For todays post as part of Diabetes Awareness Month I am reposting a segment of an article I wrote for Beyond Type 1 in 2015. Make sure to read more on their site to find out what yoga practices are perfect for Diabetes management
I’ve been practicing Yoga since I was 17; right up until my sudden diagnosis of Type 1 at the age of 42, I was convinced that Yoga made me invincible. After my diagnosis everything changed. Instead of thinking Yoga would stave off the boogieman, I took responsibility and came to terms with the role that Yoga played in my life.
I discovered that Yoga is more than a good stretch. It’s a tree with many branches, each limb a path back to harmony and balance, a way to mitigate stress. Yoga is not a trend, it’s been around for over 5000 years.
The Yoga practices are powerful because they are subtle. The physical aspect is just one component of a multilayered methodology that looks at the flow of energy in the body. Life force and immunity can be cultivated and built through posture, breathing, meditation, the right diet and lifestyle adjustments.
The word Yoga means, “wholeness, completeness, oneness.” Yoga is not a state. Rather it is the natural state of everything in the creation including ourselves. We are naturally peaceful, happy and whole. It’s only our thoughts about something, and our identification with those thoughts that create a sense of incompletion.
Yoga practice does two things — it pulls us out of the habit of identifying with our thoughts and reminds us of our true nature. When you feel all “zen” after class … it’s not the practice that’s doing it. The practices merely remind you that the peace, stillness and harmony you feel at the end of a practice are your natural state. For me, going deeper with Yoga has enabled me to better manage my relationship to diabetes and manage the stress associated with diabetes.
So what are my five Go-to Yoga practices that put me in the zone each and every day?
Writing every day about diabetes for diabetes awareness month is giving me the opportunity to share my innermost thoughts and feelings about diabetes. Hopefully it also sheds some insight into the inner world of anyone dealing with a chronic illness. Whatever crisis or challenge we face, it’s the ability to overcome, that transforms into a shared wisdom. I know for myself when I’m feeling at a loss as to how to deal with an aspect of diabetes management, finding out how someone else approached that same issue helps me enormously.
I’m someone who likes to get it ‘right’. What I am learning ( slowly but surely) is that right is just a word I have been conditioned to believe in. There is no right way to do diabetes or anything for that matter. There is only what works for each individual.
Today I had an injection blunder. I put the needle for my long acting insulin in and it bounced straight back out squirting blood and insulin everywhere. When something like this happens it’s totally different to say dropping a pill on the floor. If I fumble and drop a pill, I just brush it off and swallow it. An insulin mishap however is totally different. I can’t determine how much insulin actually went in, so if I take another injection it could mean a hypo at some point in the future. All future bolus (fast acting insulin) calculations need to be taken into account. I’m hopeless at math so that’s a big issue right there. My motto for this one is better safe than sorry. So no extra insulin for me today which means possible higher levels all day. Total bummer!
Stepping on my mat for practice it dawned on me that in spite of my earlier mishap, I make up the rules. I can’t change what happened, but I can change my reaction. A story from my teacher in India comes to mind. “When you hold something in your hand,” and he demonstrated the example by holding a red hibiscus in his hand, “holding it takes effort. But how much effort does it take to let it go? Dropping the flower is effortless.” He demonstrated this by letting go of the flower. As it effortlessly fell to the ground he added, “This is just like us. We hang on tight to our ideas, beliefs and ideologies until we are shown how easy it is to let go.”
Exactly my plan for today! Just drop it.
See you tomorrow for #NDAM #DiabetesAwarenessMonth
What’s the single most powerful tool from yoga that’s helped me manage my diabetes? Atma Vidya. Atma Vidya is Self-Knowledge. Atma means Self and Vidya means knowledge. What do you think of when you hear these two words put together? Before I was led through these beautiful teachings I thought SELF meant me, my name, my ideas, my beliefs, my broken pancreas. KNOWLEDGE referred to knowing this, getting this.
I was mistaken.
It’s easy to know what I have. I have a name, a job, a relationship. I have thoughts, ideas and beliefs. I have a condition called diabetes. It’s obvious that I know about things that I have. The deeper question is who does the name, job, relationship, idea, disease belong to? Who is that?
I travelled to India and to the heart of the tradition to find out. The tradition I studied with is thousands of years old. Knowledge shared orally in an unbroken lineage. This kind of teaching is not available in your neighbourhood yoga studio. It has only just recently been brought out of orthodoxy and secrecy. It’s a legacy that was reserved for the priests in India. It’s only due to my teacher and his teacher breaking with tradition that enabled my partner John Weddepohl (who teaches this knowledge) to study this methodology for 7 years in India. And lucky me, after meeting John in 2011, also having the privilege of studying with his teacher.
Going through the teaching on an ashram in India while dealing with diabetes wasn’t easy. I wasn’t on insulin at that stage and was trying to control my levels with diet. With special permission I was able to set up my room with a fridge and cooker. That way I could cook low carb meals and control my levels.
When I started the course, I was nervous about how I would manage. We were told we would have to sit in the teaching hall without leaving for the duration of the lecture. I needed to pee every hour so that freaked me out.
The structure of the course was three 1.5 hour lectures a day, in between we were expected to write out our understanding of the lecture and then hand those notes to our teacher. That way the teacher knew exactly how we were assimilating the teachings. Sitting on a cold marble floor 4.5 hours a day learning about the SELF that wasn’t what I thought it was was confronting.
We spent days dismantling our ideas about everything and I mean every single thing! Imagine being shown without a doubt that the idea that the body is sick, imperfect, unfixable is just that…an idea. Even my thoughts about my ideas where stripped bare. Revealing the ‘I’ thought. This idea I have about myself.
If you’re reading this and thinking…WHAT?
Yep that was me in India too. Until the whole teaching reached its peak.
You know when you’re trying to untie a knot and how it takes ages to loosen and then finally you find that one part of the string which unravels the knot? That’s what it’s like when you are shown the nature of Self.
Once I understood the nature of Self, my relationship to diabetes completely shifted. I no longer felt burdened by it. Something my teacher emphasised when I met with him privately, was that the body is not our business. We don’t know why it does what it does. Our job is to get out of the way, to see the body as something that is happening in our presence. We can do one of two things hinder or aid the body. If the body requires food, water or sleep it’s up to us to provide that. If the body needs medication, again we must give it what it needs.
I have often shared in my posts that I have diabetes I am not my diabetes. The knowledge I gained in India is the essence of that phrase. I can never be what I have.
Today the whole of our shire is blanketed in a smokey haze. The smoke is everywhere. It’s awful and there doesn’t seem to be much respite on the way. Meanwhile life seems to continue as normal…or does it? It’s pretty hard to ignore what’s happening not just on a local but global scale. The word that comes to mind is chaos.
When I think of managing diabetes I also think of the word chaos. Not because I can’t manage it, because overall I do that really well. Rather its the unpredictable nature of diabetes that keeps tripping me up. One day I’m struggling to stay above 4 mmol and the next I can’t get under 9 mmol (in range numbers are between 4-8 mmol). There is no X=Y with diabetes. The pancreas is a strange and elusive animal which doesn’t like stress. And how many times have I been stressed without even knowing I’m stressed? A lot.
The opposite of stress and what the pancreas loves is relaxation. Recently I’ve been catching those moments when I’m relaxed. Noticing a nice deep relaxed breath, a feeling of calm, soft tingles through the body, mind slow and centred. Every time I feel a ‘relax’ coming on I remind myself with a verbal prompt. This is me relaxed, this is what it feels like. Simply acknowledging these moments has helped me to sleep better, digest better, even think better. In fact, Relaxing makes everything better.
This morning I went to a yoga class with my teacher and friend Louisa Sear. Her classes are hard. Not because there are complicated postures or sequences, more because she asks you to be in the pose with every fibre of your being. She instructs the class to hold the pose, fix the gaze and still the mind. Every pose is taught like this so that by the end of the class there is a sense of being cleansed from the inside out.
The ultimate agitation is our habitual need to identify with the moving miasma of the mind. Thoughts will always be there, including thoughts about diabetes, its up to each one of us as to whether we uptake that thought or not. Thoughts don’t have power. You do!
Understanding the triggers for relaxation and fixing the gaze on that is a profound way to deal with the constant stress of living with diabetes. Instead of focusing on the tension you’re experiencing, mentally, emotionally or physically try and find somewhere in your body that is at ease. It could even just be your big toe. As soon as your mind goes there all the awareness and focus goes there too. When I do this, within seconds I’ve forgotten what the problem was.
As I write this I’ve decided to take my own advice. There’s not much I can do about the external factors such as the choking smoke or annoyance with erratic levels. What I can do is take a full breath, be kind to myself and catch a relax.
Today is World Diabetes Day and to be honest I’m flat.
The fire emergency here in Australia combined with higher blood sugars have kept me from my usual enthusiasm. But it’s not just that. It’s hard to put a positive spin on diabetes all the time.
All I can say is my daily yoga practice pulls me out of the doom and gloom. It reminds me that as much as I like to get lost in the details around my health management it’s never going to be perfect. Control is necessary but there has to be some wiggle room. Giving myself a hard time isn’t productive. I’ve learned to relax in the tougher poses, to breathe deep and find stillness. These mini lessons are perfect metaphors for the ups and downs of this disease. And believe me I need that right now.
Today marks the birthday of pioneer Frederick Banting and as such celebrates the discovery of insulin in 1921. Before 1921 they didn’t even know what insulin was. Every time I think of this I’m gobsmacked. 1921 is not that long ago yet I take so much for granted when it comes to all the available medication and tech. Here in Australia there is subsidy for our medication and equipment. I am stunned that this isn’t the case in other countries. No one should have to pay for life saving medication!
Luckily there is an initiative out there to help those in need. Its called Type 1 International and their mission is to support local communities by giving them the tools they need to stand up for their rights so that access to insulin and diabetes supplies becomes a reality for all.
Please join me today on World Diabetes Day in supporting this wonderful organisation.
It’s burning in the hills behind the town where I live in Australia. I am grateful not to have to evacuate but am concerned for those who do. The entire valley all the way to the beach is in a blanket of smoke. It’s hard to breathe. We just went to the beach for some relief but there was none. It was strange to see people out and about in cafe’s and shops as per normal. Apparently it’s only going to get worse. So many more friends are leaving their homes to be safe. It’s heartbreaking.
I feel this way about Diabetes too. Even though I live with it myself I feel for every single person who lives with this condition. It’s heartbreaking when anyone is diagnosed. I know all too well the challenges ahead. Every day can feels like Russian roulette. It’s a massive learning curve and you can’t get away from it.
In spite of all the feelings that come up after diagnosis I also see diabetes as an opportunity to live differently. Instead of taking things for granted I wake up each day grateful to be alive, I’m learning through yoga and other modalities to regulate my nervous system, to react less to the stress of variable blood sugar levels. My diet is refined and I maintain an active life. This kind of approach takes focus and sustained effort and there are plenty of times where I feel frustrated and defeated. But I try not to let my down days take over. I have always been an enthusiastic participant in life.
Today as the smoke chokes the air around us I think about all the people all over the world in crisis. How do we rise above, stay resilient and not give up in the face of uncertainty? How can we make a difference in spite of circumstances beyond our control? I draw strength from a simple Ayurvedic principle.
You can’t fight fire with fire. The softness of water is what douses the flame.
The softness of water is about slowing down, tuning in and calmly moving forward. Flowing with change rather than pushing against it. Connecting with water is about dispersion and delegation. In the face of disaster it’s coming together in community and supporting each other. If we all share the burden we’re stronger together.
It’s the same with diabetes. When I reach out into the diabetes online community I find like minded friends managing their health in myriad ways. All of this forms my pool of inspiration. Even better is going to a support group or event where we all meet and share. I’ve learned more about my condition from these brief in person events than I have from my doctors and diabetes educators.
Knowing there is a community out there to answer a question, share a technique, help me find the best product or device is priceless. Before diabetes I would never have outsourced, researched or informed myself in this way. Diabetes has literally inspired a whole new me. My mission for diabetes awareness month is to share from the heart how diabetes affects me personally but its also about sharing how yoga is an incredible balm.
In this very difficult time, no matter what the struggle, it is my prayer that the varied practices and teachings of yoga become an important part of the healing journey.
More on that tomorrow… #NDAM, #DiabetesAwarenessMonth
Nine days in to 30 days of writing for Diabetes Awareness Month and today’s topic is diet. I can’t keep count of the number of times I’ve been asked, ” What can you eat?” It’s actually a loaded question because the answer from a person with diabetes would be, “what can’t I eat?” As long as we know how many carbs we are ingesting (everything from veggies to fat to protein breaks down into a carbohydrate in the system) we can eat whatever we like based on our insulin to carb ratio. I.e how much insulin is needed per carbohydrate. Do the math and presto every food is available.
But that doesn’t mean I choose to eat whatever I want.
Since I was little I’ve been a fussy eater. I didn’t like green vegetables, any kind of meat, or corn on the cob. I can remember being at the dinner table and slowly scooting portions of pork chop into a napkin when no one was looking and then excusing myself to hastily flush it down the toilet.
In my late teens I was put on a strict candida diet which meant no dairy, sugar, fruit or fermented foods. Not being a huge fan of animal foods I became a vegan. My strict diet was hard to maintain during pregnancy so I reluctantly ate fish, chicken and eggs, but as soon as I could I went back to my vegetarian ways.
When I was diagnosed with diabetes in 2008 I had already started eating foods that resonated with my constitution. Being a fire type, pitta in ayurveda, I avoided nightshades and spicy food and instead focussed on cooling foods with sweet, bitter and sour tones, pulses, avocados, whole grains, roasted veggie salads and gut healing protein smoothies. As my initial diagnosis wasn’t clear (they weren’t sure if it was type 2, type 1 or even diabetes) the only change I made to my diet was to eat low glycemic foods and to add fish, chicken and eggs back in.
At that stage I was eating linseed/soy bread, enjoying oats, quinoa, low carb fruits like blueberries and strawberries and lots of different kinds of veggies, soft cheeses like paneer and ricotta. I still dabbled in eating pasta and pizza as long as there was a good quantity of protein in the mix. I never ate packaged or processed food even if it was a ‘healthy’ packaged food. I’ve never been able to deal with fillers and preservatives.
Once my levels became unmanageable my doctor suggested I look at the ketogenic diet. That was in 2013. Keto was just getting popular and having tried everything else bar insulin, I enjoyed the strict discipline of dropping all carbs. At that stage my diet was mainly eggs, some fish and green veggies like chard, zucchini, broccoli, asparagus, fennel, cauliflower, avocado, ghee and the same soft cheeses. My doctor expressed concern that it was too narrow a corridor of foods. So did I, it seemed that blood sugar wasn’t my only issue with what I ate, I also had a lot of trouble digesting foods. Later I found out that the pancreas also helps with digestion and that sometimes it doesn’t work as well as it should in people living with diabetes. Eating the same foods over and over was actually making me sensitive to the only foods I could tolerate. A never ending cycle.
Thank goodness I went on Insulin after a proper diagnosis in 2014. It has opened up my diet to include more foods again, even though I’ve stuck to a low carb vegetarian diet. It’s so much easier to cook the same meals at the same time each day, to take the same amount of insulin and know exactly how my body will respond. My friends wonder why I don’t get bored, or ask me if I feel like I’m missing out and my answer is always the same. Eating in a way that keeps me calm and balanced is more important and desirable than the headache of eating something that will later cause blood sugar issues or hinder my digestion.
Whether you live with diabetes or not diet is a very personal thing. The body needs nutritious food. It knows what works, how to process it and what to eliminate. All the intricacies of digestion and assimilation of food are out of our hands. It’s up to us to feed the body with nutrient dense foods.
Something I’ve learned to say to anyone who questions why I eat the way I do is this; “I eat to feel well so I can best serve others to feel well too.”
There are a lot of things that influence blood sugar. 42 to be exact, according to Adam Brown from diatribe.org . If you’re keen to know what those are you can check out his handy chart here.
In the spirit of Diabetes Awareness Month and to share more about what its like to live with diabetes, I’ve put together my own short list based on personal trial and error. For those who don’t have diabetes and are just coming along for the ride, your blood sugar levels might also be influenced by these ‘things’ the only difference between you and someone with diabetes is. When your blood sugar rises your pancreas produces insulin to lower your blood sugar level, mine doesn’t. So unless I inject insulin or do something else to lower my level like exercise, I can’t just kick back and let my body do the work. When blood sugar levels go low in a non-diabetic , the liver kicks in with a drip feed of glycogen, to bring them back to homeostasis. My liver kicks in too, but as there is no insulin to meet the liver dump my blood sugar goes up again, hence the need for more insulin and round and round I go. Fun, fun fun…NOT!
So here’s my list in no particular order.
The Sun. Every time I lie in the sun for more than 20 minutes, I have higher levels for 24-48 hours afterwards. Apparently its the oxidative stress. It’s a double edged sword because if I avoid the sun I don’t get enough Vitamin D. I’ve worked out that if I limit exposure to 15-20 min and only sunbathe every two days I stay in range.
High Fat Foods. I absolutely love my avocados and olive oil. I also love Haloumi and Feta cheese. My blood sugar however is very fussy when it comes to what I eat when. I’ve learned to avoid fatty dairy products before bed because I go high over night and for 24 hours after. Avocados are a little more friendly, they actually help me keep my blood sugar from tanking while I sleep. So I load up on a hefty avocado with my dinner. But sometimes it backfires and I am still high when I wake up. I’m still trying to work out how to dose for fat. I feel like if I could figure it out I’d eat pizza again.
Not enough sleep affects everything. Sleeping less than 7 hours a night for me definitely messes with my levels. I wake up about 1-2 times a night too so not sure what would happen to my levels if I was able to sleep through the night. I’d probably have lower levels in general.
A Daily Walk can either reduce my blood sugar level, which can be a bonus when I’m high, or raise my blood sugar level which is not ideal. When I walk, for how long and at what pace is also a factor. Walking directly uses the thigh muscles which burn glucose for fuel. It’s suggested that when levels are higher, or you’ve had a carb heavy meal, a walk will help insulin to work more effectively and reduce blood sugar. In my case a long walk (over an hour) on flat terrain raises my blood sugar whereas a short 20 minutes hike up and down hills reduces my levels.
Cleaning definitely drops my blood sugar in spades. All I have to do is look at the vacuum and I’m low. No joke!
Travel. This is also very specific to the type of travel. When we travel by car anywhere over long distances I have lows. When we fly I usually have lows and then struggle with a stubborn high when we land. Jet lag is included in travel and wreaks havoc.
Any kind of stressor like unexpected news, seeing a snake on the path, (that happened yesterday) a loud noise, change in routine, fears, emotions, frustrations. So that covers the gamut right? All of this always gives me higher levels. Especially emotional outbursts.
The one thing that doesn’t affect my levels is my yoga practice. That includes postural yoga, breathing and meditation as well as adhering to an ayurvedic daily regime. No matter how often, or how intense the practice my levels stay steady. In fact they flat line. That’s why I personally use yoga as my goto when I’m getting stressed out about my blood sugar levels. It’s like pushing the reset button.
It may not lower a stubborn high or fix a scary low, but it will calm me down enough to handle it.
Setting myself the task to write something every day for 30 days about diabetes to spread diabetes awareness is definitely daunting. I live with diabetes for 365 days a year and deal with it 24/7 so it should be easy to articulate that right? In reality the way I deal with diabetes is deeply private.
After spending 6 years ignoring it and then spending 4 years shouting about it via writing a book and being a fierce advocate through social media, it’s been interesting to spend this past year taking a break from the need to externalise my experience.
In 2019 I set a goal to lower my Hba1c, heal some of my underlying digestion issues and be brave when it comes to taking Insulin. I started 2019 using the Diabetic Health Journal, created by yogi and diabetes health coach Lauren Bongiorno, with incredible results. Writing down daily goals, things I was grateful for and staying accountable made a big difference. My Hba1c went from 6% to 5.6 % in 6 months. If you’re not sure what that means it’s like dropping your cholesterol levels or blood pressure. Moving it from a pass to a win.
I also went into hyper drive with my digestion, adding different supplements, bone broth and more variety into my daily meals. I worked on stored trauma with network spinal analysis and neuroimmunology sessions. Finally I made sure to keep up a daily walk and my twice daily yoga practice.
Making a concerted effort to shift some deep seated patterns has been an interesting process. I didn’t necessarily make great strides or have major revelations, instead I settled more into accepting what is.
“What is” might not be what I want but if I can accept it that’s a pretty good place to be. It’s how I dealt with diagnosis after fighting it for so long and pretty much how I manage my finicky digestion and volatile blood sugars and everything else that comes my way.
My latest go to phrase for everything is, ” It’s not up to me” That’s not about not doing everything I can to stay balanced. It’s about understanding that I don’t know the recipe of creation. Letting go of needing to know, enjoying the gifts I’ve been given and trusting that whatever comes is perfect, goes a long way in helping me manage my condition.
I never expected to be diagnosed with diabetes but now that I have been I can honestly share it’s a blessing in disguise.
More on that tomorrow #NDAM #DiabetesAwarenessMonth
Today I am sharing a guest post from Alicia Potts the founder of The Deep Sleep Co. I reached out to Alicia because as someone living with diabetes the biggest challenge I have is managing my sleep. I love her doable tips and I hope you will too.
Take it away Alicia…
This post may contain affiliate links to products I trust. Please read Disclaimer for more info
There is no doubt that good sleep is vital for good health. It is generally believed that a human can go longer without food than they can without sleep. Although, I’m pretty sure they haven’t tested that on someone living with diabetes!
Recent research by the Australian Sleep Foundation found that 33% to 45% of adults are either not getting enough sleep, or getting a poor quality of sleep. This means that more than a third of us are going about our day feeling exhausted not performing at our peak.
If you are one of the millions of Australians who aren’t waking up refreshed and ready to conquer the day, then read on.
Diabetes and Sleep
The relationship between diabetes and sleep is complicated and multifaceted. Both insomnia and lethargy can be related to blood sugar control. According to Diabetes.co.uk “Sleep can affect your blood sugar levels and your blood glucose control can also affect your sleep.” The symptoms of diabetes can make it harder to sleep and lack of sleep can make diabetes symptoms worse.
Unfortunately, sleep problems are more common in people with diabetes than people without diabetes. Having diabetes raises the risk of sleep disorders such as restless leg syndrome and sleep apnea. In turn, sleep deprivation can increase the likelihood of developing diabetes or intensify the symptoms in someone who already has diabetes.
Your sleep can be affected by a variety of things from hypos at night, to high blood sugars to painful neuropathy. Waking up during the night to check blood sugar levels or frequent bathroom trips, cause broken sleep which can leave you feeling tired in the morning. Having techniques to get back to sleep quickly and promote deep restorative sleep can make all the difference.
Keep the room cool. Sweating and hot flushes can be a problem during the night. Keeping the room cool can help to prevent these and allow you to react to them quickly by removing layers. Experts suggest a bedroom temperature of around 18°
Make your room as dark and quiet as possible. If your environment is unavoidably bright or noisy, invest in a sleep mask and earplugs.
Eat right and get some exercise each day. Obvious? Maybe. Important? Definitely! Diet and exercise have a profound effect on your quality of sleep. Try not to eat or exercise just before bed, though.
Cut out the afternoon coffee. Studies have shown that consuming caffeine late in the day stimulates your nervous system which prevents you from relaxing at night. The actual amount of time caffeine stays in your system varies from person to person. However, sleep experts will tell you not to have coffee after about 3pm if you don’t want it to affect your sleep.
Have a tech-free time before bed. Working late on your computer or scrolling through your phone in bed sends light cues to your brain telling it that it is time to be awake. Try cutting out technology an hour before bed to see what a difference it can make. It might be time to pick up that book you keep meaning to read.
Use relaxation techniques to help you fall asleep or go back to sleep after waking during the night. This is the part where we suggest yoga to help you sleep. Yoga Nidra is a relaxation tool that helps calm the mind and body and is great for assisting sleep. Other techniques to try are meditation, hypnosis, visualisation and controlled breathing. I like the 4-7-8 breathing technique, but there are lots of other good ones, so do what works for you.
Don’t be a clock watcher. You know that moment at 3am when you think ‘even if I went to sleep right now, I’d only get 3 ½ hours sleep’. Watching the time as you are trying to sleep makes you anxious about not being asleep. If possible, turn the clock face away from you at night to promote more relaxing thoughts.
Keep a regular routine. Last, but actually, the most important sleep tip is to have a sleep/wake routine. Sleep psychologists agree that the most powerful thing you can do for your sleep health is to go to sleep and wake up at the same time every day. This trains your mind and body to expect sleep at certain times and preserves your natural circadian rhythm.
The tips above are meant as a guide only. If you are worried that you may have a sleep condition, such as sleep apnea, see your doctor as soon as possible.
Alicia Potts is the founder of The Deep Sleep Co. She is a mum of two from Sydney, with a degree in Social Science. Alicia is passionate about helping people find the value of quality sleep.