Menopause and the 3AM Wake Up: What Light, Meal Timing and Hormones Do with Dr. Kristen Holmes

**Mary Claire Haver** (0:00)
Because there was so much to cover with Dr. Kristen Holmes, we have broken this episode into two parts. This is part one, and we will publish part two later this week.

**Kristen Holmes** (0:10)
When you've got the regular Jane and Joe actually starting to adopt some of these behaviors that we know really impact these markers of health and performance, it's transformational, and that's what surprised me the most. I get emotional when I think about it because there's so many people who have come onto our platform really struggling, and they adopt what are, quite frankly, very simple behaviors and it transforms their life.

**Mary Claire Haver** (0:46)
The views and opinions expressed on unPAUSED are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.
I want to tell you something that took me an embarrassingly long time to put together. I've been treating menopause patients for years. I understand the hormonal mechanism. I know what declining estrogen does to sleep architecture, why night sweats can fragment sleep, why three in the morning anxiety is a hallmark of the perimenopause transition, and I've been treating the symptom.
What I was not doing was treating this system. What I did not fully understand until I started looking at the circadian research is that menopause and sleep disruption are not just occurring simultaneously. They are amplifying each other in a loop that most women and most of their physicians don't recognize. The hot flash might wake her up. The disrupted sleep destabilizes her circadian rhythm. The destabilized circadian rhythm makes the hypothalamus, which is already under hormonal siege, more dysregulated, which makes the hot flashes worse, which disrupts the sleep more, around and around. Here's the part I was missing in my clinical conversations. When she sleeps matters as much as how long she sleeps. The regularity of her sleep timing may be as powerful a predictor of her health outcomes as the duration.
A UK study of 60,000 people across 10 million nights of sleep found that sleep regularity predicted mortality, independent of how many hours a person slept. We may have been measuring the wrong thing. My guest today has spent her career at the intersection of elite athletic performance, behavioral science, and one of the largest human physiological data sets ever assembled. Dr. Kristen Holmes is vice president of performance science at WOOP, a three-time All-American athlete, a former Team USA field hockey player, and one of the most decorated coaches in Ivy League history. She has access to what the human body actually does under pressure, at scale, across hundreds of thousands of people. And she has spent years asking what the data means for women specifically. What Kristen is going to tell you today is going to be uncomfortable in some places. It challenged assumptions I held for years. But this conversation will also give you practical things that you can change tonight. I'm Dr. Mary Claire Haver, a board-certified obstetrician and gynecologist and certified menopause practitioner and adjunct professor at the University of Texas Medical Branch. Welcome to unPAUSED, where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
All right, Dr. Kristen Holmes, welcome to unPAUSED. Thank you. I'm very excited about this conversation.

**Kristen Holmes** (3:59)
I know, me too.

**Mary Claire Haver** (4:00)
Our listeners are not sleeping.
I know. And you are the world's expert in the architecture of sleep and really understanding what's happening to women. But before we get there, tell me a little bit about what your Ph.D. is in and how you went from a very elite athlete, walk me through the path to get to where you are now at Whoop.

**Kristen Holmes** (4:19)
Well, I started out, I played two sports in the Big Ten at the University of Iowa. I played basketball and field hockey. And I just played one year of basketball. I walked onto the team. So field hockey was my primary sport. And then I went on and played for the US. National Team for seven years. I made the team in my sophomore year of college. So I was kind of playing throughout and then, and then kind of revamped my career in my early 30s and played another year of international hockey. And I coached at my alma mater for three years and at Princeton University. I was the head field hockey coach for 13 seasons. And while I was at Princeton, I got really into data as a way to foster human performance to help keep my athletes safe and healthy to compete. And so that was really when I started developing my own technology, which is what led me to WOOP, which is a, you know, a wrist-worn wearable that monitors physiology.