[0:00] Welcome, my name is Dr. Warrick Bishop. I'm a cardiologist, an author and a keynote speaker. I'm CEO of the Healthy Heart Network. I'm all about trying to help people [0:12] Live as well as possible, for as long as possible. [0:15] heart disease is huge in Australia. [0:18] Every 20 minutes someone suffers a heart attack. Most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand blood pressure, weight, cholesterol and weight. [0:32] for better health. [0:33] If you enjoy this podcast, I would be honored for a five-star review. [0:37] you can share it with your family and friends. It may well save [0:41] someone you love. [0:43] G'day and welcome. It's Dr. Warrick here and thank you for joining me on my podcast and videocast station. [0:52] Super excited today to be sharing some... [0:55] research that's come across my desk [0:58] that I thought you might find interesting. I'm going to be talking about... [1:03] Sleep and hormones and bone health. [1:07] So... [1:09] Let's do it. [1:10] For those watching on video, I'm going to share my screen. So let's do it. [1:18] Thank you. [1:20] Well, there are a couple of... [1:25] reasons why today's presentation might well be helpful. [1:29] First of all is... [1:32] One of the common beliefs that we have that pink noise may be helpful for sleep. [1:38] And the other common belief is that hormone therapy can be risky. [1:45] So what does that mean? [1:47] Pink noise is background noise that's different to white noise. White noise tends to be same sort of... [2:00] volume, the multiple different frequencies. Think of a TV. It goes tsssss, like that, s, like tsssss. And pink noise tends to be the lower frequencies are slightly louder, so shh, [2:17] a bit like that. [2:19] I don't know if I did it very well, but pink noise, white noise. [2:24] Thank you. [2:24] And the reason why this is important is because some apps use pink noise for helping people sleep. [2:35] That equal intensity and white noise... [2:38] Generally considered not to be useful for restful sleep. The pink noise, the lower frequency is a bit stronger. Falling rain and the ocean tend to be considered as pink noise. [2:50] noise. And a number of apps use that sort of [2:55] background to help people sleep. [2:57] Well, I came across a study where they took 25 adults, put them through a sleep lab, and ran these different sound conditions using polysonography, which is a way to measure how well someone sleeps, to assess the impact of different sorts of noises. [3:17] Well, what turned out was that environmental noise, particularly white sort of noise, reduced deep sleep and shifted people to lighter sleep. I suppose if we think about that from an evolutionary perspective, then you might think that unnatural noise could well keep people more alert. [3:40] as a survival mechanism. [3:42] Well, one of the things that they found that was... [3:46] Very interesting is that when they used pink noise alone, it appeared to reduce REM sleep, rapid eye movement sleep, and didn't have any benefit at all for deep sleep. So it really didn't enhance the quality of sleep for those exposed to it. And this is interesting if you do happen to be using it in the circumstance of sleep. [4:14] apps for sleep. [4:16] *sniff* [4:18] What they found was that when you took pink noise and added external noise, it was even worse. People had even worse sleep. So if you've got pink noise, for example, rain or listening to the ocean as we were talking about before, but you've also got other noise added to that, you [4:37] Then there was less deep sleep and less REM sleep. So not a great combination. [4:45] And what worked? Well, you guessed it. Earplugs actually restored normal sleep. So if you block that noise out, it makes a difference. So maybe sleeping with those background noises isn't as good as we sometimes think it might be. [5:02] What was the takeaway? Well, silence is actually better than noise when it comes to sleep. [5:08] And earplugs, they're a pretty simple engine. They're a pretty cheap fix. I don't know if anyone's got any... [5:15] preferences for earplugs but I've used previously the ones that you can use for surfing or swimming but they're silicon you can ball them up you get about a week's use out of them but they're really good they fit in super well in your ear [5:33] The next topic I wanted to cover was hormone replacement therapy therapy. [5:39] And is it risky or not? [5:42] And does it have an impact on osteoporosis, osteopenia? Really, really important question because we know that about 40% of the entire population will suffer a... [5:57] fracture during their lifetime as a consequence of osteoporosis. [6:02] Many women [6:03] more than men. So HRT is really important in this space. [6:09] Well, the study that came across my desk looked at a [6:13] nearly 140,000 women [6:16] and compared early hormone replacement therapy versus [6:22] no hormone replacement therapy, and follow those individuals for five years, which is pretty robust. [6:30] Interestingly, at three years, there wasn't a great deal of difference. [6:35] But at five years, there was clear bettering outcomes for those on hormone replacement therapy. I guess what this tells us, really importantly... [6:47] is that [6:49] The rate is pretty slow, so no divergence or no difference between the two groups of three years. [6:58] just tells us this is a slow process and one that [7:01] really over time, takes a long time. [7:06] to define itself. Better outcomes at five years gives us some reassurance that given long enough [7:13] that that improvement really does occur. The mechanism is that estrogen does protect bone, and I think we're all aware that postmenopausally women will run into problems with their bone health as their estrogen levels drop. And this particular mechanism, [7:31] study really made the point that early hormone replacement therapy was important. Getting on top of it and being ahead rather than trying to catch up. Why is that the case? Well of course if this is such a slow moving process, waiting until you have to catch up is really waiting till too late. [7:53] There were some cautions in the study, it didn't appear to be everyone and the needs need to be individually assessed and of course you shouldn't just be buying hormone replacement therapy off the shelf, but it is a really important conversation. [8:07] And one for women as they're approaching menopause and entering menopause to be having with their general practitioner. We know that heart health is a little bit the same. Early commencement of hormone replacement therapy. [8:21] has been shown in the longer term to be beneficial, waiting until women are right through their menopause and then looking at commencing hormone replacement therapy nowhere near as beneficial. So what's today's message? If you want to sleep well, maybe block the noise out. Get earplugs. When it comes to... [8:41] hormone replacement therapy for osteoporosis. [8:46] It can work, it can help, it does take time, but earlier is better than later. [8:53] What I'd like to do is really thank you for joining me today. I really appreciate the opportunity to share. And I really appreciate that your time is limited. So if you've listened today, I know you've given me your time and I genuinely appreciate that. If you've got any queries or questions about anything that you'd like me to speak to, and remember we are now the Healthy Life Network, so I'm happy to either share from my own knowledge base or research and share with you as best as possible, let me know. I'd be delighted to. [9:23] Until next time, of course, I am going to wish you the very best, and I hope you live as well as possible. [9:28] For as long as possible, take care and bye for now. [9:32] Hi. Ever wondered what your risk of heart attack is? You should. It's the single biggest killer in the Western world. We're talking one death. [9:41] less than every 30 minutes in Australia one death [9:45] less than every 60 seconds in the United States, nine [9:49] million deaths globally. [9:52] per annum. Well how do you check your risk? Well you can go to [9:57] www.virtualheartcheck.com.au. You'll find out about your risk and what can be done beyond that to be even more precise.