3am Insomnia: When Hormones Hijack Your Sleep in Midlife with Kathleen Saucier

If you've ever stared at the ceiling at 3 AM wondering why your brain won't shut off, this episode is for you. Therapist and sleep specialist Kathleen Saucier joins the Graced Health Podcast to break down CBTI — the evidence-based method that outperforms sleep medication and is recommended as a frontline treatment even for sleep apnea. From why lying in bed too long is actually making things worse, to the simple cognitive shift that can rewire how your brain approaches sleep, Kathleen makes the science approachable and the solutions actionable. If you've accepted poor sleep as just part of life — especially through the hormonal changes of midlife — this conversation might change everything. 

Kathleen is a licensed therapist with over 30 years of experience in community mental health, trauma, domestic violence, military and first responder support, and substance use treatment. She is also trained in equine-assisted therapy and CBTI, and completed her CBTI certification at the University of Pennsylvania under Dr. Perlis, one of the leading experts in the field. Kathleen currently practices via MD Live and Amwell and is licensed in Connecticut, Florida, Washington, and Oregon.

Main Points Discussed:

• What is CBTI?
• The Three Types of Insomnia 
• Stimulus Control
• Sleep Restriction & Sleep Compression 
• The "Swiss Cheese Sleep" Problem 
• The Cognitive Piece: What Are You Telling Yourself? 
• Relaxation Strategies 
• Sleep Hygiene 
• Hot Flashes & Menopause 
• Do You Need a Therapist? 

Connect with Kathleen

MD Live

Amwell

Links Mentioned

CBT-i Coach App

Mindfulness Coach App

Insomnia Coach App

Episodes Mentioned

Meditation Myths Busted: A Guide to Everyday Mindfulness with Ann Swanson

My latest recommended ways to nourish and move your body, mind and spirit: Nourished Notes Bi-Weekly Newsletter

30+ Non-Gym Ways to Improve Your Health (free download)

Connect with Amy:
GracedHealth.com
Instagram: @GracedHealth
YouTube: @AmyConnell

Transcript

3am Insomnia: When Hormones Hijack Your Sleep in Midlife with Kathleen Saucier

Graced Health Podcast

Amy Connell, Host

Kathleen Saucier, Guest

Amy: Hey everyone. Welcome to the Graced Health Podcast. I know I say this a lot, but I'm really excited about this conversation today and the topic, which is CBT-i. You're going to hear about what that is. I have joining me Kathleen Saucier. Kathy, I'm just going to let you describe what you do because I feel like you can help others understand it — and you do so many different things in so many different areas. I'm just going to let you describe what all you do real quickly.

Kathleen Saucier: Sure, I'll just give a quick background. I started in community mental health in '91, working in domestic violence and sexual trauma, and then decided to get my master's degree. After that, I started working with children in trauma, adults again in trauma, then moved on to military and first responders, law enforcement.

Through all of this trauma work, a big, consistent thing I would see was sleep issues. I didn't really know how to treat sleep issues at the time. What progressed for me was working in that space, then my husband retired out of the military, and I started working with people in substance use treatment — and also working with horses. I do a lot with horses and the nervous system, calming the nervous system, and the effects that has on us. And again, here comes sleep.

So when you and I were talking and you mentioned CBT-i, I thought, "Oh yeah, I'm trained in that." That got me excited to come on here and talk about sleep, because honestly, they really didn't train us in it. They talked about how we needed to ask patients whether they were sleeping, but they didn't really tell us how to help them sleep. When I was working with the military, it was really obvious that this was an issue contributing to increased anxiety, increased depression, and struggling in all sorts of different ways. I would try different strategies and they just didn't seem effective enough.

Then I had the opportunity to take a CBT-i training at the University of Pennsylvania with Dr. Perlis, who is one of the leaders in CBT-i — which is really cool. I stayed there for what I think was about a week-long course, but it seemed much longer. I had dual intentions: one was for the people I was working with, and the other was for myself, because during that time I was starting to go through menopause. Between the type of work I did and my hormonal imbalances, my sleep was horrible. I had just kind of gotten used to it and told myself, "That's who I am and this is how I'm going to have to be."

Then I took this class. I thought, "Well, if I'm going to teach other people how to do it, I better do it myself." So I applied everything to myself — and wow, it worked.

Amy: Okay!

Kathleen Saucier: That's when I got sold. This was around 2010.

Amy: Well, I feel like you just locked in my entire community with that, because this all came together right during the menopause transition — and that has changed our sleep. It's changed mine. For the most part I do okay, but I have these little moments of not having good sleep. After learning about CBT-i, I thought, "Oh yeah, this makes sense given what else is going on in my world right now." I have more comments, but we'll get to those as we dig in.

First — we haven't yet said what CBT-i is, so I'm going to ask you to define that and explain how it's different from what the internet is calling "sleep maxing" right now — all the tips, tricks, hacks, supplements, and so on. So what is CBT-i, and how is it different from everything we're seeing online?

Kathleen Saucier: Most people know what CBT is — cognitive behavioral therapy. CBT-i adds a small "i" for insomnia. So it's Cognitive Behavioral Therapy for Insomnia. Truly, if I were to define it simply, I'd say it's behavioral therapy for insomnia. We'll talk more about that as we go.

What I really like about it is that it's evidence-based and research-based — it works. Part of what sold me on it was that I had been taking medication to sleep and I felt worse in the morning than when I hadn't slept well, because I was groggy, I felt crappy, and I didn't function well. I was already experiencing some level of brain fog because of menopause, and then I was adding this on top of it — so that wasn't working.

I should also mention that I struggled with sleep apnea, which had been diagnosed early on. That was an added complication, which isn't uncommon. One of the frontline treatments for anyone with a sleep disorder — when you go to a sleep clinic for a sleep apnea test — is CBT-i. They provide it because it works.

Amy: Mm-hmm.

Kathleen Saucier: And when you have sleep apnea, if you take sleep medication, it can actually make it worse. If you have neurological pauses in your breathing, medication can worsen those pauses — it can actually cause you to stop breathing.

Amy: Wow.

Kathleen Saucier: So it's something you really want to be mindful of. What am I actually doing to my body in desperation to sleep? Am I making it worse?

CBT-i is a pretty simple tool to use. There are strategies you practice, and it typically takes four to eight sessions, depending on the person's level of willingness to do the work and their ability to change certain things in their environment. It revolves around a few key components: sleep restriction, stimulus control (which involves the environment), and the thoughts associated with sleep — what do you believe about sleep?

Amy: You mentioned a few things I'd like you to clarify. I might be jumping ahead, but you said "sessions." Does that mean someone needs to see a specialist to do this, or can they do it on their own?

Kathleen Saucier: I really think it depends on the person. I did it on my own, but I had just come out of an intensive training. Since I took that class, they've created an amazing, completely free phone app called CBT-i Coach. It's through the Department of Veterans Affairs, but you don't have to be a veteran — it's available to everyone.

It has all of the tools I used to carry around in three-ring binders when meeting with someone — all in one app. So you can do it on your own with that, but you need to follow the protocol. There's a protocol to practice.

That said, I think it is helpful to have someone as an accountability partner or guide — someone who understands the concept of CBT-i. Most therapists are trained in relaxation techniques, meditation, and mindfulness, but CBT-i is a bit different. It wouldn't take much for a therapist to get that training or to guide someone through it using the app while providing support. So again, it really depends on the person and their needs.

I've had people come to me saying, "I have horrible sleep — I need help." I'll say, "Okay, let's start here." They'll come back the next session and say, "Wow, I'm in the app and I love it — it's working!" And I'll say, "Okay, let's just check back in a couple of weeks. Maybe you don't even need to see me."

Amy: Okay, that's good. So I'll put a pin in my next question — which is going to be "define sleep restriction," because that sounds a little strange — and we'll come back to that.

This is one reason I was so excited to find out you do this work. I hear so many women — my friends, my community, my Graced Health community — talking about how they're exhausted but their minds won't shut off at night. Or the other common scenario: they fall asleep fine, but then wake up at 3 a.m. and are wide awake. So many just say, "Well, I guess this is how much sleep I get," and get up for the day.

Talk to us about what's happening in the brain in those two situations. They might be different, so feel free to define them separately and then explain how CBT-i can help.

Kathleen Saucier: Good question. We call waking up in the middle of the night "mid insomnia." Early insomnia is when you can't fall asleep at the start of the night. Mid insomnia is waking up in the middle of the night and not being able to go back to sleep. Late insomnia is when you wake up early — say, you normally get up at five, but you're waking at three-thirty and can't go back to sleep.

First, we want to define what the issue is, because that sometimes determines what changes we make.

But I want to go back to a couple of foundational things, and then we'll get to what you're asking. One of the core aspects of CBT-i is stimulus control — what am I associating with my bed?

I always ask people, "When do you go to bed?" They'll say, "Ten o'clock." Then I ask, "When do you fall asleep?" "Oh, not until twelve or one." So they're lying in bed for two hours. There's a rule in CBT-i: only two things happen in bed — sleep and sex. That's it. If you're not doing one of those, you need to get out. We talk about re-associating the bed with sleep.

The problem usually starts with people going to bed before they're tired — maybe because their partner goes to bed at a certain time and they want to be together. So they lie down and read or watch TV, and now they're in bed doing something that shouldn't be associated with that space.

Amy: Wait — you're saying even reading in bed for ten minutes is not part of this protocol? I'm shocked.

Kathleen Saucier: Ten minutes could be okay, but here's the thing — if you're coming to me, you have a problem. If you can read in bed for ten minutes and then fall right asleep, you don't have a problem.

Amy: Okay.

Kathleen Saucier: We'll talk more about mid insomnia in a moment. But when it comes to early insomnia, what often happens is that someone goes to bed at the same time as their partner — whether for intimacy or just companionship — lies there, and the mind starts going. Now the brain has associated that bed and that pillow with thinking. It becomes the place for rumination, and it struggles to shut off.

For mid insomnia — waking up in the middle of the night — a lot of us, myself included (I'm 62, so I'm past menopause, but I've got other things going on), wake up to use the bathroom. You get up, come back, and can't fall back to sleep. The problem is lying in bed while the mind starts going again.

One of the strategies — like sleep restriction or sleep compression — is: if I haven't fallen back asleep within fifteen minutes, I get up. I go sit in a chair somewhere. Even in the bedroom is fine, as long as it's not the bed. I can read, I can do something, until I start to feel sleepy. As soon as I feel sleepy, I go back to bed.

This is the behavioral modification piece. We're retraining the brain. It's frustrating at first and you think, "This is never going to work" — but it really does.

For late insomnia — waking up early in the morning and not being able to fall back to sleep — part of the reason we can't fall back asleep is that the brain gets going and we tell ourselves, "I'm not even going to try." But if we have time left in our sleep window, we can get up for ten or fifteen minutes, do that same thing, and then go back to bed and get some rest.

It takes time — those four to eight sessions I mentioned are typically spread over about a month and a half to allow time to practice and integrate different strategies.

This is where sleep restriction and compression come in. Most people think, "I need to go to bed at nine o'clock to get up at six — that's nine hours." But nine hours in bed is actually too long. We really don't need that much sleep. We need about seven to eight hours — but we need it compressed and restful.

Amy: I wonder if people think they need to go to bed at nine because two or three of those hours will be spent lying awake.

Kathleen Saucier: Correct. And so they lie awake trying to fill that window. What we do instead is called sleep compression. I start from when I need to wake up. If I need to get up at six and I need seven to eight hours, I go to bed at ten or eleven — and that's it.

When you have a disordered sleep pattern, resetting it allows the brain to relearn what it's supposed to associate the bed with — which is sleep. Sleep restriction and compression create a kind of sleep debt. You make yourself a little sleepier so that when you do go to bed, you actually sleep. Sometimes I'll have someone go to bed even a little later than that initial window to build that drive.

Let's say they go to bed at eleven and get seven hours, but they're still waking during the night and feel they want more sleep. Once they can sleep those hours without waking up, we can start to add a little time — but only in fifteen-minute increments. Not thirty minutes, not an hour. Fifteen minutes, and only after a full week of stable sleep.

Amy: That's not a huge variance.

Kathleen Saucier: No, but what's fascinating is that I can't predict exactly where a person's ceiling will be. What I've seen is that when the brain reaches almost a tipping point — when it's getting more sleep than it actually needs — the disruptive pattern will start again. So if someone's goal is to add a full hour, but their brain only truly needs thirty more minutes, once they push past that point, the disruption returns. It's physiological — the body tells you what it actually needs.

Amy: Why does that happen?

Kathleen Saucier: It's simply what the body requires physiologically. And this is why when someone says, "My friend gets ten hours — I'd love to get ten hours," the reality is that ten hours is probably too much for their body. The only time you might genuinely need that extra sleep is if you're sick, or going through something extremely stressful and your body just needs rest. But even then, sometimes what you need isn't more sleep — it's more rest. Those are different things.

One more important note: there is no daytime napping during CBT-i. If you're a napper, that has to go while you're doing the protocol.

Amy: I am really sorry to hear that. I don't nap all that often, but I do go through phases — though I don't typically struggle with what you're describing. Still, so many people in my world do.

Kathleen Saucier: Yes. And when you think about what we're saying, it's neurological — it's all connected. Mind, body, spirit. It's all neurological and physiological. But basically, if you're getting what you need for sleep and it's restful, the amount of energy you have during the day is exponentially greater. Sleep restriction and compression — that's one key component.

The other part involves what's sometimes called a "prescribed sleep window." My focus when working with someone is always: what time do you need to get up? If you need to get up at six, I'll have you go to bed at eleven. We start with seven hours and see how that goes.

Here's what I find fascinating about CBT-i. I had that major sleep disturbance in 2010, did the protocol, and fairly quickly reset my sleep. Then I used these strategies consistently. After about a month of solid, restful sleep, I was able to be more flexible. I had a job that involved a lot of travel — late nights, different schedules — and at first I thought, "I'll never be able to do that again." But that wasn't true. I could do it, and when I got home from a trip, I'd go back to the reset: "Okay, Kath — you get up at six, this is when you go to bed." Within a few days, I'd be back on track. As long as I could return to that foundation, I could be flexible.

Amy: Okay. I'm sitting here listening through the lens of so many women — in my community, among my friends — who deal with that mid insomnia you described, that 3 a.m. wake-up. How does sleep compression and sleep restriction impact that? Because I can hear the voices: "But I can fall asleep fine — it's just the window between three and five a.m."

Kathleen Saucier: It's usually because they're going to bed too early — giving themselves too long of a sleep window. We call it "Swiss cheese sleep" — there are holes in it. You're not cycling through sleep properly.

One of the guys in my training described it like a washing machine cycle. You know how some machines have a favorite cycle, but if you try to repeat just the rinse cycle, it messes up the whole sequence because it wasn't designed to work that way? That's what's happening with sleep. We're disrupting the cycle, not getting good REM sleep, not getting truly restorative sleep. A lot of people with those wearables — rings, watches — see they're not reaching REM, and that's often why. There's too much space between when they went to bed and when they need to get up. The compression closes that window.

Once you teach your brain what it's supposed to do in bed, it starts to get that restorative sleep and begins to recognize the benefit of it.

Amy: So you're saying: even if you're falling asleep at nine or ten, but you're waking from three to four-thirty almost every night, you should compress that window and try to reset the brain — so all the sleep happens in one consolidated block. But then what? I can already hear the responses: "But what if I go to sleep at ten, still wake up at three, and now I've gotten even less sleep because I didn't go to bed at nine like I used to?"

Kathleen Saucier: That can happen for a little while — until the brain realizes you're pushing it, restricting it, compressing it. Because what's happening in that time around three to four-thirty? You're not getting restful sleep anyway.

It can be uncomfortable at first. When I talk to people about it, I suggest choosing a time when you can practice over a long weekend — a few days where you have some flexibility. Also, a lot of people ask, "Does this mean I have to go to bed at the exact same time every night, including weekends?" And the answer is no. After about a month of getting the brain reset, it's smart enough to know, "Oh, it's Friday night." I don't know about you, but on Friday nights I can stay up — I'm wide awake. Yet on Thursday night, I'm zoning out at eight o'clock.

Amy: Right.

Kathleen Saucier: What's the difference? I know I don't have to work Saturday morning. I don't have to get up at any particular time. So this is more cognitive than we often realize — and this is where the cognitive therapy piece of CBT-i comes in. What are the messages we're telling ourselves about sleep?

Amy: That's actually something I wanted to ask about. I heard someone make a passing comment on a podcast once — essentially saying, "If you say things like 'I can't sleep' or 'I'm always awake at three o'clock,' that actually contributes to the problem." As a therapist, I have a feeling you can speak to that. What are the green flags and red flags of the things we say to ourselves?

Kathleen Saucier: Right — that's where the "C" part, the cognitive part, comes in. We look at the messages we carry. Some I've already mentioned: "I need eight hours of sleep," or "I've always needed ten hours — I've been this way since I was a kid." These are unhelpful narratives.

What I'd say to someone with that belief is: what if I told you that you could sleep seven or eight hours and wake up feeling like you slept ten? Because that's actually the goal — not staying in bed for ten to twelve hours and still feeling unrested.

The statements like "I always wake up at this time" or "I never get any sleep" — it's really important to acknowledge that narrative. Often this is where having a therapist is helpful, because I can listen and reflect back: "Here's what I'm hearing you say. That's based on past experience — and rightfully so, because in the past, you haven't slept well. But if you keep telling yourself that, your brain will just keep doing it."

A simple but powerful reframe is adding the phrase "in the past." Instead of "I only get four hours of sleep," try: "In the past, I have struggled with sleep." Just adding "in the past" gives your brain the neurological permission to do something different in the future. It's a simple cognitive strategy.

Amy: That seems like such a small thing to add — and if I hadn't spent so much time learning about this kind of work, it would feel very woo-woo to me. But I believe you.

Kathleen Saucier: I thought it was all woo-woo too! And honestly, if the instructor in 2010 hadn't been so matter-of-fact and even a little funny about it — basically saying, "Yeah, I didn't believe this stuff either" — I don't know that I would have tried it. But I tried it, and it was such an amazing thing. Because I had not slept well my entire life. I'd had sleep apnea issues since I was a little kid, and no one really knew what it was. When I finally got a CPAP machine, that was a whole other challenge — sleeping with that thing.

But now? I go to bed, put on my CPAP, and I'm asleep within five minutes. If I wake up to use the bathroom, I'm back asleep in less than five minutes.

Amy: That's beautiful.

Kathleen Saucier: It took time. And when things disrupt it, I go back to the tools. I think, "Okay, time to reset." But the other piece that's really important — beyond the behavioral and cognitive components — is what you touched on: lying in bed and not being able to quiet the mind. That's where relaxation strategies come in.

Amy: Talk to us about that — I think it would be really helpful.

Kathleen Saucier: Sure. One of the things I mentioned is the CBT-i Coach app, which is free. Just search "CBT-i Coach" — it has a purple icon with a moon. We'll put the link in the show notes.

Inside the app, there's a section called "Quiet Your Mind" — imagine that. It has bedtime stories, ambient sounds, different breathing strategies, and progressive muscle relaxation. It really depends on what's going on for you.

One thing I tell people is: your brain is finally slowing down from the day, and it's trying to remember everything you forgot to remember. So put a pad of paper next to your bed. Just jotting things down tells your brain, "I've acknowledged this — there's nothing I can do about it right now." Your brain won't let go until it knows you've captured it.

Amy: Quick question — I'm assuming you'd want someone using actual pen and paper rather than pulling up the notes app on their phone?

Kathleen Saucier: I used to just say pen and paper, but honestly — I use my notes app.

Amy: Oh! That's a hot take.

Kathleen Saucier: It is! But the key is making sure you're not getting pulled into other things. The CBT-i Coach app, for instance, addresses this — it talks about turning off notifications, setting up your sleep environment, only going to bed when sleepy, getting out of bed when you can't sleep. We live in a world of technology, so that's the nuance there.

The other thing CBT-i is pretty firm about is no TV in the bedroom. That's a big no-no. A lot of people say, "I can't fall asleep without my TV on." But here's what's happening: your brain is staying awake to follow what's on. You may fall asleep, but you most likely won't reach deep REM sleep because your brain is still attending to the environment.

This principle also applies to people who work night shifts — combined with blackout curtains and other environmental strategies, CBT-i can be very effective for shift workers. The goal is to create an environment that says "this space is for sleep."

Progressive muscle relaxation is one of my favorites from the app. It's simple — you don't need a guided version, though there is one in the app. You start at your toes, tighten them, hold, then relax. Then your calves, and you work all the way up — legs, glutes, back, hands, even your face. Tighten, hold, release. Slowly, from bottom to top.

The logic behind it: when we try to "just relax," we do this — exhales — and it doesn't really work. But when you deliberately tighten a large muscle group, it also engages the smaller muscles and fascia around it. When you release, the body sends a signal to relax not just that muscle, but everything connected to it. Doing it piece by piece, all the way up and back down, is very effective.

There's an audio version inside the app, and I really like that one. But you don't need it — you just start at the bottom and move up.

Amy: That's good to know. My husband and I practice breathing and mindful breathing at different times of the day. He's found he needs to do his at the end of the day to quiet his mind. I'm also remembering when Anne Swanson came on to talk about her book Meditation for the Real World and she guided us through something very similar. I love when things keep connecting across conversations. I'll link to that episode in the show notes too.

Kathleen Saucier: Progressive muscle relaxation is so easy. You don't need the audio — you just start at the bottom, move your way up, and then come back down. Very simple.

Amy: Okay. You mentioned sleep hygiene earlier. Can you walk us through that — the basics and beyond, including the TV-in-the-bedroom issue?

Kathleen Saucier: Sleep hygiene is really just having good sleep habits. It starts before you get into bed — things like brushing your teeth, washing your face. What do you do every night before bed? A lot of people say, "I don't really have a routine." Okay — let's create one. Because what a routine does is start to prepare your body and brain: we're getting ready for sleep. It's a signal.

Some of it is individual. Some people can exercise at night and still fall asleep easily. Some people absolutely cannot.

Amy: I am one of those people.

Kathleen Saucier: Know your body. I'm the same way — I'm wired after a workout. The same thing applies to intimacy. Some people are fine with that before bed; others do better in the morning. Having those conversations — especially when you're already dealing with disrupted sleep — is important, so you can protect the intimacy in your relationship while also being mindful of what affects your sleep during a reset period. It's strict while you're in it, but it doesn't have to be that way forever.

Eating before bed is also part of it. How does food affect your digestion, your brain, your body? And medications — some people take everything at night just out of habit or because it's easier to remember. But the timing of certain medications matters. A pharmacist can usually tell you more about this than anyone. When is the most effective time for you to take that medication?

The sleep environment matters too. Less light, a cooler temperature for most people, and — I'll say it — investing in a good mattress. I love the newer adjustable mattresses where each side can be a different firmness. My husband likes very firm; I like soft and squishy. We have a king, and if I roll over onto his side — wow. And if he comes to my side, he sinks right in.

Amy: We had a Sleep Number bed, and he would always call my side "mashed potatoes." I completely understand.

Okay — I'm thinking about the woman who wakes up in the middle of the night with hot flashes. Is there a relationship there, and can CBT-i help manage those nighttime disruptions? Because from what I understand, hot flashes can also be blood-sugar related.

Kathleen Saucier: Nighttime hot flashes can be caused by different things — hormonal, blood sugar, blood pressure, or even sleep apnea. Various things can trigger that response. So the first thing I usually say is: let's go to the doctor. Let's get some bloodwork done and find out what else might be going on. It's not uncommon for women in their late thirties, forties, fifties, or sixties to develop some of those underlying conditions.

But in the meantime, CBT-i can help — and it certainly can't hurt.

Amy: Okay.

Kathleen Saucier: When you wake up with a hot flash, whatever the cause, the strategy is the same: become present, use your breathing, do some relaxation techniques, and see if that helps. If the cause is chemical or hormonal, what the relaxation does is calm some of the secondary response — because when the brain has that chemical surge, there's still a reactive response. The body goes into a kind of alert state: What's going on? Am I under attack? Heart rate increases, respiration increases. If you can just bring that down a little, you may be able to drift back to sleep.

Also — be graceful with yourself. Be kind to yourself. Say, "My body is going through a change right now." Instead of tossing and turning and trying to force yourself back to sleep — which increases frustration and helplessness — get up. Have a good book nearby. Use one of the meditations in the app. Just allow yourself some grace and remind yourself: it's going to get better. It will pass.

Amy: And that ties back to the narrative piece. Telling yourself, "It won't be this way forever. I will go back to sleep." Using your inner voice to calm yourself down.

Kathleen Saucier: Yes, absolutely. Perfect.

A good takeaway here is the CBT-i Coach app. It has assessments, and you can track your sleep progress over time. A lot of times we think, "I'm not doing any better" — but then you look at the data and realize, Huh — I did gain a couple of minutes. It takes time, but when you can see the progress, you start to feel more empowered. I felt so helpless — the narrative I was telling myself was "I'm never going to get a good night's sleep." Once I saw I was making changes, it was genuinely empowering.

Amy: Absolutely. And especially now — there's so much panic and fear around poor sleep. There are valid conversations about how it affects long-term health, including dementia risk. I understand the need for education, but sometimes I feel like the intensity of "you must get a good night's sleep" is backfiring on people.

Kathleen Saucier: And what's really frustrating is that men seem to have fewer issues with this. I'll see guys for sleep apnea, but the hormonal changes we go through, and the way our brains hold on to things — it's just so different for us.

Amy: I believe that. Though at my house, my husband's sleep is very tied to work stress. God bless him — he's trying.

Kathleen Saucier: Give him the CBT-i Coach app.

Amy: I will!

Kathleen Saucier: Because it can't change the level of stress at work, but the tools can still help. When I was going through my most disruptive sleep period, I was on call twenty-four-seven — answering calls from the veterans' crisis line. I couldn't turn off notifications. Part of my disruption was the constant "what's next?" CBT-i taught me how to compartmentalize that.

Amy: You mentioned the CBT-i Coach app was created by the Department of Veterans Affairs. Does someone have to be a veteran to use it?

Kathleen Saucier: No — anyone can use it.

Amy: Okay, great. So that's available to everyone.

Kathleen Saucier: Yes. And the National Center for PTSD is also one of the supporters of that app. The VA actually has several apps I love. There's also one called Insomnia Coach. I don't like it quite as much as CBT-i Coach, probably because I'm a bit of a CBT-i loyalist at this point. But they also have one called Mindfulness Coach, which I recommend a lot to clients. It's completely free. When you open it and click "Practice Now," then select "All," you get a huge list of resources. I love it.

Amy: That's really good to know — thank you. We'll include that in the show notes.

Okay, I have questions I ask all my guests. First: I love learning about people's tattoos, because when someone puts something on their body for the rest of their life, they usually have a reason. Do you have a tattoo? If so, what's the meaning behind it? And if you don't, but you had to get one — what would it be, and where?

Kathleen Saucier: I do have one. My husband and I got matching tattoos that I designed — it's my ring finger. It's a Celtic heart. We both got the same one. He has other tattoos, but that's my only one. I was afraid it would hurt terribly, but it really didn't.

Amy: I'm surprised to hear that! I've always heard that the closer the skin is to bone, the more painful it is.

Kathleen Saucier: Well, my husband was jumping around more than I was. I think I was trying to prove I could handle it — since he already had tattoos. Competition is a great motivator.

Amy: It really is sometimes!

Kathleen, I know you have a private practice. Tell us how people can connect with you, and particularly which states you're licensed to practice in.

Kathleen Saucier: I practice mostly through MD Live or Amwell — two telehealth platforms. I also do work specifically with firefighters in Oregon and Washington. My states of licensure are Connecticut, Florida, Washington, and Oregon. If anyone is interested in finding me, you can Google my name — Kathleen Saucier — and I'll come up. People find me that way, and I can either work with them or connect them with a referral if I'm not licensed in their state.

Amy: Perfect — thank you! And can you share a meaningful Bible verse with our community?

Kathleen Saucier: I thought about this. I wanted to find one related to sleep, and I landed on Psalm 4:8 — "In peace I will both lie down and sleep, for you alone, O Lord, make me dwell in safety." Because so often we can't sleep because our brain is trying to keep us safe. It might be afraid we'll forget something, or afraid for our safety. Just focusing on the fact that we can give that to God, and rest in peace.

Amy: That's beautiful — thank you. I love that.

Okay, you get the last word. What is one simple thing you'd like us to remember?

Kathleen Saucier: You can get better sleep. You can. And there are so many tools and strategies to help. You might be able to do it on your own — the CBT-i Coach app is a great place to start. Or find a therapist. And if you talk to a therapist who isn't familiar with sleep treatment or CBT-i, find another one — because there are people out there who do this work, and you deserve that support.

Amy: That's all for today. Go out there and have a graced day.