The Upside: Invested in Wellness with Jessie Sarafian – February 4, 2026

[00:00:22] Jessie Sarafian: Hello, and welcome to Invested in Wellness. I'm Jessie Sarafian. I'm super excited for today's show. We are joined by special guest, Marlee Boyle. She's a registered respiratory therapist and co-founder of SleepWorks. Today we will dive into insomnia, break down what it really is. We'll also discuss cognitive behavioural therapy, its core components and how they work together to improve sleep, reduce nighttime struggle and help many people decrease or eliminate reliance on sleep medications. Marlee, thank you so much for joining us today. 

[00:00:55] Marlee Boyle: Thank you so much for having me back, Jessie. I'm so excited to talk about this.

[00:00:59] Jessie Sarafian: Looking forward to our conversation. Those on the line if you have any questions for Marlee throughout the show please type it in the Q&A box at the bottom of your screen. We'd like to keep this as interactive as possible. Marlee, for those of you meeting you for the first time can you tell us a little bit about yourself and your journey in the sleep space?

[00:01:20] Marlee Boyle: I did take a kind of unconventional path into sleep therapy. I was a registered respiratory therapist working in critical care and had to do shift work. I struggled with my sleep myself for most of my life and then that disruption of trying to stay awake all night and sleep during the daytime and then shift back and forth, I knew I was kind of falling apart. I remember being very early in my career thinking, ooh, I think my sleep is going to create an expiration date for my career.

[00:01:58] Ironically, I looked into other areas where I could work and I got a job in a sleep disorder clinic and lab. It was working there that I found some solutions that I had been looking for and a lifestyle that was more conducive to better sleep. It was really where I fell in love with sleep as part of our health care. It's such an undervalued part of our system and part of our lives and yet it's so foundational. I do believe sleep is the best medicine. It was just through being able to see people get well and improve quality of life with improved sleep and overcome different health problems by being able to properly rest and get adequate sleep, I just fell in love with it and became obsessed with it and really grew from there and went on to do further education so I could continue to educate and help people.

[00:02:58] Jessie Sarafian: I love that and I couldn't agree more. The work that you and your team does at SleepWorks is amazing, so we appreciate you. I agree, sleep is so, so important. If we can't sleep we can't function. The big first question, what is insomnia? It's such a broad term.

[00:03:17] Marlee Boyle: Absolutely. Insomnia is kind of an umbrella term and within that there's short term insomnia. Short term or maybe it's lasting a few weeks or a few nights and it's generally caused by something kind of obvious. It's usually stress, travel, illness, a big life change, and typically when that situation resolves the sleeplessness resolves. Either they're having difficulty falling asleep, staying asleep, or waking up too early. That's a short term insomnia that most people have experienced or will experience in our life. Then we look at the more clinical side of insomnia, which is chronic insomnia or long term insomnia.

[00:04:05] That's generally where we want to start to address some strategies and things because it is so detrimental to our health. Chronic insomnia looks like whatever that initial precipitating factor was that caused that sleeplessness is probably in the past now but the sleep problem is still continuing and operating on its own. The hallmark of that chronic insomnia is that we start to worry about our sleep and worry about not being rested, worrying about our health and different things from the impact of not sleeping. That, therefore, perpetuates the sleep problem. That's where we see the chronic insomnia which is people having trouble falling asleep, staying asleep or waking up throughout the night or too early for more than three nights a week for longer than three months.

[00:04:56] Jessie Sarafian: Yeah, wow. Why do you think so many people are so affected by it? Statistics show that it affects up to 30% of adults.

[00:05:07] Marlee Boyle: It is the most common sleep disorder in the world, in the developed world anyway. I do think that modern day life really isn't conducive to good sleep. We have very busy schedules. We have sometimes 24 hour operations of things, irregular schedules, we have screens, it's just not that conducive to good sleep naturally. It is something that we actually have to put effort towards to improve our sleep. Insomnia does affect women more often than men at a higher prevalence rate. Stress and all of those things that come along with it certainly are factors. For women, we're experiencing biological shifts and hormones and things like that, hormone changes, pregnancy, postpartum, perimenopause, menopause, we have all of those challenges to our sleep on top of the modern day life. Women tend to take on most of the cognitive load, we're the glue holding it together, and I do think that that's also adding to the higher prevalence for women.

[00:06:22] Jessie Sarafian: I can relate, as a woman, as a mom, we take so much on in the household with parenting and work and trying to juggle a successful and healthy relationship with our partner and work-life balance. I know when my son was very little, hardly any sleep but then I can still function and I can get stuff done which is wild. Kudos to the moms out there.

[00:06:49] Marlee Boyle: The mom super power.

[00:06:49] Jessie Sarafian: I totally agree. What do you think are some of the misconceptions about insomnia?

[00:06:56] Marlee Boyle: I think probably one of the biggest misconceptions about insomnia and about sleep in general is that we all need eight hours of sleep, and that if we got eight hours of sleep we would all be feeling great and doing great and our health would be perfect. The reality is that sleep varies and the amount of sleep that we need varies throughout different times in our lives. What you explained with raising your baby and you were getting by on very little sleep. You were totally surviving and doing something very important but you didn't maybe need as much sleep at that time to function. There's a big variation. The general recommendation is that we're getting seven to nine hours of sleep but there's a $100 billion industry that is very invested in us worrying about not getting eight hours of asleep, and that worry actually creates more problems around insomnia because when we're worried about not getting enough sleep being anxious or worrying is not conducive to being able to fall asleep.

[00:08:02] Our sleep needs vary a lot throughout our lives and eight hours is not a magic number. A lot of people thrive on seven hours and do very, very well. I do think that a big misconception is that we need to get eight hours of sleep and not getting that's going to cause us problems. Humans are pretty resilient and we can usually manage with less sleep at different periods of our life. The goal is just to get enough sleep that we can function well throughout the day. Worrying about not getting enough sleep is one of the reasons that we're not sleeping well.

[00:08:40] Jessie Sarafian: Yes, I totally agree. I want to touch on briefly, because I know we brought this up in our sleep series, all these tools, the aura ring and all these sleep apps, that can be counterintuitive because now you're focusing on, oh, no I didn't get the seven to eight hours. What are your thoughts on that?

[00:09:00] Marlee Boyle: Great question. Since there's been so much new wearable technology for tracking our sleep there's been a new term coined called orthosomnia. It's essentially being kind of worrying about looking at that data and waking up every morning and saying, oh, no, I only got 4% of REM sleep. It actually does impact the way that they're feeling and the way they're sleeping. It's creating more anxiety and more pressure on them to try to achieve better sleep, when really trying to sleep is usually the problem. It's more of a passive behaviour. We have to kind of set ourselves up for sleep and let it happen. When we're so focused on the tracking and the numbers it's a lot of pressure. Our nervous system responds to that as, ooh, there must be something wrong around our sleep because we're having all these worries around it. Take the wearable information with a grain of salt. It is not objective data of your sleep. I'm sure if any of you have those wearables sometimes you're just lying really still and it's registering you that you're in deep sleep and you're, like, I'm sure I'm awake right now.

[00:10:11] Jessie Sarafian: That's great. I now want to get into the cognitive behavioural therapy. Can you explain to our viewers what that is?

[00:10:19] Marlee Boyle: Cognitive behavioural therapy for insomnia is a modality of therapy. Cognitive behavioural therapy is very common in psychology, very effective modality of treatment. In insomnia it is the gold standard treatment for those chronic cases of insomnia. A misconception also would be that sleeping pills are the treatment for chronic sleep problems but we know that sleeping aids don't really fix the problem because we can take sleeping aids when we have these long term sleep problems and they either don't work that well or when we stop taking them the insomnia just comes right back. It never actually addressed the root problem.

[00:11:02] Cognitive behavioural therapy for insomnia actually addresses the underlying causes of insomnia which is whatever that initial precipitating factor was, it was the worrying about it and then our behaviours that followed that really ingrained in us that insomnia. Chronic insomnia is a learned condition so it can be unlearned and the modality is cognitive behavioural therapy for insomnia which is considered the first line treatment for insomnias. It's supposed to be the first line treatment. It's the preferred treatment because it's changing the way we think and the way that we behave around our sleep. There's no side effects to that which is wonderful compared to a lot of the pharmaceuticals that we can take that are much less effective for treating chronic insomnia.

[00:11:51] Jessie Sarafian: I understand that there's five core components of cognitive behavioural therapy. Can you explain each one, please?

[00:11:59] Marlee Boyle: Absolutely. Cognitive behavioural therapy for insomnia is typically delivered over several weeks, one session a week, between five and eight sessions is pretty typical for a program. Each week you're introduced to a new core component of CBTI. A lot of people get cognitive behavioural therapy for insomnia confused with sleep hygiene, which is making sure your room is cool, dark and quiet and all of those things, but not going to be effective if you have chronic insomnia. The five core components that really start to change the trajectory of insomnia are cognitive restructuring is the first one. Cognitive restructuring is taking the worries that we have about our sleep which are very normal human responses when we are struggling with sleep. We have those worries, oh, no, how will I be able to function tomorrow, or I'm going to get sick because I'm not sleeping enough or we start doing the countdown which is very common. You see the time on the clock and you're like, okay, if I fall asleep right now I'll get six hours. I'm familiar with that one.

[00:13:14] It's that very normal human response but that becomes a repetitive experience so those worries start to create anxiety for us around sleep. That is not conducive to good sleep. Those thoughts aren't really helpful. They're very human but they're not helpful to our sleep. Cognitive restructuring is addressing those thoughts and just changing them to more adaptive and helpful for our sleep. Instead of lying in bed and being like, oh no, I'm not gonna be able to function tomorrow and just perpetuating the worry about not sleeping and then continuing to not sleep, we can address that thought of like, no, I'll probably be okay tomorrow. There's no guarantee that if I have a bad night's sleep I'm gonna have a bad day tomorrow. The more realistic adaptive thought that we would restructure to is, I could have a good day tomorrow. I've done this before, I've gone to work with less sleep and I was okay, the day went fine, and it could be fine tomorrow too. It's not that you're telling yourself you're a great sleeper but it is changing that so you're not putting so much pressure on yourself, I gotta fall asleep right now, which doesn't work. That's one component.

[00:14:28] The second component is sleep scheduling, sometimes people call it sleep consolidation. One of the most common things that people do when they're struggling to fall asleep or stay asleep is they start spending more time in bed. If it's taking me two hours to fall asleep, well, I'm gonna get in bed two hours earlier so I can fall asleep by a certain time. While that does seem intuitive to do it's actually counterproductive because what happens is we have a regulator of our sleep, which is how tired we are, when we're lying in bed for extended periods of time we're not getting sleepy. We might be laying in bed feeling fatigued but we're actually feeling that drowsy effect. We're as sleepy in a consolidated amount of time to be able to sleep for seven to nine hours. Sleep scheduling or sleep consolidation therapy involves we track your sleep for a period of two weeks, we see what your average sleep time is over those two weeks, and we start to limit your time that you're spending in bed to get closer to that time so most of the time that you're in your bed you're sleeping. That's probably one of the tougher components for people.

[00:15:44] Stimulus control is a third component. We like to kind of rebrand it and call it the 2020 rule. Stimulus control is very common in psychology as far as Pavlov's Law. He would ring a bell and feed his dogs and ring a bell and feed his dogs and eventually he could ring a bell and his dogs would salivate, they'd be hungry as a response to the bell even if there was no food present. We do build these subconscious associations with our environment. When we have gone to bed and struggled with sleep over and over again our brain, our subconscious has made the connection with our bed, his isn't where I go to sleep, this is where I go to worry about not sleeping. For a lot of us women we're going to solve the problems of the world, organize our family's schedule for the next week, all of those things. Our brain is making the association that bed isn't for sleeping.

[00:16:41] Stimulus control is a very simple concept. It's get out of bed when you can't sleep. We don't want to lie there continuing to try. You want to remove yourself from the bed, go do something kind of boring until you feel sleepy, and then only put yourself back into bed when you do feel drowsy. So your brain starts to associate your bed with this is where I go when I'm drowsy, to fall asleep, not where I go to start worrying. That's a big one that's a technique that everyone can use even if you're not struggling with chronic insomnia, not lying in bed when we're having difficulty falling asleep or staying asleep for too long can be beneficial, kind of short circuit that spiral of anxiety and thoughts that we have while we're lying there, trying to sleep.

[00:17:28] Fourth is more of your specialty, Jessie. It is relaxation, relaxation and resetting our nervous system. We do go through a bit of active relaxation training. By no means am I a meditation guru or a yoga expert but those things can be so beneficial for your nervous system. Most people with insomnia have a hyper arousal of their nervous system. Their awake system is very strong, they're vigilant, all of those things, but it's hard to shut it down at night. Our daily relaxation practise, even as little as 10 minutes per day of actively, consciously relaxing, trying to elicit that parasympathetic nervous system, has been shown to be very beneficial to our sleep. It's not that we need to create elaborate, extensive relaxation practices. It can be as simple as giving yourself that 10 minutes to reset your nervous system.

[00:18:29] The fifth and last component is sleep hygiene. Once you can sleep then practicing those healthy habits of making sure your room is cool, dark and quiet, going to bed at the same time every night, waking up at the time every morning, not eating large meals before bed, all of those things that we kind of know as healthy sleep habits, then they're very helpful to the sleep that we are getting. Sleep hygiene and practicing some of those behaviours can be really frustrating when we've struggled for a long time and those things are not effective. We'll often hear from clients, I know I'm supposed to put my phone away but I put it away and I'm still not sleeping. While putting your phone away is a great technique it's not gonna fix a clinical case of insomnia. That's where cognitive behavioural therapy is very effective and it is an evidence-based treatment with about an 80 to 85% efficacy, which is high in medicine.

[00:19:26] Jessie Sarafian: That's so informative. I was gonna say our cell phones, the phone, is the biggest culprit. As you say, we're laying in bed, we can't fall asleep, we're scrolling on our phones which obviously does not help.

[00:19:39] Marlee Boyle: That's right. It really reinforces that this isn't where we go to just rest. This is where we're going to be stimulated or read the news cycle, doom scroll, all of those things, even playing games on our phones, sometimes people are like, oh, but it helps me down regulate but really the light and the stimulation is not helpful to conducive good sleep.

[00:20:01] Jessie Sarafian: Totally, and speaking of not functioning we have two questions from our audience. One of our viewers, they get about six to seven hours of sleep but then one day a week they get about three to four which really throws them off for several days to recover. What are your suggestions or tips?

[00:20:24] Marlee Boyle: That can be really tough. They're doing a good job on the majority of days prioritizing getting six to seven hours. Seven hours is kind of the goal to feel well rested, the minimum amount. On those days that we have those short sleeps or really disrupted sleeps it can take a toll on us. My advice for those days, one is to not stress about it too much. There's a lot of research that worrying about, oh, I only got three hours of sleep, how will I function today, that actually impacts our ability to perform and our mood throughout that day, more so than the sleep loss itself. Trying to change your mindset going into it and remembering you've been doing this once a week for a while, you're probably really good at getting through those days. That can just alleviate the pressure on yourself which will usually relay into better sleep. When you do have those off nights, if you can make time for a quick 30-minute nap during the days of short sleep can be really helpful to fill some of those gaps and make you feel better and easier to get through your day. Not worrying too much about that one night can be a good starting point, to not stress yourself out about it because you don't want your nervous system to learn that there is a problem.

[00:21:49] Jessie Sarafian: That's super helpful. Another question from our audience, what are your recommendations for someone who has a learning disability and has difficulty using a CPAP machine and having difficulty sleeping? What do you recommend?

[00:22:04] Marlee Boyle: That's a really good question. Often what we see is there's problems with executive functioning, which is difficulty making the plan and then following the plan, executing it. With neurodivergence, learning disabilities, things like that, sometimes it is the executive dysfunction that can really prevent us from being successful with some of these treatments.  On top of that, if you're neurodivergent and then you're sleep deprived it actually exaggerates all of those symptoms of executive dysfunction so it does kind of feel like you're in this vicious cycle of how will I ever get this? The good news is, if we can get you ahead with your sleep a little bit your executive function does improve and then everything gets a little easier. What you have to do for a lot of things, for CPAP especially because there's so many steps and you might have some sensory issues, is perseverance and pre-planning, having everything set up so you're not doing it when your executive function is at its lowest as you're trying to go to bed.

[00:23:13] Our decision making really down goes as the night goes on so trying to make those decisions earlier in the day to set yourself up for success later at night when we're a little bit more compromised is really helpful. And looking for specific sleep programs and adaptations specific to your learning disability. At SleepWorks we do a lot of modifications specifically for neurodivergent clients because it is hard to keep track of everything, stay on top of it when they're just trying to manage the symptoms of ADHD. Certainly breaking it down into the smaller chunks of when you are higher functioning that day can be really beneficial to set yourself up for success for a better night's sleep if you're struggling with CPAP.

[00:24:04] Jessie Sarafian: That's great. Thank you, Marlee. One more question from our audience, what are your thoughts on white noise? Can it help?

[00:24:11] Marlee Boyle: Great question. I actually have a little travel white noise machine right here at my desk. I am a big proponent of using white noise brown noise, pink noise, there's green noise, all the different frequencies. Anecdotally some people prefer one frequency over the other, personally, I find that any kind of consistent sound, even if it's just the sound of your air conditioner or your fan in your room can really mitigate any of those intrusive sounds like traffic or neighbours or anything like that, house sounds, as our house makes noise, the furnace kicks in and could disrupt our sleep. Having something like white noise or fan noise just basically kind of silences out any of these little acute noises that can really pull us out of deep sleep. I'm an advocate for it because we live in a noisy society.

[00:25:12] Jessie Sarafian: As a takeaway for our viewers what is one thing they can do right now to help with their sleep?

[00:25:20] Marlee Boyle: I want to go back to the cognitive behavioural therapy. I think the one thing that I want people to take away is having an appropriate level of concern for your sleep, not to downplay any problems. If it's affecting you in the way that you feel and function and affecting your health it's certainly worthwhile to address that, seek out help, get the supports, the resources that exist. Generally, we don't want to become obsessed with worrying about our sleep, worrying about our watch data, worrying about having one or two bad night's sleep. Really, if you haven't had chronic insomnia and you do have something that disrupts your sleep short term for a couple of days or maybe even a couple weeks, remembering that that situation can be temporary. We are meant to sleep, we're not broken, just sometimes things can get in the way and do not worry about it so it doesn't become this ingrained learned condition can help prevent chronic insomnia from taking hold. So appropriate levels of concern but you don't wanna spend all night worrying about it.

[00:26:26] Jessie Sarafian: I love that. Thank you so much, Marlee. For our viewers, if you have any more questions or if you want to learn more about Marlee and her program and her team at SleepWorks you can visit sleep-works.com. I know Friday, March 13th is World Sleep Day. Can you tell us a little bit more about that before we end?

[00:26:47] Marlee Boyle: Yes, I'd love to. March 13th, Friday the 13th everyone, is World Sleep Day. This year the theme is Sleep Better, Live Better, or Sleep Well, Live better. For World Sleep Day SleepWorks is doing a promotion where you can access cognitive behavioural therapy for insomnia, just a self-guided program. Typically, there's a cost associated with it no matter where you go but SleepWorks likes to provide that on World Sleep Day for pay what you can. You can buy it for as cheap as a dollar on World Sleep Day so if you do want to check out what cognitive behavioural therapy for insomnia is, get a program without breaking the bank, it's very accessible on World Sleep Day through SleepWorks. It's just available on our website and it just gives everybody an opportunity to give it a taste without that huge financial investment to see is this gonna be the right type of program for me. It kind of gives everybody the opportunity to check it out.

[00:27:54] Jessie Sarafian: I love that. Thank you so much and thank you again for joining us today.

[00:27:59] Marlee Boyle: Thank you so much for having me back, Jessie. It's always so fun.

[00:28:01] Jessie Sarafian: I hope everyone has a restful sleep tonight. We'll see you next time.