Dr. Saema Tahir is a quadruple board-certified physician specializing in Pulmonary Disease, Critical Care Medicine, and Sleep Medicine in New York City. She completed her medical training at Ross University School of Medicine, followed by residency at Case Western Reserve University and fellowships in Sleep Medicine at Temple University Hospital and Pulmonary and Critical Care Medicine at Drexel University Hahnemann Medical Center. Known for her patient-centered and holistic approach, Dr. Tahir focuses on building trust through personalized care that considers each patient's physical, social, and psychological well-being. After serving on the front lines in New York City intensive care units during the COVID-19 pandemic, she returned to her passion for sleep and pulmonary medicine. Outside of medicine, she enjoys traveling with her husband and two children and staying active through fitness, including spinning, Lagree, and Pilates.
Dr. Saema Tahir is a quadruple board-certified physician specializing in Pulmonary Disease, Critical Care Medicine, and Sleep Medicine in New York City. She completed her medical training at Ross University School of Medicine, followed by residency at Case Western Reserve University and fellowships in Sleep Medicine at Temple University Hospital and Pulmonary and Critical Care Medicine at Drexel University Hahnemann Medical Center.
Known for her patient-centered and holistic approach, Dr. Tahir focuses on building trust through personalized care that considers each patient's physical, social, and psychological well-being. After serving on the front lines in New York City intensive care units during the COVID-19 pandemic, she returned to her passion for sleep and pulmonary medicine. Outside of medicine, she enjoys traveling with her husband and two children and staying active through fitness, including spinning, Lagree, and Pilates.
SHOWNOTES: ( 10-12 points)
😴 Why do some people feel tired after a normal sleep study?
😴 What if your sleep problem isn't sleep hygiene?
😴 Could a normal test still miss a sleep disorder?
😴 Why are sleep trackers useful but not diagnostic?
😴 What does a good sleep score really mean?
😴 Could poor sleep affect more than your energy?
😴 Why do many women miss important sleep symptoms?
😴 What changes during perimenopause affect sleep?
😴 Could sleep be the missing piece in your health?
😴 Why should doctors ask more about sleep?
😴 What happens when sleep complaints get dismissed?
😴 Could consistency be the simplest sleep strategy?
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The information contained in this podcast, our website, newsletter, and the resources available for download are not intended to be medical or health advice and shall not be understood or construed as such. The information contained on these platforms is not a substitute for medical or health advice from a professional who is aware of the facts and circumstances of your individual situation.
Welcome to the Sleep Is a Skill podcast. My name is Mollie Eastman. I am the founder of Sleep Is a Skill, a company that optimizes sleep through technology, accountability, and behavioral change. As an ex-sleep sufferer turned sleep course creator, I am on a mission to transform the way the world thinks about sleep.
Each week, I'll be interviewing world-class experts ranging from researchers, doctors, innovators, and thought leaders to give actionable tips and strategies that you can implement to become a more skillful sleeper. Ultimately, I believe that living a circadian-aligned lifestyle is going to be one of the biggest trends in wellness, and I'm committed to keeping you up to date on all the things that you can do today to transform your circadian health and, by extension, allowing you to sleep and live better than ever before
Welcome back to the Sleep Is a Skill podcast. One of the biggest mistakes we make is assuming every sleep problem has the same solution. Sometimes better sleep isn't about trying harder, it's about asking better questions. Now today, I'm joined by Dr. Seema Tahir, a quadruple board-certified physician specializing in pulmonary disease, critical care medicine, and sleep medicine.
Together, we unpack why a normal sleep study doesn't always tell the whole story, how sleep disorders are often overlooked, especially in women during perimenopause and menopause, and why identifying the right diagnosis can completely change your path to better sleep. So tune in, stay curious, and see what resonates.
And if you know someone who's been searching for answers about their sleep, send this episode their way. Remember, sleep is a skill and you can train it. And welcome to the Sleep is a Skill podcast. This is gonna be a treat today. It's so fantastic when we get to be connected with other incredible experts in the area of sleep through none other than social media.
So one, you're gonna have to follow our guest. She's fantastic. And two, just really committed to making a difference in the area of sleep, and we're gonna get into all those things and so much more. But Saima, thanks so much for taking the time to be here. Of course. I'm so excited. I love meeting all the other sleep people in the world.
This is a small- Yes ... community growing, but it's always fun. Exactly. We all understand each other very well, so- Yes ... I'm happy to be here. I'm very, very happy. Oh, me too. Me too. This is fantastic. You know, I know we got a lot of things we want to cover in this episode, but just maybe in the beginning, just how you found yourself in this area of sleep, an expert in the arena of sleep.
It's funny, I do a few different specialties, but sleep is one thing I'm attracted to because I know how much it affects my life. Throughout my medical training, I truly lived what ba- what bad sleep does to you and what good sleep does to you. Yeah. And I had a great comparison, 'cause sometimes if we don't have a comparison of good and bad, it's hard to really understand why we're feeling certain things that we're feeling.
And I'm a very regimented person. I've always been like that. And my medical training kind of threw me off more so. I've always worked out in the same time, kind of pretty, not like so detailed, but I like a routine. And I noticed that when I was off of my routine, my entire person really fell apart. And I was more attracted to sleep from the personal perspective.
Like, what does it do? Why do we do it? Why am I having these dreams? Why do I feel tired some days when I sleep normal hours, et cetera. And in the sleep, I did the sleep fellowship more so out of interest, but when I was doing the fellowship, I really learned about myself. Mm. And I was able to learn more about the patients that came to me with breathing complaints or chest pain or et cetera, et cetera, et cetera.
Maybe what are we missing? What's the whole big picture here? And through my sleep fellowship, I really l- learned that potentially sleep is that missing piece. So that's kind of what led me down the sleep road. Mm. And I, it taught me a lot about myself, and in turn I was able to apply these things to my patients when I found it was often missed.
So- Wow ... so it brought me to where I am. Well, I love that, and I can certainly relate. I don't know if you know much of my backstory, but it is very bizarre that I've got into the world of sleep, and it was through my own circuitous route of- failing in the world of sleep. And it's not quite, you know, we don't pass or fail.
But I experienced a period of time where it wasn't working in the way that I could count on it, and it was all these things that I was unbeknownst to myself kind of doing and partaking in, and just the magic that opened up when understanding some of these things that could really make a difference. So grateful too for sharing of this journey of your own personal passion and how that can expand to others.
So maybe we can kind of begin of what do you see right now that is missing in maybe our current approach to sleep? If someone's struggling, maybe they've- they've tuned in 'cause their sleep isn't working, whether it's an acute situation or they're just looking to kind of up-level or optimize. But it's not where they'd like it to be.
What might be kind of the standard approach that they might experience if they were to kind of seek out the help of their doctor, and how are you looking to kind of disrupt some of that? It's a very good question. Sleep is everywhere now. We know that. Yeah. And I love it with limitations because- Yeah ... we group sleep as into we can't sleep or sleep problems, but there's differences.
There's bad sleep habits, and then there's sleep disorders. And everything that's been talked about in the press doesn't really tailor itself to one person, because sleep is not a one-size-fits-all. So I love that there's a lot of like options and education out there, but it's really not targeted to the correct people.
A lot of emphasis on sleep hygiene. Sleep hygiene is great. It does not fix a sleep disorder. Yes. So don't get the fifth pillow. Don't get the other mattress, the- Yeah ... 10th mask, the, it's the fourth... Don't do it. That- Yeah ... that quad triple complex is probably no better than the double complex. Not gonna work for you.
So what I tell my patients, and I do get this all the time, you- you're, give yourself more credit than you think you... You- you're smarter than you think you are. I mean- Yeah ... if it's not, if you've tried all these things, don't go, go again. You have a real medical problem that needs- Yeah ... to be addressed. So it's sold to us, it's heavily being pushed down our throat with a lot of limitations because It's not educating the sleep population correctly.
Some tips may help bad sleep behaviors. It's never gonna treat a sleep disorder. And most people do not know that sleep disorders exist because they don't know what they are. Yes. And many people and many physicians in medicine are also unaware of the differences between poor sleep habits and a true sleep disorder.
So there's a lot of different holes. If it's not working, sh- truly seek out a sleep professional, truly, who can help maybe navigate if the symptoms are bad habits versus a true sleep disorder. So don't wait too long because it really will affect who you are in the long run. It will change who you are, your relationships, your job, et cetera.
I can go on and on about what this does. Yes. And you know it. Yes. I love, I love the passion. Exactly. Yes. And how about for that person that maybe is, is listening and they've said, "Okay, I really went up to bat. I talked to my doctor. I really got myself in front of a sleep doctor," which sometimes can take a while to even have that happen, and then they get there and they've taken the test and it came back normal.
And so they're kind of at a loss of next steps. I know you've been really a person that people are able to go to when that is the case. What is an action item that they could do there? Well, I, I often see this. I had a normal sleep study, so I was told nothing was wrong. I had my third normal sleep study.
So first of all, not every sleep disorder needs a sleep study- Mm ... for a diagnosis. Yes. Okay? That is one thing that we do really bad in medicine. On top of that, there's more than one type of sleep study. So if the sleep disorder, if a sleep disorder is present, that may not have been the correct sleep study, or you may not have needed one at all.
And when I see this, it's so sad for my patients because they have this normal sleep study and all their symptoms are dismissed. Uh, or maybe not even dismissed. Maybe there's some encouragement or, you know, try this X, Y, and Z. But it is very dismissive to the patient. What happens then, the rebound response over time is they're feeling something, they think something's wrong with them.
It's a professional is telling them, "This is normal. This is normal." It's making them feel like, "Well, if it is normal, what's wrong with me?" And you develop this really, uh, this self-doubt, this insecurity, which is so hard to turn around in many aspects. Um, so if some- if you have a normal sleep study- And things still feel off, and everyone's so good at doing their own research, and I hate that they have to do that, but I love that they have that as their backup because they need it.
Something is wrong. Real- you need to reach out to someone who truly deals with all of the sleep disorders. And the sleep in medicine that you know, Mollie, like you can do it from the pulmonary aspect. I'm a background pulmonologist. You can do it from psych. You can do it from neuro. Pluses and minuses to that, are we just anchoring from our fields, you know?
I do a lot of sleep disorder breathing 'cause I'm a pulmonologist. Interestingly, I like all the sleep dis- other sleep disorders more. I find them more fascinating because they're organs that I'm not an expert in, so I get to learn and, you know, experiment, et cetera. But in general, if it seems off, if something's off, don't just dismiss it.
Don't let it get dismissed, and don't question yourself. Try to find someone who really looks at it from the bigger picture. There are sleep doctors that do that. There really are. I know they're far and few between, but they are. And I'm gonna help navigate that too because I see that so often. It's years before someone comes to see a sleep doctor who truly acknowledges all of the things, all the symptoms, all the possibilities, and it's so sad.
Absolutely, and I'm so glad you kind of illustrated that it's not just a one and done, 'cause some people might think, "Well, I already did the... I, I spent 150 bucks and got the watch pad, and so we're done here." So maybe just real quick, a little bit of a breakdown of some of those different types of tests that people might not even be aware are available or might kind of sound the alarm to them that, "Oh, maybe this one could potentially fit my case."
And I also hear you too, 'cause we're not trying to puzzle work this all together. Ideally, we're being guided by a knowledgeable expert that can help kind of do this work for us. And so maybe, this is a two-part question, a bit about those different types of tests, and then if someone is saying, "Oh, wow.
Maybe I should, I didn't consider consulting my neurologist," right? Right? Like what are those paths- Mm-hmm ... to get in front of the right person? So the home sleep study, the watch pad is one of them, or the ones that you wear at home, the disposable devices. Some aren't disposable. They're good. They're good in, but they're limita- there are limitations to them.
They're good for s- sleep apnea For most types of sleep apnea, not every type of sleep apnea, most types. They're very good, but they're not good at picking up other components of abnormal sleep. So if there's any movement disorder present, you cannot do a sleep study. And people are not aware that it's not like you're kicking and thrashing.
It may be subtle muscle twitches that are never gonna be picked up even by a partner, that will nev- that intrude in sleep and cause poor, poor quality sleep or sleep disorders that you'll never pick up on a home sleep study. And if that's present, you're never gonna get a diagnosis from that. Sorry if you can hear the siren.
And then- No worries. ... hypersomnia. Hypersomnia, so when people are sleeping, and despite that, they're so tired or dozing off during the day or just they're struggling to wake up or stay awake, those cannot be diagnosed by an overnight home sleep study at all. You need to go to a lab to sleep overnight, and then stay the next day for a certain amount of naps to diagnose a hypersomnia.
In-lab sleep studies, so there's home sleep studies and lab studies. One I told you about for hypersomnia. But some people, the home sleep studies are not very accurate on picking up different flows and abnormal breathing. Don't know ... They really don't pick them up absolutely perfect. So an in-lab overnight sleep study is helpful in a lot of, like, upper airway resistance syndrome I see or central sleep apneas.
The watch pad does pick up on central sleep apnea, but sometimes you need to see a little bit more of what your blood pressure's doing right before the abnormal breathing. And that has to be done in a lab study for me to really see, break down your sleep in 30-second increments for me to really get to a diagnosis, because many people really need that.
And then there's other studies where you basically stay overnight, stay during the day, or they're prolonged for multiple days. But then majority of sleep disorders, insomnia is the most common sleep disorder, does not need a sleep study whatsoever. And the interesting thing about it is common sleep complaints overlap.
So sleep disorders will have, like, I'm tired throughout the day or brain fog, and it could be sleep apnea, it could be insomnia, it could be hypersomnia. But let me just tell you, a pulmonary history takes me, like, 20 minutes. A sleep history takes me one hour the first time I meet a patient. Wow. Yeah.
There's that much overlap, that, that many etiologies of different sleep complaints. And really to get them the best testing if needed, it takes me that long, and I've been doing this for years. Mm. Wow. Yeah, I mean, anyone tries to say s- I, I see this. I s- they say they're tired, they get a watch pad. Well, they're, they just feel tired.
Is it the new blood pressure medication you started? Maybe it's not a sleep disorder. You know, there's so much to it. It's so complex. So much. Yes, I know. I feel like we need sleep sherpas to kind of guide through- ... to get to the right people in front of the right, right? That's, that's the problem with sleep, too.
It is, um... You gotta love it. You really have to love it and know everything to really get to a good treatment plan, and that's probab- it's a part of the reason why no one really ever fixes their sleep truly, to be honest. It's- Or very few do. Well, and I was glad you mentioned things like upper airway resistance syndrome, because sometimes we'll hear instances of people that they say, "Okay, and I even took the time to go in-lab, and it appeared as if people that I was communicating with there just were not even looking at some of the..."
It was either like, "Can we give you a CPAP or bust?" And so I'm wondering, do you have certain kind of criteria for a sleep lab that you can trust is going to be very thorough in how to read these results in some of the latest and more nuanced ways that we might be thinking about some of this information, and the differences between things like men and women, and certain nuances there?
So any sleep lab that does studies well, which generically when they pri- print out the summary graph, like I can tell if it's done well or not. Okay. But in order to really be able to apply my patients' symptoms to potential possibilities of what they may have, I need the sleep study. I need the entire thing.
Yes. Because an upper airway resistance syndrome is one of those things where you really have to break down, look at the actual EEG, the heart rate, the breathing all at once in those 30 seconds. Because what it will do is, the, the generic, um, report that people get about their sleep study, it's kind of a summation.
It cuts out some of the details that are needed to get to that diagnosis. Mm. So I ask the lab for I'm running this for, let's use upper airway resistance for, syndrome for, as a di- as an example. Sure. I'm running this for this reason. The lab I use already knows they're gonna have to give me the actual, like they're...
And it's a lot to go through, but that's- You have to do that to help your patients sometimes. It's a lot. It's hard to do in a lot of facilities where you're bogged down with mul- multiple bookings, et cetera. But that's why it's so missed often because it's... You can't... You have to read it yourself. You have to break it down.
Yeah. 'Cause actually we've done a couple episodes on specifically upper airway resistance syndrome and just how it can kind of hide in plain sight or just be a little bit trickier to notice some of those particular symptoms, and people might not look in a particular way that you might think of for someone with sleep apnea, even though those can be misnomers too.
But I say all that because we have had many people reach out or communicate that they have an inkling or, and/or a full diagnosis of upper airway resistance syndrome, but no actions taken thereafter. And so I'm curious what you might see for particular paths for people so that... 'Cause that's just seems to still be a block where it's like, "Well, I'm not gonna wear the mask," or, "I'm not gonna take some of these steps," so then they just don't treat it.
And now they might have this there, and they just turn a blind eye. What do we see there? People are reluctant to the mask. Um, I've been... I'm very pushy. I get them on a one-week plan that I've- Yes ... you know, it's a lot of, like, back and forth, a lot of communication. Um- And it does seem to work for many of my patients.
You know, the alternatives are surgery, I mean, or, like, aggressive measures. And I always view surgery, anything that you have to use anesthesia for, as a last resort. Yeah. And the reason why is because I- I'm also an ICU doctor. I put people to sleep on ventilators. I know the risk that comes with that. Mm.
So I always use surgery as a last resort, and because I don't do the surgeries myself, usually if there is some component, actually I'm seeing a few patients with, uh, the same symptoms, uh, next week. Mm. And they're, they, before seeing a sleep doctor, they were recommended to have surgery, so I, I've been sent many files to review, 'cause I wanna make sure it's worthwhile.
But I'll get on the phone with the surgeon also and say, "What is your plan? How do you think this is gonna work? What's the data behind it?" Because their data comes out all the time, and differences. Upper airways resistance syndrome is difficult. Mm. I have noticed that my patients, the, the ones that I see, when we get them on a really good game plan to tolerate CPAP- Mm-hmm
even with them being reluctant- Yes ... it does work. I'm not gonna say it works for everyone. I will say that compared to my sleep apnea patients, so they're a little bit more difficult to, the CPAP will maybe get them 80% better, but there's still some residual, like, something is off still. Mm. And then we really have to kind of figure out what we're missing there.
Is a coexisting sleep disorder present? Mm. Is there something else? I send all of my patients with upper airways resistance for DICE procedures. Mm. I'm not sure if you guys are familiar with that, where they do, like, a sleep endoscope, like a endoscopy. Yeah, I was wondering, 'cause we've only briefly alluded to that on the podcast, so maybe that could be a area to, you know- Yeah
dive into. It's probably, I don't do them, but I send them to ear, nose, and throat doctors who do them- Okay. Sure ... where they're able to look at the collapsibility when sleeping, when there's any blockage. It's a better, it's a more accurate assessment of what's happening, and, um, I like that data because it really clarifies things for me when I'm like, "Well, I don't see much on the sleep study, but is it because we're missing something?"
Et cetera. Mm. And I take their report of the DICE, apply it to the sleep study and the symptoms. But it is a challenging area in, um, the sleep world, and I think it's because we don't have a lot for it, and we don't know much about it. Sure. I think the pulmonologist's actually a little bit more well-versed in it.
Mm. And I tend to still use PAP therapy. It is the gold standard for that. Sure. Yeah. Um, and then we go down other avenues of whether we need stimulation in terms of nerve stimulation or surgeries, just because they're a little bit more aggressive in treatment. Yeah. Wow, very interesting. Okay, and so you also mentioned that you get a certain type of person commonly coming through that you're also able to support, things like perimenopause, menopause, and so some of these times in life where maybe before they were like, "I slept okay," or what have you, but a marked shift.
Any things to share, ways to think about that time of life? Oh, yeah. I mean, because sleep disorders during this age group and in men- perimenopause goes like, for some people, middle 30s and then onwards, post-menopausal, like all those years. It's a long time, so not everybody actually realizes when they're in it.
And interesting is sleep is one of the first complaints when people en- women enter this age or this stage of their life, but it sometimes doesn't manifest as sleep right away. It's like, "I just feel tired. I just feel groggy." Yeah. "I just, I'm not myself anymore. I don't like to do the things I do." And then I ask about the sleep, and, "Well, yeah, I sleep lighter."
Yeah. Or, "I've no- notice I get up a little bit earlier, but it's great. I, I get to, like, have my coffee by myself." And then at that early, that was 5:00, now becomes 3:00, et cetera. So it happens gradually, but for many people, the symptoms are so vague and could be a, just from Being busy or whatever it may be- Yes
they become blessed very easily. And I, a lot, I see a lot of patients with this, and it's one of my favorite patient populations, 'cause women are always told, like, "Oh, it's, you're just transitioning. Oh, it's about that time now." Mm-hmm. And I hate transitioning. Really, that word makes... It seems like you're becoming someone else, and that's not true.
The, sleep is a symptom of the perimenopause and menopause years. Hmm. And we're treating the symptoms, just like, you know, high blood pressure is a symptom of heart disease. We treat the high blood pressure. And menopause and perimenopause sleep has been sold so different. Just put up with it. It's just happening.
It's just hormones. Once you get through it, fine. But so many different sleep disorders happen during those years. They just come about during those years. They develop from the lack of hormones or the dwindling hormones, and they're just dismissed. And we know so much that men and women with all different types of sleep disorders have different presentations, different complaints.
Even sleep apnea is not the overweight male sitting upright, snoking- Mm-hmm ... s- snoking and gasping. It's- Exactly ... it's a woman a quarter of your or my size that- Mm-hmm ... you know, just feels a little run down throughout the day, or making more lists nor- than normal, or a little bit moodier than they think they are, just having a lot of, like, different changes in who they once recognized.
So it's so dismissed in the, the menopause population, perimenopause population. But there's true sleep disorders that have long-term side effects that are dismissed during this time too. Yes. So, and it's really sad because society makes them feel that this is normal, when I tell them these are symptoms of sleep disorders, that if you don't treat, will take your life.
Hmm. So I, it, it's just really sad. And they cry in my office, like, "Why can't this woman get through it? I can't." I go, "Well, wait a minute. S- let's change the narrative about this whole time of our life." Yes. You know? Yeah. Oh, I'm so glad you language it like that. And I'm curious your thoughts, 'cause one of the things that might occur now in, you know, 2026 and beyond, is that we have people coming our way partly because of more awareness, more of this information getting out.
I mean, in some instances with wearable data and seeing things that might be they're questioning. And now of course in some of the things that we shared, there might be pluses and minuses, particularly insomnia and kind of getting a little too obsessive with some of this data. Question if you see or if people could be aware of if they are tracking of particular signs to be on the lookout for, that might really warrant reaching out to someone like yourself to get more guidance, like something might be kind of some potentially red flags and/or if you have any thoughts on wearables to share as well.
I don't hate a wearable. Yeah. I think they're great for trends. Sure. I mean, obviously limitations in diagnosis. They're not the best at picking up different sleep stages. They're not perfect or ever, they were never made to look at movement disorders- Yes ... which are a huge component of sleep disorders.
They don't really track insomnia, and interestingly, some people come in, "Oh, it says I was in light sleep," or, "I was awake." In light sleep and awake, it really can't differentiate a lot. Yes. So it's really hard to really apply some of the insomnia data. But they're good for general trends. Like are you sure, like in the past month, did you not get enough deep sleep?
Well, why is it? What, what medical problems do you have? What medications are you taking? What are other your sy- symptoms? Why are we not getting deep sleep? Or why is our REM early? Or why is our deep sleep super, super early? There's certain patterns- Mm-hmm ... it can really give us some information about, but it really can't be used as a diagnostic tool.
Yeah. I do agree with what you're saying, that having... We love trends now. We like immediate data, but now we're in this phase where we like the trend of what's happening, you know? Mm-hmm. And we like score. We even, we used to hate report cards. We'd hide them from our parents. Now this is all we want. Now it's like a nightly report card.
Exactly. How can we- Yeah ... get this report? Yeah. I know. And n- and we just judge ourselves based off of that. Yeah. Or we ignore certain things, or we dismiss certain things. So if you're, if you're saying, if your sleep tracker's saying that you had a great night of sleep, okay, maybe you did, but how do you feel?
I wanna know how you feel- Mm-hmm ... in the morning. Then I wanna know- Yes ... how you feel mid-morning, mid-afternoon, late afternoon. Yeah. Forget the score if you can, and see how you feel. Mm-hmm. Or take the score and compare it to how you feel. Yes. And then we'll get somewhere. So I need that more so than the score.
Mm-hmm. And having a high score doesn't mean you had good sleep. Mm-hmm. It may just mean you had great hours, and hours do not correspond with good sleep. The quality of sleep does not correspond to hours, I should say. Yeah. So trends are great, details are off, and fixating on those details may not translate to you having a sleep disorder or may not eliminate a sleep disorder as a possibility.
Absolutely. Yeah. We'll see certain instances where people, they have clear sleep disorders and can then diagnosable and, and testable, and yet to your point, the wearables often love them because then they might be sleep deprived, and now they're sleeping a ton. And so they're kind of getting those rewards there.
Then we'll see other instances where people have been on benzos or, you know, Z drugs for long stretches of time, and they get rewarded nicely when they're using some of those in certain cases, not always. So to your point, there's a lot of specificity or gray area with this. And so hopefully zooming out, being aware of the trends, the breadth of information potentially being helpful for behavioral change, environmental shifts, and what have you.
But certainly remembering as to your point, that it's not infallible, and by any means this data, particularly sleep stage classifications and not diagnostic, et cetera. Great. Great. Great. Okay, and then before we shift over to how you're managing your own sleep and what we can learn from there, is there anything...
I know this is a huge topic, and we only just scratched the surface, but is there anything that we wanna make sure we underscore or kind of put a bow on in this area of sleep and how you're thinking about it? No, but I think that we... I would like to kind of give a message maybe more so to the medical community.
I think we're all trying our best, and we- that's all we can do. Yes. But I think the next time that we're treating our patients and we're looking at possible symptoms, always think about sleep as a possibility. That may be the one thing we're missing, is we're adding on symptoms or another organ is a little bit injured.
We're adding on another medication, increasing a dose. Have we evaluated their sleep? Because- Often I see that there is a sleep disorder present, and sleep affects every organ in the body, affects our longevity, affects our overall health. And we're not good at asking the question. You don't have to know all the questions, but maybe thinking about the sleep may help navigate w- how we can address the sleep better.
But that's really my message to the medical community. Mm. We all are trying our best. I'm not trying to dismiss anyone- Mm-hmm ... as not looking at sleep or being bad at sleep. Yeah. We're not bad at the heart. I'm not a heart doctor, you know? Yeah. But keep it in mind every time our patients come with a complaint or they are, something doesn't fit, or you feel like maybe I can increase the dose, but why am I increasing the dose?
Mm. There's something else. That's something I think that we all need to remind ourselves in our practice. I so appreciate that because... And that's one of the things, that stat that has been thrown around over the last few years of how the average doctor, even out of Harvard Med, is getting around two hours of training in sleep, and yet we don't imagine that it's something malicious.
I'm sure the average doctor would love to learn more about that. I mean, there's, everyone sleeps. Yeah. And so potentially even using you as an example of what could be possible of seeking out some of this more information, if available. I'm sure, you know, it's busy. Most doctors are dealing with tons of stuff, and as if, they're like, "Oh, just add another thing."
But if- Yeah ... possible, just really a vote for the power and the kind of spidering into nearly every aspect of health. Yeah. It could be a real bang for your buck to, to explore more of this sleep topic, fellowships in this arena, et cetera, et cetera. So really appreciate you kind of demonstrating that and what could be possible path for other doctors like yourself.
So great. And then we do ask every person that comes on our podcast four questions, 'cause we find that it's really helpful for the average person to kind of get a sense of someone that's been thinking about sleep for so long, just how they're doing it, how they're managing it on, in their own world. So the first question we ask everyone is, what does your nightly sleep routine look like right now?
So I keep the same s- for the most part, the same sleep time. I I have a lot to do. We all have a lot to do, but I try to keep the hour before I go to sleep very calm. So I put my kids to bed, excuse me, I put my kids to bed a couple hours earlier, and I open the computer only for a bit, this is around 8:00, and I kind of briefly look at my emails, look at what I have to do.
And I am someone who's a list taker, et cetera, so before I'm going into my bedroom, I now take the power out of the computer that's feels like it's just telling me so many things I have to do, and I start l- writing things down before I go to bed. Mm. It makes me feel like I have the controls in my hand, in my brain.
Make a quick list. And then I go, you know, I do my, like, skincare, my teeth, teeth, et cetera, and change my clothes. And, um, I get into bed around the same time at 10:00 PM, between 10:00 and 10:20, and it is cool, it is dark, it is quiet despite living in New York City. Nice. And, um, I make sure that it is just a safe, nurturing environment- Mm-hmm
and I, like, not a lot around me, and I'm able to go to sleep. But consistency, same time, same routine. I don't shift out anything. Oh, I love that. Yes. And I love the list piece. There's, like, that, uh, corny old saying, "Feeling listless? Make a list." And I just- I use the computer and it's like everything is glaring.
Yes. Like, all the emails pop up, the calendar pops up, and it's, I feel like it's telling me what to do. Like, how can I take that back into I'm telling it what to do? Mm. So I summarize, like, my day-to-day activities the next day by writing it down. Yes. And it makes me, my personality, feel like it's back in my hands, and now I can graph it out or kinda list it out in the way I wanna do it tomorrow.
And it, it doesn't seem as so- Aggressive Yes. Ugh, I'm so glad you mention that and demonstrate that, 'cause, I mean, there's a reason that that is such a go-to suggestion for people just to g- like that brain dump, and get it out onto paper. It helps. Yeah. So wise. Great. Okay, and then the consistency piece, so beautiful, and often people don't always wanna hear that, 'cause then it takes the commitment- Oh, wow
and the discipline and the da, da, da, da, da. But the difference that can become available, and just the ease. Like, that was one of the biggest blessings for me, is realizing all of the shifts of the psychology around sleep, and often it's really not thinking about sleep that much. It's like shifting it all to the day.
Right. It is. Right? Yeah. Oh, well, I... You live with this how do you go out, how do you have fun? I do. I just have boundaries. I have certain stop times. Yeah. I shift them a little bit earlier, and I am still... I, I enjoy the city. So- Yes. Um, I know that if I were to shift those times too much, I know exactly how much ti- how long it would take me to step back, but I just don't like the way it feels.
The next day's not fun. We have to have balance. Same. If you want it all, you have to have boundaries. You really do. Mm. Ugh, so true. I know we talk about sleep leadership, if you will, and so the demonstration of being the person that, you know, is able to have it all. How to go out and be with people, and then also leave at a time that makes sense for you, and is in alignment.
And, and also, hopefully, you know, maybe you get creative. Maybe you are someone that hosts the brunch, or does like s- you know, some of these early... And we're seeing some trends, which is pretty exciting, where, I think it was maybe OpenTable or some group had shown that they're seeing such earlier meal timing trends across the board, even in younger generations.
So hopefully we can all be a bit more circadian aligned, which we love. We're the brunch, we're the brunch house, 'cause I have little kids. We have, we... Our play dates are brunch. Same. Same. The parents have fun, the kids have fun. It is the best. Yes. A brunch play date that's also a play date with the adults.
Ideal. The best. I love it. Okay, well- We'll have to do it again ... next, next time you're in Austin, brunch it is. Yes. Yes, exactly. Please. That's my favorite. I know. My husband is a, you know, born and raised New Yorker straight talker. And so he's upstairs, so that's why I'm pointing. And so he'll always say, "Yep, sorry, I could only get a 5:00 dinner."
You know, so if there, people are pressing for dinners, it's like, "Yeah, that's all we got. That's all we have time for." You know, so- I love it. I'm taking that one. So yeah. Yeah, the early bird. Exactly, so good. I know the early bird definitely gets the worm, okay? Oh, 100%. So, and, and this is coming... We used to be extreme night owls.
I have a niche in high-stakes poker, so I work with a ton of high-stakes poker players, and they are all skewing really late. And I used to do the exact opposite. I used to be so... And I'd be justified and righteous. And I'd say, "I get my best work done in the wee hours of the morning" and ba, ba, ba, ba, ba. And not to say that there's not variance and genetic drift and what have you, but I would be setting up all of the conditions to show that I was right because then I would put all the lights on, and I'd be working and just activating the brain at all the wrong times.
See? I'm an adult. So anyway. Okay, so our second question would be what might we see in your morning sleep routine with the idea that how we start our day could impact our sleep? So I get up at the exact same time. Um, I'm at that age where I have a two-year-old, so I'm stuck in that I don't no longer need alarm because I'm still kind of at that- Yes.
I get up at seven. Well, I get up between 5:00 and 5:30 when I... I work out in the morning. So I work out at 6:30 in the morning, and that, having a routine, a regular schedule for working out has also allowed me to have these nice sleep and wake times that are consistent. And, um, I don't do much in the morning besides enjoy my peace and quiet with my cup of coffee.
I get to finish my coffee 'cause everyone is asleep. But the big thing is I wake up at the same time. I know that's really... Everyone hates hearing that, but for me it works. You know why? Because I have... What I like to do in a day is I like to work out, I like to see patients, I like to see my family, I like to meet a girlfriend for an outing, I like to run some errands.
I... The only way I can do all that and actually work out regularly is to Make it a part of my daily habit. Yes. In the morning is the time I have, and so that's allowed me... Setting up a time where I wake up and go to bed at the same time allows me to accomplish everything I need to in a day. Ah, I love it.
And that's one of the reasons why I really always feel like I hit the jackpot in this topic of sleep because people are like, "Are you sick of talking about sleep yet?" And it's like, no, never. Because it just- Never ... Right? It hit- it- it hits on every aspect of life, and I believe it can serve as a very cool vehicle for personal development, for self-actualization- Yes
for living the life of your dreams. Because if your sleep isn't working, often something in your life is not working. Now, of course, it's not to discount sleep disorders, anatomical situations, et cetera. But even if from a physiological perspective something is not working, it's gonna show up in your sleep results, and so that ability to take action, get aligned with the people like yourself that are gonna help Sherpa, as we say, or help support getting that result, and then living a life where you have a reason to get up every morning is another thing that we'll see is, right, when people are starting to lose that purpose or fulfillment, then oftentimes sleep is what starts getting all funky.
So it just keeps us in the game of growth and what could be possible. So love that. And then our third question would be what might we visually see on your nightstand? I know you already mentioned kind of sounded like minimalism, which I love, just the simplicity. So anything or maybe an absence of anything, uh, that we might see on your nightstand.
A lot of absence. There's a bottle of water in case I get thirsty, which is rare, and then my phone is on the ground. Love that. Yes. Distance. With a very short charging cord. I probably wouldn't look at it in the middle of the night because, uh, I pr- I may not, may not. Yeah. But, um, I usually- I recommend it outside the room if it's really kind of distracting you.
Yeah. But mine is on the ground, so it's like so much more effort to kind of reach down that I just don't reach down. Yes. It's nearby, but I don't have much besides a water bottle, and that's it. I love that. Nothing, nothing glaring, nothing loud, nothing. So good. Yes, and we often see that. There's been different people that have come on the podcast in different areas of sleep, and sometimes, you know, it's more gadgets or something along these other various lines.
And so some of the people that are not d- directly in sleep as much, we've seen some tendencies where the more things that are on the nightstand, the more l- like reliance, right, and the efforting, then often the more they're like, "Well, I'm still working on this problem with sleep," et cetera, et cetera, right?
I'm sure you're seeing that all the time with insomnia and just when they have 52 steps for their nightly routine, it's often a f- a flag. Yeah. Too much. It doesn't let your mind calm down and kind of clarify itself. So- Yeah ... minimalism is my way out. Abs- It's my prefer- it w- works with my needs though. Yes, yes.
I love that, minimalism, so good. Okay, and then the last question would be, so far to date, what would you say has made the biggest difference in how you're thinking about your sleep, managing your sleep, or maybe biggest aha moment in how you're thinking about your sleep? Prioritizing it. Yeah. So putting boundaries.
I used to work nights in the ICU. Saying no in order for me to be a good person and the person I wanted to be. I r- become very, very s- strict with this. I know it's not an option for everyone. Yes. I'm not trying to dismiss and say that this is easy, just stop working that night shift job or whatever it may be.
Yes. But for me, it was an option. And I could have done it. It was fun. It was y- whatever. It paid well. But I had to have boundaries in order for me to feel better, to function best for myself, number one, for my kids, and then for my husband, but, and my patients as well. But in general, boundaries, saying no, missing out on that late night nine o'clock dinner or, like, going out to the club at...
You know, I'm over it now. I'm glad I did it in my 20s. Yes, same. I probably would've been better off though if I had boundaries then, but you know, it's- Same ... like I'm learning. Uh-huh. Yeah. But prioritizing it, respecting it, and not just for one night, giving it respect every single day, evening, and night. And really saying no has allowed me to just perform better as a person because I'm very well aware of what that lack of sleep or those changes in sleep do to me, and it's always tempting.
It's always tempting. Yeah It never feels good after, truly. Ugh, I couldn't agree more. And I hear you too. I, I really resonate with there are seasons of life, so if someone's listening and they're, like, 22, I understand there might be a little bit of difference in values and things that are important to you.
But we do see, over time, as we bring more of that levels of consistency, just how much easier all of this often becomes, right? And then also, w- we don't always wanna adapt to, as it's often been called, a bit of a sick society in that so many people are struggling with their sleep. So many people are not having ease and peace of mind when their head hits the pillow.
So if we are kind of taking the steps or following the steps of the masses, it's maybe gonna yield similar results. So we might have to step outside of the flow of the traditional river and current that we have right now. So love that you demonstrate that. And then how can people follow you, work with you, be your patient, all of those things?
I have an office in New York City, in the Upper East Side, so you can always call the office and book an appointment. I do have social media. I have an Instagram and a TikTok. More so active on Instagram. Um, do you want me to say it, or do you wanna put that in the- Yeah, please. Yeah, and we'll also include in show notes, but yeah, if you could, that'd be great.
Okay. It's DrSaima_Tahir, my, so my first name underscore la- last name. And, um, I'm also available by email. If you go to my website, you can put in a website inquiry and ask questions and see... Just, you know, ask if you can help me, if there's certain questions, concerns, happy to address them. Oh, so great. I appreciate you making yourself accessible.
And just the stand that you're taking in the area of sleep, and to really act as kind of a demonstration of what's possible, and that it doesn't have to, we don't have to remain kind of pigeonholed in particular areas of medicine, that we can expand and branch out and really, really, not only for the benefit of for ourselves and our own interests, which I am biased, but I think it's one of the most fascinating areas- Oh, yeah
and, and it sounds like you, uh, w- certainly do as well. And so, but then even for the, just the spillover, and so more and more people to kind of represent and share about this just is so important. For so long it's been sort of the, the snooze topic of just, oh, well, of course sleep is important for you, but, you know, it's like an afterthought.
I'm loving it. I'm loving the awareness. Um, it posed some challenges, but at least we're talking about it. Before, we were just ignoring it, honestly. Yeah. We were just dismissing it, ignoring. Yes. So at least there's conversation now. Exactly. Exactly. And then for someone like yourself to be able to help cut through the noise of just some of the, the trends and fads and, and what have you, to really get to the heart of what's happening.
So thank you so much for your time and your energy and intention on all of these topics. Thank you. And then I'm excited to meet you in real life at- Great ... 2026. Let's go. So excited. Yes, I'm so excited. Thank you. Yeah. This was great. Thank you. Amazing. You've been listening to the Sleep Is a Skill podcast, the top podcast for people who want to take their sleep skills to the next level.
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