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Welcome to “Should I Call a Doctor?” The podcast where we dive into trending health topics to separate fact from fiction. We bring in experts to talk about all things health, to empower you with knowledge and answer your questions hosted by Inova Health.
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Welcome to should I Call a
Doctor?
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The podcast, where we dive into
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the questions you have about
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your health and today's trending
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health topics.
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To separate fact from fiction.
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I'm one of your hosts, Doctor
Samuel Cowley, an internal
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medicine physician at Inova.
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I'm Tracy Schroeder.
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I lead communications for Inova.
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Doctor Sam will give you the
clinical perspective while I ask
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the questions that keep patients
up at night.
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Welcome to the show.
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Today we'll be talking about a
topic that affects all of us and
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that is sleep.
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Joining us today is Doctor Eric
Sklar.
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Doctor Sklar is a neurologist
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who is board certified in
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neurology, sleep medicine,
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clinical neurophysiology and
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vascular neurology.
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With more than seventeen years
of experience.
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I've known Doctor Sklar for
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years myself, and I can
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definitely attest that he knows
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what he's talking about in these
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areas.
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He treats patients with a wide
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variety of disorders, including
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sleep apnea, restless leg
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syndrome, narcolepsy, um, and
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serves as a medical director of
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the Anova Sleep Disorders
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Program.
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Welcome, Doctor Sklar, we're so
happy to have you today.
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Let's just start at the basics.
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Why is sleep so important?
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I think we all read a lot.
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We know it's important, but it's
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also sometimes the first thing
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that we give up if we if things
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are stressful or busy or, you
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know, sometimes by choice and
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sometimes not.
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But talk to us about, you know,
why it's so important and how we
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can make sure that we can get to
sleep and stay stay asleep.
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Well, like Sam said, the very
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beginning, it affects all of us,
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right?
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Everyone needs to sleep so that
that that just tells you the
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importance right there.
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Um, sleep has a lot of, uh, a
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lot of important functions in
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terms of, uh, you know, physical
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rejuvenation, uh, cognitive, uh,
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restoration.
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Um, the brain gets rid of waste
products during sleep, and the
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body has a chance to recover.
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And so, uh, so it's intimately
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tied into a lot of cognitive and
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physical things.
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And so, you know, if to maintain
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optimized cognitive and physical
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activity.
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You know, sleep is an important
part of that.
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Um, why we treat a lot of people
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who have problems because they
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want to get back to feeling
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better.
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And I know I'm always amused by
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or maybe just fascinated by the
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people that are like, I only
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need four hours of sleep a
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night.
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Is that really true for some
people?
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Like, I know it's not true for
me.
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I'm more of an eight hour kind
of girl, but, you know, anywhere
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between six and eight feels like
more the norm.
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But some people I know say like,
oh no, I can.
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I can be at my best with four
hours.
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Right.
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I mean, there's a wide range.
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I mean, the typical adult will
require somewhere between seven
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to nine hours of sleep for for
real, optimal sleep.
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Um, obviously people get by on
less as far as people who
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actually need less or require
less, I think there is a small
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subset of people who who don't
need as much sleep as others.
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Um, and they would be able to
function without, like loading
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up on caffeine or taking a nap
or things like that.
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But, but most, most healthy
adults need between seven and
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nine hours of sleep.
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Okay, so the person who says,
oh, I only need four hours of
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sleep and actually plays out
that they're very functional on
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those four hours of sleep, even
for those people.
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Is there any long term
detrimental effect to that, or
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is how functional you are with X
numbers of sleep?
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A good marker of the effect it's
having on your body?
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You know what I mean?
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Sure.
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If I get by in a few hours of
sleep, does that also mean it's
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not harming me?
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Right.
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I wouldn't go that far.
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Um, you know, uh, because lots
of people function on less sleep
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than they should be getting.
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Um, and, and in society, we have
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a lot of ways to compensate for
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that.
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Right?
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Uh, caffeine being one of them.
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Um, so I wouldn't correlate, uh,
daily functioning with, with,
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like, hey, lack of sleep is not
going to cause you any problems.
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I guess it depends.
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Uh, and this is what we do in
our clinic.
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Uh, you have to kind of do a
deep dive as to why they're
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getting so little sleep.
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Um, you know what's happening
when they are sleeping?
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Do they wake up a lot?
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And and how do they feel?
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How do they feel in the morning?
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How do they feel during the day?
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Do they need to take a nap or
like, really wish they could
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take a nap or nap on the
weekends when things are quiet?
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Uh, those, those kinds of things
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usually fill in the blanks in
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terms of, okay, well, you're
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probably more tired than you
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really realized.
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I mean, it's great that people
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can function, but, you know,
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that doesn't really take away
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the detrimental effects of lack
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of sleep.
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Well, let me ask you, so what is
the most common complaint you
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get as it relates to sleep?
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Uh, I would say the most common
thing that we see is like for a
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sleep apnea evaluation, it's
kind of been in the news, um,
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it's more, uh, there's more
awareness behind it.
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So we get a lot of people, uh,
for that.
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Um, as in terms of complaints,
it's it's one of two things.
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And this, this is kind of the
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end result of any sleep
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disorder.
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It's either insomnia, like not
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being able to sleep well, waking
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up a lot, or being tired during
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the day.
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Excessive daytime sleepiness.
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Um, and usually from there,
we'll we'll find out what the
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causes are, um, sleep apnea
being the most common or
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certainly most of these
referrals, like somebody sent
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someone over or does someone
show up and say, hey, I was
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watching the news and I thought,
I have I might have sleep apnea,
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or my girlfriend is telling me
I'm snoring a lot.
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Um, like what happened to me.
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And, um, you know, they asked
you to come see you.
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It's any of that stuff.
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It's, uh, you know, most of the
referrals are from either
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primary doctors, or we see
people from the Bariatrics
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clinic or the cardiology clinic
is pretty common.
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Um, but but invariably, when
someone comes in and I start
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talking, and if they're talking
about snoring or their breathing
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at night, they'll say their
spouse was concerned.
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They talked about it with their
primary doctor.
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So, um, so it's a little bit of
everything that's great.
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And so talk about how, you know,
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what are like when somebody
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seeing you what are the
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treatments.
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Yeah.
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So obviously, uh, we do a deep
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dive into what their sleep
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pattern is, what they're doing,
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what's happening?
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Um, and depending on what those
answers are, will kind of guide
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what we're talking about.
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So, uh, for example, one of the
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more common things we see is
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people have bad sleep hygiene,
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right?
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So, um, they they're watching TV
late at night.
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They're, uh, they're on their
phone in bed scrolling for a
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while before they turn it off
and try to go to sleep.
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Um, and those types of
electronics and screens are very
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activating to the brain.
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Mhm.
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Um, and so if, if they have a
problem with sleep hygiene then
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that's the first step.
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Hey turn those off now.
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Easier said than done.
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Uh it's a process but um, you
know uh, usually we'll recommend
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that they not use any of that
stuff in bed because that
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creates a subconscious
connection to kind of being
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cognitively activated while
you're in bed, so that's
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counterproductive to good sleep.
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Um, and, um, you know, and then
then we'll suggest that they,
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they also kind of, uh, give
themselves a buffer time between
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turning off the screens and
going to bed, usually between
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thirty and sixty minutes.
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I would say longer is better.
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Just allow their brain to kind
of power down and kind of relax.
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And it can be hard because, you
know, scrolling on your phone
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while you're just vegging in bed
is skyrocketing, right?
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Right.
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Uh, but but the screens are
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very, um, very activating to the
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brain.
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And, and a lot of people, uh,
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will say, well, I have the blue
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light filter.
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I was going to ask about that,
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so forth, the Kindle or whatever
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product.
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Yeah.
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And there's obviously a spectrum
of like worse and better.
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So, you know, using the filter
is probably better than not
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using the filter.
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But there have been studies that
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showed that the retina is just
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as activated even with the
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filters.
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And so I will recommend,
especially if I'm seeing someone
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who has a sleep problem.
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Right.
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Like, you know what?
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You just got to turn it off.
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Yeah.
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And this is the library.
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Get a real book.
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Well, I was going to say so it
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sounds from what you're saying,
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that it's not just that your
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brain is being fogged or
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cognitively stimulated because
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reading a book could do the
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same.
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So is it specifically the screen
that you're talking about?
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Yeah.
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The idea of the screen.
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Right.
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Not the fact that I'm reading
something.
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Well, I mean, again, there's or
is that also a spectrum?
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Yeah, there's a spectrum of of
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what's like the worst thing you
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can do.
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It's probably like a seventy
inch TV in your bedroom.
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Um, and like, probably the least
worst thing you could do, which
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would be reading a book in bed,
it's still generally recommended
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not to read in bed.
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Um, but sure.
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I mean, reading a paper book is
going to be less of an issue
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than, like, reading a book on a
bright, uh, iPad.
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So what are the things you
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should be doing to sort of wind
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down?
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Is it you're like, well, maybe
take a shower or do some yoga or
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just lay in bed or write.
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I know a lot of people do.
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They just delay and delay and
delay.
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But, uh, you know, to your
question, um, so what I try and
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do is I tell people, well, you
know, you want to do things that
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are not, like, very stimulating.
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Now, um, they can listen to to
things.
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So I, I mean, swap out would be
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an audio book or an audio
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podcast or listening to some
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soft music.
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Now I do I do have to kind of
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specify, hey, don't don't have a
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page turner audiobook that you
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just can't wait to hear the next
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chapter.
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You know, um, you want something
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more mundane that's not going to
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have you on the edge of your
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seat.
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Then I also tell people, you
know, as a little bit of a
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switch up, you know, I think a
lot of people will kind of do
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their chores, you know, empty
the dishwasher or fold the
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laundry and then, like, reward
themselves by watching TV.
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So I would say, well, maybe,
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maybe save your laundry for
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last, you know, fold your
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laundry last.
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That's kind of a mundane.
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Definitely more appealing.
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Yeah.
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And then, you know, maybe that
gets him to sleep.
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So. But so I tell people to do
things like that.
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Yeah.
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Shower.
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You know, uh, you know, baths
certainly is a relaxing thing.
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So, you know, things like that.
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I mean, you have to be creative.
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I mean, the world we live in is
kind of, uh, you know, uh,
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screens are a big part of it.
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Part of it.
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Yeah.
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Um, but, um, yeah, for for
someone that has a real problem.
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I mean, that's, that's the first
place to start.
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So what about talk about the
impact?
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I feel like I've read a lot
about this.
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How does drinking alcohol and
sleep correlate?
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Yeah.
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Well, I think there's a lot
about alcohol in the news now.
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Right.
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Um, just about like they want to
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classify it as a carcinogen and
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so forth.
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Um, as far as sleep goes, it's
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one of these paradoxical things
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because it is relaxing and it is
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a sedative.
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Um, but it is also disruptive to
sleep architecture.
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And so while alcohol will and
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probably most people can attest
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to this, while alcohol will help
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put you to sleep, you're not
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going to have a real great
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sleep.
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Um, and so, uh, that that's just
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another reason to not drink
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alcohol.
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And certainly we don't want to
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push that people to drink
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alcohol to kind of help them get
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to sleep.
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No. Um, from a medical
standpoint, um, alcohol and
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sedatives like that actually
worsen sleep apnea.
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Mhm.
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Um, so if there is an underlying
sleep condition like sleep
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apnea, um, alcohol can
exacerbate it or make it worse.
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So, so I tell people, I mean, if
they're having a glass of wine
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at dinner, you know, at six
thirty and they go to bed at
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ten, I mean, that's probably not
going to have a real effect.
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But if they're like drinking two
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or three beers, you know, into
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the evening while they're
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watching a game on TV, I mean,
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that that could have more of an
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effect if you take all the
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patients who come in, you know,
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with some sort of insomnia type
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complaint.
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And you, you put aside the sleep
apnea category, are the majority
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of the patients you see, um, who
have a sleep problem.
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Really, it comes down to sleep
hygiene.
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Is that the most common cause?
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I wouldn't I wouldn't say that.
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I mean, insomnia is certainly
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like one of the most common
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sleep things out there in the
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world.
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Um, so I wouldn't say that sleep
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hygiene is always like the
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cause.
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It's like anything, there's
usually a bunch of factors and
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that's one of them.
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And I'll tell people, I'll say,
listen, this isn't probably
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going to solve everything, but
it's not going to hurt.
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Um, so yeah, I mean, there's a
lot of different things that
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play into insomnia.
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So, um, you know, mental health
plays a big role in insomnia.
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Uh, there's a very high
correlation with things like
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anxiety, depression, PTSD.
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Um, and so we'll get people who
are not really controlled in
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terms of anxiety or depression.
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Um, and they can't sleep.
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And that's another day, like,
hey, talk to your psychiatrist,
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your primary doctor, but you got
to treat your anxiety better.
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You know, you got to get that
under control.
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Because if you, uh, if you lie
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down and your thoughts start
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racing and you can't shut down
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kind of ruminating thoughts and
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so forth, that's going to affect
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your sleep.
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And, you know, uh, it's not
really a sleep disorder.
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It's it's a mental health
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disorder that has a symptom of a
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sleep problem.
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And does that exacerbate the
mental health disorder?
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So does it also have a secondary
effect?
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So if I don't sleep now I'm more
anxious.
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Yeah.
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Yeah I mean it's a it's a real
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chicken or egg kind of thing
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because you know, you don't
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sleep well because of anxiety,
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depression and then you're tired
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and then you're kind of like
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more depressed and you have
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lower energy.
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And, and, you know, a lot of
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people can develop what's
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called, um, psychophysiologic
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insomnia where they start
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worrying about about the next
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night because like, okay, you
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know, not sleeping well and they
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get a little anxious about
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what's.
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Yeah.
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What's that going to be like
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tonight can be another one of
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those nights.
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Are there things people can do
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if they are finding that they're
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waking up in the middle of the
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night?
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What what do you usually tell
those patients?
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Yeah, I mean, so it's definitely
not recommended to just, like,
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lie in bed for hours on end.
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Yeah.
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Um, because again, you, you
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create a subconscious
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connection.
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Being in bed and not being
asleep.
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You want to have the connection
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that when you're in bed, you're
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sleeping.
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Um, so if someone wakes up
during the night and can't get
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back to sleep again, you know,
you want to make sure.
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Are there any mental health
issues?
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Because a lot of times, why
can't they get back to sleep?
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Right.
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Well, then the thoughts kick in
then.
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Then the anxiety comes up.
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So uh, again, then you go back
to treating that part of it.
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But, um, but if someone cannot
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get back to sleep and, um, you
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know, I say don't look at the
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clock, but if you feel like
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fifteen twenty minutes go by,
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you know.
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Maybe thirty, then, you know,
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you can get out of bed, go into
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a different room, keep the
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lights low.
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You could read a book, a
magazine, you know, don't turn
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on your phone, don't watch TV,
don't go eat anything.
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Um, but, uh, you know, try to
keep, uh.
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To do something very mundane,
like we talked about before.
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And, um, and then if you start
to get tired again, then go
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right back into bed and, um,
and, and, you know, that's,
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that's kind of the strategy for
some of that stuff.
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So talk I know we've kind of
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danced a little bit around and
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mentioned sleep apnea, but tell
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us what the symptoms are of and
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we use uh, you know, in terms of
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like a screening tool, we use
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something called a stop-bang,
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um, which is basically eight,
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uh, risk factors for sleep
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apnea.
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And it's been shown that if you
score three or more that you are
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that correlates with a higher
risk of sleep apnea.
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So that would be that you snore
would be one.
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Snore.
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Loudly.
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Um.
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Uh. Stop breathing at night.
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So someone says maybe you stop
breathing.
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Um. Uh, you know, if you have
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high blood pressure is another
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one.
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Um, are you tired during the
day?
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Is another one?
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Uh, if you're over fifty years
old, if you're a male, um, if
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you have a large neck size.
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So in men, that's seventeen
inches and women over sixteen
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inches, um, and, um, and if your
BMI is above thirty five,
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although I would probably argue
that, uh, BMI over thirty is a
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higher risk, you know, of the
people that I see and, and, you
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know, most of these people do
have a sleep study ordered
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because that's what they're
there for, and that's what they
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need to find out.
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Um, I would say it is pretty
rare to, to see like a totally
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negative sleep study.
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Interesting.
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In, in the snorers.
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In the snorers.
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Yeah, yeah.
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Now, uh, they might not have
full blown sleep apnea.
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But, um, there there's also a
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spectrum of sleep, disturbed
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breathing.
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Right.
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So they could have what's called
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upper airway resistance
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syndrome, uh, which is
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disruptive, but it's not really
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meeting criteria for sleep
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apnea.
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They could have mild, moderate
or severe sleep apnea.
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They could just have primary
snoring.
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Yeah.
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Um, but, uh, but but I would say
of the people we're seeing in
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clinic for sure that that kind
of kind of self-select, you
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know, for snoring, uh, very high
percentage, have some degree of
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sleep, disturbed breathing.
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Is there a role or what is the
role for medication?
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And and I'm even more simply
than prescription medication,
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just the go to.
Speaker:
Right.
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The average person who's having
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issues with sleep, I'm sure has
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at least at one point, at one
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point taken a Benadryl or
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Tylenol PM or something over the
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counter.
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Is there a role for that?
Speaker:
What is the role for that?
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Do you generally caution against
it separate from the long term
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strategy type stuff?
Speaker:
So for just treating insomnia
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without some other comorbid
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sleep disorder.
Speaker:
Yeah.
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Um, so it depends on the
situation, obviously, whether
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it's kind of an acute insomnia
or more chronic.
Speaker:
Um, but but the main treatment
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for, uh, certainly chronic
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insomnia is actually not
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medicine.
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It's a, it's behavioral therapy
CBT or cognitive behavioral
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therapy for insomnia.
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That's really first line
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research proven treatment for
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chronic insomnia.
Speaker:
Now, you know, in more acute
cases where, you know, someone
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had a death in the family and
they're really distraught and
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they need something to sleep.
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We do use, uh, like sedative
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hypnotics, um, on a short term
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basis.
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Um, and then, uh, for people
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that, uh, that, that need
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something on a more chronic
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basis, uh, we always push for
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CBT because that's really
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important.
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And some people are more into it
than others.
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Yeah.
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Um, but there are some
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medications that are, um, that
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are used for chronic insomnia,
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that are like, not controlled,
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like some of the more acute
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medications.
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Um, and so we'll use those in
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conjunction with the behavioral
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therapy.
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But the acute being.
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Yeah.
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Just to restate what you already
said.
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But the idea there is, listen,
you have some specific thing
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going on or whatever it is,
physiologic, mental etc. and
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you're just getting through this
zone that's more of the powerful
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or more relevant.
Speaker:
Yeah.
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Type of let's use medications to
get you through this.
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But it is a long standing
problem, right?
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We try to avoid and we want to
get to the underlying issues.
Speaker:
Right.
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And so people who have had
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insomnia in the past are more
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prone to bouts of acute
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insomnia.
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So again is that an anxiety
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issue that probably needs to be
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controlled.
Speaker:
Is it just a predisposition to
to, to kind of acute stressors,
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uh, causing insomnia?
Speaker:
It depends on the situation.
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Yeah.
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Um, you know, if it's a real
anxiety component, then we might
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use a benzo again.
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Very, very short duration.
Speaker:
Um, we have the sedative
hypnotics.
Speaker:
There's some other medications.
Speaker:
Even over-the-counter
medications are, uh, in a very
Speaker:
short term basis.
Speaker:
Probably.
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Okay.
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Uh, we don't like to have people
use, like, Benadryl long term.
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You know, those antihistamines
can have cognitive side effects
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if used long term.
Speaker:
How long is the average sleep
study?
Speaker:
Is it like you come in because,
you know, for our listeners, I'm
Speaker:
sure they're curious.
Speaker:
Um, is this like a come in and
you spend a full night?
Speaker:
Is it?
Speaker:
Hey, we just need to watch you
for four hours.
Speaker:
Is it.
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What is it, one hour?
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What does it look like?
Speaker:
Well, I mean, uh, you know,
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think about how long you'd want
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to sleep.
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You'd want to sleep a whole
night.
Speaker:
So it is a whole night thing.
Speaker:
There's a couple of different
types of sleep studies we use.
Speaker:
So it depends on the situation,
other medical problems.
Speaker:
Um, you know, if there's been
past testing, things like that.
Speaker:
Um, but, uh, an overnight
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polysomnogram, which is when
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someone would come in the lab
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and kind of get, quote, hooked
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up.
Speaker:
Uh, they would come in, you
Speaker:
know, in the evening and they'd
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be given instructions by the
Speaker:
technician, and then they have
Speaker:
the electrodes put on them, and
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then it's usually lights out,
Speaker:
you know, ten thirty, eleven and
Speaker:
then they go until about six,
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six thirty when they're, uh,
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either they're up or they get
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woken up and then they get
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disconnected.
Speaker:
Um, and so we usually have, you
know, seven, eight hours of, of
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data to review.
Speaker:
And do people tend to sleep
pretty well?
Speaker:
I mean, are you giving them like
nice cozy conditions in these
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sleep tabs for them to.
Speaker:
Yeah.
Speaker:
Or question a lot.
Speaker:
Yeah.
Speaker:
Does it feel like it's a Chicago
style.
Speaker:
Yeah.
Speaker:
I wouldn't say a luxury hotel,
but, uh, but we have rooms that
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are done up like a little small
studio, you know, there's like a
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real bed, um, night table.
Speaker:
Um, and, um.
Speaker:
Yeah, it's set up like a little
mini bedroom.
Speaker:
It's not like you're on a hard
exam table, right?
Speaker:
Right.
Speaker:
And in some cases, you can send
Speaker:
the study home with people,
Speaker:
right?
Speaker:
They can do it in their own
home.
Speaker:
Yeah.
Speaker:
So another option again, usually
Speaker:
for very medically uncomplicated
Speaker:
patients.
Speaker:
But, um, uh, a home sleep study
where patients will wear a
Speaker:
device, uh, the one that we use
is called Watchpat and it goes
Speaker:
on the arm.
Speaker:
Uh, there are a lot of other
traditional ones that you strap
Speaker:
something around your chest and
so forth, but, um, but
Speaker:
basically, yeah, the patient
would go home with like, a kit
Speaker:
and they would put that on and
that that can be helpful for
Speaker:
some people that maybe have like
more irregular hours.
Speaker:
Right.
Speaker:
Like if they're working a late
shift and, um, and they don't go
Speaker:
to bed until two a m. Well, I
mean, having them come in the
Speaker:
lab and try to go to bed four
hours earlier than that.
Speaker:
I guess sometimes be a problem.
Speaker:
So. So the home tests are, uh,
they're they're good screening
Speaker:
tests for sleep apnea.
Speaker:
What are your thoughts on this
upcoming all the the recent
Speaker:
trend in wearables.
Speaker:
So it's sort of a two part
question.
Speaker:
One, just the wearables in
general, like the wearing on
Speaker:
sleep and then two, the Apple
Watch claim on sleep apnea.
Speaker:
What are your thoughts on either
of those things.
Speaker:
Yeah I mean, so as far as sleep
Speaker:
apnea goes, um, you know, I
Speaker:
think it's all about screening,
Speaker:
right?
Speaker:
So they're they're not medical
grade, obviously, but I mean, if
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the Apple Watch is showing that
you have dips in your oxygen and
Speaker:
you know that you snore, you
know, I don't know what the
Speaker:
algorithm is for it to say, hey,
get checked out.
Speaker:
But, um, but but you know, that
could definitely prompt people
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to get checked out.
Speaker:
Things like the aura ring or
other trackers.
Speaker:
I always tell patients to to
kind of take it with a grain of
Speaker:
salt, if certainly some patients
will come in with like a list
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of, uh, you know, or a printout,
where's the data?
Speaker:
Or I print out of, like, their
night's sleep and, and I think
Speaker:
in general with what the data
that this, that these trackers
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collect, um, it kind of
correlates with what they
Speaker:
already know, right?
Speaker:
Hey, I'm not sleeping well, and
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this is showing me that I'm
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waking up ten times a night,
Speaker:
right?
Speaker:
And so I think it can be helpful
for trends, um, you know, uh,
Speaker:
but it, it can't so much call
like it's telling you.
Speaker:
Yeah.
Speaker:
Hey, you did a good night's
sleep.
Speaker:
It's good.
Speaker:
It's me.
Speaker:
It's alright.
Speaker:
With what?
Speaker:
You know that.
Speaker:
Hey, you're not sleeping great.
Speaker:
And it's not going to tell you
why.
Speaker:
Um, and and and it can be
counterproductive.
Speaker:
I mean, in certain patients with
the right personality, they can
Speaker:
get a little too fixated on,
like, the number.
Speaker:
You know, what was my sleep
quality?
Speaker:
Oh, I got a seventy five
tonight.
Speaker:
You know, it can get a little
too fixated on that stuff.
Speaker:
Um, again, good data points to
have, but probably telling you
Speaker:
what you already know.
Speaker:
Um, but, yeah, uh, the the the
new Apple Watch, uh, app, um, I
Speaker:
think, uh, it it just says, hey,
you may be at risk and it could
Speaker:
be, like you said, a screening,
like a prompter for you to say,
Speaker:
okay, I should look into this.
Speaker:
I should call my doctor.
Speaker:
Yeah.
Speaker:
Anything you'd like to leave us
with?
Speaker:
We're really grateful and
Speaker:
appreciative of all this great
Speaker:
information you shared with us
Speaker:
today.
Speaker:
Yeah.
Speaker:
I mean, the thing I tell
Speaker:
patients all the time is, you
Speaker:
know, they only know their own
Speaker:
experience.
Speaker:
And I see a lot of patients that
put off getting evaluated for a
Speaker:
long time because they think,
oh, everyone with kids is tired.
Speaker:
Everyone who works a job is
tired.
Speaker:
Um, and and, you know, I mean,
there might be some truth to
Speaker:
that, but, um, but but it
doesn't mean that that you might
Speaker:
not have something else.
Speaker:
And, um, a lot of people put
Speaker:
this off because they think they
Speaker:
just feel the way they should
Speaker:
feel.
Speaker:
And, and in reality, they might
Speaker:
have something that could be
Speaker:
treated and, and not only be
Speaker:
treated and make them feel
Speaker:
better, but also have a more
Speaker:
positive impact on their general
Speaker:
health.
Speaker:
Right.
Speaker:
Great advice.
Speaker:
Agree with Tracy.
Speaker:
Thank you so much.
Speaker:
Really appreciate the time
today.
Speaker:
Yeah.
Speaker:
No problem.
Speaker:
Glad to be here.
Speaker:
Thanks for tuning in.
Speaker:
We hope you enjoyed this
episode.
Speaker:
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