Ep064: Sex and Sleep: A 2 Way Relationship - with Dr. Blair
WHAT WILL WE LEARN
In this episode, we will learn the connection between sex and sleep. How a healthy sex life can lead to better sleep health.
01:47 What encourages Dr. Blair to pursue her career as a Sleep and Sexual health specialist
03:33 What is Sex Therapy
05:02 How sex affects sleep and vice versa
08:46 How stress can lead to low libido or sexual desire and what you can do about it
11:36 Why most women have low sexual desire
13:52 Things you can do to improve and optimize your sexual wellness
15:03 Seek help from professionals
16:25 Prioritizing versus Pressuring: How to balance sexual desires
TODAY’S GUEST
Dr. Britney Blair is a licensed clinical psychologist and a board-certified behavioral sleep medicine specialist in the San Francisco Bay area. Dr. Blair has extensive clinical and research expertise in behavioral medicine with specializations in sleep and sexual health. She is also a Stanford consultant and is on the adjunct faculty at The Stanford Center for Sleep Sciences and Medicine. She completed her postdoctoral fellowship at Stanford University Medical School and her predoctoral internship at the VA Greater Los Angele Healthcare System. Dr. Blair received her doctoral degree in Clinical Psychology from the PGSP-Stanford Psy.D Consortium. She is also the Co-Founder and Chief Science Officer of loverapp, a mobile application designed to address sexual concerns.
“I really encourage couples to try to avoid falling into a rut of intercourse, that sex can be making out with your partner. Sex can be holding each other naked as you fall asleep. Sex can be taking a shower together. Sex can be a massage together.” - Dr.Britney Blair
RESOURCES
American Association of Sexuality Educators, Counselors and Therapists
Dr. Yishan Xu is getting AASECT certificate for sex therapy, if you need to seek sex therapy, please contact Dr. Xu at yishan@mindbodygarden.com.
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Transcripts
Dr. Yishan Xu 0:00
If I tell you, sex problems and sleep problems, actually are very similar in many ways. Will you believe it? Let's use performance anxiety as an example. We talked about sleep performance anxiety before, the more we want to control sleep, the more we won't sleep well, the worse the sleep gets. Sex is the same. The more we focused on how well we perform, how good we can do, how we can make our partners satisfied, the worse the sex can get. So how to wrap our head around this, how to understand the association between sleep and sex. And most important, possibly many of you want to know how to improve our sex quality and sexual health in general. So today, our guest is Dr. Britney Blair. She is a board-certified Sleep Medicine Specialist, and a Board Certified sex medicine specialist. She's also the founder of a very big group practice in the San Francisco Bay area called The Clinic. If we want to know how sleep and sex interfere with each other, and how to improve sex health, possibly no one will know it better than Dr. Blair. I'm really excited about this. Are you ready? Let's go. Dr. Blair, welcome to the podcast.
Dr. Britney Blair 1:35
Thank you.
Dr. Yishan Xu 1:36
So I'm really excited to have you because I know you are board-certified in both Sleep Medicine and Sexual Medicine. So I'm very curious what got you interested and entered the field of sex medicine on top of sleep medicine training?
Dr. Britney Blair 1:54
Yes, it's a great question. I always like to say the very first year, I was exactly both the two of my favorite things. And I didn't realize that there were so many people who struggled in these areas. So my very first year of graduate school, I went to a workshop at Stanford on sexual health. And I was shocked to learn that one in every two women and one in every basically three and a half men, roughly like 37% of men have a sexual complaint. So 50% of women and 37% of men have a sexual problem. And then I started to research treatments and how effective they are. And I just decided then and there that this would be my life's work because treatment is very effective. It's very effective relatively quickly. And lots of people are suffering. So I decided this was what I wanted to do. I actually had no interest in being a sleep doctor. Until my third year of graduate school, I was kind of forced to and we're in grad school, we don't have the option of the kind of choosing what we want to study, we're forced into different clinics. And so I was assigned to a sleep clinic. And I was like, what do psychologists have to do with sleep, and misery, treating insomnia and seeing people who would come in that were like green, you know, suffering from lack of sleep. And then you know, just four to six weeks later, they were doing really well. So I got kind of hooked on, hooked on sleep in my third year, and so did and fellowship basically at UCSF, UCLA, and couples, and sex therapy. And then one at Stanford, I did my postdoc at Stanford and Sleep Medicine.
Dr. Yishan Xu 3:24
Wow, great. So we both know Sleep Medicine, the treatment like you mentioned, it's short, it's quick, it's very effective. How about sex therapy is that a long-term therapy or is also kind of efficient?
Dr. Britney Blair 3:39
It's efficient, it depends on the problem. But sex therapy tends to be very problematic and solution-focused. So it's not meant to be years long and therapy, exploring what happened in childhood, it's very much thinking about what is leading to the problem and getting really specific behavioral recommendations, as well as doing some cognitive workaround if people need it around sexual dysfunction. So for example, with erectile dysfunction, one of the things that most commonly happens is people become very anxious about it, but obtaining an erection during their next sexual encounter, which then makes it more likely for them to lose their erection or not be able to obtain it in their next sexual encounter. So performance anxiety actually plays a really significant role. And a similar way that performance anxiety plays a role with sleep, if someone has insomnia and they have this experience of going to bed, not being able to fall asleep, or waking up and can't get back to sleep, all of a sudden, the sleep becomes some anxiety-provoking, right. And that's where it kind of the problem is perpetuated by that because of the anxiety and the same with sexual health as well. So people will start, either avoiding it or getting highly anxious around erotic encounters.
Dr. Yishan Xu 4:46
That's so interesting how sleep and sexual problems can be so similar in a way. Then it's because you are possibly the very rare psychologist I ever heard in both fields who is an expert. So what have you noticed that is there any overlap between these two fields like sleep impact sex, for example, or sexual dysfunction or difficulties impact sleep somehow?
Dr. Britney Blair 5:17
They’ll be definitely so I can speak to that piece around how they actually interact sex and sleep. And there are a couple of interesting points there. But the underlying mechanisms that facilitate sexual wellness and sleep wellness are very similar. So one of the things I work with a lot of like executives in Silicon Valley, and I always say, if you give them most problems, they'll give you missed solutions to almost every problem, right? They give you a problem, and they'll give you 10 solutions. With sleep and sexual health, the more you try to solve the problem, oftentimes, the less well, things go. So with both of these aspects of our health, it is optimized by our ability to let go and let our body take over sleep and sex are very primal systems. The body knows what it needs to do what it has to do, right, we need to sleep and we need sex to survive, we sex as a species, but we need to just as survived, it's when our head gets in the way of either one of those that things tend to go sideways. So how sleep problems and sexual problems interact. Sometimes they don't always have lots of people, have sleep problems, and no problems with their sexual health. And a lot of people have sexual health problems and zero problems with sleep, so they don't always interact. But one of the ways they do is if you're getting insufficient sleep, oftentimes, you notice a drop in libido. Stress isn't the number one libido killer. So 85% of people when stressed, a report like low or no desire. And sleep problems can also just affect generally your health and how your body functioning. In addition, if you're not sleeping, well, the bed gets paired with anxiety around the sleep. And for most people, that's where most of their erotic activity comes, happens is when they're in bed, and for sex. Similarly, if you're having a sexual, some kind of problem with your sexual health, the bed and bedroom often gets paired with anxiety, right, so that can actually impact your sleep. In addition, sex is one of the top three things that couples fight about. And so if you're in conflict with your partner around sex, and then your expect your body to get in and fall asleep next to this person that you're in conflict about, you can be kind of activated. So those are just kind of some of the ways that people who have both the way these things interact. Also, we know that sex before bed is a great way to calm the mind and prepare the mind for sleep. So that kind of as a positive way that they interact as if people are having sex, especially pleasurable sex, right before bed, they can actually be a way to kind of relax and prepare the body and the mind for sleep.
Dr. Yishan Xu 7:45
Yes, for the relaxation part. I know a lot of people like to have sex before bedtime or masturbation before bedtime, that kind of helps them relaxed and fall asleep easier.
Dr. Britney Blair 7:56
Yes, absolutely.
Dr. Yishan Xu 7:58
I also heard I think I heard you mentioned once that for people with sleep apnea, actually, that has something to do with their sexual health.
Dr. Britney Blair 8:09
Yes, the number one physiological symptom of sleep apnea is erectile dysfunction. For folks who really struggle to adhere to their CPAP machine, the men that I work with that have trouble adhering to the treatment for sleep apnea. When I explained that it's linked correlated highly with erectile dysfunction, all of a sudden, they were much more motivated.
Dr. Yishan Xu 8:31
That's a great motivator. I don't care about my health consequences, but sex life. Wow, that's important.
Dr. Britney Blair 8:39
Exactly. I don't care if I have a stroke, but telling my penis is not going to work and I will be really activated.
Dr. Yishan Xu 8:44
Yes. So regarding stress, I’m really interested because I know a lot of couples have talked about or complaining about it or they're stressed out at work because they have children. So they're so tired, and it impacts their sex life, their sexual health. So does that means we need to figure out how to help them feel less stressed, feel more chill, relaxed, less anxious, and then they can improve their sex life? Or are there some things they can do at the same time while the stress level is still there, like life still busy?
Dr. Britney Blair 9:21
Yes, I mean, absolutely. I would say go at it from both angles struck. Chronic stress is not good for the body, right? We know this. It's really bad for the body. So prioritizing the ways in which you de-stress is really important. And definitely, stress kills libido for most people 85%. With that said, if you feel like you have low libido or low sexual desire, what I generally encourage people to do is actually engaged in some type of erotic activity anyway, so maybe that's watching porn, maybe that's making out with your partner for a few minutes and see if you have what we call responsive desire. Which is after your body starts to get turned on, you get aroused. You're like, Hmm, this sounds fun. I want to keep doing this, right. So if you're stressed out and you're waiting to have that spontaneous desire for sexual contact with either solo sex or sex with your partner, you may be waiting a while. So it may be that the stress zaps the spontaneous desire, but that you're still able to have a responsive desire if you engage in an erotic activity. And sex is a great de-stressor. So orgasm in particular is a great way to kind of release some of the hormones that build up when we're stressed out.
Dr. Yishan Xu 10:34
Yes, what you mentioned reminds me I read something recently about, sometimes people are waiting, they feel like I don't have the sexual desire I don't want to have sex and upset their partners. What you mentioned sounds like sometimes we can just go ahead engage in some kind of this activity, sexual desire can be built up instead of just passively waiting.
Dr. Britney Blair 10:57
Exactly, yes, passively waiting, you may be waiting your whole life, right? It's not it's not a problem that's gonna solve itself. And with sex, that old adage, if you don't use it, you lose it is very real. So if sexual desire, if you just wait until ha, someday I may feel sexual desire again, you may never, and you may be waiting a really long time. So definitely I encourage people to engage with the erotic that does not mean forcing yourself to have intercourse with your partner. Right, but it does mean either reading erotica or have to masturbate regularly or something like that, in order to kind of prime the pump, get your sexual pump primed to want to engage in the erotic activity. The other thing is, for most women that report low sexual desire. They don't have low sexual desire. Generally, they have a low desire for the sex that they're having. Right, so only about 60% of women consistently have an orgasm during sexual encounters. And over you don't orgasm is not the end all be all of every sexual encounter. Sometimes you can have a wonderful time without orgasm. But most women report and 82% of couples report that satisfying sex life isn't more important for relationship satisfaction, right? So if every single time you're having sex, it is this kind of what I call getting into a sexual rut, you kiss for a minute, maybe there's some genital touching, and then you're having penetrative intercourse, for speaking about heterosexual couples at the moment, and then you're, it's over in five minutes. You know, a lot of women are not gonna want to sign up for that three times a week, whereas, in the average woman, they need 20 minutes of direct clitoral stimulation to orgasm. And so if your whole entire sexual encounter that lasting seven minutes and most of it includes penetrative intercourse, then you're not going to want to be having that sex all the time. So that's the other thing to think about. Especially if you have if maybe you have a female partner and their libido. You have a desire discrepancy. They don't seem to be wanting to have sex as frequently, you may think to yourself, I wonder if the sex that we're having is pleasurable to my partner.
Dr. Yishan Xu 12:59
Yes, I know, sex looks very different for men and for women. So it sounds like a lot of couples, they really need to learn and practice and explore each other to figure out what really works for each other.
Dr. Britney Blair 13:11
That's right. And don't just assume that low sexual desire is just some kind of, a stuck place that you can't get out of thinking about how you can make your sex life more pleasurable. How do you make sex more pleasurable? And how do you engage in the erotic even if you're not spontaneously feeling like it?
Dr. Yishan Xu 13:28
Right. I know, there's some sometimes people talk about well, maybe the certain person is broken, they're just not able to enjoy sex, they're not able to have orgasms. There's something wrong, it's not something you can improve. Every time I hear that I just feel like wow, this cannot be right and make people feel so hopeless.
Dr. Britney Blair 13:51
No, absolutely. There's, there are things you can do to improve, and definitely ways to kind of optimize your sexual wellness. So, there is no such thing as broken sexual people. Unfortunately, a lot of people don't realize that there are really effective treatments out there. Because a lot of people don't talk about sex. It's a very difficult topic for most people to bring up. Even with their doctor. They don't talk about sex. So yeah, I was just talking to a colleague who's an OB-GYN today. And she was talking about how free will even your ob-gyn doesn't bring up sex, and how your sex life isn't sexual pleasure, right. And they're giving you a gynecological exam. So it's a much-needed conversation to be having on a much broader level.
Dr. Yishan Xu 14:30
Yes, it feels like it's really similar to sleep. Because in sleep, we always say, well, your body's not broken, you are able to sleep right? But there are very effective treatments out there. People just don't know about it. Sounds like sex is the same.
Dr. Britney Blair 14:44
Yes, that's exactly right. Yes. I mean, behavioral Sleep Medicine is also a relatively new field. So there isn't a whole lot of us that are board-certified in that. And then in sex therapy. There's also not a lot of people that are board-certified. So there's basically 900 of us in the entire US. They have this board certification. And so you know, it also makes sense that you know, people wanted to get the help. It's hard to find someone who does this work.
Dr. Yishan Xu 15:08
Yes, especially, it's hard to find a legit provider. I see so many sex coach out there, but I'm not sure what is their different names sex educator, sex consultant, Counselor, sex therapist, sex coach, how do people choose and pick?
Dr. Britney Blair 15:28
Yes, I mean, this is one of the problems in the field, one of the really regrettable problems is it attracts a lot of just odd, weird people. So I usually recommend that people go through AASECT, which is aasect.org. That is the governing body, that board certifies people. So by going through that, I mean, there are weirdos on there. But by going through there, you at least know that they've had training, they have to agree to certain ethical code of conduct. For people that are coaches, they, I mean, anyone could call themselves a coach, just anybody could. And so there's no guarantee that they've had any form of training that you're safe with them. The world of sexual health and Sexual Medicine is just ripe for potential trauma, you know, people getting this very personal thing that people are working on. I encourage people to be quite careful.
Dr. Yishan Xu 16:14
Right. That's good to know. And I will put that website on the show notes also. So one more question, when you talk about relaxation, use sex, and engage in these activities. Is there any frequency you recommend for sexual activities between couples and versus masturbation? I feel like that's a question. I'm often asked by people, but I'm not sure what's the best answer for that?
Dr. Britney Blair 16:41
Yes. And that is a great question that I get asked all the time. And it's a little bit of a delicate answer. Because what I like to say is, you really, really, really want to prioritize this aspect of your, of your health and well being of your overall wellness, but not put pressure on it. So there's nothing less sexy than pressure, right? And so how do you as an individual, and how do you as a couple, balance, prioritizing versus pressuring. Oftentimes, when you have one partner who has the lower desire, they feel constantly, like, raided and pressured and pulled on to have sex, right. And that's the last thing that is going to make you feel sexy. With that said, I generally recommend men over the age of 30, not ejaculate, but every 72 hours. So they can engage in sexual activity more frequently, but not actually ejaculating but every 72 hours. With women, the more you masturbate, the better assuming it's not getting in the way of your work life or something, right. But for women, if they're masturbating quite frequently, daily, or every other day, you start to train your body how to experience a pleasure. And that doesn't necessarily mean orgasm every time you masturbate, but some type of pleasurable self-touch, whether that be in the shower, whether that be with a toy, whatever it is, the more frequently you're kind of allowing your body to experience pleasure, the more your body is going to want to experience pleasure, and the more you're going to be hardwired to experience pleasure. With couples stages of life, this varies a lot. If you have young kids under five, I'm generally like, just do no harm. Like if you can get through to when they're, you know, over five years old, your sex life can bounce back. For couples that aren't in an acute stress period of life, I generally recommend two times a week or every 72 hours, not swinging from the rafters and reports but some type of erotic contact with your partner every 72 hours. And by doing this every 72 hours, it becomes almost like, brushing your teeth or taking a shower in the sense that it would feel really weird if it all of a sudden was missing from your life, where couples go wrong as they stopped engaging in any kind of erotic touch with contact and then a week goes by. And then two weeks go by, and then three weeks go by and now it's awkward because you're thinking, Oh, why aren't they trying to initiate sex? or Why is she trying to initiate sex, right? And then you have this kind of hurdle to overcome and then it becomes the sex become something that you're stressed about or that you're having arguments about. So I think if you can get into that kind of cadence every 72 hours or a couple of times a week, again, without pressuring yourself or your partner, you know, I think that's ideal.
Dr. Yishan Xu 19:15
I really like that to really make it small chunks like a small engagement of pleasant activities instead of like a huge to-do list. Like I have to do this and have to nag each other let's do it is the big project.
Dr. Britney Blair 19:31
Yes, we want to hold sex lightly. Right? The same with sleep. The more you think about sleep during the day and get frustrated about it and worry it's going wrong, the less it is going to go well, right, the worse it's going to get and the same with sexual health. If you're constantly badgering your partner or feeling guilty or feeling whatever, you know, it's not sexy. It's not sexy. And I do think I really, really encourage couples to try to avoid falling into a rut of intercourse, right that sex can be making out with your partner. Sex can be holding each other naked as you fall asleep. Sex can be taking a shower together, sex can be a massage together, right? So there's just many, many, many ways to think about sex that aren't either, somebody's got to be penetrated with something.
Dr. Yishan Xu 20:15
Yes, wonderful, let's rethink about sex, what is healthy sex? What is pleasant sex, and then decide what to do just like sleep right? Sleep does not look the same for everyone. This is wonderful. So thank you, Dr. Blair. I know you build a really great successful group practice in the Bay Area also. So if people want to look for your service or any of your providers' services, how can they find you?
Dr. Britney Blair 20:43
So the easiest way to find the clinic is just to go to our website, which is the clinic ca for california.org, the clinicca.org. And then another resource that may be helpful for you is in February of last year, my team and I created an app. It's called lover. And basically, that app is a digital platform for sexual wellness. You know, it solves sexual problems if you have low desire, or if you have difficulty with orgasm or erectile dysfunction. And then there's also features, there will be features where you're able to talk to a professional and get consultation through the app through like texting and the app. So that may be a helpful resource for people if they're listening and have any kind of sexual problem.
Dr. Yishan Xu 21:23
That's really cool. I can just download it first, after our conversation to check it out. This is a great resource, I think, especially this year. People have a lot of time to stay at home, either exploring by themselves or with their partners. I'm sure a lot of people start wondering what are some great resources out there like this?
Dr. Britney Blair 21:43
Yes, absolutely. So that can hopefully be of help to people.
Dr. Yishan Xu 21:46
Cool. Great. I will put all this on the show notes. Thank you again for coming to the show. Dr. Blair, thank you for your time. Are you ready to drop the burden of performing well, and just explore the fun part of sex? I remember another psychologist used to say sex, is really about emotional communication and emotional connection between two people, not just about how long you last how well you do. I totally agree with that. And I think after talking to Dr. Blair, I want to add one more thing that sex is also about building self-confidence and this connection with ourselves. So if this is something really bothers you, and you want to seek some professional help, you can go to aasect.org to find a board-certified sex therapist, or you can try Dr. Blair's app, the lover. If you are in California, you can also seek Dr. Blair's service through their website, clinicca.org I will put all the links on my show notes at deepintosleep.co. I hope today's episode helps you to have a really sweet week. Thank you for listening to Deep into Sleep podcast. I'm your host Yishan. I will see you next week.
23:06
Sleep is an individual thing. We all sleep differently. And there is so much we can do to improve sleep quality. Keep hope and carry on. This podcast is for general informational purposes only and does not include the practice of medicine or other health professional services. The usage of the information we share is that the listeners own risk, and our content does not intend to be a substitute for any medical and professional services, diagnosis, and treatment. Please seek professional health services as needed.