Ever find yourself at 1 AM, phone in hand, thinking: how did this happen again? I’m a psychologist. I literally know better. And I still do it.

That’s actually how I opened this conversation with Dr. Alison Kole — because I think the shame spiral around sleep is one of the most underrated things keeping high achievers stuck. We’re good at so many hard things. And somehow sleep, this thing we’ve been doing since we were born, feels impossible.

Dr. Alison is triple board-certified in pulmonary medicine, critical care, and sleep medicine — and she’s a reformed chronic insomniac who didn’t sleep well for 25 years. She gets it from the inside out. And in this episode, she drops more truth bombs than I was prepared for. In the best way.

In This Episode

Why high achievers are specifically bad at sleep — and it’s not a willpower problem

Dr. Alison traces it back to generational conditioning: many of us were raised by parents who lived through times of scarcity and conflict, where rest wasn’t survival, work was. That message got passed down. Layer on the double standard women face — expected to perform at work and run the household — and you have a generation of high-achieving women who were never given permission to prioritize themselves.

“It’s just never been a priority. Something else is always more important.” That was the message. And we absorbed it completely.

What sleep deprivation is actually doing to your body

Every organ system. Brain health (the glymphatic system that clears metabolic waste only works when you sleep), heart health, immune function, hormone regulation, weight — all of it is downstream of sleep. Dr. Alison also connects poor sleep to disrupted hunger hormones that make us reach for comfort food, and to increased dementia risk over time.

Sleep isn’t a luxury. It’s the foundation. Everything else gets built on top of it.

Bedtime procrastination: why we scroll and what to actually do

For many high achievers, the end of the day is the first moment that belongs to us — not our inbox, not our families, not anyone else’s needs. Scrolling isn’t laziness. It’s the dopamine hit of finally getting some time that’s ours. The fix isn’t shame or cold-turkey phone bans. It’s:

* Start your wind-down earlier in the evening

* Set a timer — allow the scroll, just give it an end

* Shift the narrative: sleep isn’t taking something away. It’s a gift to yourself

* Go incrementally — you can’t go from midnight to 8 PM overnight

ADHD, autism, and sleep — what’s different

For neurodivergent folks, the late-night scroll isn’t always procrastination — it can be genuine nervous system regulation. The quiet of night may be the first time the day has felt manageable. Dr. Alison also notes that autistic individuals may have lower baseline melatonin, making supplementation more genuinely helpful for them than for the general population.

What the research actually says about sleep aids

* Sleeping pills (OTC or prescription): approximately 60% of their effect is placebo

* CBT for insomnia (CBT-I): effective in about 80% of people — with no medication

* Benadryl/antihistamines: builds tolerance quickly, may affect memory centers in the brain

* Melatonin: not a sleep aid in the classic sense — it adjusts circadian rhythm; most helpful for jet lag and for autistic individuals

* Marijuana: people report sleeping deeper, but long-term research is limited and complicated

* The pattern to avoid: chasing the magic bullet while skipping the behavioral work that actually retrains the brain

You can’t force sleep — but you can set the conditions

Sleep is one of the few things you genuinely cannot control by willpower. The more you try to control it, the more it escapes you. What CBT-I teaches is how to set the right conditions — the environment, the wind-down routine, the relationship with your bed — and then surrender to the process. A particular challenge for high achievers who are used to pushing through anything.

Warning signs: when it’s time to stop pushing through

* Excessive daytime sleepiness, especially if you’re worried about driving safely

* New high blood pressure, palpitations, or your wearable flagging a possible sleep disorder

* You’re self-medicating with marijuana, melatonin by the handful, or escalating supplements

* Mood that’s tanked: uncontrollable anxiety or depression regardless of what you try

* Your doctor keeps dismissing your concerns — don’t accept that. Advocate for yourself.

Key Quotes

“We were sold a bill of goods. That’s a bunch of BS and the exact opposite of what we needed to do.”

“Sleep is foundational. You cannot build a house without a strong foundation.”

“The only person who’s going to prioritize you as much as you need to be is yourself.”

“Self-discipline is self-love.”

“The more you want to sleep, the more elusive it will become.”

“Do not identify as a bad sleeper — we can always be better at our sleep.”

“The goal is not to have perfect sleep every single night. It’s to be able to roll with the punches.”

“Leave the perfection tendencies at the door.”

“If you’re really concerned about your sleep, do not take no for an answer.”

“Cognitive behavioral therapy is effective in about 80% of folks — completely medication free.”

“We’re little girls inside who grew up to be big, baddie women. And as little girls, we needed routine.”

“You can’t sleep better if your nervous system is dysregulated all day.”

Why This Episode Matters

Season 2 of Checking In is about the mind-body connection — and sleep is where that connection is most obvious and most ignored. You can do all the therapy in the world, but if your nervous system is dysregulated because you haven’t slept well in years, you’re working against yourself.

This episode gives you the science, the psychology, and the permission — to stop shaming yourself, to stop chasing the magic pill, and to start building a relationship with rest that actually works for how your brain operates.

One practical starting point: a simple wind-down routine. Not 15 steps. Not a TikTok skincare hour. Something quiet and consistent that tells your nervous system the day is done. And if you have a rough night, you have a rough night. Don’t spiral. Just try again tomorrow.

If You Loved This Episode

* Share it with the high achiever in your life who swears they’ll sleep when they’re dead — they need this one

* Leave a review on Apple Podcasts — it’s one of the best ways to help this show reach more people who need it

* Subscribe so you don’t miss what’s coming in Season 2: nutrition, movement, stress management, and everything that works together to help you actually live the life you’re working so hard to build

Listen now: Apple Podcasts:

Spotify:

Watch the video version on YouTube (including the moment Dr. Alison explains why high achievers are wired to resist sleep):

About Checking In:

This podcast is for high-achievers, perfectionists, and eldest daughters who look like they have it all together but are silently struggling. Think of Dr. Therese like a big sister with a doctorate who’s been there too and knows what actually helps.

No confusing academic jargon or pretending she has all the answers. Just real conversations about building a life you don’t need to escape from.

New episodes every Thursday.

Season 2 theme: the mind-body connection — because you can’t think your way to wellness. You have to live it.

About Dr. Therese:

Dr. Therese Mascardo is a Filipina-American psychologist and author of Love The Journey. For over a decade, she’s been in therapy rooms noticing patterns most people never get to see: what happens right before someone breaks through to genuine joy, what keeps people stuck, what actually helps when everything feels heavy.

Her mission is simple: to help people build lives they don’t need to escape from.

Sponsored by TherapyNotes:

This episode is made possible by TherapyNotes, the all-in-one practice management software that helps therapists handle notes, scheduling, billing, and telehealth so they can focus on people, not paperwork.

Try it free for 2 months with code DRTHERESE: https://bit.ly/3IjR482

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit exploringtherapy.substack.com