PP 685: Effects of Sleep Deprivation: Drop everything and Sleep! with Elizabeth Hughes

Are you feeling stressed out, tired, listless, and unproductive? If so, get some sleep! Those are signs of sleep deprivation! And that’s the secret to productivity everybody is missing. Often we find ourselves awake and working when we should be sleeping. Join Kim and Elizabeth Hughes as they talk about the direct correlation between sleep and productivity. They discuss how a deep restful sleep helps in the overall physiological processes, which in turn equates to efficiency and functionality. On top of that, get some helpful tips on how to get the best out of your diet, experience better sleep, say NO without guilt and arguments to buy yourself more sleep time, and build a healthy concept of relaxation.

We’ve always had a blind spot in medicine. But everybody, doctors themselves included, needs to give themselves the sleep they deserve. This is the real antidote to stress. So before you pop another pill, make sure to check out today’s episode! 

“You don’t have to wear yourself thin in order to give the best.”  – Elizabeth Hughes


02:24 Sleep Is Productive
10:00 Healthy Lifestyle
16:17 Find Your Purpose
23:18 Stress & Sleep Together
30:39 Setting Boundaries Around Everything
45:11 Effect Of Stress
48:08 Self Healing
55:31 Learn & Listen To Our Patients

The secret to productivity and a stress-free life revealed: sleep. Listen in as @thekimsutton and @ehughesmd talk about the biology, practicality, and urgency of getting a deep restful sleep. #positiveproductivity#podcast#sleepisproductive#healthylifestyleClick To Tweet

Resources Mentioned


Inspirational Quotes:

04:34 “Sleep is this prime time when your body is working hard while you’re relaxing.” – Elizabeth Hughes

17:46  “Illness happens for us, not to us.” – Elizabeth Hughes

24:28 “You could never ever get the productive deep rest that you need when you’re in the state of constant stress.” – Elizabeth Hughes

34:45 “You don’t have to wear yourself thin in order to give the best.”  – Elizabeth Hughes

49:52 “The body works at its own pace and you need to give it that time and understanding.” – Elizabeth Hughes

55:04 “Take care of yourself now or it will be worse.”  – Elizabeth Hughes

01:05:59 “Stress may be common, but it’s not normal and it’s not healthy, so don’t neglect your own self care.”  – Elizabeth Hughes

About Elizabeth Hughes:

Elizabeth is a Board Certified Dermatologist, a Registered Yoga Teacher, an advanced PSYCH-K facilitator, and a Whole Health Medicine Institute certified provider. Elizabeth received her undergraduate degree from Princeton University and her medical degree from the University of Virginia. She did advanced medical training at the University of Pennsylvania and Stanford University. After completing her residency she joined the Stanford faculty, where she taught for eight years. After witnessing the nearly spontaneous resolution of an “incurable” disease, Elizabeth became obsessed with finding out why mainstream medicine fails so many people. She combines her medical background with wide ranging studies of alternative modalities of health and healing into a one of a kind system designed to help people who feel like their lives have been hijacked by exhaustion and brain fog reclaim their energy and mental clarity.

Welcome back to another episode of Positive Productivity. This is your host Kim Sutton. Today, I am just going to jump right in to introducing our guests, Dr. Elizabeth Hughes. I am so excited about this conversation because we’re going to be talking about stress, fatigue, how we need to be taking care of ourselves and so much more.

But before I throw the mic over to Elizabeth, I want you to go back, if this is your first episode, I want you to go back to listen to episode #5, you can find it down below. Episode #5 was actually titled, “Sleep, and why would rather you do it than listen to me.”

I have been through two major cycles of sleep deprivation in my various entrepreneurial journeys. The first major cycle was in 2008, when I was actually admitted to the mental hospital due to the effects sleep deprivation and not taking care of myself. And the second was in 2016, just prior to the Positive Productivity Podcast launching.

I was suicidal, I nearly gave up at all, because for 8, or for 18 months, I’d only been sleeping two to three hours of night. I was on a mad quest to achieve everybody else’s successes, and I had forgotten what my own look like; I thought it was all about money. I didn’t think about all the other facets of happiness, of which money is not even on my radar anymore. I just wanted my bills to get paid.

So, if you have not yet listened to that episode, please go back and listen to it. But if you are severely exhausted right now, just pause, go to sleep and come back later. That is so much more important. With all that said…

The war on Sleep

Elizabeth, I am so happy you are here.

Oh, I’m so happy to be here, and I love the idea of talking about the importance of sleep! We can start there if you want, hehe.

Oh, please. I need to tell you, there was a time in my business like 2015, 2016 that I was trying to develop a sleep schedule where I would work for four hours, take a half-hour nap; work for four hours, take a half-hour nap. That’s all I would do all day long.

I had that grand idea, thankfully, that was just an idea that I never tried to implement, but it would have been better than what I was doing which was working 20, 22 hours a day for 18 months and then sleeping two to three. That was a disaster.

No kidding, hahaha. I can imagine.

Well, I often think, that there is a war on sleep. You see billboards for Red Bull, you know, “Red Bull gives you wings”? And you have to push, you need the pick-me-up and you need some sort of burst of energy. But if you are resting, sleeping, relaxing in any way, there’s this thought that not only are you not getting being productive, but that you’re somehow worse than that.

You’re lazy, or selfish, or something along the lines.

I can totally relate because my name is Elizabeth. And when I was younger, my nickname for myself anytime I wasn’t moving constantly, was Lazybeth. “Lazybeth is here”, “Make Lazybeth go away!” That was crazy! But I think so many of us are just taught, schooled, and shown by example, that sleep isn’t important. Which is ridiculous, because that is the time when your body repairs itself.

That’s the time when your body is replacing cells, rebuilding structures, making new proteins, all of those essential things happen during sleep. I mean, they happen all the time, but sleep is this prime time when your body is working really hard while you’re relaxing. So, it’s productive. You can look at it as productivity in a different way, renewing yourself… Which you have to do.

Effects of sleep deprivation on Academic Performance

Elizabeth, I majored in interior architecture and I was an interior architect/designer for a decade after college. I remember, we had our main studio class, which is the big one. We had it two days a week, Mondays and Thursdays. And often what would happen was that on Mondays, our professors were still revising, or giving us feedback on our projects.

We knew better than to ignore the feedback, because if we did not incorporate their feedback in, then we would hear about it at our final critique for that project on Thursday. So yes, three days later, we had to have that done, but in between, we would have other classes; many of us worked as well. I remember from those days, fueling myself with Mountain Dew all through the night, for two nights straight, working full time during the day. By the time the critique happened on Thursday, my heart was beating out of my chest.

I would have classmates who are sleeping in the chairs, even though they’re supposed to be giving feedback. It’s like, hello? How is this safe? Every single project, at least one of my classmates, not myself, I don’t think I ever went to the hospital for cutting myself… It was like a disaster with an exacto knife waiting to happen as we were building our models. Now we’re not talking about the effects of sleep deprivation on academic performance, we have to acknowledge the effects of sleep deprivation in mental health.

Oh, yeah, absolutely.

So, architecture students, doctors… It’s insane to me! How are we doing anything good for ourselves, or civilization, when we’re running ourselves into the ground with exhaustion.

Right. Right! And it’s funny, you mentioned architecture, because I do remember, the architecture building in college was lit up 24/7, there was always somebody in there. I thought science majors were crazy, but there was that.

So, this is a good question. We forget that our brains literally need that downtime to replenish themselves and think clearly, creatively. And when you rest, you actually are able to integrate that feedback, let’s say, or the new idea, whatever it is that you’re doing. You’re able to integrate it and make it so that when you’re awake, you’re more efficient and effective.

I found that I’m also more confident, and I see the value in myself more when I’m rested.

We are taught, trained, to think about health in batches of time

Maybe two months ago from when we were recording, I met this fabulous doctor in my town who is just my internal medicine doctor, but he was brand new to me. He came in and sat down. He’s like, “Tell me about yourself.” This was our first appointment, and I was completely shocked because I’m so used to internal medicine doctors running in “What do you need?”, “Get out” and “Next patient coming in.”

I was going through a major period of transition in my business where I was working way too hard again. Yes, everybody, this has been a cycle. I’ve never let it get back to the two to three hours a night, like I had been. But now, I find myself that when I’m only sleeping four to five hours a night, that’s a problem for me. I was finding myself in those periods of anxiety and depression again.

So, I went into this doctor’s appointment and I asked him to prescribe me an anti-anxiety medicine. Rather than doing that, he said to me, “Tell me what’s going on.” And I was a little annoyed, hahaha.

“Just give me my pill and let me go.” Yeah! Hahaha!

Yeah, like “I have a 20-gazillion mile long to-do list, just… Give me the darn medicine!” hahaha.

He’s like, “Tell me what’s going on.” So, I went through and I told him, “I’m leaving a big client relationship that I’ve had for years. I’m just trying to get it done, I’m not sleeping very well.” He’s like, “Well, how much are you exercising?” So instead of prescribing me anti-anxiety medication, he sent me away with a prescription to exercise 30 minutes a day and sleep.

He said: “Come back in three months.” Oh, in full disclosure, it’s been longer than I thought. Those three months, would have been two months ago. But because they let everything just go through, and I slept, and I started exercising, and they sort of stopped, I’m okay.

I’m not having the anxiety and depression anymore, but I’m also not sacrificing my sleep to get things done. I thought I always had to be a totally get the, what did you say, Lazybeth?

Lazybeth, yeah.

I totally get it! Because if there was a way that I kind of work that into Kim, I totally would have done it. I mean, If I was sitting still… Oh! Even watching Game of Thrones, before the series wrapped, I felt lazy for taking that hour off on Sunday nights. But that was the only time I would give myself all week, was an hour. We shouldn’t be doing that.

Which leads into this other concept that I have about the way we think about health in batches of time: I’m going to exercise for this period of time, and that’s going to be my healthy period. The rest of the time, I’m allowed to run myself ragged.

Health doesn’t work that way. It really needs to be more integrated into your normal life.

So yes, it’s good to go exercising, and it’s good to sleep. But if the rest of the time is spent in frenzied stressful activity with no other breaks, your scale of stress, stress vs. repair, is still going to be tripped in that toward stress, toward frenzy, a less healthy lifestyle. You wouldn’t be living a normal live, you would be living on the negative effects of sleep deprivation.

Oh, my gosh. And not just the scale of stress and disrepair, but the scale of weight too.

Let’s talk about Stress and Weight

I noticed that, it could have been 2019, I was eating significantly less because I was so stressed, but the scale just kept on showing bigger and bigger numbers.

Isn’t that amazing?


Yes, yes. Like I said, you’d be living on the negative effects of sleep deprivation. Because the stress hormones and neurotransmitters affect every single solitary cell in your body. Every cell has receptors for those stress hormones.

People talk about calories, a calorie isn’t a calorie, and they think, well, a calorie of lean, protein is worse than junky hotdogs or something like that. But it really has everything to do with how your metabolism is set. You can eat the same things in a situation of stress and gain weight, but the same exact thing when you’re not stressed and lose weight.

I think the world of dieting, and diets, has a long way to go because we have to really think about how we eat in addition, and why we’re eating. Why you’re wolfing down food in a particular situation.

Well, I’ll be honest, during my internship, working minimum of 100 hours a week, routinely staying awake for 36 hours at a time and working the whole time. Basically, living on Graham crackers most of the time; like, Graham crackers and apple juice it’s what I would eat that for a large portion of the day. I might eat one meal a day and then munch all the time. I ballooned up, even though I was barely eating anything because it was just unhealthy!

Isn’t that what they provide to the patients?

Yeah. And I’d raid the cabinet, haha, I’d raid the closet! It’s 6:00 o’clock at night, I’m not going to get out for dinner. I am going to go eat some of that.

Yep. Oh, my gosh.

I was so crazy, and because in those states of craziness, you don’t even have the clarity to think, “Oh, my gosh, I can order my groceries and just go pick them up, and it would be faster than going through the drive-thru.” But it didn’t even occur to me.

We would spend so much time and money going through the fast-food drive throughs around here. I interviewed a business coach once from the McDonald’s drive thru.

Hahaha! Oh, my gosh.

Like “I am so crazy right now that I didn’t even have time to pick up dinner. My three kids are in the backseat: This is where I am.”

When professional help fails

When I went to the mental hospital in 2008, I was working full time as an interior designer, and the commute was an hour each way: country roads, so no traffic. Then I was also building an Ecommerce business… Building isn’t really accurate, I was just trying, but let’s just say building. So, I was doing that every single night, it was the same story, just different decade, getting two hours of sleep at night.

When I was admitted into the hospital, it was because I was suicidal. They did a blood-work, my thyroid levels were way off. I’ve had hypothyroidism since birth, but they never asked me a thing about sleep, ever. Instead, they prescribed three different antidepressants, and they made me completely numb. I would have to think that the shutdown on my business that resulted after I left the hospital did more for my health, for my sanity and for my wellbeing than those antidepressants ever did.

I’m not going to get into a whole dialogue about the drug industry, but I believe that there needs to be a lot more when we see and hear of people who are struggling emotionally or physically and asking them, “Well, how much are you sleeping?” Because just like you and I have already discussed: It’s not laziness, it’s crucial!

Oh, absolutely. You’re in a way very lucky to have that internal medicine doctor who said, “Tell me about yourself.” Because doctors are literally not trained to ask or even think about these non-pharmaceutical ways that we keep ourselves healthy.

That’s a huge blind spot in medicine about, how much are you sleeping? What’s the quality of that sleep? How do you exercise? How do you relax? Do you have fun? Do you laugh? Do you do something that’s creative? Those are things that keep us healthy.

Longevity studies about having a purpose show that that’s really the thing, it doesn’t matter if you, well… I mean, it matters to some extent if you smoke, or drink, have bad genes, or things like that. But people who have a purpose and a joy about getting out of bed because, write down your Positive Productivity angle, they may not need to, but it’s something that feeds their spirit. And that’s what keeps you healthy.


The importance of Taking people to Bed… *Wink-Wink*

After I went through that whole transition in 2016, that’s when I finally got my purpose. I wouldn’t actually have to say, “Yeah, that’s when I got it, and that’s when I saw it.” Because I realized that everything I was doing contributed to the relief and release of stress.

I do marketing and business automation, so I joke about it now by getting business owners away from their business and back into bed. Some people raise their eyebrow and think about sex…


And well, yeah, it could be, because that’s a great stress relief as well. But no, I’m totally talking about sleep. I want to see people sleeping or spending time with their family.

In 2018, I ate dinner with my family a whole 10 times. There’s seven of us, so there were seven birthdays. Well, there’s twins so they shared a birthday, that one doesn’t count. There were six birthdays and four holidays. I don’t know what the four holidays were but, no joke, 10 times that I ate dinner with my family because I was running myself into the ground thinking that, this was 2018.

So, even past the point when I realized what my purpose was, I was still chasing money, instead of pursuing my purpose, and living into my purpose.

Yeah, well, I have two thoughts on that…

First off, it is amazing that you, because of an illness, found your purpose. I really do think that… This is a weird thing to say, and I’ll say it anyway: Illness happens for us, not to us. If you can take the time to look at it in a different way, and find that beautiful fertilizer, even in that muck of being sick, you’re going to find something great and something can grow.

It happened to you, so your perfect example. But at the same time, it’s so easy to get pulled back. It’s so easy not to have that even when you have that realization, “I found my purpose, I know where I want to go”, habits are so strong! It takes some work, it takes someone keeping you accountable in a way, to keep you on track, so that you don’t fall back into the habits that you feel like they are comfortable even though they’re not.

Mm hmm. There have been so many nights where I’ve taken my laptop into the bedroom and I told my husband, “I just need a half hour nap.” And I actually borrowed that “Mm hmm” from him, that’s what he’ll say to me.

And as soon as he knows that I’m asleep, he’ll just turn off the light, pull the laptop and the mouse aside, he puts them away. He won’t wake me up because he’s seen the side effects of sleep deprivation, he doesn’t want to see it again, and I’m so appreciative. Last night was honestly one of those, “I just need to close my eyes and meditate on what I’m working on.” He’s like, “Mm hmm”. Hahaha.

It was like 10:30, I felt there was a little piece of me that felt guilty this morning when I woke up. Admittedly, it was 4:30, my body just woke up between six and seven hours of sleep afterwards, not at 6:00 or 7:00. So, it was 4:30 when I woke up this morning, and I was so wide awake, so refreshed, I knew exactly what I was looking for last night. I could feel it, I could feel the answers, and I jumped right in.

There was that little moment of me… Feeling guilty for falling asleep. But then I was like, “Nope, you needed that. You wouldn’t have had these ideas if you had gotten up after a half hour. If you had ideas, they probably would have been crap. And then you would be redoing the work this morning anyway.”


The Effects of Sleep Deprivation on the Brain

This brings up an interesting thought. I just want to share a little bit of biology around that when we’re tired, when we’re stressed out, we get that brain fog feeling. That’s because the sympathetic nervous system, the part of your body that’s responsible for flight, fight, push, do… When that’s active for a long time, it actually cuts off blood flow to the frontal lobe of your brain, which is our critical thinking, planning, ideas, the judgment part of the brain. It actually gets 25% less blood flow.

So, really, your brain is sort of starving. Or those really important parts of your brain, are starving. People will say:

“Oh, I feel so stupid! I can’t believe I just can’t figure this out. I should know how to do this intellectually.”

It’s because your brain is running on fewer cylinders. And when you rest, then your brain keeps processing, keeps doing its thing while you’re sleeping. That’s why you wake up with these ideas, it’s sorted out.

That’s so fascinating!

How does sleeping actually works

I’ve noticed that when I get to that point of exhaustion, I get that brain fog, but then what happens is, I get so irritated and I want to kick something. I’m just gonna say, like my legs feel restless, I literally want to kick something, and that’s when I know it’s time for me to go to bed, hahaha, because I really don’t want to kick anything.

I just want everybody to know this: I am not a violent person. But when I am super tired, I could be a child having temper tantrums. That, and when I’m hungry. You don’t want to mess with me when I’m tired and hungry.

Hahaha. Well, that’s your fight reflex coming in, those are the effects of sleep deprivation on the brain. And again, you’re not aggressive, but we all have it within us, you gotta let it out in some way. And it feels weird, it doesn’t feel like you, and that’s very unpleasant. So, it’s like:

“Not only am I not thinking clearly, but I’m also acting like a toddler. Who am I?!”

You’re just a sleepy person.

Yeah, yeah.

My husband knows when I’m grouchy that it’s either that one day of the month that I get super grouchy like that, or I’m hungry, or I’m tired. So, if he knows it’s not that one day, he’ll ask me: “Did you eat?” And he feeds me so he’ll know if I ate, haha, ‘cause I can’t cook, I burn. Or, “When did you get up this morning?”, “Why don’t you take a nap?”, “Lay down for a bit” because my grumpy-self it’s not normal-Kim. And, normal-Kim does annoy some people, because she’s not grumpy.

Hahaha, that’s right. People are just not in touch with happiness.

Exactly. Yeah. And those people make me grouchy so I just can’t be around them. I need to say it: Come on, be happy and go get a nap. And then let’s talk.

Stress and Sleep working together

So, how do you see stress and sleep working together, and against each other?

Well, whoo! Wow! That is a good question. Let me formulate an answer because there’s a good answer in there.

When you are in stress mode, when your body is being flooded with the stress hormones and neurotransmitters, it is almost impossible to get the restful sleep you need. This is why people who have traumatic experiences of any sort, people who are living in a state where there’s fear, or… I will take me! Let’s say, as a doctor, when I was on call, even if I was able to “sleep”, my beeper could go off at any moment, and I was expected to be awake, standing up and in control within 30 seconds.

So, in those situations, you could never, ever, get the productive deep rest that you need, when you’re in the state of constant stress.

And not everybody needs eight hours, that’s totally true; some people need more, some people need less. But when you’re able to get to that state of deep relaxation, your stress hormones wash out of your body entirely, that can take up to about 90 minutes to just have your body metabolize away all those hormones. That’s when your parasympathetic, or your restore-response, can turn on and start to rebuild your neural functions; or help you digest your food, or whatever it is.

So, lack of the deep restful sleep, really doesn’t allow enough time for those stress hormones to wash out. And, also, for your body to really start repairing itself and restore its blood flow properly, and all the other wonderful things.

Kids need sleep and rest too!

I’m in Ohio, and both of my sisters are in New York. I believe in one of my sisters’ towns, they’ve actually switched the elementary school starting time, with the high school starting time, so that the older kids could get more sleep, just for that reason.

They have so many activities, they’re working jobs that expect them to get up hours before the sun comes up and get to school. They decided to flip flop the two, which at first, I was confused by… I can’t imagine getting my littles up and out at that late of an hour, at that early of an hour. But knowing what my teenagers go through and what they’re doing every day, it makes so much sense now that you’ve said that. I didn’t realize those numbers.


So, I live in Seattle, and the school district here did that exact same thing of two years ago, I think. I have an eighth grader right now who goes to a private school, and we’ve made the decision that he’s going to go to public school next year, and part of it is he’s going to start an hour later than he would have, if he had gone to one of the more… We were looking at a couple of different private schools.

But it’s more time to get up, get organized. Time to not be rushed and get transportation done in the morning, because the schools were all roughly the same distance apart. This makes an enormous difference. There’s a difference between leaving the house at 8:30 in the morning, and 7:30 in the morning or earlier. So, I think it’s wonderful.

And boy, teenagers need sleep. That frontal lobe that I was talking about earlier, what is coming online during teenage years and young adulthood. And it literally takes time and rest to have that part of your brain wire itself up properly.

Absolutely. I have an eighth grader as well. He’s doing track and soccer… I mean, pretty soon there won’t be one afternoon of the week that he’s home, and he has the tournaments on the weekends and such. The other ones are Junior this year, they’re having to get up at 5:30 to get the bus at 6:30. If they’re lucky, they’re both home, if there’s nothing going on after school, which is rare, they’re home at 3:30. So they’re a whole nine-hour day.

I had to stress with my husband because he wanted them to just get on their chores right away, when they got home. Like, no; they’ve been up since 5:30, it’s 10 hours later, they can have a break before start their chores. I mean, the last thing we want to do is work for 10 hours and then go straight into a second shift job, which is how I joke about it. Being in my business is first shift, and then, at the end of the day, that’s when they start the second shift: Mom.

Right, hahaha. And this is what so many parents, especially moms, but anybody who’s primarily responsible for children, or adult parents… It is a second shift job.

You’re probably a little like me, haha. Sometimes I walk through the door, and before the coat comes off, the oven goes on, stuff comes out on the calendar. And then I’ll be like, “Oh, yeah, I probably should take off my coat, land in the coach and die”, hahaha!

Yep, yeah.

Removing Stress from the Equation

I had the crazy idea of signing up to be a Girl Scout troop leader this past year, for my kindergarten daughter. I did that because I wanted to say what day of the week the Girl Scout’s meetings were. Now, if I’ve had a long-standing history of failing to say the word No, hahaha, and this is an example of that.

I could have had a say in what day of the week the troop meetings were, without signing up to be a leader, but it didn’t occur to my overstressed, overtired brain. But thankfully, I’ve gone through that now and I won’t make the mistake again when I have another kindergartner next year.

When we’re overstressed, when we’re overtired, I find that I have over… I’m gonna make up a word right now: Hyper-tendency to say Yes, when it’s the last thing I should be saying. I really should have a zipper over my mouth.

Hahaha. Why yes, a filter.

Yes. There should be a timer. I get asked a question, and the zipper will not let me open it for three seconds until I have a chance to think.

Heh! Yeah.

And then of course, you say, “Well, that’s one more thing on my long list of to do’s. How am I going to get out of it?” and “How am I going to be able to get myself out of these responsibilities?” It’s hard. I mean, it really is difficult.

I will tell you what I did for this. One year I made my New Year’s resolution, I don’t use a resolution, I usually use a single word or an intention, something short. And one year, my resolution was basically “No.”

Hahaha, love that.

I just had to say No to certain things. It felt totally against type, my first my first response was going to be No, and then I can always backpedal and say, “Well, yes, maybe I do, maybe that is a good thing.” Boy, that year totally rocked my world.

Faith, Focus and Family

I have three words for 2020, they are Faith, Focus and Family. And when we’re recording this, I’m doing a darn good job on the three of those. I don’t want to use the word, but I’m going to use the word, but I’m going to use “NO” for 2021.

So, by keeping my focus on faith, focus and family, I have been able to say No, a lot easier than I ever have in the past. And because I’ve been saying No, I have not allowed myself to be guilt tripped into saying Yes. My No means No.

Right? You gotta have priorities.


Nancy Levin was a previous guest on the podcast, and she has a book on boundaries. She was the first person, maybe I just wasn’t listening if I heard it said before, but she said:

“No, is a complete sentence.”

I always felt like I had to have an excuse for No, but no, I don’t; just, no! It’s so fun just saying No, to my children. They look at me, and they want me to say more so that they can argue with whatever else I say. And t’s the same with clients, they’re waiting for me to say something else. “Can you do this for me today?” “No.”

At first, I felt like I wasn’t doing my job, but I’m totally doing my job and avoiding the effects of sleep deprivation. Because if I say Yes to everybody, then they’re not going to get the best of me. I’m also doing them a disservice, because I’m allowing them to wait till the last minute to ask for stuff.

Totally, totally. That idea of giving the best of yourself is… I actually like that, and I haven’t really thought about that the way you just put it.

Having those boundaries, whether it’s sleep, commitments, around the time you’re going to focus with family, that is going to make sure you’re going to give the best of you in all ways. You don’t have to wear yourself thin in order to give the best. In fact, that’s not what’s going to do it.

I find that I give like the worst of myself, when I’m doing more of myself.

It really pains me to say it, because I am all about under-promising and over-delivering. I don’t like the expression of under-promising but, on the flip side, what I was doing was over-promising and chronically under-delivering. And that doesn’t do anything to help anybody have faith in me and what I promise, including myself.

I would tell myself that I would do things, and then I would just not do it because I was over-promising and under-delivering to myself as well. “Yeah, sure, you’ll get up tomorrow morning at 4:00 o’clock and exercise.” Then two more months goes by and I still haven’t touched it. Well, you stop believing that you’re actually going to do what you’re telling yourself…

Right. Oh, my goodness, yeah. Letting yourself down, we are so quick to let ourselves down, and we should be the last people that we’re letting down.


Find your Stress Hack

So tomorrow, as of the date of this recording, I’m actually driving from Ohio to Florida for a conference this upcoming weekend. That’s due to a variety of reasons, but can I just tell you how excited I am? The reason I’m driving is because I waited too long to book my flight, and then it just got astronomical. It was creating more stress to fly, because I had to think about my hotel and all these other factors. Like if I’m going to make them my connection and all that.

It’s going to be a long drive, it’s going to be 14 hours each way. I don’t want you to worry about my sleep, because as I already admitted, I can sleep anywhere. I’ll just pull over and sleep in parking lots whenever I need to. However, I am so excited, and my husband is actually jealous. My 14-year-old was joking last night, he says: “Mom, just your drive is going to be a vacation. You’re going to have 14 hours of silence without us.”

I just broke out into the biggest smile. “Yes, dear. Yes, I am.” Hahaha.

Hahaha! I think that’s a great way to prepare for a big conference, they’re always fun. But you can be bombarded to have that silence before and to prepare yourself in silence, and afterwards to decompress. Wow, I love it.

I’m an introvert. So having the 14 hours down and the 14 hours back, on either side of a conference with 2,000 people, it’s gonna be such a joy.

Plus, if this is your first episode listening, my dear listener, you know who you are, I drive a 1996 GMC conversion van. Can I just tell you how much I’m looking forward to renting something that’s from this decade?

Hahaha. This century!

Exactly. My van that I drive is older than my oldest child. It has a tape cassette player inside and no auxiliary port. So, the fact that I will be able to take my phone into the car, connected via Bluetooth so I can write my book if I so choose via Siri…? Or, I don’t know if I want to say that, because I don’t know if that’s the app.

Hehehe, via voice or voice automation.

Yeah, I don’t need to worry about anybody’s elbows in my sights.

I love to fly, but I don’t like being constrained by… When can I listen to my music? And belt out my tunes, and listen to my audio books, and just write? The fact that I’m going to be able to write my book with my voice, and not have to worry about somebody peeking over my shoulder to see how many typos I have. Because I admit that I’m that person who does that sometimes. I tell them that they misspelled that word. It should not have just admitted that.

But I know that that might sound ridiculous to some people, that I’m driving 14 hours each way. Nonetheless, the stress that it has taken off of me is amazing. I encourage everybody to find those little stress hacks, this is going to be the mom of vacation just in a car.

Right. Yeah, relaxation does not have to look like a beach with an umbrella drink by any means. It might look like a 14-hour drive, belting out show tunes. So, you don’t have to sleep all the time to avoid the effects of sleep deprivation, you just have to find a way to rest and keep the stress at bay.

The many faces of Stress

Can we actually talk about that for a second? You said umbrella drink, and that’s what my interpretation of a fabulous vacation is. My husband and I still haven’t taken our honeymoon. So, we were joking about taking that week-long trip to Cancun or something, and making sure that it was an all-inclusive resort so we could keep on getting a non-stop flow of whatever alcoholic drinks we wanted.

In the midst of all my stress, I actually gave up alcohol, and I haven’t had a drink in three months. I’m finding that my ability to handle stress has increased, without the stress, my sleep has gotten so much better. And while there are still days that I joke about wanting an aquarium sized margarita, for the most part, I’m over it.

Interesting. So, in my year of No, I also dropped alcohol. Just out of the blue, there was no worry about addiction, or over drinking, or anything like that, I just stopped; I just realized that I don’t feel well when I drink. So, I had experienced the same thing. And, you know, occasionally I would love to have a gin and tonic, hahaha. But I just don’t, because I don’t want the side effects.

You were mentioning earlier about the antidepressants making you just numb. I think alcohol has, I mean, it is a neural depressant… It just is, it suppresses and depresses neural activity. I don’t think that that’s healthy, because it’s probably suppressing some of our good resilience, some of the activity of self-repair that we need.

This is not an abstinence commercial by any means, but it is an interesting idea! You got the two of us here to say: Maybe that’s something to try. If you’re stressed, what you’ve been reaching for might not actually be helping.

Avoiding and Alcohol

I am, by no means a lightweight, weight-wise. But when it came to alcohol, I was a lightweight. I wouldn’t consider myself an alcoholic by any means, but all it would take was one drink, and I was out for the whole night.

So, I was giving myself guilt for going to alcohol, because I was using it as a way to control the stress of all the extra work I’d committed to. Then I would drink, and I would pass out. Like… “Yeah, that helps! What a genius Kim, you just knocked yourself out with that. Go have another!”

Going to this conference this weekend is going to be a whole lot of fun too. There will be groups going to bars, and I have been in one of those groups where, in order to curb the introvertedness, I drink; I’m not so introverted when I drink. So, it’s gonna be fun to be Me the whole event and see how I can shine, when I’m not under the influence.

Wow. I have to tell you, I can feel you shining from a distance right now as you say that. You’re gonna be awesome!

Thank you. I just hope I’m not hiding in the corner because I’m scared, hehehe.

Coffee, sodas and sugar

I would love to know if you did this during your year of NO, as well. But maybe you don’t drink, but I’ve also, just this year gave up soda.

I was never a big soda person. And not during the year of No, but the following year of coffee vent. Which is weird because I live in Seattle, and it’s really hard to throw a stone and not hit a coffee shop here.

So, I don’t drink coffee anymore. I’ve not dropped caffeine, but the high dose, high octane coffee… At one point in my life, I was drinking about eight cups a day. That’s gone too.

Wow, that is brave. I was up to two or three coffees a day, and then two or three Mountain Dews a day, I guess that’s pretty much…

Pretty much the same, yeah.

So, I’m down to two cups of coffee and no soda. However, my husband’s drinking Dews to make it up for me.

But having that caffeine out… It’s noon, it’s my time right now, and my coffee was done an hour ago. So, for the rest of the day, I won’t be having caffeine, and that has done so much for my sleep as well. It’s incredible how coffee and sugar can solidify some effects of sleep deprivation. I would say that I’m embarrassed to admit, but I’m not embarrassed to admit, that there have been many nights in the last month or so where I have fallen asleep at 8:00, 9:00 o’clock and not given myself that guilt.

I was tired, I needed to sleep. I shouldn’t be giving myself guilt to fall asleep.

And then, as I already said, I wake up six hours later. So yes, there have been quite a few weeks when I am up at 3:00 or 4:00 in the morning. Clients know that I have enough respect for them, that I’m not going to text them and email them when I wake up just because I’m awake. I have some clients that do that to do that to me, though. “I’m at the gym at 4:00 o’clock in the morning. I had an idea, here!” So, I’ve politely asked them not to do that.

It’s been amazing though, letting myself sleep, letting the stress go.

What are the effects of Sleep Deprivation?

I’ve seen, and I would love to know if there’s a medical reason for this. With the sleep going up, with the stress going down, with me taking care of myself and saying No, that the raccoon eyes are disappearing.

Oh, I definitely think so. I don’t know if there is a real medical explanation that I can give you on that… I mean, it’s very clear that that goes away, all of those darkshiners around your eyes that just make you look exhausted. Maybe there’s something about normalizing the blood flow through the head, because those dark circles are very frequently blood vessels close to the surface of the skin that have opened up. So, they will look dark, sometimes brownish, or purple-ish underneath the surface of the skin, because they’re way down deep.

I don’t know that there’s any actual science on it, to be honest with you. But that would be my suspicion: Your body is no longer trying to send blood flow to your head because it’s not deprived, and it normalized it.

That is so fascinating, now that you’ve said that. My hair was falling out when I was super stressed. I don’t think my hair has ever looked healthier, either. It’s not falling out like it was before.

Please, to any listeners who have gone through chemo, I’m not trying to make a joke, but there were days that I felt like I should have been on chemo or something. Just put my hand through my hair, and big chunks of hair were falling out because of stress. We shouldn’t be doing that, right?

The Stress Antidote, a must to understand the effects of sleep deprivation

I feel like we’ve gone everywhere, I suppose. What do you do? How do you work? And what is your business about? We’ve gone everywhere else.

I work with people who feel that stress is making them sick, where they have an awareness that that’s a concern for them. And it can be something like hair falling out, it could be something like digestive problems, but I help people really find the antidote to their stress so they can overcome whatever chronic illness that they’re having.

Have it not derail them in the future. To learn how to future-proof themselves.

Was it until after I started the podcast that I was introduced to the expression, adrenal fatigue?


It amazed me when I heard that this is not an overnight remedy. I mean, going back to my entire architecture school days, we would sleep through the weekend and expect ourselves to be top notch again when we got thrown into the next project, four days later.

But it’s not like that. You can’t just wear yourself to the bone for six months, and then sleep for two nights good, and expect yourself to be back. Can you speak up that?

It’s absolutely true, because it just takes time to rebuild. Maybe I’ll back up for just a moment: The number of basic cells that our body needs to replace on a regular basis is tremendous, and we lose all of our white blood cells every 10 days, they’re just gone. So, you need to rebuild those.

When you’re in, not sleeping, not resting, not restoring yourself mode, your body is just scraping by to make the minimum of blood cells, skin cells, repairing muscle, replacing the lining of the intestines and all of those really basic things… If you’re expecting to also restore something, like get your hormones back in balance, get your metabolism back in line, have your liver work properly, you need more time. You need time to let the body regenerate all of that.

It can, it really can, you can regenerate a new liver. Basically 50 to 100% of your liver regenerates every year, but it takes time, which is the opposite of what medicine promises. Medicine nowadays is “Quick fix! We’re going to do this, 10 days you’ll be back on your feet.” And in general, we’re not doing anyone a real favor. When, we, doctors say that, it’s not a realistic expectation.

Not that you can’t recover from adrenal fatigue, or having your hair fall out or whatever… It just means that the body works at its own pace and you need to give it that time and understanding. Be happy when you’re seeing the little changes, for instance, that you’re noticing. Like, “Wow, my hair really is staying in better.” Those things, those moments to celebrate, we forget that.

Well, the positive side of my hair not pulling out is that my grays are singing around. But I call them my platinums, and I earn them dammit.

I have not dyeing my hair, so every time I go to an event, and the events are where my friends are, and because I’ve totally built a community among podcasters, and entrepreneurs, we often wind up at the same ones. But every single event, I have more gray hairs, compared to three years ago. But I’m not going to color, I earned these.

Your immune system it’s taking the kick

So, a year ago from when this episode is released, as well as two years ago from when this episode was released, I had those major stress points. Maybe this isn’t ironic, but in both time periods, I got severe kidney infections. Does stress in sleep moments lead or could it lead to a kidney infection?

Yes. It’s more, the immune system is unbelievably sensitive to levels of stress. There’s a whole variety of things that happen when you’re under stress.

First off, as I said, your white blood cells, which are your immune system, replace themselves every 10 days. So, if you’re under enough stress that your body is not able to do that replacement, you’ll have effectively an incomplete immune system. It might not show if you look at numbers, if you do the blood draws and look at it, but the cells that are being produced are sort of quick facsimiles, let’s say. Maybe not fully functional.

The body under stress reduces very specific types of cells that will detect cancer, that will detect viruses, that will detect abnormalities of your own cells that need to be removed, that’s the process of what’s called apoptosis, or programmed cell death. That’s how stress relates to cancer, because cancer really is a lack of the immune system working. But when you are under stress, your immune system just basically doesn’t function. It may be there, but it’s not working in the same way that it should.

Some people will notice that they’ve gotten kidney infections, other people will get colds that they just can’t shake, a whole variety of things! People will get the flu, stomach upset, wounds that don’t get better.

All of that relies on your immune system to remove abnormal particles, whether it’s a virus or a bacteria, and your body just can’t because the immune system isn’t functioning.

It’s so fascinating. Actually, I can’t believe I’m admitting this, but I also have noticed that in the reduction of stress, I had this one here that was popping out of my chin that hasn’t come back. That’s reason enough for me to say, no, to stress.

Hahaha, absolutely!

Because I have a ton of jokes with my husband, I was like… “If I’m ever unable to take care of myself, you need to make sure that the chin here is gone because I will come back and haunt you forever if you let that thing stay there.” He’s like “Don’t worry, I’ll take care of it.” But it just occurred to me that, especially going to this event, I don’t want this chin here. And it just occurred to me all together, I had to deal with that sucker in months now!

That’s sucker, people. That’s was not a bad word that you wouldn’t let your kids know.

Getting really sick can be so easy

A kidney infection, up until two years ago, I had never had one of those, and that is also something that I would never wish upon everybody. It was the first day, I was literally here recording a podcast, got the most ridiculous chills, could not get warm, spent a day in bed, like just trying to warm up, and then the fever started, and the pain started, and it was just… Bam! “What the heck is this?”

I resisted even going to the doctor, even after feeling like all that because I felt like I had too much to do. But thankfully, I had an amazing team who said: “Get your butt to the doctor, we need you.”

Haha, yeah! Take care of yourself now or it will be worse.

Yep, “We will change the password for your email if you do not go to the doctor.” That’s who we all need in our life, is that person, or that group of people who will make sure that we’re doing those things that sometimes we don’t want to do, but we definitely have to do.

Sleep Deprivation on Doctors

How did you decide this area of medicine? What brought you here?

Wow. It’s a combination of personal events, my personal experience… And seeing patients. Again, this is one of the things doctors should realize we should learn from our patients as well, and not just sort of as a spur to read something more in a journal.

So, my experience was, there was a time when I was just a stressed-out mess; morning to night, I had anxiety all day long. Which eventually became panic attacks that would completely sideline me, I couldn’t do anything. Along with that, I had some chronic pain in one of my hips that was so bad no matter what I did. I had weird neurologic tingling’s in different fingers, different toes that would come and go. I had started to worry about, “Do I have multiple sclerosis? What’s happening?” I was completely fatigued, I thought “This sounds like multiple sclerosis.”

And this whole variety of symptoms, there was no medical cause for it. I would see a doctor and I’d be perfectly fine. Nobody ever asked me about stress. Nobody ever asked me, “Are you getting enough sleep?” Or “Are you spending enough time resting?” Because I would talk with my colleagues and we all have the same sort of little set of symptoms along those lines. There really wasn’t anyone who walked in and said, “I feel refreshed, I feel ready to go, I feel perfectly healthy”, which is a dirty little secret I’m telling’ about the medical profession right now: There are very few doctors who feel really well.

And at the same time, I had so many people asking me about their medical conditions. I’m a dermatologist so we wear stressed about our skin. I would see people with acne, with eczema, psoriasis, hives, allergies, all asking, “Do you think stress has anything to do with this?” And I gave a terrible answer. I was the worst, I would just basically laugh it off and said: “Well, I can’t prescribe Hawaii, ha-ha-ha.” Which was incredibly demeaning, and I feel very badly about it now.

But it was the way that I was trained to think that stress doesn’t matter: Stress doesn’t matter to me, personally, Elizabeth, and it doesn’t matter to anyone else.

And these feelings of fatigue, and exhaustion, and anxiety were just part of being alive. And it was when I became really, so, debilitated that I was running into the point where I was thinking about quitting medicine entirely, that I had to stop, look and say: “Wait, there’s got to be an answer to this. I am smart enough to figure this out.”

The very truth about the effects of sleep deprivation, long term

Well, I was actually reading an article in a medical journal over lunch because you can’t ever relax, about the first case of a condition called Cushing’s disease, which is an overproduction of the adrenal hormones, the stress hormones. And the very first case of this Cushing’s disease, which was about 100 years ago, I think was 1912. The very first patient had high blood pressure, obesity and abdominal obesity. She couldn’t get pregnant, she didn’t have a period, she had acne, she had stretch marks, she had thin skin. And I started to say: “This is what all of my patients have, this is what I’m experiencing.”

“Why is nobody putting this together? The fact that these adrenal hormones are now rampant? That this patient, who 100 years ago was a rarity, is now something that I encounter every day?”

And that moment sort of clicked for me that the stress has just turned on to a point where that is now a new whole set of conditions that we slid into as medicine; as a society, as medicine. we’ve slid from that rare to that common. That’s when I knew I had to make a change because I’m doing more good for people by really focusing on stress, fatigue and all of that chronic preventable illness that is related to the overproduction of the stress hormones. As you can see, there are some major side effects of sleep deprivation on long term, and they’ve been recorded for centuries.

Leading into my 2016 meltdown, I got caught up in looking at the successes of all these online entrepreneurs, why aren’t I achieving that? I work just as hard. It wasn’t until after I went through my mouth that I realized that they’re only showing part of it.

They’re not talking about the dirty, and the ugly, and the crap that happens on the other side. So, in that moment, I decided, on my podcast, I’m not only going to be talking about what’s working. Because I’ll tell you, a lot more doesn’t work than actually works. I know that might not sound positive, but it’s the persistence and the perseverance that keeps it positive. Because you gotta keep going, but give yourself that break.

I realized that we’re not doing ourselves a favor by pretending everything is perfect. And I so appreciate you admitting that, you saying that you can’t prescribe Hawaii vacations; I mean, that’s huge. Seeing how it all clicks together, that’s huge too. Bravo to you.

Learning to Relax, and Focus

I’m thinking about the entrepreneurs, including entrepreneurs who listen to the show, all the entrepreneurs that I’m friends with… We’re tired. We are tired.

I’m feeling more refreshed this year, than I have in years, but that doesn’t mean I’m not tired. I know that my positive attitude rubs some people the wrong way, but it’s gonna rub people even longer when I can finally say: I feel refreshed all the time. I’m positive.

I don’t know if that day will come, I gotta be totally honest. Because I have five kids, two of them, they will always throw something at me. I can pray that that day comes, and I can pray that I rub some people the wrong way. And other people just want to know how to do it themselves.

Well, here’s what I’ll tell you: You can do it. It’s within you all the time.

There is this source of calm that you can learn how to tap into the middle of a mess, in the middle of kids walking into your podcast and deadlines.

I have found that I am more productive now, doing more different things with a schedule that’s way fuller than it was when I was being just a regular doctor. There’s the spaciousness that opens up, and you can get quite a bit done when you learn how to relax and focus at the same time.

So, you don’t have to be sort of a numb person with the umbrella drink that we were talking about, you can have that dynamic focus. Athletes talk about it as flow, I don’t know if I love that term, but it is a state that you can achieve, anybody can learn to achieve, when you are familiar enough with how it feels in the first place, can then keep capturing it and keep moving your personal compass toward that feeling.

I love that. I actually didn’t realize they call it flow; I call it, my let it go flow. Which drives a couple of my kids are crazy, because they know I’m referring to Frozen. It’s like “Let it go, let it go. If I can’t do anything about it right now, I’m just not going to, and I’m going to let it go. I’m going to allow that stress to wait.”

I don’t mean that I’m going to allow it to wait, but I’m not going to, I’m just not going to worry about it right now.


A final golden nugget on Sleep Deprivation

Elizabeth, I have loved every moment of this conversation. I appreciate the generosity of your time today and the value that I know you have given to listeners, so thank you so much for joining me. Listeners, I would love to hear the AHA that you’ve gotten out of this episode. Even if it’s a laugh at me, that is totally acceptable. Head on down below and leave us a comment in the show notes.

But Elizabeth, where can listeners learn more about you, connect, get in touch and all the great awesomeness?

Well, they can go to my website, which is my name, Elizabethhughesmd.com, and I have a free stress antidote guide at Thestressantidote.com. So, either place, I’d love to connect with you.

Fabulous, the links will be in the show notes. If you’re driving, if you’re trying not to burn dinner, if you don’t want to fall off the elliptical, those links will be waiting for you when you are ready.

Thank you so much. Again, this has been an absolute pleasure.

It’s been my pleasure too. This is fun!

Absolutely. Do you have a parting piece of advice or a golden nugget that you can leave the listeners?

It’s this:

Stress may be common, but it’s not normal and it’s not healthy, so don’t neglect your own self-care and stress reduction. It’s more valuable pretty much than anything else.