties you need to consume every week into your meals  Why fermented foods and prebiotics are essential for your gut health The benefits of giving your digestive system a 12-hour break each day How chronic stress affects your weight, hormones, and gut function The connection between sleep quality, gut health, and hormonal changes in midlife How to balance exercise intensity in midlife to support muscle maintenance and recovery Specific supplements to support gut integrity and energy production How hormone replacement therapy impacts the metabolism and microbial diversity  The value of improving your gut health to reduce menopausal symptoms Connect with Cynthia Thurlow   Follow on ⁠X⁠ ⁠Instagram⁠ ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Submit your questions to ⁠[email protected]⁠

Today, we have another episode in a series of conversations with experts and highly vetted companies. In this episode, we feature CocoaVia, a brand of cocoa flavanol supplements made from a proprietary cocoa extract that aims to support cognition and heart health. I am delighted to welcome Dr. Amy Shah, who trained at Cornell, Harvard, and Columbia. Dr. Shah is a well-known expert on metabolic health and intermittent fasting. With a background in internal medicine, allergies, and immunology, she has helped many patients transform their health with cutting-edge nutritional and medical science.  In our conversation, we explore cocoa flavanols, explaining what they are, their benefits, and how they work mechanistically. We discuss how perimenopause and menopause can lead to endothelial dysfunction due to low sex hormones, and the effects of lifestyle factors like circadian rhythm alignment. Dr. Shah shares foods she finds particularly helpful for middle-aged women and reviews the research on cocoa flavanols. We also cover the impact of cocoa flavanols on health span, longevity, and brain health, including improvements in memory, word recall, and spatial reasoning, and Dr. Shah offers guidance on supporting the maturation and health of teens and young adults. Today’s conversation with Dr. Shah is practical and evidence-based. I also share how cocoa flavanols have helped my younger son’s focus and attention, and how my husband and I use these products in our daily lives. IN THIS EPISODE, YOU WILL LEARN: How cocoa flavanols support heart health, brain health, and longevity Why nitric oxide production matters for vascular flexibility, especially in perimenopause How circadian rhythm optimization improves energy, mood, and metabolic health Why introducing fiber and probiotic foods slowly may be necessary for gut adaptation How cocoa flavanols and other bioactives can enhance health span and lifespan The importance of selecting the right supplement quality and dose to prevent ineffectiveness or excess How cocoa flavanols can improve cognition, memory, and brain function over 8–12 weeks Why natural drinks (coffee, cocoa flavanols) are far better than energy drinks or caffeine for teens How combining core lifestyle habits with targeted bioactive compounds supports long-term health and longevity Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Amy Shah On her website CocoaVia

I am thrilled to have Gary Taubes back on the show today. (He was with me before on episode 137. Gary is an investigative science and health journalist whose work has been pivotal in catalyzing the low-carb keto movement. He has written many books, including his most recent, Rethinking Diabetes, and his articles are in many of the best anthologies. He has also received many science awards. Today's discussion is particularly significant, given the recent report from the American Diabetes Association revealing that the annual cost of diabetes in the United States reached a staggering $412.9 billion in 2022, with individuals diagnosed with diabetes now representing one in every four dollars spent on healthcare.  In our discussion today, we dive into the history of diabetes, pertinent statistics, the prevailing standard of care, and the transformative influence of insulin on diabetes management and reactive hypoglycemia. Gary provides insights into his reactions to GLP ones, the integration of medical and nutrition science into the medical field, and the influence of organizations such as the American Diabetes Association, AHA, USDA, and NIH. Our discussion also extends to the effects of pharmaceuticals, the shortcomings in our approach to diabetes management and existing models, and the challenge the low-carb community faces. Stay tuned for today's eye-opening conversation, where we shed light on the complexities surrounding diabetes care, explaining how simple lifestyle changes can tremendously improve quality of life. IN THIS EPISODE YOU WILL LEARN: Rethinking Diabetes is a groundbreaking exploration of diabetes diagnosis, management, and treatment Gary discusses the evolution of evidence-based medicine Why the traditional medical approach to treating diabetes is inadequate How the guidelines of the American Diabetes Association were based on outdated assumptions  How medical treatments compare with lifestyle changes for managing diabetes Controversies surrounding how the pharmaceutical industry has influenced the way medical associations have shaped their diabetes management policies How medical guidelines and dietary advice have evolved What constitutes a healthy diet? How patients often have trouble following diet recommendations, despite their best intentions Is obesity a hormonal disorder or caused by overeating?  Connect with Cynthia Thurlow Follow on X, ⁠Instagram⁠ & ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Submit your questions to [email protected] Connect with Gary Taubes On his ⁠website⁠ X ⁠Facebook⁠ Previous Episode Mentioned ⁠Ep. 137 – High Blood Sugar Levels And Its Long-Term Damage with Gary Taubes⁠ Book Mentioned: Rethinking Diabetes: What Science Reveals About Diet, Insulin, and Successful Treatments is available from most bookstores or on ⁠Amazon⁠.

As a nurse practitioner, I feel a deep responsibility to my listeners and community to ensure that every guest I bring on shares accurate, evidence-based information. A few months ago, I decided to remove two podcasts from earlier this year to make way for an expert who could speak specifically and authoritatively on breast cancer health. So, I am honored to welcome Dr. Robin Roth today, better known as The Boobie Docs, on her popular breast health social media platform, where she shares information about breast cancer in a fun and educational way.  Dr. Roth is an associate professor of radiology, specializing in breast and abdominal imaging. She is also the host of The Girlfriend's Guide to Breast Cancer podcast, created to support those navigating a breast cancer diagnosis or caring for a loved one. In our discussion today, we dive into misinformation about breast health and breast imaging. We explore the importance of acknowledging disinformation on social media, risk factors for early breast cancer screening, significant and modifiable risk factors, and the effects of dense breast tissue. We examine breast imaging, exploring ultrasound and mammography, the differences between 2D and 3D mammograms (the gold standard), and when to use MRIs. We clarify why thermography and QT imaging are not the gold standard, and why we need to request different types of imaging modalities. We discuss the importance of screenings, challenges, including diagnoses like DCIS, personalized approaches to breast cancer screening, breast cancer staging, and issues with imaging after mastectomies and with implant placement. Dr. Roth also explains how 80% of breast biopsies end up being benign, how to manage anxiety and callbacks for mammograms, how to understand lab reports in plain language terms, and the benefits of supportive resources like cancerbesties.com. With her expertise and approachable style, Dr. Roth reminds us that proper information can make all the difference when it comes to breast health. You will not want to miss this conversation, especially during Breast Cancer Awareness Month. IN THIS EPISODE, YOU WILL LEARN: How online platforms fuel confusion around breast health and imaging Disinformation may influence breast cancer screening decisions Modifiable factors that can reduce or increase your risk of breast cancer Why dense breast tissue matters for imaging accuracy Ultrasounds, 2D and 3D mammograms, and MRIs  Thermography and QT imaging are not gold standards Why every individual DCIS diagnosis needs a personalized approach Breast cancer staging and how it guides treatment 80% of biopsies are benign, but still essential How to manage anxiety around callbacks and make sense of lab reports Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Robyn Roth On her website Social Media: @the boobie docs Preorder a copy of Everyone Has Boobies

Today, I am thrilled to reconnect with a friend and colleague, Dr. Mariza Snyder, to discuss her new book, The Perimenopause Revolution.  In our conversation, we explore some of the most pressing challenges around aging, including shame in a youth-obsessed culture, the lack of research on women’s health, and the physical toll of the aging process. We explain why the menstrual cycle should be considered a fifth vital sign, and what happens when metabolic health begins to decline in midlife, highlighting the value of apps and technology in empowering women to track their cycles. Dr. Mariza clarifies why biometrics, VO₂ Max, DEXA scans, and grip strength matter. She also shares her core pillars of metabolic health and the non-negotiables she believes make the most difference for women navigating the perimenopause-to-menopause transition. I truly enjoyed Dr. Mariza’s book, and I know it will be a powerful resource for women who want to take charge of their metabolic health during perimenopause and beyond. IN THIS EPISODE, YOU WILL LEARN: How hormonal shifts in midlife can alter energy, mood, and metabolism in unexpected ways Changes that ripple through sleep, stress, and cognition during perimenopause Why, in perimenopause, old diet and exercise strategies often stop working the way they used to  How cultural messages around aging fuel shame and confusion for women How DEXA scans reveal much more about your body composition than weighing yourself does What lab work can reveal about hidden risks  Why you should consider doing bone and muscle scans early in life The benefits of daily strength training for maintaining vitality and independence How regular movement stabilizes energy and glucose levels Why food choices become a critical foundation during midlife transitions Bio:  Dr. Mariza Snyder is a powerhouse advocate for midlife women, leveraging 17+ years as a practitioner, author, and speaker to spark a massive movement for women in perimenopause and beyond. With her top-rated Energized with Dr. Mariza podcast (13 million downloads) and a passionate social media audience with over 400K and 8 million monthly views, she’s a trusted guide—offering science-backed solutions for perimenopause and metabolic health. Her upcoming book, The Perimenopause Revolution (Hay House, October 2025), is the ultimate resource for women ready to take charge of their health and embrace perimenopause with resilience and confidence. Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Mariza Snyder On her website Energized with Dr. Mariza Podcast The Perimenopause Revolution

I’m honored to reconnect with Dr. Felice Gersh today! She is a multi-award-winning physician with dual board certification in OB-GYN and Integrative Medicine. We connected once before in Episode 221, where we spoke about PCOS and metabolic health. Today, Dr. Gersh joins me to dive into perimenopause and menopause. We discuss various issues surrounding the Women’s Health Initiative and talk about estrogen as a family of hormones, estrogen-mimicking chemicals, synthetic hormones, and oral contraceptives. We get into the importance of thyroid function, the pro-inflammatory state of a loss of estrogen in perimenopause and menopause, and the importance of nutrition and exercise for metabolism. We also speak about the lesser-known changes that occur in menopause, including changes in body odor, constipation, sarcopenia, osteoporosis, and vocal changes.  I intend to invite Dr. Gersh back again to discuss women and mitochondrial health, and then once again to talk about her latest book, Menopause: The Fifty Things You Need to Know.  Stay tuned to find out what menopause really is, and what it does to a woman’s metabolic system. IN THIS EPISODE YOU WILL LEARN: The Women’s Health Initiative study and its devastating effects Differences between synthetic and bioidentical hormones How chronic diseases of aging can be delayed when hormones are incorporated along with other lifestyle refinements What do hormones do? Why every immune cell in the body has receptors for vital hormones Menopause is not defined by a specific moment in time. Changes that occur physiologically during the perimenopause years How hormones can change the perimenopause paradigm  Why perimenopause translates into many sleep issues Phytoestrogens: nature’s gift to women Connect with Cynthia Thurlow Follow onX ⁠Instagram ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠  Connect with Dr. Felice Gersh On her website: ⁠Integrative Medical Group of Irvine⁠ Instagram⁠ All of Dr. Gersh’s books are available on ⁠Amazon⁠ ⁠Episode 221 on PCOS with Dr. Felice Gersh⁠

I am delighted to connect with a physician friend and colleague, Dr. Heather Hirsch, today. Dr. Hirsch is an entrepreneur and a board-certified internist by the American Board of Internal Medicine. She is also the Founder and CEO of Health by Heather Hirsch, and has a telemedicine practice offering best-in-class individualized care for perimenopause and menopause. In our discussion, we explore heavy menstrual cycles and the benefits of journaling and shared decision-making. We discuss common and frustrating causes of weight loss resistance in middle age, the power of strength training and adequate protein intake, and estrogen as a metabolic regulator that is intricately linked to many physical systems, including digestion. We also examine how educating clinicians on shifts in estrogen, progesterone, and testosterone during perimenopause could prevent countless ER visits, and we tackle concerns surrounding contraception and pregnancy prevention in perimenopause, a biopsychosocial approach to low libido, and the often-overlooked silent symptoms Dr. Hirsch often sees in perimenopause and beyond. Today’s conversation with Dr. Hirsch is truly invaluable. I highly recommend her Perimenopause Survival Guide, written by an internal medicine doctor extremely well-versed in perimenopause and menopause. IN THIS EPISODE, YOU WILL LEARN: How hormonal fluctuations disrupt the body and create confusion in perimenopause The benefits of journaling  How hormonal and lifestyle shifts disrupt metabolism, weight, and insulin sensitivity during perimenopause Why body composition changes matter more than your weight How declining estrogen affects insulin resistance, metabolism, and diabetes risk The value of shared decision-making  How hormones, medications, sleep, relationships, and past trauma can cause changes in libido  How siloed healthcare often leaves perimenopause symptoms misunderstood  How irregular ovulation increases pregnancy risk and why hormone therapy is not a contraceptive Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Heather Hirsch On her website YouTube  Social media: @Heather Hirsch MD