Dr. Matthew Walker: Protocols to Improve Your Sleep

00:00:00.000 | - Welcome to the Huberman Lab Guest Series,

00:00:02.460 | where I and an expert guest discuss science

00:00:05.140 | and science-based tools for everyday life.

00:00:07.300 | I'm Andrew Huberman,

00:00:09.660 | and I'm a professor of neurobiology and ophthalmology

00:00:12.660 | at Stanford School of Medicine.

00:00:14.620 | Today marks the second episode

00:00:16.260 | in our six episode series all about sleep

00:00:18.660 | with our expert guest, Dr. Matthew Walker.

00:00:21.180 | During today's episode,

00:00:22.100 | we discuss the do's and the do nots of sleep.

00:00:25.180 | Focusing for instance,

00:00:26.460 | on how to use light and absence of light

00:00:28.700 | as well as temperature, both of your sleep environment,

00:00:31.260 | specifically the room you're in, your body temperature,

00:00:34.100 | and much more in order to regulate the timing

00:00:36.660 | and quality of your sleep.

00:00:38.420 | And we discuss how things like alcohol,

00:00:40.220 | caffeine and cannabis impact sleep

00:00:42.580 | and the various stages of sleep.

00:00:44.340 | And we discuss the various tools that exist now

00:00:47.060 | and that are rapidly becoming available

00:00:48.940 | to improve your sleep.

00:00:50.420 | This episode is essential

00:00:51.660 | for anyone trying to optimize their sleep.

00:00:53.700 | And when I say optimize your sleep,

00:00:55.580 | I mean trying to optimize the formula

00:00:57.660 | that was addressed in the first episode of this series,

00:00:59.940 | which is the QQRT formula,

00:01:01.980 | the quality, quantity, regularity and timing of your sleep.

00:01:05.620 | Four variables that combine to determine

00:01:08.020 | whether or not your sleep is optimized for you

00:01:10.300 | and thereby providing the most restoration and improvement

00:01:13.660 | to your mental health, physical health and performance.

00:01:16.260 | Before we begin,

00:01:17.140 | I'd like to emphasize that this podcast

00:01:18.900 | is separate from my teaching and research roles at Stanford.

00:01:21.600 | It is however, part of my desire and effort

00:01:23.700 | to bring zero cost to consumer information about science

00:01:26.340 | and science related tools to the general public.

00:01:29.020 | In keeping with that theme,

00:01:30.260 | I'd like to thank the sponsors of today's podcast.

00:01:32.940 | Our first sponsor is Helix Sleep.

00:01:35.180 | Helix Sleep makes mattresses and pillows

00:01:37.020 | that are customized to your unique sleep needs.

00:01:39.620 | It's abundantly clear that sleep is the foundation

00:01:42.020 | of mental health, physical health and performance.

00:01:44.540 | When we're getting enough quality sleep,

00:01:46.220 | everything in life goes so much better.

00:01:47.740 | And when we are not getting enough quality sleep,

00:01:49.920 | everything in life is that much more challenging.

00:01:52.340 | And one of the key things to getting a great night's sleep

00:01:54.520 | is to have the appropriate mattress.

00:01:56.480 | Everyone however, has slightly different needs

00:01:58.440 | in terms of what would be the optimal mattress for them.

00:02:01.220 | Helix understands that people have unique sleep needs

00:02:03.860 | and they've designed a brief two minute quiz

00:02:05.980 | that asks you questions like, do you sleep on your back,

00:02:08.420 | your side or your stomach?

00:02:09.380 | Do you tend to run hot or cold during the night?

00:02:11.060 | Or maybe you don't know the answers to those questions.

00:02:13.300 | If you go to the Helix site and take that brief quiz,

00:02:15.180 | they'll match you to a mattress that's optimal for you.

00:02:17.660 | For me, it turned out to be the Dusk D-U-S-K mattress.

00:02:20.580 | It's not too hard, not too soft.

00:02:22.020 | And I sleep so much better on my Helix mattress

00:02:24.340 | than on any other type of mattress I've used before.

00:02:26.820 | So if you're interested in upgrading your mattress,

00:02:29.020 | go to helixsleep.com/huberman,

00:02:31.820 | take their brief two minute sleep quiz,

00:02:33.540 | and they'll match you to a customized mattress for you.

00:02:35.580 | And you'll get up to $350 off any mattress order

00:02:38.820 | and two free pillows.

00:02:40.100 | Again, that's helixsleep.com/huberman

00:02:43.220 | to save up to $350 off and two free pillows.

00:02:46.680 | Today's episode is also brought to us by Woop.

00:02:49.600 | Woop is a fitness wearable device

00:02:51.100 | that tracks your daily activity and sleep,

00:02:53.300 | but also goes beyond that by providing real-time feedback

00:02:56.180 | on how to adjust your training and sleep schedule

00:02:58.380 | to perform better.

00:02:59.820 | I've been working with Woop

00:03:00.660 | on their scientific advisory council

00:03:02.660 | to try and help advance Woop's mission

00:03:04.580 | of unlocking human performance.

00:03:06.540 | As a Woop user, I've experienced the health benefits

00:03:08.600 | of their technology firsthand for sleep tracking,

00:03:10.760 | for monitoring other features of my physiology,

00:03:12.860 | and for giving me a lot of feedback

00:03:14.760 | about metrics within my brain and body

00:03:17.100 | that tell me how hard I should train or not train,

00:03:19.500 | and basically point to the things that I'm doing correctly

00:03:21.860 | and incorrectly in my daily life

00:03:23.580 | that I can adjust using protocols,

00:03:25.540 | some of which are actually within the Woop app.

00:03:28.220 | Given that many of us have goals

00:03:29.520 | such as improving our sleep, building better habits,

00:03:32.300 | or just focusing more on our overall health,

00:03:34.580 | Woop is one of the tools

00:03:35.500 | that can really help you get personalized data,

00:03:37.540 | recommendations, and coaching toward your overall health.

00:03:40.640 | If you're interested in trying Woop,

00:03:42.160 | you can go to join.woop.com/huberman today

00:03:45.880 | to get your first month free.

00:03:47.180 | Again, that's join.woop.com/huberman.

00:03:50.620 | Today's episode is also brought to us by Waking Up.

00:03:53.460 | Waking Up is a meditation app

00:03:55.320 | that has hundreds of different meditations,

00:03:57.220 | as well as scripts for yoga nidra

00:03:59.500 | and non-sleep deep rest or NSDR protocols.

00:04:02.820 | By now, there's an abundance of data showing

00:04:05.820 | that even short daily meditations

00:04:07.540 | can greatly improve our mood, reduce anxiety,

00:04:10.620 | improve our ability to focus, and can improve our memory.

00:04:14.140 | And while there are many different forms of meditation,

00:04:16.540 | most people find it difficult to find

00:04:18.640 | and stick to a meditation practice in a way

00:04:20.660 | that is most beneficial for them.

00:04:22.780 | The Waking Up app makes it extremely easy

00:04:24.820 | to learn how to meditate

00:04:26.420 | and to carry out your daily meditation practice

00:04:29.140 | in a way that's going to be most effective

00:04:31.060 | and efficient for you.

00:04:32.700 | It includes a variety of different types of meditations

00:04:35.060 | of different duration, as well as things like yoga nidra,

00:04:38.260 | which place the brain and body into a sort of pseudo sleep

00:04:41.460 | that allows you to emerge

00:04:42.580 | feeling incredibly mentally refreshed.

00:04:44.500 | In fact, the science around yoga nidra is really impressive,

00:04:47.180 | showing that after a yoga nidra session,

00:04:49.460 | levels of dopamine in certain areas of the brain

00:04:51.800 | are enhanced by up to 60%,

00:04:53.520 | which places the brain and body

00:04:54.760 | into a state of enhanced readiness

00:04:56.880 | for mental work and for physical work.

00:04:59.360 | Another thing I really like about the Waking Up app

00:05:01.400 | is that it provides a 30-day introduction course.

00:05:04.040 | So for those of you that have not meditated before

00:05:06.640 | or getting back to a meditation practice, that's fantastic.

00:05:10.120 | Or if you're somebody who's already a skilled

00:05:12.200 | and regular meditator,

00:05:13.560 | Waking Up has more advanced meditations

00:05:15.480 | and yoga nidra sessions for you as well.

00:05:17.580 | If you'd like to try the Waking Up app,

00:05:19.460 | you can go to wakingup.com/huberman

00:05:22.180 | and access a free 30-day trial.

00:05:24.700 | Again, that's wakingup.com/huberman.

00:05:27.700 | And now for my conversation with Dr. Matthew Walker.

00:05:31.140 | Professor Matt Walker, welcome back.

00:05:33.420 | We're all so happy to have you here.

00:05:35.260 | And in episode one,

00:05:37.380 | you beautifully described the biology of sleep,

00:05:40.740 | why sleep is important,

00:05:42.140 | what happens when we don't get enough sleep,

00:05:44.300 | and you incentivized getting adequate amounts

00:05:47.480 | of great sleep, and you defined what great sleep is,

00:05:50.000 | and you provided some excellent practical protocols

00:05:53.840 | and tools for getting great sleep.

00:05:56.120 | However, today you're going to tell us, I believe,

00:06:01.120 | about the protocols for really optimizing one's sleep,

00:06:06.400 | both conventional tools and protocols

00:06:09.280 | and some, let's say, unconventional.

00:06:12.040 | Not heretical, but unconventional tools

00:06:14.980 | for optimizing one's sleep.

00:06:16.840 | So let's start with the basics.

00:06:19.480 | What are the basics of what I think I've heard you refer

00:06:22.680 | to previously as sleep hygiene?

00:06:25.760 | - Yeah, I think many of us can resonate

00:06:28.760 | with the idea of dental hygiene,

00:06:31.840 | but it turns out there's something called sleep hygiene.

00:06:34.880 | And there are probably, I would say,

00:06:38.040 | five edicts of sleep hygiene.

00:06:42.920 | I offer them as tools and not necessarily rules

00:06:47.920 | because I don't think people respond to rules.

00:06:53.400 | People respond to reasons and not rules.

00:06:56.200 | So if it's okay, I'll probably just unpack each one of them

00:06:59.080 | rather than just sort of bark them at you

00:07:01.560 | and hope people assume that it's the right answer.

00:07:05.480 | I'll explain the answer

00:07:06.560 | so people understand why it's important.

00:07:09.000 | So as I said, there are probably five things

00:07:11.920 | that you can start doing tonight

00:07:13.960 | to try to improve your sleep.

00:07:16.200 | The first we've spoken a little bit about

00:07:18.520 | in that first episode,

00:07:20.360 | it's part of the four macros of good sleep.

00:07:23.040 | First piece of advice, regularity.

00:07:26.240 | Go to bed at the same time and wake up at the same time,

00:07:30.120 | no matter whether it's the weekday or the weekend.

00:07:33.600 | Regularity is king.

00:07:36.160 | And the reason is because when you feed your brain

00:07:39.240 | the signals of timed regularity for your sleep,

00:07:43.920 | it will anchor your sleep and improve the quantity

00:07:47.960 | and the quality of that sleep.

00:07:50.520 | Because part of that signal of regularity

00:07:53.200 | going into your brain in terms of that repeated behavior,

00:07:56.760 | night after night sleep, in other words,

00:07:59.720 | helps train that central 24-hour circadian clock

00:08:04.720 | that we also spoke about in the first episode.

00:08:07.720 | So that's the first piece of advice.

00:08:09.280 | Try to keep it as regular as you possibly can.

00:08:12.360 | The second piece of advice is darkness.

00:08:17.440 | In my view, we are a dark, deprived society

00:08:21.880 | in this modern era.

00:08:23.760 | And we need darkness at night,

00:08:26.240 | as well you've spoken about,

00:08:27.840 | to release a hormone called melatonin.

00:08:31.240 | And melatonin will help time

00:08:33.840 | the regular onset of your sleep.

00:08:37.000 | So that sounds great, but boots on the ground, Matt,

00:08:41.200 | what does that mean?

00:08:43.040 | I would suggest the following.

00:08:44.440 | In the last hour before bed,

00:08:47.280 | try to dim down 50%, if not more,

00:08:50.920 | of your lights in your home.

00:08:53.840 | And you will be quite surprised

00:08:55.800 | at how sleepy and soporific that will make you feel.

00:09:00.080 | I will do this in a regimented way.

00:09:03.000 | I have a little reminder that pops up

00:09:07.560 | and tells me now is the time to dim the lights

00:09:10.320 | based on your bedtime.

00:09:11.840 | And I'll go around and I'll shut lights down.

00:09:14.320 | In my bedroom, I will actually have a smart light bulb,

00:09:17.880 | and it is way down to probably

00:09:20.760 | as little as maybe five lux.

00:09:23.840 | And lux is just a metric of the light.

00:09:27.480 | It's way down there,

00:09:28.560 | and it's also very deep orange, sort of red,

00:09:32.480 | and we can come on to why that's the case.

00:09:35.040 | So that's the first thing,

00:09:35.920 | even before you're thinking about sleep,

00:09:38.040 | start to decrease the light.

00:09:40.360 | For example, if you were there at, let's say,

00:09:45.920 | for a standard sleep schedule at 10 p.m.,

00:09:48.600 | and normally you are getting into bed at 10, 30 p.m.,

00:09:51.920 | but you feel pretty wide awake,

00:09:54.040 | if there was an electrical blackout

00:09:56.880 | and you lost your phone, magnetic too,

00:09:59.760 | phone goes down, lights go down, total blackout,

00:10:03.160 | my suspicion is that fairly soon you'd say,

00:10:06.160 | "Gosh, I actually feel quite sleepy."

00:10:09.520 | Whereas if the lights were blazing,

00:10:11.520 | you've got your phone, televisions on, lots of stimulation,

00:10:15.640 | you're probably going to think 10, 30,

00:10:17.360 | no, I could probably push through

00:10:19.040 | for at least another hour.

00:10:20.760 | So try to dissipate that light.

00:10:23.600 | And then if you need to, wear an eye mask,

00:10:26.240 | blackout curtains, always good as well.

00:10:29.040 | But we need that darkness at night

00:10:32.040 | because when you give the brain the signal of darkness,

00:10:35.080 | it releases effectively a brake pedal.

00:10:37.760 | That brake pedal has normally been applied by way of light

00:10:42.240 | on the release of that spigot of melatonin.

00:10:46.040 | And when you take the brake pedal off,

00:10:47.800 | it starts pumping out into the brain.

00:10:51.080 | You can also then, of course,

00:10:54.520 | probably reverse engineer this trick in the morning.

00:10:58.200 | And this is another component of why you've been,

00:11:01.440 | I think, such a wonderful advocate

00:11:04.640 | for light in the morning.

00:11:06.120 | It does many things, but one of the things that it does

00:11:09.440 | is reapply that brake on melatonin

00:11:12.680 | and therefore you lose the signal to your brain of darkness.

00:11:17.360 | That's what melatonin in some ways is doing.

00:11:20.000 | We often call it the hormone of darkness

00:11:22.680 | or the vampire hormone.

00:11:24.480 | Not necessarily 'cause it makes you look longingly

00:11:26.760 | at people's necklines and want to bite in,

00:11:29.400 | which is great if you're into that,

00:11:31.240 | but it's really simply about it's releasing melatonin,

00:11:35.600 | which tells the brain, "My goodness, it's nighttime."

00:11:38.640 | But if you've got bright light on,

00:11:40.800 | you come from your office, you're driving home,

00:11:43.520 | so you've got artificial light during the day,

00:11:45.440 | which is probably not strong enough to stimulate you

00:11:49.080 | and bring you awake.

00:11:50.320 | You come home and you've got, again, bright light,

00:11:54.000 | but it's still strong enough now

00:11:56.600 | to prevent the release of melatonin.

00:11:59.240 | You start to shift in your timing

00:12:01.120 | and you may have problems with your sleep.

00:12:02.760 | So that's the second piece of advice.

00:12:05.320 | I would love to ask you about that morning light too

00:12:08.200 | and the alertness benefits.

00:12:10.280 | I'm, as a sleep researcher,

00:12:11.920 | more focused on the evening component of light

00:12:14.520 | and decreasing it, but you've done a great job.

00:12:16.800 | I don't know if there's anything-

00:12:18.400 | - There are a couple of quick points

00:12:19.640 | that are based on some,

00:12:21.800 | what I consider really nice studies.

00:12:24.320 | There's beautiful work in humans

00:12:25.800 | showing that bright light exposure in the morning,

00:12:28.560 | especially from sunlight,

00:12:29.840 | but if one doesn't have access to sunlight

00:12:32.520 | for whatever reason, there are commercially available

00:12:34.880 | so-called SAD lamps, Seasonal Affective Disorder lamps.

00:12:37.800 | They range anywhere from 5,000 to 10,000 lux, very bright.

00:12:41.600 | But certainly morning sunlight viewing

00:12:45.480 | and lamps of the sort I just described

00:12:47.920 | have been shown to increase the amplitude

00:12:50.800 | of the morning cortisol spike by as much as 50%, five zero.

00:12:55.200 | So people hear cortisol and they freak out.

00:12:58.120 | They think that's not good.

00:12:58.960 | I want my cortisol low,

00:12:59.800 | but you actually want your cortisol highest in the morning

00:13:02.680 | and lower in the afternoon and evening.

00:13:05.920 | And there's a lot of reasons for that elevated mood focus

00:13:09.160 | and alertness in the morning and throughout the day.

00:13:11.160 | And ease of getting to sleep at night, lower anxiety,

00:13:14.600 | lower depressive symptoms, and so on.

00:13:16.000 | So that bright light also serves to control

00:13:19.320 | the amplitude of cortisol in the direction you want

00:13:22.600 | in the early part of the day.

00:13:24.160 | The other thing that's just more of a underlying dynamics

00:13:27.560 | of the circadian visual system,

00:13:29.520 | which is a system that I worked on for years,

00:13:32.460 | these wonderful cells in the eyes

00:13:35.060 | that are not for image forming,

00:13:36.300 | but rather for detecting sunlight and bright light

00:13:38.720 | for sake of setting circadian rhythm,

00:13:40.440 | is that the sensitivity of that system early in the day

00:13:43.720 | is actually quite low.

00:13:44.800 | So you need a lot of bright light early in the day

00:13:47.820 | to effectively wake up your system

00:13:50.360 | and shut down the sleepiness signals such as melatonin.

00:13:53.840 | But later in the day, it's a rather diabolical system.

00:13:57.000 | It takes very little light, even from artificial sources,

00:14:01.900 | to disrupt your circadian rhythm and quash melatonin

00:14:05.440 | as little as 15 seconds of bright light in the evening.

00:14:09.400 | I think Chuck Zeisler's laboratory

00:14:11.460 | at Harvard Medical School showed

00:14:12.920 | can quash melatonin in the evening.

00:14:15.440 | Now, I don't want people to freak out

00:14:16.760 | and think that if they go into a hotel bathroom,

00:14:18.640 | which oftentimes those are very bright,

00:14:20.280 | in the middle of the night, flip on the light

00:14:22.000 | that they're going to completely screw up

00:14:25.400 | their circadian rhythms.

00:14:26.600 | But if I'm honest, they'd be much better off

00:14:29.500 | using their phone as a flashlight to navigate.

00:14:32.800 | People always say, well, wait,

00:14:33.960 | but the flashlight on the phone is very bright,

00:14:35.720 | but let's just get logical here.

00:14:37.320 | A light shown into your eyes, such as a flashlight,

00:14:40.840 | is very different than looking

00:14:41.680 | at a flashlight beam on the ground.

00:14:43.480 | Far and away difference.

00:14:44.880 | So the point is that if you don't get enough bright sunlight

00:14:48.000 | or light in your eyes early in the day,

00:14:50.320 | and then you're indoors under artificial lighting,

00:14:52.560 | you might think, well, this is really bright lighting.

00:14:54.800 | This is the kind of lighting

00:14:55.640 | that could disrupt my circadian rhythm at night,

00:14:57.520 | and therefore it's sufficient to wake up my system.

00:15:00.080 | No, early in the day and throughout the day,

00:15:02.040 | you need a lot of bright light,

00:15:03.640 | as much as safely possible to avoid sunburn

00:15:05.800 | and things of that sort, which you don't want.

00:15:08.040 | But then as the evening comes around, after sundown,

00:15:11.000 | you need very little artificial light

00:15:13.720 | in order to disrupt your circadian rhythm.

00:15:16.360 | And then just very quickly,

00:15:18.200 | light from candles, fireplaces is okay.

00:15:21.360 | This is kind of interesting.

00:15:22.200 | It seems bright, but the measurements indicate

00:15:25.760 | that that's not gonna shift your circadian rhythm much.

00:15:28.120 | Candles are great,

00:15:28.960 | but of course don't burn your house down.

00:15:30.680 | So the orange and red tones in the evening way dim down,

00:15:34.720 | that's the way to go early in the day,

00:15:37.360 | bright, bright, bright light,

00:15:38.560 | as bright as you safely can tolerate.

00:15:41.240 | - And what I like about, firstly,

00:15:42.800 | your mention of cortisol.

00:15:44.560 | You described how cortisol is rising in the morning,

00:15:47.640 | and that's a great thing, and it is a good thing.

00:15:49.640 | And in the evening, it's starting to drop.

00:15:51.840 | And if you look right around your prototypical bedtime,

00:15:55.640 | and we're going to speak later in this episode

00:15:58.600 | as to what your real natural bedtime is

00:16:01.320 | versus the one that you may be taking right now,

00:16:05.480 | it's very interesting.

00:16:06.480 | Cortisol will almost hit its lowest point,

00:16:10.160 | something that we call its nadir,

00:16:11.760 | it's the lowest point in that trough of its decline

00:16:15.120 | right around the time when you should be sleeping.

00:16:17.960 | However, there's a great study

00:16:20.240 | that looked at people with insomnia.

00:16:23.000 | And in subsequent episodes, we'll discuss this too,

00:16:27.000 | but one of the ways that we think about

00:16:29.680 | or conceptualize insomnia is in two different flavors,

00:16:33.360 | sleep-onset insomnia, I can't fall asleep,

00:16:36.040 | and sleep-maintenance insomnia, I wake up,

00:16:38.680 | I can't get back to sleep.

00:16:41.360 | And what they looked at was essentially cortisol levels.

00:16:45.120 | They had a catheter in the arm

00:16:48.080 | and they were sampling it from the bloodstream,

00:16:50.240 | and they were able to do that every 30 minutes.

00:16:52.480 | So it's a little bit like time-lapse photography,

00:16:55.520 | and you're getting a data point every 30 minutes

00:16:58.080 | across the 24-hour period,

00:17:00.120 | looking at cortisol across now a full 24-hour period.

00:17:04.400 | And sure enough, when you look at healthy controls

00:17:06.840 | who can sleep well and insomnia patients,

00:17:09.280 | they look almost identical across the day.

00:17:12.560 | But then when it comes to falling asleep

00:17:15.920 | right around that bedtime period,

00:17:18.240 | the healthy controls are going all the way down.

00:17:22.040 | The insomnia patients go down and down and down,

00:17:24.160 | and then they have a rise back up

00:17:25.920 | right around that sleep-onset period.

00:17:28.920 | And then they start to drop back down again

00:17:30.880 | just as the control group.

00:17:32.680 | But then they also often will have a spike

00:17:36.320 | in the middle of the night, which then comes down.

00:17:39.080 | And then both of them are staying low

00:17:41.120 | throughout the early morning period,

00:17:42.960 | and then it starts to rise back up.

00:17:45.000 | So it's not as though net-net overall,

00:17:48.000 | there is a higher level of cortisol

00:17:49.600 | in people with insomnia.

00:17:50.680 | It seems to be right at those trigger zones

00:17:53.240 | that map very nicely to sleep-onset problems,

00:17:56.760 | sleep maintenance problems.

00:17:59.080 | - Very interesting.

00:18:00.200 | As somebody who wakes up in the middle of the night

00:18:01.880 | and sometimes has trouble getting back to sleep,

00:18:03.720 | that resonates.

00:18:05.320 | I have no trouble falling asleep whatsoever.

00:18:07.720 | - Yeah.

00:18:08.600 | - Knock on wood.

00:18:09.960 | Superstitious about this at this point.

00:18:11.880 | But I use tools like non-sleep deep rest,

00:18:14.040 | yoga nidra, long exhale breathing.

00:18:16.200 | But, you know, and I think these wake up episodes

00:18:21.360 | seem to happen more when I'm processing a lot of stuff

00:18:24.160 | from my daily life.

00:18:25.560 | - That's right.

00:18:26.400 | - You know, the unconscious brain oftentimes

00:18:30.040 | is working through things and will wake us up.

00:18:32.800 | - Yeah, I often think that sleep maintenance insomnia

00:18:37.200 | that you've just described

00:18:38.840 | is the revenge of daytime emotions unresolved.

00:18:43.840 | - That's a great way to put it, yeah.

00:18:45.760 | - So that would be, so we've spoken about regularity,

00:18:48.040 | we've spoken about darkness,

00:18:49.720 | and we've spoken about the inverse of that in the morning,

00:18:52.040 | which is light, a little bit of cortisol.

00:18:54.320 | So the third out of the five is going to be temperature.

00:18:58.680 | And the advice here is keep it cool.

00:19:01.160 | As we mentioned a little bit in the first episode,

00:19:03.680 | and we will go into great detail

00:19:05.080 | when we speak not just about these conventional

00:19:07.560 | and unconventional tips,

00:19:08.840 | but we're also going to go into the future of science

00:19:11.640 | and where sleep science is taking us to,

00:19:14.640 | in fact, optimize and even enhance our sleep.

00:19:18.320 | We will speak a lot about temperature.

00:19:20.560 | Suffice to say that you need to drop your core

00:19:24.760 | body temperature and your brain temperature

00:19:26.960 | by a little less than one degree Celsius,

00:19:28.800 | two to three degrees Fahrenheit

00:19:30.760 | to get to sleep and stay asleep.

00:19:32.760 | The general target that we have in sleep science,

00:19:37.960 | if you look across the literature,

00:19:39.800 | is somewhere around about the 67 degree Fahrenheit,

00:19:43.840 | or I'm trying to do the calculation,

00:19:45.720 | maybe 18.5-ish degrees Celsius.

00:19:48.800 | Now I know that that sounds cold and cold it is,

00:19:53.800 | but you can also wear thick socks to bed.

00:19:55.520 | You can have a hot water bottle at the end of the bed.

00:19:57.880 | That's great too, but the ambient must be cold.

00:20:01.720 | The fourth piece of advice is walk it out.

00:20:06.720 | And here, what I mean is do not stay in bed

00:20:10.400 | for long periods of time awake.

00:20:13.600 | And I think we mentioned this perhaps

00:20:15.920 | in the first episode too.

00:20:17.960 | When you are awake in your bed for long stretches of time,

00:20:22.160 | because your brain is an incredibly associative device,

00:20:26.800 | it will quickly learn that this thing called my bed

00:20:30.800 | is the place where I'm awake and not asleep.

00:20:34.040 | And what you need to do is break that association.

00:20:39.200 | If you've learned that time and time again

00:20:41.200 | because you've stayed in bed,

00:20:42.440 | and the rule of thumb, and it's just a rule of thumb,

00:20:45.640 | about 20, 25 minutes,

00:20:48.040 | if you can't fall back asleep or you can't fall asleep,

00:20:51.360 | it's okay.

00:20:52.360 | Just say, "Tonight is not my night.

00:20:55.320 | "It's not a problem.

00:20:56.800 | "Tomorrow is not completely shot.

00:20:59.280 | "It's fine.

00:21:00.160 | "I'm just going to get up, get out of bed."

00:21:02.200 | If you can, if you're lucky enough,

00:21:03.560 | try to go to a different room.

00:21:05.360 | And in dim light, read a book, listen to a podcast,

00:21:09.800 | whatever it is that relaxes you, just do that.

00:21:11.920 | Don't check email, don't eat,

00:21:13.760 | because if you start eating,

00:21:15.560 | that again trains your brain to start waking up

00:21:18.120 | and feeding at that time.

00:21:20.440 | And only return to bed when you are sleepy.

00:21:23.280 | And there is no time limit for that.

00:21:25.520 | I don't want you to come back after half an hour

00:21:28.280 | when you are still awake and not feeling sleepy enough.

00:21:32.000 | Why?

00:21:32.840 | Because you're going to get back into bed

00:21:34.240 | and be in the same problem again.

00:21:36.400 | And gradually, if you do this, and it's hard to do it,

00:21:40.840 | you will relearn the association that you had,

00:21:43.800 | I'm sure, as a child,

00:21:45.360 | which is that your bed is this place of sleepiness.

00:21:49.000 | Because often people will be saying,

00:21:50.560 | "I feel so tired in the evening."

00:21:53.560 | And then they get into bed and they say,

00:21:56.000 | "But now I can't fall asleep at all.

00:21:58.200 | "I don't understand it."

00:21:59.480 | In part, it's because of that learned association.

00:22:01.840 | So that would be the fourth tip.

00:22:04.520 | The fifth tip makes me even more unpopular

00:22:09.920 | as a personality and character,

00:22:11.880 | which is try to be mindful of your alcohol and caffeine.

00:22:16.400 | Now, in a subsequent episode,

00:22:18.240 | we'll go into great detail as to how caffeine works,

00:22:21.920 | its mechanisms, why it is sleep disruptive,

00:22:25.360 | and why, in fact, I've even perhaps changed my mind

00:22:29.040 | on caffeine and its benefits.

00:22:31.920 | But it also does have significant detriments to your sleep.

00:22:35.560 | So the rule of thumb here would be,

00:22:39.240 | try to cut yourself off from caffeine

00:22:42.320 | probably at least 10 or so hours

00:22:45.520 | before you expect to go to bed.

00:22:47.400 | And you can just calculate back, calculate that.

00:22:50.640 | And try to limit it.

00:22:52.200 | So the dose and the timing make the poison.

00:22:55.120 | Cut yourself off after maybe two or three cups of coffee.

00:22:59.080 | And then that timing component,

00:23:01.640 | count yourself back, cut yourself off.

00:23:03.680 | Decaffeinated coffee, not too bad

00:23:05.520 | if you find the right thing to, if you need that fix.

00:23:09.200 | Alcohol is probably one of the most misunderstood sleep aids,

00:23:15.200 | in quotes, that there is.

00:23:18.440 | It is no sleep aid at all.

00:23:21.080 | Now, if I didn't understand what I know about alcohol and sleep,

00:23:25.920 | I would think that too, which is,

00:23:27.880 | look, when I have a nightcap just before bed or two,

00:23:32.240 | even though I don't wear them,

00:23:34.600 | I may actually just fall asleep very easily.

00:23:39.200 | It feels like I stay asleep very soundly across the night.

00:23:43.000 | So it's a great sleep aid and it really helps me.

00:23:46.600 | There are at least, I would say, three issues with alcohol.

00:23:50.520 | The first is that alcohol is in a class of drugs

00:23:53.280 | that we call the sedatives.

00:23:55.720 | And sedation is not sleep.

00:23:59.400 | But when you take on board alcohol in the evening,

00:24:02.360 | you mistake the former for the latter

00:24:04.920 | and you think it helps you fall asleep.

00:24:07.440 | The second thing is that because it's sedation,

00:24:12.000 | or actually it's probably related to sedation,

00:24:14.560 | if I were to show you the electrical signature of your deep sleep

00:24:19.400 | when you're just sleeping naturally

00:24:21.640 | versus when you have alcohol in your system,

00:24:24.280 | it's not really the same.

00:24:25.880 | It's not a naturalistic form of deep sleep.

00:24:28.560 | It mimics it, it looks not too dissimilar.

00:24:31.040 | But if I really do my analyses and I almost like that Pink Floyd album

00:24:35.200 | where I take the white light of electrical brain activity

00:24:37.680 | coming from your head as you're sleeping

00:24:39.840 | and split it apart into all of the different components,

00:24:42.560 | there are some components that are no longer present

00:24:45.640 | or some that are abnormally present.

00:24:48.120 | The second issue with alcohol is that it fragments your sleep.

00:24:52.040 | So it will litter your sleep

00:24:53.640 | with all these punctuated awakenings throughout the night.

00:24:57.640 | The danger there is that many of those awakenings with alcohol

00:25:01.320 | you don't remember because they're too brief.

00:25:05.240 | But then you wake up the next day and you think,

00:25:07.320 | "Well, I didn't have a problem falling asleep.

00:25:09.320 | I didn't have a problem staying asleep.

00:25:11.800 | But I just feel rough.

00:25:14.160 | I just don't feel restored by my sleep."

00:25:16.840 | And you don't add two and two together.

00:25:19.920 | The final concern with alcohol is that it's quite a potent blocker

00:25:24.240 | of your rapid eye movement sleep or REM sleep.

00:25:27.680 | And in subsequent episodes, we'll go into great detail

00:25:31.400 | as to the incredible learning and memory creativity benefits

00:25:36.640 | that come by way of REM sleep.

00:25:38.240 | Also, it's essential for our emotional regulation

00:25:42.080 | and recalibrating our moods.

00:25:45.240 | So for all of those reasons, I would say two things.

00:25:50.120 | First, if you are struggling with sleep,

00:25:52.360 | not feeling restored by your sleep,

00:25:54.800 | keep in mind your alcohol intake.

00:25:57.960 | And also just in general, be mindful of that

00:26:01.040 | if you are thinking about your sleep and want to preserve it.

00:26:04.600 | - So much of what you just said resonates.

00:26:06.880 | I confess that in my lifetime,

00:26:08.560 | I've had periods of pretty spectacular sleep.

00:26:12.560 | I characterize myself as somebody

00:26:15.200 | that could fall asleep anywhere, anytime.

00:26:18.200 | But I've also experienced the extreme challenges of sleep.

00:26:22.720 | And that relates to different things,

00:26:25.320 | life circumstances, et cetera.

00:26:26.680 | In fact, recently, I've had some challenges with sleep

00:26:29.120 | despite using the protocols that I and others suggest.

00:26:33.400 | I hadn't heard some of the things that you're referring to here.

00:26:37.680 | And middle-of-the-night waking has become more of an issue.

00:26:41.720 | I communicated this to a former girlfriend of mine

00:26:45.440 | who I was in relationship with when I was a junior professor,

00:26:50.760 | meaning before I got tenure.

00:26:52.440 | And she said, "You don't remember.

00:26:54.960 | You had a," Andrew, "But I do.

00:26:57.440 | You had a pattern back then of after I would fall asleep,

00:27:01.400 | you would continue working on your laptop,"

00:27:03.720 | probably on Grants.

00:27:05.680 | "And then I would fall asleep working.

00:27:09.000 | And then according to her,

00:27:10.120 | I would wake up in the middle of the night

00:27:11.360 | and work a little bit until I'd get tired again

00:27:14.000 | and then fall asleep, and then this would repeat."

00:27:16.080 | So really stamping down the associative learning element

00:27:22.000 | that you talked about before.

00:27:23.040 | So that was probably the first period of time in my life

00:27:26.000 | in which I created this rather deleterious association

00:27:31.920 | of work in the middle of the night in bed, right?

00:27:35.480 | And then more recently, I've had the experience of waking up,

00:27:39.720 | probably due to these like daytime things

00:27:41.920 | that I'm waking up in the middle of the night thinking about.

00:27:45.040 | And now because of our discussion

00:27:46.960 | during the course of recording this series,

00:27:49.440 | I get out of bed after even 10, 15 minutes

00:27:53.080 | so that I can start to eliminate that association.

00:27:55.880 | And another piece is that I've always felt

00:27:58.680 | that when I get out of bed in the middle of the night

00:28:00.720 | because I can't sleep and I go to the sofa,

00:28:02.720 | I often can sleep very well.

00:28:04.840 | And the reason being, right, it's a control experiment,

00:28:07.480 | proving that the location of sleep is...

00:28:12.000 | and the association of wakefulness and sleep in bed

00:28:14.720 | as opposed to on the sofa is a clear component.

00:28:17.400 | And this is in an environment that's of equal temperature.

00:28:19.800 | I mean, it's not a perfect experiment, right?

00:28:21.960 | It's anecdata, as we say.

00:28:23.400 | But I think that the associative piece is, oh, so strong

00:28:28.760 | for many people.

00:28:29.600 | And so this is something to really take seriously.

00:28:32.000 | - I love that notion of people will often say,

00:28:34.200 | "I just get up, I go to the couch or the sofa,

00:28:37.240 | "and that's where I'll wake up in the morning."

00:28:40.680 | Also, they'll say, "When I travel and I go to a hotel room,

00:28:44.200 | "I just can sleep fine."

00:28:45.880 | Now, for some people, it's the inverse,

00:28:47.520 | but for those people, it's the contextual difference,

00:28:50.840 | meaning the change of the environment is so unfamiliar

00:28:55.720 | that it has not been bound to the association

00:28:58.360 | of wakefulness, it's related to sleep

00:29:01.200 | or at least the opportunity to sleep.

00:29:03.520 | Sometimes even I've heard from some people,

00:29:06.520 | there's no studies or data on this,

00:29:08.800 | even turning yourself around.

00:29:10.480 | Now, this is hard if you have a partner in bed,

00:29:13.080 | but you just switch top to bottom of the bed

00:29:16.720 | and you take your pillow

00:29:18.120 | and you pull the duvet all the way down

00:29:20.880 | and you put the pillow at the opposite end

00:29:22.560 | where your feet used to be and you get into bed.

00:29:24.560 | And even just looking around

00:29:26.320 | and sort of having a difference,

00:29:28.360 | that alone is so subtle, but it can make a real difference.

00:29:33.320 | So again, just keep these things in mind.

00:29:35.920 | I know it sounds strange or this whole sort of get up,

00:29:38.920 | get out of bed, break the association.

00:29:42.320 | And we'll come on to something.

00:29:44.080 | Well, actually I'll come on to it now

00:29:45.560 | 'cause I think it's one of the unconventional tips

00:29:47.280 | and you mentioned it.

00:29:48.520 | A lot of people say to me, "That all sounds great.

00:29:51.680 | "Science makes sense."

00:29:53.320 | I just don't, it's dark, it's kind of cold.

00:29:57.040 | I really don't want to get out of bed.

00:29:59.520 | So give me some alternatives.

00:30:02.880 | I think the single best piece

00:30:05.680 | of unconventional sleep advice I can give you

00:30:09.240 | is do anything that gets your mind off itself.

00:30:14.240 | The principal reason that if you look at insomnia

00:30:18.600 | as a physiological condition or current working model

00:30:21.520 | mechanistically of how insomnia plays out

00:30:25.000 | is that you are in this state of almost low level anxiety

00:30:30.720 | and you are somewhat stressed.

00:30:34.200 | And when you go to sleep or you try to go to sleep

00:30:37.080 | or you wake back up and you try to get back to sleep,

00:30:39.800 | you just have this Rolodex of anxiety.

00:30:42.560 | In the modern world, we are constantly on reception

00:30:47.040 | and very rarely do we do reflection.

00:30:49.480 | And unfortunately for many of us,

00:30:52.520 | and I've been guilty of this,

00:30:54.400 | the only time we do reflection

00:30:56.480 | is when our head is placed on the pillow

00:30:59.000 | and we turn the light out.

00:31:00.320 | And that is the last time you want to be doing reflection.

00:31:04.320 | That's the worst moment.

00:31:06.440 | And at that point,

00:31:07.480 | I think everyone can empathize with the idea

00:31:11.000 | of you turn the light out, you're under stress,

00:31:14.840 | your mind goes to those few things.

00:31:17.280 | In the darkness of night,

00:31:19.800 | thoughts become almost 10 times worse than they do

00:31:24.120 | in the bright of day.

00:31:26.760 | And at that moment, you start to ruminate.

00:31:29.840 | When you ruminate, you begin to catastrophize.

00:31:33.200 | And when you catastrophize,

00:31:34.840 | you're dead in the water for the next two hours.

00:31:38.000 | So what do you do?

00:31:39.440 | The problem is, as I said, your mind is on itself

00:31:43.200 | and it's going through these repeated loops.

00:31:46.160 | Anything you can do, for example,

00:31:48.680 | you can do some kind of a meditation.

00:31:51.280 | And when I was researching data for my book some years ago,

00:31:55.840 | I did look into meditation and I wasn't a meditator.

00:31:59.160 | I was a hard-nosed scientist.

00:32:00.840 | I didn't really kind of embrace with that notion

00:32:05.440 | or even that group of people.

00:32:09.320 | But time and again, I read paper after paper

00:32:12.160 | and the data was very strong

00:32:13.520 | and it was coming from research groups

00:32:15.040 | that I respected very much indeed.

00:32:17.920 | So I thought, well, okay,

00:32:19.200 | I should probably give this a try.

00:32:22.120 | And that was six years ago.

00:32:25.080 | And since then, I now meditate for 10 minutes

00:32:28.120 | every single night before bed.

00:32:30.120 | I do a guided meditation 'cause I'm not particularly skilled.

00:32:33.400 | So I use an app that moves me through that.

00:32:36.400 | But you can do whatever meditation you like.

00:32:40.800 | That's one example.

00:32:42.120 | The second example is you can do breathing methods

00:32:46.360 | because again, you're focused on your breath.

00:32:49.200 | And what are you not focused on?

00:32:51.320 | Your thoughts. (laughs)

00:32:53.640 | And so anything that will allow you

00:32:57.280 | to explore some other focus,

00:33:01.760 | maybe it's a body scan

00:33:03.040 | where you start at the top of your head

00:33:04.320 | or you start at your feet and you work your way up

00:33:06.400 | and you just say, moving through now my neck,

00:33:09.880 | what sensations am I feeling?

00:33:12.360 | Now into my shoulders, moving down into my chest now,

00:33:16.760 | I can feel the ends of my fingers.

00:33:19.520 | Am I sensing anything?

00:33:22.440 | And when you start doing that

00:33:23.880 | or any of these types of things,

00:33:25.880 | the next thing that you remember

00:33:28.320 | is your alarm going off in the morning

00:33:30.640 | because you got your mind off itself.

00:33:33.160 | So I would say that that's probably

00:33:34.640 | one of the unconventional tips.

00:33:36.400 | But let me come back to the conventional.

00:33:38.560 | Anything else I've probably missed out

00:33:41.000 | or been unclear about there?

00:33:43.000 | Actually, I should probably say one thing

00:33:44.440 | in terms of these, they're not tips.

00:33:47.120 | I don't like the word.

00:33:48.120 | I know you don't either or hacks

00:33:50.960 | these are protocols

00:33:52.640 | and they're well-informed scientific protocols.

00:33:55.640 | In all of this discussion today,

00:33:57.560 | you can get all of these things in place

00:34:01.560 | and still have problems with sleep.

00:34:03.360 | The reason is because you may be suffering

00:34:06.720 | from a sleep disorder.

00:34:07.920 | So the analogy would be,

00:34:09.800 | let's say that I'm your athletic coach

00:34:11.880 | and you're a sports superstar.

00:34:14.240 | I can perfect everything.

00:34:15.440 | I can perfect your diet, your supplements.

00:34:19.360 | We can perfect your technique.

00:34:20.960 | We can perfect.

00:34:22.560 | But if you've got a broken ankle,

00:34:26.040 | none of those things are going to alter

00:34:28.520 | your performance right now.

00:34:29.880 | You've got to get to a doctor

00:34:31.720 | and get that seen to.

00:34:32.720 | And then we can come back

00:34:34.320 | to fine tuning your performance.

00:34:36.400 | It's the same with sleep.

00:34:37.520 | If you've got a sleep disorder,

00:34:38.760 | such as snoring, sleep apnea, or insomnia,

00:34:41.760 | we need to get you to a doctor first.

00:34:43.600 | And then only after that,

00:34:45.080 | come back once you're resolved,

00:34:47.120 | then we can start to optimize.

00:34:48.960 | That's the only other thing

00:34:49.960 | I probably should mention.

00:34:51.840 | - Yeah, this is all very useful discussion

00:34:53.760 | because I think that, of course,

00:34:56.200 | there will be those folks out there

00:34:57.640 | that just like, what are they talking about?

00:34:59.920 | I sleep so well.

00:35:01.520 | Consider yourself blessed.

00:35:02.640 | Many, many people struggle

00:35:04.120 | with challenges with sleep.

00:35:06.640 | And I think it's fair to say

00:35:08.360 | that sooner or later,

00:35:09.520 | most everybody experiences some challenges

00:35:12.480 | with sleep for whatever reason.

00:35:13.760 | - You look at the statistics,

00:35:14.640 | that's highly likely in your lifetime,

00:35:16.720 | you are more than likely

00:35:17.840 | to go through either a period

00:35:19.360 | of challenging sleep,

00:35:21.000 | or in fact, a bout of insomnia.

00:35:23.640 | - I'd like to take a brief break

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00:35:37.160 | that I've been taking AG1 since 2012.

00:35:39.400 | And indeed, that is true.

00:35:41.200 | Now, of course,

00:35:42.040 | I do consume regular whole foods every day.

00:35:44.520 | I strive to get those foods mostly

00:35:46.400 | from unprocessed or minimally processed sources.

00:35:49.200 | However, I do find it hard

00:35:50.800 | to get enough servings of fruits

00:35:52.040 | and vegetables each day.

00:35:53.400 | So with AG1, I ensure that I get enough

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00:35:58.120 | and other things typically found

00:35:59.400 | in fruits or vegetables.

00:36:00.480 | And of course, I still make sure

00:36:01.840 | to eat fruits and vegetables.

00:36:03.160 | And in that way, provide a sort of insurance

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00:36:07.000 | In addition, the adaptogens

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00:36:12.000 | and ensure that the cells and organs

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00:36:14.920 | are getting the things they need.

00:36:16.560 | People often ask me

00:36:17.400 | that if they were gonna take just one supplement,

00:36:19.320 | what that supplement should be.

00:36:20.560 | And I always answer AG1.

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00:36:32.800 | Again, that's drinkag1.com/huberman.

00:36:37.200 | You talked about alcohol.

00:36:38.600 | I'm not a consumer of alcohol anymore.

00:36:41.880 | - Nor am I.

00:36:42.720 | And it's not 'cause I have anything

00:36:44.360 | against it.

00:36:45.200 | - Yeah, many people do enjoy it

00:36:46.440 | and we're not calling judgment on them.

00:36:51.120 | I mean, certainly much of the world enjoys alcohol.

00:36:54.000 | Could we talk a little bit more about,

00:36:56.360 | aside from demolishing REM sleep,

00:36:59.480 | do we know that alcohol causes these disruptions

00:37:05.400 | in sleep directly,

00:37:06.440 | meaning by changing the pattern

00:37:08.520 | of release of neurotransmitters like GABA,

00:37:11.160 | things of that sort,

00:37:12.000 | or is this an indirect effect?

00:37:13.880 | Is this like through the gut microbiome

00:37:16.000 | that then impacts sleep?

00:37:17.280 | And the reason I ask is maybe we could get

00:37:20.640 | to some more specific do's and do not protocols.

00:37:25.480 | So for instance,

00:37:26.320 | if somebody wants to have a cocktail,

00:37:28.120 | how close to sleep can they get

00:37:30.280 | and not diminish their rapid eye movement sleep too much?

00:37:35.280 | You know, because people are still going to want to drink.

00:37:38.720 | And with that said,

00:37:40.800 | if people do have a couple of drinks

00:37:42.800 | and then they go to sleep,

00:37:44.520 | is there anything they can do prior to sleep

00:37:46.440 | to try and rescue some of their quality sleep?

00:37:51.440 | - Great question.

00:37:52.600 | So in terms of the mechanism,

00:37:54.480 | it seems actually not to be the alcohol,

00:37:57.480 | but some of the metabolic by-products of alcohol.

00:38:02.000 | We think that perhaps the main culprit

00:38:04.200 | may be some of the aldehydes

00:38:06.040 | that are the metabolic separate consequences

00:38:09.680 | of alcohol metabolism.

00:38:12.680 | You make a good point though,

00:38:14.720 | in terms of the dose response timing curve,

00:38:19.720 | how late or how early do I have to cut myself off

00:38:24.600 | from alcohol?

00:38:25.680 | People have done those studies

00:38:27.080 | and they have found that even an afternoon

00:38:29.600 | single glass of wine,

00:38:31.160 | if you measure sleep in the way that we measure it

00:38:33.600 | at Bicenter with high fidelity,

00:38:35.920 | you can see compromises and impairments.

00:38:38.920 | I wish I could tell you otherwise.

00:38:42.340 | I would say that based on that data,

00:38:45.480 | the principal protocol advice I would have for you

00:38:48.560 | is go to the pub in the morning.

00:38:50.840 | That way, by the time you're about to sleep,

00:38:52.760 | the alcohol is out your system and you could...

00:38:54.760 | No, no, I would never.

00:38:55.880 | As a public scientist,

00:38:57.920 | I would never advocate necessarily for morning.

00:39:00.040 | I'm just kidding you.

00:39:00.920 | But that's sort of one of the unfortunate consequences

00:39:05.920 | that does seem to be an impact.

00:39:09.360 | To say that there isn't

00:39:10.880 | is just me not being truthful about the data.

00:39:14.800 | But again, if you think about the trade-off here,

00:39:19.800 | if you're going out or you're having friends over

00:39:22.920 | and you're gonna make an incredible evening of memories

00:39:26.160 | and you're going to open a favorite bottle of wine

00:39:28.280 | and have a couple of glasses of wine,

00:39:30.400 | is your sleep going to be compromised?

00:39:31.960 | Yes, it is.

00:39:33.200 | But maybe that's worth the trade-off

00:39:35.320 | for that specific night.

00:39:36.960 | I would just not wish you to...

00:39:38.960 | And you've spoken a lot

00:39:40.560 | and so has our dear friend, Peter Attir and others.

00:39:44.320 | There just doesn't seem to be any safe amount of alcohol.

00:39:48.680 | But I would say, think about that trade-off simply.

00:39:52.920 | However, don't make it a habit that you're doing it

00:39:56.160 | multiple nights a week or more.

00:39:59.680 | That would probably be the advice.

00:40:01.640 | - Great.

00:40:02.480 | What about food and sleep?

00:40:06.880 | How close to sleep is it okay to have a meal

00:40:11.640 | if you want to optimize your sleep?

00:40:14.480 | I like to eat my final meal somewhere around 6.30 p.m.

00:40:19.480 | And I go to sleep somewhere around 8.30, 9 p.m.

00:40:23.960 | In an ideal world, sometimes I go to sleep a bit later.

00:40:26.760 | Sometimes I eat a little bit later.

00:40:29.120 | It's just, there's some variability with these.

00:40:31.120 | But put differently,

00:40:33.400 | what is the relationship between food intake

00:40:35.640 | and sleep quality in terms of timing of food intake?

00:40:39.360 | And then perhaps we can talk a little bit

00:40:41.120 | about food macronutrients.

00:40:43.760 | - It's very interesting.

00:40:45.000 | There was somewhat of a dogma out there

00:40:48.520 | that we have to stop eating three or four hours

00:40:52.160 | before bed for optimal sleep.

00:40:54.440 | If you look at the data, the data is quite a spread,

00:40:57.680 | no pun intended.

00:40:58.640 | There are some people for whom that works very well.

00:41:02.320 | And if they eat even two hours before bed,

00:41:06.280 | they just get disrupted in terms of their sleep.

00:41:09.680 | Some of that is about people just feeling too full

00:41:14.320 | and not feeling comfortable.

00:41:16.560 | Other aspects are that when you become recumbent,

00:41:19.520 | when you lie down,

00:41:21.000 | you have a higher risk of gastric reflux coming back up

00:41:25.520 | and therefore you get heartburn and that's pretty miserable.

00:41:27.920 | And people will describe that too

00:41:29.360 | by way of closer proximity of food intake

00:41:33.080 | relative to when you're falling asleep.

00:41:35.720 | Nevertheless, if you look at the data,

00:41:38.960 | and I did a recent very deep dive on this personally myself

00:41:43.200 | about 12 months ago,

00:41:45.600 | it's not quite as extreme as the dogma makes out.

00:41:50.000 | If you eat two hours before bed on average,

00:41:53.560 | it doesn't seem to necessarily harm your sleep.

00:41:56.240 | Now that's very different than saying

00:41:58.000 | what is best to improve or enhance your sleep.

00:42:01.080 | But the way these studies were designed,

00:42:03.240 | it was looking at detriments.

00:42:05.480 | They then went to 90 minutes before sleep onset.

00:42:09.320 | And even there, there didn't seem to be marked impairments.

00:42:12.800 | 60 minutes, you started to see maybe some signs,

00:42:17.760 | but on average, the effect size was somewhat weak.

00:42:21.360 | But then when you get close to sort of 45 minutes or so,

00:42:25.520 | then things did start to deteriorate.

00:42:29.120 | I think it depends hugely on your chronotype

00:42:32.720 | and also just on your appetite,

00:42:35.040 | circadian rhythm preferences too.

00:42:38.040 | I am someone who I do not feel very hungry

00:42:41.480 | when I first wake up in the morning.

00:42:43.160 | I don't feel very hungry throughout most of the day.

00:42:46.360 | And I will onboard most of my calories

00:42:49.320 | probably in the hours,

00:42:53.880 | probably in about a four-hour period,

00:42:57.120 | maybe less, even three-hour period.

00:42:59.960 | And then I will cut myself off

00:43:02.080 | about 90 minutes before sleep.

00:43:05.600 | So classically, I would have been considered

00:43:08.400 | as violating this sleep dogma

00:43:12.400 | of cutting yourself off at least three hours.

00:43:14.760 | I think it's very personal though.

00:43:16.880 | Just experiment with it.

00:43:18.520 | You will know the situation.

00:43:21.880 | As for macros and specific food components,

00:43:26.120 | the data is a little bit mixed.

00:43:28.360 | Certainly what we know is that if you're eating a diet

00:43:32.120 | that is high in sugar and low in protein,

00:43:38.480 | your sleep is worse.

00:43:41.280 | Why would that be the case?

00:43:43.120 | Well, one of the reasons that we think is that if you onboard sugar,

00:43:47.240 | it can be somewhat metabolically active.

00:43:50.040 | And when it becomes metabolically active,

00:43:53.120 | it can increase your body temperature,

00:43:55.240 | your core body temperature, even just very subtly.

00:43:58.000 | But that's enough to disrupt your sleep as we spoke about with temperature.

00:44:03.120 | But I think in terms of really the...

00:44:08.000 | what would be the ideal macro-nutrient

00:44:11.480 | and even micro-nutrient dietary recommendation

00:44:15.480 | that I would have for you,

00:44:17.080 | I don't think we have enough data yet above and beyond that statement.

00:44:21.880 | Yeah, I've experienced when I eat a very low-carbohydrate diet,

00:44:29.840 | which I've experimented with in the past,

00:44:32.240 | maybe even full ketogenic diet for brief periods of time,

00:44:35.160 | although I'm an omnivore, so I eat meat and eggs,

00:44:38.000 | and I also eat starches, pastas, rice, et cetera.

00:44:41.560 | But we know, based on beautiful work from, for example,

00:44:45.920 | Chris Palmer from Harvard Medical School,

00:44:49.000 | who is a guest on this podcast.

00:44:50.440 | I listened to that. It was a great podcast.

00:44:52.480 | Yeah, Chris is spectacular

00:44:54.160 | and has advocated the exploration of ketogenic diets

00:44:59.520 | for the treatment of various psychiatric conditions,

00:45:01.760 | not all, but psychiatric conditions.

00:45:03.360 | And it seems, and he agreed with me on this,

00:45:06.840 | that when people go on very low-starch, very low-carbohydrate diets,

00:45:10.800 | that sometimes they can experience a bit of hypomania.

00:45:13.600 | Some people can and challenge this with sleep.

00:45:17.280 | And sometimes there are psychiatric reasons

00:45:21.120 | why people stay on those diets anyway,

00:45:25.480 | and then they have to do other things to encourage their sleep,

00:45:27.800 | either pharmacology or supplementation or some combination.

00:45:31.240 | But I can say anecdotally for myself,

00:45:33.440 | if I don't eat starches for a extended amount of time,

00:45:38.440 | a couple of days, I find it very hard to get quality sleep,

00:45:42.400 | as indicated by sleep trackers,

00:45:45.280 | and just latency to fall asleep is longer than it is, et cetera.

00:45:53.520 | So, I've opted to eat most of my carbohydrates later in the evening,

00:45:59.120 | which kind of violates every rule of eat your carbs early in the day.

00:46:03.280 | And I think there are some data to support

00:46:05.120 | that eating carbohydrates early in the day

00:46:06.720 | may actually have certain benefits for weight maintenance or weight loss.

00:46:10.600 | So, I realized that, but those aren't my goals at the moment,

00:46:14.000 | weight maintenance, yes, weight loss, no.

00:46:16.120 | So, I think I've certainly feel after eating a dinner

00:46:19.600 | that has a bit more starch, pasta, rice, these things of that sort,

00:46:23.680 | and a little bit lower protein as opposed to the inverse,

00:46:26.320 | like eating a couple of ribeye steaks and a salad,

00:46:29.360 | but no starch, that my sleep is substantially better.

00:46:34.840 | And I always attributed that to the relationship

00:46:38.480 | between some of these starches and the tryptophan/serotonin pathway.

00:46:42.440 | There is some data on that with the carbohydrate intake in the evening.

00:46:46.880 | And of course, that tryptophan and that carbohydrate intake

00:46:52.240 | will contain the precursor ingredients

00:46:55.120 | to something else that we've spoken about, which is melatonin.

00:46:58.640 | And so, that may actually help healthily boost that melatonin signal.

00:47:02.560 | And there's a little bit of data on that to support it too.

00:47:06.720 | We also did a study where we were looking at night-to-night-to-night sleep

00:47:11.680 | and carbohydrate intake the next day.

00:47:13.960 | And it did seem to support what you're describing

00:47:16.800 | in terms of some of the carbohydrate benefits.

00:47:19.680 | We also found a strange result that was almost the opposite prediction

00:47:24.200 | that we made, carbohydrate intake in the morning

00:47:27.400 | to equally help people wake up.

00:47:30.280 | And we were a little bit uncertain as to why,

00:47:33.000 | but we're going to go into more detail.

00:47:36.040 | The reason that you mentioned the suggestion of not to take on carbs in the evening

00:47:43.000 | is in part based on the evidence that your body's ability to dispose of sugar

00:47:49.800 | and obviously when you're eating carbohydrate you can have a higher spike of sugar.

00:47:54.360 | Now that in part depends on what you're eating with that carbohydrate

00:47:58.560 | and also of course the nature of that carbohydrate,

00:48:01.240 | whether it's simple or whether it's complex,

00:48:03.480 | whether it's simple sugars versus complex more starchy carbohydrate.

00:48:10.480 | But the idea is that your body,

00:48:12.800 | even if you were to eat the same amount of carbohydrate in the morning,

00:48:16.720 | in the afternoon or in the evening, same carbohydrate dose and type,

00:48:22.120 | but your body's ability to dispose of that

00:48:24.840 | without having excessive spikes of glucose

00:48:28.120 | is worse in the evening, better in the morning,

00:48:30.440 | i.e. if you're concerned about your blood sugar and your metabolic health,

00:48:35.800 | maybe that's what you should do.

00:48:37.800 | I think that that data is unclear on the basis of if you are glycemic normal,

00:48:45.440 | meaning that you currently do not have signs of type 2 diabetes

00:48:49.200 | or you're not prediabetic, then that may not necessarily be the case.

00:48:53.080 | And so I think that's why it could be beneficial for you

00:48:56.400 | and I know that you think deeply about that.

00:49:00.160 | I've even been tracking blood sugar as well, I don't have any signs of that,

00:49:03.520 | but I'm just fascinated by some of that data

00:49:05.720 | and how it interacts with my sleep because I'm a sleep nerd.

00:49:08.760 | So I think right now we just don't have plentiful data

00:49:13.160 | to recommend a particular sleep "diet" for improved optimization.

00:49:18.960 | I would say though that we can be a little bit more relaxed

00:49:22.760 | about the timing of our food.

00:49:25.280 | Earlier you mentioned caffeine

00:49:27.560 | and caffeine is a topic that we get into substantial depth in episode 3,

00:49:33.320 | but there and now I will emphasize that

00:49:38.360 | caffeine is the most commonly used drug worldwide.

00:49:41.920 | I think the statistics says that 90 plus percent of adults

00:49:46.520 | consume caffeinated beverages every day, which is remarkable.

00:49:51.040 | And a few years back, I recall there was an article in The Economist

00:49:53.680 | that charted the countries for which the caffeine consumption was highest.

00:49:59.520 | And way out on the peak, peak, peak of almost triple or quadruple

00:50:07.080 | what the second place country consumed each day was,

00:50:13.920 | can you guess the country that consumes the most caffeine?

00:50:16.880 | Could be tea, coffee, any form.

00:50:18.720 | I'm going to suggest it's a Scandinavian country.

00:50:20.960 | No, but they're up there.

00:50:24.280 | It was Switzerland.

00:50:25.800 | Now, I don't know if that's still the case,

00:50:27.640 | but apparently the Swiss-

00:50:28.800 | - The reason I went, I was thinking it was,

00:50:30.480 | because I've seen the graph, I was thinking it was Sweden,

00:50:32.440 | but hence the Scandinavian.

00:50:34.040 | - And if I have that wrong,

00:50:35.800 | certainly someone will put it in the comments on YouTube.

00:50:38.040 | - No, I'm sure you're right and I was wrong with Sweden.

00:50:39.440 | - But as I recall, the Swiss drink so much caffeine.

00:50:42.760 | They have a lot to think about.

00:50:44.560 | So I love caffeine.

00:50:46.120 | I drink black coffee, black espresso and yerba mate.

00:50:51.000 | I love yerba mate.

00:50:52.120 | I've been drinking it since I was a little one

00:50:54.840 | because of the Argentines in my family.

00:50:57.400 | And I drink it in the early part of the day,

00:50:59.520 | typically a couple hours after waking or so,

00:51:02.800 | I'll have my first sip of caffeine.

00:51:04.920 | And then I try to stop drinking caffeine

00:51:07.640 | somewhere around noon or 1 p.m.

00:51:10.440 | Occasionally, I'll have a shot or two of espresso

00:51:13.080 | in the early afternoon

00:51:14.280 | if there's important work to be done

00:51:16.200 | and I need to do that.

00:51:17.040 | But I've noticed that even that can alter my sleep

00:51:20.560 | in ways that I don't like.

00:51:22.440 | But that afternoon coffee, for some reason,

00:51:24.200 | tastes so much better than the morning coffee for me.

00:51:26.520 | I don't know what it is.

00:51:27.720 | So it's coffee, yerba mate packed early into the day

00:51:31.400 | and a lot of it for me.

00:51:33.520 | I have a high tolerance for it, but then I let it taper.

00:51:37.480 | Is that an optimal contour of caffeine intake?

00:51:43.120 | Would zero caffeine be better

00:51:44.640 | if someone's just really committed to sleep

00:51:46.280 | and they don't like caffeine?

00:51:47.760 | Would zero be better than any?

00:51:49.600 | And what about that afternoon coffee

00:51:53.040 | or tea containing caffeine?

00:51:55.440 | I mean, how disruptive is it for sleep?

00:51:58.400 | - So the profile that you described,

00:52:00.920 | which is high peak early on,

00:52:02.920 | first thing when you wake up

00:52:04.200 | and then tapering off nicely down

00:52:06.040 | into the sort of early afternoon, ideal.

00:52:09.880 | That sounds great to me.

00:52:12.000 | As for that afternoon coffee,

00:52:14.360 | it really depends again on when you're expecting

00:52:17.400 | to go to sleep.

00:52:18.240 | Now, for someone like you,

00:52:20.200 | I would say I would love to look at abstaining from that

00:52:24.080 | or just switching it out to,

00:52:25.680 | if you're using these pods or however you're brewing it,

00:52:29.280 | let's just switch it out and do an experiment for two weeks.

00:52:33.320 | And we will look to see how much is that afternoon coffee

00:52:38.000 | really impacting your sleep?

00:52:39.240 | And we'll track your sleep

00:52:40.280 | with some degree of high fidelity with a wearable.

00:52:43.200 | And let's test that hypothesis

00:52:46.480 | because you go to sleep quite early.

00:52:48.400 | You are an early bird,

00:52:50.320 | maybe bordering on an extreme early bird.

00:52:54.360 | And we'll speak about,

00:52:56.240 | we have spoken about those different flavors of chronotype.

00:53:00.120 | I would prefer you not to be having that caffeine

00:53:07.160 | in the afternoon based on how early you go to sleep.

00:53:10.880 | And I mentioned that preference

00:53:13.320 | because of what you described

00:53:14.680 | regarding your sleep maintenance insomnia.

00:53:19.160 | One of the issues with caffeine

00:53:20.880 | is that not only can it make it more difficult

00:53:23.280 | for you to fall asleep,

00:53:24.680 | which you don't have in part

00:53:26.280 | because if you're waking up quite frequently

00:53:28.800 | throughout the night and struggling to get back to sleep,

00:53:31.240 | you're going to be carrying a sleep debt into every night

00:53:35.160 | and that debt continues to grow.

00:53:37.120 | And it's almost like compounding interest on a loan.

00:53:39.440 | So you will not have a problem falling asleep.

00:53:41.600 | In fact, sometimes the speed with which people fall asleep

00:53:45.600 | and some of these sleep trackers

00:53:47.920 | will almost penalize you for falling asleep too quickly

00:53:52.320 | is because in sleep science and clinical sleep medicine,

00:53:55.320 | if you're, it should take you somewhere,

00:53:58.320 | healthy sleep onset, five to 15, 20 minutes.

00:54:04.680 | But if you put your head on the pillow

00:54:07.720 | and you turn off the light and within a minute or so,

00:54:10.800 | you're dead to the world and you're gone.

00:54:13.040 | I'm exactly, I'm worried that you're

00:54:15.400 | A, carrying a sleep debt.

00:54:16.760 | Now, not necessarily,

00:54:18.000 | but I would like to explore it with you.

00:54:21.440 | And then I would say, even if you can fall asleep fine,

00:54:24.960 | this factor of waking up in the middle of the night

00:54:29.520 | is also related to caffeine.

00:54:31.000 | Why?

00:54:31.840 | Because caffeine not only can make it harder to fall asleep,

00:54:34.960 | not your problem,

00:54:36.240 | but it keeps you out of that deep, deep sleep.

00:54:40.440 | And it puts you into a more shallow state

00:54:42.800 | of non-rapid eye movement sleep.

00:54:45.360 | And when you are in the shallow state,

00:54:48.120 | it's A, easier for you to be woken up,

00:54:52.320 | but B, and I think more of the problem,

00:54:55.960 | it's harder for you to fall back asleep

00:54:58.760 | because your brain doesn't necessarily want

00:55:00.880 | to go back down into that deep sleep

00:55:03.000 | and nor has it come up out of that deep sleep.

00:55:06.080 | So you're not in that wonderful, glorious,

00:55:08.200 | thick, treacly sort of sleepy state.

00:55:11.520 | When you wake up, you go to the restroom,

00:55:13.480 | you come back and you just know,

00:55:15.560 | oh, this is gonna be great.

00:55:17.280 | As long as I can fumble my way back to my mattress,

00:55:20.240 | I'm gonna be asleep within another two minutes

00:55:21.920 | going back to it.

00:55:22.760 | Whereas for you, you probably wake up

00:55:24.520 | and you feel pretty wide awake.

00:55:26.480 | I would like to see what happens

00:55:28.080 | when we negate that afternoon coffee

00:55:30.280 | on the frequency and the duration

00:55:32.760 | of those middle of the night awakenings for you.

00:55:36.000 | - Yeah, I'm definitely making the effort

00:55:37.720 | to avoid caffeine intake in the afternoon.

00:55:39.880 | And I think I'm already starting to see

00:55:42.400 | some of the positive benefits of doing that

00:55:44.960 | as evidenced by the days that I consume caffeine

00:55:47.920 | in the afternoon and experience the deficits.

00:55:50.840 | It's a real thing.

00:55:51.680 | And I believe you've about the numbers

00:55:55.720 | on a different podcast previously.

00:55:57.680 | Talk a little bit about the metabolism of caffeine

00:56:00.320 | and maybe even some of the variations

00:56:02.600 | that exist between people

00:56:03.600 | in terms of the metabolic regulation of caffeine.

00:56:07.600 | So how long, let's say drink a standard cup of coffee

00:56:10.960 | or a couple of espresso and it has a,

00:56:13.280 | gosh, I don't know, 150 milligrams of caffeine.

00:56:15.520 | Is that 200?

00:56:16.360 | - Yeah, it could be 150, 200.

00:56:18.480 | - Yeah, let's say 200 because certainly a barista these days

00:56:23.320 | is gonna draw a beverage that's-

00:56:25.160 | - They're gonna over-index.

00:56:26.000 | - Yeah, so let's say 200 milligrams

00:56:27.840 | and somebody consumes that after lunch at 1 p.m.

00:56:32.640 | and their bedtime is,

00:56:33.840 | let's make them more conventional than I,

00:56:36.280 | somewhere between 10 and 11 p.m.

00:56:40.160 | Okay, so they're about- - Nine to 10 hours.

00:56:42.280 | - Nine to 10 hours out from their bedtime.

00:56:44.640 | They're having a nice strong, quote-unquote,

00:56:46.240 | nice strong cup of coffee after lunch.

00:56:48.360 | What does that look like in terms of their biochemistry

00:56:53.600 | and impact on sleep?

00:56:55.600 | So caffeine has something that we call a half-life

00:56:59.040 | of about five to six hours,

00:57:01.080 | meaning that after five to six hours,

00:57:03.440 | about 50% of that caffeine is still circulating

00:57:06.920 | in your bloodstream and thus your brain.

00:57:09.320 | That means that caffeine has a quarter-life

00:57:12.680 | of somewhere between 10 to 12 hours.

00:57:15.880 | Now this is on average and we'll come back to variations,

00:57:19.280 | but think of it this way.

00:57:21.720 | If you're taking a cup of coffee,

00:57:24.160 | like you described there, at midday,

00:57:26.160 | and then you're going to bed at, let's say, 11 or midnight,

00:57:31.160 | that would be the equivalent,

00:57:32.880 | based on what I've just told you,

00:57:34.000 | the quarter-life of getting yourself into bed.

00:57:37.480 | And just before you took yourself into bed,

00:57:39.280 | you swig a quarter of a cup of coffee

00:57:41.280 | and you hope for a good night of sleep.

00:57:43.120 | And the chances are that it may not happen.

00:57:46.280 | Now, again, that's a little bit sort of hyperbolic

00:57:49.640 | as a statement, but just try to conceptualize it

00:57:53.320 | in that way.

00:57:54.160 | You would never think about taking on a last quarter

00:57:58.640 | of a cup of coffee just before you put your eye mask on.

00:58:02.640 | - No, but I have some friends and somebody actually

00:58:06.000 | who works with the podcast team,

00:58:07.600 | and we'll go out to dinner as a team when we're on the road

00:58:09.800 | and he'll order a big coffee right after 9 p.m. dinner.

00:58:14.800 | And I'm like, "Can you sleep?"

00:58:16.360 | And they say, "Oh yeah, no problem."

00:58:17.840 | - And that no problem is in part this,

00:58:20.880 | I don't have an issue with falling asleep,

00:58:23.280 | but if we were to, based on the data,

00:58:25.560 | map their electrical brain activity,

00:58:28.160 | you would be able to see this reduction

00:58:31.400 | in the deep non-REM sleep.

00:58:33.840 | And it can reduce it, if you look at the data,

00:58:36.800 | somewhere between 15 to 20%.

00:58:39.480 | Now, for me to reduce your deep sleep by 15 to 20%,

00:58:44.480 | I would probably have to age you by about 20 to 22 years.

00:58:50.560 | Or you could just do it every night

00:58:52.200 | with a late night coffee, should you wish.

00:58:55.960 | So again, and maybe we'll speak about this

00:58:59.400 | in later episodes, I have changed my mind on caffeine.

00:59:03.280 | I think morning caffeine use, or coffee, I should say,

00:59:06.920 | being more specific, is fine

00:59:08.880 | because I think there are health benefits

00:59:10.560 | and we can go into in subsequent episodes

00:59:12.880 | why coffee and the coffee bean itself

00:59:15.880 | can provide those benefits.

00:59:17.440 | So I've become a little bit more bullish on morning caffeine

00:59:22.440 | but evening caffeine,

00:59:24.400 | I just think the data is just not supportive.

00:59:28.320 | Even if you are, and there are variations

00:59:30.400 | and you were very astute in your question,

00:59:33.400 | some people, I said, on average,

00:59:35.800 | caffeine has a half-life of about five to six hours.

00:59:39.440 | For some people, it's quicker.

00:59:41.040 | And for other people, it's slower.

00:59:43.520 | Why is that?

00:59:44.360 | It's based on a gene and we know the gene.

00:59:47.200 | It's a gene that is part of a set of liver enzymes.

00:59:50.800 | And the gene is called the CYP1A2 gene.

00:59:55.800 | And there are variations in that gene,

00:59:59.280 | what we call polymorphisms.

01:00:00.960 | And you can do these genetic tests

01:00:02.520 | that you can buy these kits

01:00:03.640 | and they will probably tell you which you are.

01:00:06.000 | Are you sensitive or you're not sensitive?

01:00:07.720 | You probably already know. (laughs)

01:00:10.080 | And so some people will not be as sensitive

01:00:12.840 | and therefore they can have a more compressed timeframe

01:00:17.040 | of a half-life because it's moving out of their system

01:00:20.000 | in a quicker manner.

01:00:21.840 | So again, I'm not trying to be scaremongering.

01:00:23.680 | I think you can have coffee in the morning

01:00:25.640 | and you'll be just fine.

01:00:27.920 | That late night coffee, I would like to see you obviate that

01:00:32.600 | if you are someone who's doing it.

01:00:34.240 | - And the afternoon coffee sounds like,

01:00:36.680 | maybe only every once in a while

01:00:38.360 | and try and make it mostly decaf or decaf for that matter,

01:00:41.800 | if it's really just for the taste.

01:00:43.280 | - Yeah, if it's just for the taste, go decaf.

01:00:45.240 | If it's not, I understand that in some ways

01:00:48.000 | what I'm talking about is the ideal world

01:00:50.680 | and drum roll, it turns out that most of us

01:00:52.640 | don't live in that.

01:00:53.480 | We live in this thing called the real world. (laughs)

01:00:56.080 | And so if you are facing a circumstance

01:00:58.400 | where if you're under pressure at work

01:01:00.480 | or if you're a high-performing athlete and this is it,

01:01:03.000 | this is the event, it's all or nothing,

01:01:06.400 | understand that you are going to sacrifice

01:01:08.920 | some sleep at night,

01:01:09.760 | but maybe that sacrifice is well worth it.

01:01:11.640 | So again, I'm very open-minded.

01:01:13.440 | I'm not trying to be simply too rigid with this.

01:01:18.440 | - I wanna take a brief break

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01:02:24.280 | So you've talked about alcohol and its effects on sleep.

01:02:27.480 | You've talked about caffeine and its effects on sleep.

01:02:29.720 | And we talked about food and its effects on sleep.

01:02:32.800 | What about THC and CBD?

01:02:36.360 | Sometimes they're referred to more generally as cannabis.

01:02:39.720 | And it's interesting, gosh, when I was growing up,

01:02:43.100 | cannabis was illegal.

01:02:47.720 | Nowadays it's either legal or tolerated

01:02:52.200 | or decriminalized in many places, not all.

01:02:55.120 | But I would say there's been a tide shift

01:02:59.200 | in terms of cannabis,

01:03:01.920 | meaning that many people consume cannabis

01:03:05.840 | who are consuming it legally

01:03:08.760 | and consume it for a lot of reasons

01:03:10.520 | that other people consume alcohol,

01:03:13.600 | in a sedative effect, a slight hypnotic effect.

01:03:17.320 | I mean, the actual definition of what these drugs do,

01:03:19.800 | it goes by certain terms

01:03:20.920 | in the psychiatric literature, of course,

01:03:22.460 | but in order to quote, unquote, mellow out,

01:03:25.200 | to feel more relaxed, to reduce their anxiety,

01:03:28.160 | it's far and away different than when I was growing up

01:03:30.880 | where, I mean, you would get into a lot of trouble

01:03:33.960 | if you were caught smoking a joint

01:03:36.740 | or taking a bong rip in the middle of the day.

01:03:40.680 | And I realize most people aren't doing that at work.

01:03:42.880 | I guess it depends on where you work.

01:03:44.960 | But you know, edibles, tinctures,

01:03:47.760 | I mean, the consumption of THC and CBD

01:03:50.880 | is quite robust in a lot of places.

01:03:54.720 | So with all the issues of legality

01:03:58.080 | and the fact that young people should not be consuming them,

01:04:02.360 | I mean, people 18 and younger,

01:04:04.200 | not just for legal reasons,

01:04:05.240 | but the brain is still developing.

01:04:06.940 | What is the story with THC, CBD, cannabis,

01:04:12.040 | edible, smoked, tinctures, on sleep specifically?

01:04:17.040 | - It's very interesting if you look firstly

01:04:20.360 | at the motivational reasons why people use cannabis.

01:04:24.840 | Based on the published study,

01:04:28.400 | somewhere in the top two reasons, sleep.

01:04:32.740 | - To fall asleep.

01:04:34.440 | - To fall asleep and stay asleep.

01:04:36.040 | Obviously, usually the principle first reason

01:04:37.960 | is just to get high and have the experience

01:04:40.440 | and the pleasure of being high,

01:04:42.040 | if that's what sort of floats your train.

01:04:46.400 | But certainly it's sleep as what we call a hypnotic

01:04:50.960 | to put you asleep from the Greek derivative

01:04:53.560 | of the God for sleep.

01:04:55.720 | That is high among the reasons that people will use.

01:04:59.340 | We currently don't recommend it.

01:05:02.840 | And here is why.

01:05:04.900 | Certainly THC helps you fall asleep faster.

01:05:08.640 | Very clear in the data.

01:05:10.860 | The problem is that first you start to develop a tolerance

01:05:15.360 | and to get that same sleep onset benefit,

01:05:18.380 | you need to get use, I should say, a higher dose.

01:05:22.040 | So you start to develop dependency

01:05:24.160 | and your dose regimen starts to increase.

01:05:27.040 | The second issue with THC is that it's very good

01:05:30.880 | at blocking your dream sleep, your REM sleep.

01:05:34.120 | And in fact, many people, when they come in,

01:05:36.640 | they tell me, look, I was a heavy cannabis user,

01:05:39.040 | even a light cannabis user for some time.

01:05:41.360 | And then I stopped using.

01:05:43.160 | And one of the strangest things happened to me.

01:05:45.920 | I just started to have the most wild, vivid, crazy dreams.

01:05:50.920 | And I didn't know what was going on.

01:05:53.720 | And it's a very simple explanation.

01:05:55.880 | As you've been using, your brain has been compromised

01:06:00.380 | in the amount of REM sleep it's been getting.

01:06:03.480 | And you've been building up chronically a REM sleep debt.

01:06:08.480 | And your brain is smart in the sense

01:06:10.680 | that it does try to clock to some degree

01:06:15.160 | a counter of how much REM sleep you've lost.

01:06:18.560 | And many people will say, yeah,

01:06:19.600 | I don't really remember my dreams when I'm using.

01:06:22.120 | But when they stop, the brain finally,

01:06:24.680 | because it's been cleansed of the thing

01:06:26.440 | that's the roadblock to REM sleep,

01:06:29.260 | not only do they go back to having the normal amount

01:06:32.520 | of REM sleep that people would have, they have that,

01:06:36.240 | plus they have what we call a REM sleep rebound,

01:06:38.840 | which is even more and more intense REM sleep,

01:06:42.400 | which leads to more intense dreaming.

01:06:45.480 | So it's a very, I suspect there's a lot of people

01:06:48.000 | who've had that experience listening

01:06:49.600 | if they have been users and they've stopped.

01:06:52.240 | So that's the second reason we don't advocate it.

01:06:55.240 | The third reason is that when you stop using,

01:06:59.160 | you also go through a very vicious

01:07:03.280 | insomnia withdrawal syndrome.

01:07:05.280 | Often many people will do.

01:07:06.720 | Now that depends on how much you've been using

01:07:09.480 | for how long you've been using.

01:07:11.060 | If you look at the data, and by the way,

01:07:14.320 | part of the clinical diagnostic,

01:07:17.960 | the psychiatric diagnostic description

01:07:21.120 | of cannabis withdrawal is insomnia.

01:07:24.600 | That's how reliable this insomnia problem is

01:07:28.560 | when you come off cannabis.

01:07:30.040 | And if you look at the data,

01:07:33.400 | one of the main reasons that people relapse

01:07:36.720 | and start using cannabis again,

01:07:38.640 | even though they don't want to,

01:07:40.680 | is because they can't deal with the insomnia

01:07:43.800 | that withdrawal has given them.

01:07:45.560 | So you don't want to get into that vicious cycle.

01:07:48.620 | Should you wish again, it's your choice.

01:07:52.120 | So THC, I think is not to be advised right now.

01:07:58.800 | CBD is interesting.

01:08:01.720 | I don't think there's enough data yet

01:08:03.320 | for us to have a very strong opinion,

01:08:05.040 | but I can at least offer mine.

01:08:07.660 | The data so far is a little bit mixed

01:08:10.480 | in what we call the effect size.

01:08:12.480 | In other words, how reliable and how powerful

01:08:14.560 | is the benefit of CBD on sleep,

01:08:17.040 | but it does seem to have some benefit.

01:08:19.740 | What's interesting is that it doesn't seem to have

01:08:23.020 | the detriments that I just described for THC.

01:08:26.700 | You've got to be looking at the data

01:08:30.280 | a little bit careful with CBD.

01:08:33.020 | It has what's called a U-shaped function to it,

01:08:36.040 | which is that if you're taking too little,

01:08:39.940 | and again, I really am so mindful of not trying to be,

01:08:43.920 | okay, here are the numbers, but if you look at them,

01:08:46.760 | I would say, kind of cross your eyes, squint your eyes,

01:08:51.380 | maybe less than 25 milligrams,

01:08:55.260 | you run into the danger of CBD being wake promoting

01:09:00.260 | rather than sleep promoting.

01:09:02.280 | But once you get past, if you look ish,

01:09:05.160 | 50 milligrams and above,

01:09:07.800 | then you start to go in the opposite direction

01:09:09.800 | where it seems to be sleep promoting.

01:09:13.280 | And I mentioned that just because

01:09:15.280 | at least here in the United States

01:09:16.920 | and in many places in the world,

01:09:18.520 | that industry is not regulated.

01:09:21.720 | So it may say 50 milligrams on the bottle.

01:09:25.440 | You don't really know how some of those companies

01:09:28.800 | will have what's called third party laboratory testing

01:09:31.680 | where they'll send it out and you can scan a QRI code

01:09:34.360 | and you can look at an independent laboratory

01:09:36.120 | that tested it and show you the purity of it.

01:09:39.200 | So that may be one way to go.

01:09:41.920 | So CBD, I think has some favorable evidence right now.

01:09:46.640 | If that's the case, let's just assume

01:09:48.960 | that you and I speak in another five years time

01:09:51.040 | and there's really good data now for this.

01:09:53.680 | What could be the mechanisms?

01:09:55.700 | I think there's probably at least two,

01:09:59.720 | maybe three mechanisms.

01:10:02.000 | The first is an indirect mechanism.

01:10:04.720 | CBD has been demonstrated very nicely

01:10:07.040 | in some fantastic studies to be an anxiolytic,

01:10:11.240 | which is a fancy term for saying

01:10:13.080 | it reduces down your anxiety.

01:10:15.320 | And earlier you and I discussed that anxiety and stress

01:10:19.440 | is one of the things that will keep you awake.

01:10:21.880 | So indirectly it removes this kind of gate

01:10:26.760 | that is preventing you from moving down

01:10:29.360 | the Royal road of sleep.

01:10:31.200 | And it opens back up the gates

01:10:32.920 | because it's removed that gate mechanism,

01:10:35.340 | which is high anxiety.

01:10:37.440 | And by way of being an anxiolytic,

01:10:39.640 | it's soften that anxiety and it's easier for you

01:10:42.160 | to fall asleep.

01:10:43.000 | I think that's probably the principle mechanistic bet

01:10:45.680 | I would have right now.

01:10:47.520 | Another indirect mechanism.

01:10:50.000 | If you look at some of the studies in rats

01:10:52.120 | and we do human work at my sleep center.

01:10:54.920 | So we don't do animal studies,

01:10:56.600 | but if you look at the data in the rats,

01:10:59.800 | CBD can be hypothermic,

01:11:03.480 | which means that it drops your core body temperature.

01:11:06.160 | And just as we spoke about in earlier in this episode,

01:11:09.320 | you need to drop your body temperature to get to sleep.

01:11:12.000 | So I think that's the second reason.

01:11:13.680 | I think the third reason is that it could have

01:11:15.840 | a direct sleep promoting mechanism.

01:11:19.040 | I think it's unclear right now exactly how it's interacting

01:11:22.840 | with the sleep machinery of the brain.

01:11:24.600 | We've got some hypotheses.

01:11:26.360 | The danger is, again,

01:11:27.440 | it's just not a well-regulated substance.

01:11:29.640 | So I am actually just full disclosure.

01:11:32.640 | I'm working with a company in the United Kingdom

01:11:36.400 | in collaboration with King's College

01:11:39.760 | and the Institute of Psychiatry there

01:11:41.200 | to see if we can create an analog,

01:11:44.920 | a clean analog of CBD.

01:11:47.360 | But I think the potential upside of it,

01:11:50.000 | not just for sleep,

01:11:51.200 | but for a number of different psychiatric conditions

01:11:54.120 | like anxiety could be beneficial.

01:11:57.440 | So I would say that that's right now

01:11:59.480 | the sort of the skinny on THC and CBD.

01:12:03.360 | - Okay, so just to make sure that I have the basic list

01:12:07.720 | of sleep hygiene factors, correct.

01:12:11.640 | I have regularity is king.

01:12:14.920 | - Yep.

01:12:15.760 | - Light and dark,

01:12:17.480 | meaning that one should optimize

01:12:19.840 | or at least seek to optimize their exposure to light

01:12:22.600 | in the morning and throughout the day

01:12:25.000 | and then in the evening to make things dim and dark.

01:12:27.800 | - Yes.

01:12:29.140 | - Temperature.

01:12:30.320 | And there you have, it's not a mantra,

01:12:33.520 | but what is it?

01:12:34.360 | It's a warm up to cool down to fall asleep.

01:12:38.440 | And then it's stay cool, like Fonzie,

01:12:42.240 | stay cool to stay asleep and then a warm up to wake up.

01:12:47.240 | - Yep.

01:12:48.280 | And we will come onto that I think in a little while again.

01:12:50.200 | - Then there's walk it out,

01:12:51.760 | which is if I understand correctly,

01:12:53.400 | if you're trying to fall asleep or fall back asleep

01:12:56.160 | and it's taking you longer than about 20, 25 minutes,

01:12:58.960 | you should just get out of bed

01:13:00.120 | and go elsewhere in the house, do something else.

01:13:02.040 | Maybe even lie down on a different surface in the house

01:13:04.680 | to try and see if you can sleep there,

01:13:06.500 | but don't stay in bed.

01:13:07.480 | Don't create a paired association of wakefulness

01:13:10.120 | and your bed,

01:13:11.680 | because that can lead to problems in subsequent nights.

01:13:13.920 | - Yeah, and I would only say that try to resist if you can,

01:13:16.760 | if you really want your bedroom to be the place

01:13:19.200 | where you now become consistently asleep,

01:13:21.900 | try not to start sleeping in some other location

01:13:25.160 | consistently because then all of a sudden

01:13:27.180 | you bond that with good sleep

01:13:29.040 | and you unbuckle this notion that we're trying to relearn,

01:13:33.640 | which is no, your bedroom is the place of sleep.

01:13:36.600 | So it's fine to go elsewhere.

01:13:38.620 | Try to stay awake and force yourself to stay awake

01:13:41.460 | until you are absolutely sleepy, then go back to bed.

01:13:44.420 | - Okay, and then we discussed alcohol, food, caffeine,

01:13:49.280 | and THC/CBD, aka cannabis.

01:13:53.720 | And with respect to alcohol,

01:13:55.080 | it's clear that none is best

01:13:58.120 | if you're going to have some,

01:13:59.900 | you don't want to drink too early in the day,

01:14:02.260 | but you don't want to drink too much

01:14:03.480 | or too close to bedtime

01:14:04.720 | because it can disrupt rapid eye movement, sleep.

01:14:07.200 | Food, it seems that creating some sort of buffer

01:14:09.860 | between your last bite of food and your to bed time by,

01:14:14.640 | anyway, somewhere between, you know, maybe two, three hours,

01:14:17.600 | but for some people it'll be more like 90 minutes.

01:14:19.840 | And of course that's going to depend

01:14:20.900 | on the size of the meal, et cetera,

01:14:22.160 | but eating a big meal and then going straight to bed,

01:14:25.440 | probably not a good idea.

01:14:27.720 | Caffeine has this long half-life.

01:14:30.200 | So if you're going to indulge, which I do,

01:14:32.720 | do so early in the day.

01:14:35.280 | Beware of the afternoon caffeine.

01:14:38.880 | - Yeah, do the Huberman taper

01:14:40.480 | is what I'm going to call it right now,

01:14:41.760 | which is not an interpretive dance.

01:14:43.480 | It's simply the caffeine tape.

01:14:45.120 | - And then THC/CBD does nothing good

01:14:48.960 | for your sleep architecture.

01:14:51.040 | Although some people have the impression

01:14:53.520 | that it is good for their sleep

01:14:54.600 | because it makes it easier for them to fall asleep.

01:14:56.320 | But what they're unaware of is that it is disrupting

01:14:59.080 | the quality and architecture of the different stages

01:15:02.600 | of sleep in ways that are not serving people well.

01:15:06.160 | - That seems to be the case for THC.

01:15:07.680 | And I think CBD, you know, has promise

01:15:12.000 | and research must try harder, including my own.

01:15:15.960 | - And you very kindly emphasize

01:15:19.760 | that you're not telling people what to do.

01:15:21.400 | They just should know what they're doing

01:15:23.040 | so that they can make changes if they so choose.

01:15:26.400 | - That's right.

01:15:27.240 | I would always say that I'm not trained

01:15:29.280 | to be a medical doctor.

01:15:30.440 | Any advice that I give

01:15:31.760 | is simply scientifically descriptive advice.

01:15:35.200 | It's not medically prescriptive

01:15:37.080 | nor lifestyle prescriptive advice.

01:15:39.680 | - I'm smiling 'cause what I always say

01:15:41.040 | is I'm a scientist, not a physician.

01:15:43.320 | So I don't prescribe anything,

01:15:45.360 | but I profess lots of things.

01:15:47.800 | Whereas my good friend, who's a musician,

01:15:49.680 | Tim Armstrong says, "I'm not a cop."

01:15:52.120 | - That's right, so do what you want.

01:15:54.120 | Okay, what a wonderful list to leap off

01:15:59.480 | into the unconventional and more advanced tools

01:16:03.480 | for sleep enhancement.

01:16:05.160 | So let's go there.

01:16:07.960 | - So I think many people may have heard

01:16:10.320 | of some of the conventional,

01:16:11.840 | but what about the unconventional?

01:16:13.920 | I would probably offer five or six.

01:16:17.360 | The first one I would say is that

01:16:19.440 | if you are struggling with sleep

01:16:20.880 | and you have had a bad night of sleep,

01:16:24.520 | the first recommendation is do nothing.

01:16:28.800 | And what I mean by that is

01:16:30.200 | if you've had a bad night of sleep,

01:16:31.720 | you're awake for three hours,

01:16:33.840 | do not sleep in any later into the morning.

01:16:38.560 | Do not go to bed any earlier.

01:16:42.240 | Do not increase your caffeine intake

01:16:45.040 | to try to offset it.

01:16:47.240 | And do not nap during the day.

01:16:49.200 | Why am I telling you those things?

01:16:50.960 | If you wake up later that following morning,

01:16:55.800 | your adenosine clock that we spoke about,

01:16:58.560 | this building up of sleepiness

01:17:00.560 | that happens when we wake up,

01:17:02.480 | is going to start later in the day.

01:17:05.400 | So when it comes time for you to fall asleep

01:17:08.120 | at what would then be the next night at your normal time,

01:17:12.240 | you're not going to feel as sleepy, why?

01:17:14.720 | Because you woke up that much later

01:17:16.720 | and you're setting yourself up for failure again.

01:17:20.320 | Equally, don't go to bed any earlier.

01:17:23.480 | If you have become accustomed and your brain has,

01:17:26.360 | and your circadian clock has become accustomed

01:17:27.960 | to going to bed at a certain time

01:17:29.440 | and hopefully you're doing it regularly,

01:17:31.560 | then getting into bed two or three hours early

01:17:34.120 | has the danger, it's not a certainty,

01:17:35.880 | but a danger of you then getting into bed and thinking,

01:17:39.160 | well, I know I had a bad night of sleep last night,

01:17:42.040 | but I still can't fall asleep straight away.

01:17:44.440 | So now you're spending another 90 minutes in bed

01:17:47.600 | at the beginning,

01:17:48.440 | 'cause you've gone to bed 90 minutes earlier

01:17:49.960 | thinking it's a good idea to compensate.

01:17:52.000 | Don't do that either.

01:17:53.560 | Hold out, even if you do feel tired,

01:17:56.760 | my recommendation would be after that bad night of sleep,

01:17:59.600 | hold out for as long as you can,

01:18:01.800 | as close to your natural bedtime as possible,

01:18:05.000 | then go to sleep

01:18:06.440 | and you will give yourself highest chance of success.

01:18:09.200 | Don't over-caffeinate, that's the obvious one,

01:18:11.600 | follow the beautiful Huberman taper,

01:18:13.960 | and then obviously try not to compensate with a nap.

01:18:17.840 | Why?

01:18:18.680 | Because that nap, as happens when we sleep,

01:18:22.040 | is going to remove some of that sleepiness,

01:18:24.440 | that adenosine, and once again, you get into bed

01:18:27.960 | and you're not as sleepy as you would naturally be.

01:18:30.080 | So you again go through a bad night

01:18:32.320 | 'cause you're struggling to sleep,

01:18:33.560 | or you wake up and you can't get back

01:18:36.400 | because you've got less weight of sleepiness

01:18:38.640 | on your shoulders due to the nap that happened earlier.

01:18:41.920 | So I know it's hard,

01:18:44.000 | but I would say when the alarm goes off after a bad night,

01:18:46.800 | you just think, I do not want to get up,

01:18:49.320 | it's been such a rough night.

01:18:51.120 | I know it's a short-term gain,

01:18:53.880 | but trust me, it's a long-term loss

01:18:56.920 | because you're going to then just get

01:18:58.160 | into this vicious cycle.

01:18:59.840 | So that's the first unconventional tip.

01:19:02.160 | - Can I just pause you for a second?

01:19:03.680 | I'm a little wide-eyed over here

01:19:05.400 | because I did not know any of that.

01:19:09.640 | Typically, if I get a poor night's sleep,

01:19:11.320 | I'll do whatever I can to recover that sleep,

01:19:14.160 | take a nap, I'll adjust to bedtime the next evening.

01:19:19.160 | So I hope everyone is paying careful attention

01:19:23.440 | to what Matt just said.

01:19:24.720 | I mean, that's an important list

01:19:27.680 | because I think one of the very common things

01:19:29.600 | is for people to just not get a great night's sleep.

01:19:31.720 | And I think most people think,

01:19:32.720 | okay, I'll drink a little more caffeine,

01:19:34.320 | I will go to bed a little earlier tonight,

01:19:37.840 | maybe catching a nap in the afternoon, this kind of thing.

01:19:41.300 | And I would have thought that too,

01:19:42.600 | and maybe even suggested that.

01:19:44.480 | And if you listen to the first episode

01:19:46.440 | and where I list in a doomsday manner

01:19:49.280 | the things that can happen by way of a short night,

01:19:51.320 | you would think that that's what I would then recommend.

01:19:54.020 | But it was really imprinted on me

01:19:55.560 | by a wonderful sleep clinician, Michael Perlis,

01:19:59.120 | who sort of described some of these features

01:20:01.280 | and exactly the reasons sort of underlying them.

01:20:03.640 | And I think I've just tried to bake that out

01:20:05.740 | into a formula that makes sense.

01:20:07.800 | Again, it's not about the rule, it's about explaining it,

01:20:11.160 | because when you explain it,

01:20:12.680 | at first, it sounds contradictory and paradoxical.

01:20:16.040 | When you understand it,

01:20:17.280 | it hopefully sounds logical and actionable.

01:20:20.440 | So that would be the first suggestion.

01:20:22.800 | - Could I just, sorry to interrupt again.

01:20:24.900 | My audience hates when I interrupt,

01:20:26.560 | but I'm doing it on their behalf.

01:20:28.160 | - Oh, I love it.

01:20:29.420 | - Because I like to think that there's some value

01:20:32.160 | in some of at least what you say in response.

01:20:35.840 | I saw a really terrific post from Dr. Rhonda Patrick,

01:20:40.600 | who we both know and admire for her public education

01:20:45.200 | or public health education work.

01:20:46.920 | And she described a study whereby if people are,

01:20:50.280 | I think it was slightly sleep deprived,

01:20:51.920 | maybe by a few hours,

01:20:53.360 | that some of the disruption

01:20:55.960 | to morning blood glucose regulation

01:20:57.980 | that is known to accompany partial sleep deprivation

01:21:00.680 | and certainly complete sleep deprivation,

01:21:02.840 | but in this case, partial sleep deprivation could be offset

01:21:06.800 | by still exercising in the morning.

01:21:09.240 | - That's right.

01:21:10.360 | - Which, frankly, I have to say,

01:21:12.360 | if I haven't slept that well,

01:21:13.600 | then normally I'm like,

01:21:15.360 | maybe today's the day I don't exercise.

01:21:16.960 | But now having heard that information,

01:21:18.920 | I make it a point to still exercise,

01:21:22.640 | sometimes with a little bit less intensity,

01:21:25.600 | because I don't want to be completely exhausted

01:21:27.360 | in the afternoon and go to sleep at 4 p.m. or something,

01:21:32.200 | really disrupt my schedule.

01:21:33.520 | But I thought that was really interesting

01:21:35.080 | because it's a sort of partial inoculation

01:21:38.500 | of the blood glucose disruption

01:21:40.920 | caused by sleep deprivation.

01:21:43.320 | - I'm so glad you brought it up.

01:21:44.780 | It's a fantastic study, and Rhonda and I,

01:21:48.160 | I think even tried to discuss it some years ago on a show,

01:21:52.160 | but I like it because it does offer

01:21:54.880 | some degree of actionable hope and a strategy.

01:21:59.080 | Blood sugar, absolutely critical.

01:22:03.360 | It is very sensitive to sleep.

01:22:05.880 | When you don't get enough,

01:22:07.160 | it goes in bad directions.

01:22:09.560 | You used a very specific word, cleverly so,

01:22:12.920 | and that word was partially.

01:22:14.700 | At first you hear or read that study,

01:22:18.400 | and Rhonda was never suggesting this too,

01:22:20.280 | I'm not saying that.

01:22:21.760 | You think, well, if it offsets blood sugar,

01:22:25.760 | and the study was saying exercise

01:22:27.960 | can nullify a lack of sleep,

01:22:31.880 | you conflate that single outcome benefit

01:22:35.860 | with the idea that, well,

01:22:37.440 | but maybe it doesn't actually,

01:22:39.700 | does it compensate for the deficits in immune function,

01:22:44.960 | or cardiovascular disease concerns,

01:22:48.320 | or my hormonal health, or my learning and memory,

01:22:51.360 | or my emotional and brain health.

01:22:53.460 | Maybe it does, but maybe it doesn't.

01:22:55.440 | So I think I would always just caution people to saying,

01:22:58.280 | when you hear a study like that,

01:23:00.400 | it's very natural to think,

01:23:01.760 | oh, that must mean that it translates

01:23:03.980 | to everything else in my body,

01:23:05.520 | and everything else in my brain.

01:23:08.040 | It may, but it also may not be.

01:23:10.480 | - Terrific, so if you don't sleep that well,

01:23:14.480 | do your best to still get some exercise,

01:23:16.400 | but just be mindful of the fact that,

01:23:19.840 | in the winter months, especially,

01:23:21.120 | that might, if you go too hard in the gym or on a run,

01:23:24.080 | you might be a little bit immune compromised,

01:23:27.400 | just be mindful of the fact

01:23:28.640 | that you're a more vulnerable being

01:23:30.840 | when you're sleep deprived,

01:23:32.400 | but that exercise can help adjust things

01:23:34.700 | in the right direction.

01:23:35.540 | And if it's early in the day,

01:23:36.940 | presumably that's not going to disrupt the proper bedtime.

01:23:41.300 | And if it's later in the day,

01:23:43.420 | I suppose, as long as you don't need caffeine

01:23:45.220 | in order to do that exercise,

01:23:48.060 | and/or if you're familiar with exercising later in the day,

01:23:53.060 | fine, I find if I exercise,

01:23:56.380 | I'm not one of these people that can go for a run,

01:23:59.060 | seven o'clock at night,

01:23:59.900 | and then just shower and go to sleep.

01:24:00.740 | - Of course, because you're a morning type.

01:24:01.940 | - Because I'm a morning type, other people can.

01:24:03.700 | Okay, we'll get into exercise a bit more in a later episode.

01:24:06.020 | - We should do, yep.

01:24:07.220 | - We'll be sure to do that,

01:24:08.100 | but nonetheless, just raise that now.

01:24:11.620 | So what are some of the other

01:24:13.020 | unconventional protocols for sleep?

01:24:15.740 | - So I think other suggestions I would have

01:24:18.280 | after do nothing would be,

01:24:21.440 | try to think about limiting your time in bed.

01:24:24.440 | If you are struggling with sleep,

01:24:26.560 | this is something that is used

01:24:28.340 | in probably the most well-validated

01:24:32.940 | psychological intervention for insomnia,

01:24:36.240 | and it's called Cognitive Behavioral Therapy for Insomnia,

01:24:39.220 | or CBTI for short.

01:24:41.740 | What happens is that you work with a clinician,

01:24:44.580 | they interview you,

01:24:45.620 | they assess all of the reasons that you may not be sleeping,

01:24:48.380 | and then they create,

01:24:49.580 | from their toolbox of many different options,

01:24:52.540 | a bespoke, tailored sort of Savile Row soup prescription

01:24:56.020 | for you for your treatment.

01:24:58.220 | If you look at the studies

01:24:59.540 | of that collection of different tools

01:25:01.420 | in the CBTI box for intervention of insomnia,

01:25:05.700 | and you ask of all of those,

01:25:08.180 | which seems to carry the greatest impact on insomnia,

01:25:12.220 | which has the greatest sort of gravitas,

01:25:15.140 | it seems to be this thing

01:25:16.340 | that we call Bedtime Rescheduling.

01:25:19.100 | It used to be known as Sleep Restriction Therapy,

01:25:22.340 | but obviously, if you come to me and you say,

01:25:25.020 | "Look, I am not sleeping very well.

01:25:27.260 | "I've got insomnia."

01:25:28.660 | I say, "I understand, and I've got a treatment for you.

01:25:31.460 | "It's called Sleep Restriction Therapy."

01:25:33.220 | And you say, "No, no, no, you didn't understand.

01:25:35.180 | "I'm not getting enough sleep."

01:25:37.660 | But it's not quite that.

01:25:39.100 | Here's how it works.

01:25:40.900 | If you are spending so much time in bed,

01:25:44.020 | too much time in bed,

01:25:46.060 | you are not forcing your brain to be efficient.

01:25:50.380 | And by way of constraining your sleep window,

01:25:53.700 | even to, let's say, five hours a night to begin with,

01:25:58.220 | I brute force ruthless efficiency

01:26:01.620 | from your sleeping brain after several days.

01:26:04.820 | So another analogy would be,

01:26:06.020 | let's say you're trying to make

01:26:07.020 | a nice thin crust of pizza base,

01:26:10.380 | and you put the dough on the table,

01:26:12.300 | and you start rolling it out.

01:26:13.780 | If you roll it too thin,

01:26:15.300 | it starts to get gaps and holes in it.

01:26:17.900 | Why?

01:26:18.740 | Because you've spread it out too far,

01:26:21.260 | and you've started to create these absences.

01:26:24.740 | That's the same thing that happens.

01:26:26.420 | And it's very natural.

01:26:27.420 | As an insomnia patient, you would say,

01:26:29.580 | "I'm just not getting enough sleep,

01:26:30.660 | "so I'm going to start spending more time in bed."

01:26:33.060 | It's the very worst idea.

01:26:35.340 | Another way would be to say,

01:26:36.620 | "Look, I go to the gym,

01:26:37.700 | "and I spend about an hour and a half working out."

01:26:40.700 | But if I were to videotape you,

01:26:42.620 | a lot of people are doing the,

01:26:43.860 | I think I've coined it as your phrase,

01:26:45.820 | but the 11th rep, where people do the 10 reps,

01:26:50.180 | and then all of a sudden there's the selfie,

01:26:51.740 | or there's the social media.

01:26:53.420 | - Oh, yeah, the texting.

01:26:54.700 | They finish the last rep, put it down,

01:26:56.140 | and then immediately to their phone.

01:26:58.220 | - And if you look, they're only working out

01:27:00.540 | for about, let's say, 45 minutes,

01:27:03.660 | and the other is wasted.

01:27:05.300 | So what if the next day you came to the gym,

01:27:08.260 | and I said, "Look, I'm sorry,"

01:27:09.420 | and there's some big bouncer guys at the door,

01:27:12.060 | "You are only allowed to work out for 40 minutes,

01:27:14.580 | "and then we're going to eject you."

01:27:16.620 | And the first day, you go back and you do the same thing.

01:27:19.900 | And then you've only got through 30% of your workout.

01:27:23.900 | So you get booted.

01:27:24.740 | The next day, you come back and you do a little bit more,

01:27:26.380 | and you get booted again.

01:27:27.820 | After about five or six days,

01:27:30.020 | you've built up such a strong desire

01:27:32.540 | and hunger to get your workout in.

01:27:34.620 | You walk in, you put your phone on silent,

01:27:36.700 | you put it over in the corner, and you just get to it.

01:27:40.180 | And that's the same thing that we're trying to do

01:27:42.300 | with sleep restriction therapy.

01:27:44.220 | So you have to be a little bit careful,

01:27:46.020 | do it under supervision,

01:27:47.180 | especially if you're driving or you're operating,

01:27:49.420 | heavy machinery.

01:27:50.260 | We just want to keep an eye.

01:27:51.380 | It's not necessarily a big concern,

01:27:53.220 | but we would say, "Okay, Andrew,

01:27:55.500 | "you're currently spending almost total

01:27:58.140 | "about eight-ish or seven and a half hours in bed.

01:28:02.340 | "Tonight, I'm going to restrict you down

01:28:04.700 | "to five hours a night,

01:28:05.940 | "and we're going to do this for the next week."

01:28:08.300 | And the way that we normally do it

01:28:09.740 | is I don't change your wake up time.

01:28:12.060 | I change your to bed time.

01:28:13.860 | Why?

01:28:14.700 | It's easier to stay awake longer

01:28:16.660 | than it is to wake up earlier.

01:28:19.140 | So I put it on the front end of the compromise,

01:28:22.420 | and at first, things don't change.

01:28:25.580 | But after maybe about four or five days

01:28:27.740 | of going through this,

01:28:29.180 | I build up enough of a short-term debt in your system

01:28:34.180 | that your system all of a sudden thinks,

01:28:37.540 | "Gosh, I just cannot be as lazy anymore.

01:28:40.300 | "I can't do this thing of waking up

01:28:42.020 | "in the middle of the night

01:28:42.980 | "and spending an hour and a half awake.

01:28:45.620 | "I don't have the choice anymore."

01:28:47.180 | There's so much physiological buildup

01:28:49.900 | and pressure to do this.

01:28:51.620 | And gradually, what happens is that you sleep longer.

01:28:55.340 | You don't wake up as much.

01:28:57.020 | And after maybe about two weeks of doing this,

01:28:59.980 | all of a sudden, you go to bed at this later time.

01:29:03.420 | So for you, let's say you normally go to bed at eight.

01:29:05.580 | I'm going to have you go to bed at maybe 10, 30, 11,

01:29:08.820 | but we're still going to have you wake up

01:29:11.220 | at that sort of 4.30 a.m. mark

01:29:13.980 | that you would normally wake up.

01:29:15.980 | And all of a sudden, you go to bed at 10, 30, 11,

01:29:20.700 | you're out like a light.

01:29:22.220 | And then again, the next thing you remember

01:29:25.060 | is your alarm going off saying,

01:29:26.300 | "I'm sorry, you've got to wake up."

01:29:28.220 | And what happens by way of that reset

01:29:30.780 | is gradually we will then, once you're stable,

01:29:33.700 | we will start to back it off.

01:29:35.300 | We'll start to have you go to bed at 10.

01:29:37.780 | And if it stays stable, then 9.45, then 9.30,

01:29:41.660 | and titrate you back to where you were.

01:29:44.660 | And if there's any sign

01:29:46.020 | that you're starting to not sleep well,

01:29:48.060 | we zip it back up again.

01:29:49.820 | The goal here is, in some ways,

01:29:51.700 | almost like hitting the reset button on your Wi-Fi router.

01:29:55.700 | I'm trying to retrain your brain to better sleep

01:29:59.940 | because when you are not sleeping well,

01:30:03.260 | you've lost your confidence in your ability to sleep.

01:30:06.780 | And when I do this technique with you,

01:30:10.100 | gradually your system and you cognitively relearn

01:30:14.380 | that you are a good sleeper and you can trust in sleep.

01:30:17.380 | And now your sleep does not control you.

01:30:20.380 | You control your sleep.

01:30:22.580 | The hard part, however, is that it's not easy to go through.

01:30:26.700 | And we have to be,

01:30:28.580 | we have to usually ask two questions with individuals.

01:30:31.220 | Firstly, what is your motivation for better sleep?

01:30:34.820 | We need to know that you really are motivated.

01:30:37.140 | And then second, you just stay

01:30:39.020 | with a high touch white glove frequency,

01:30:41.460 | checking in on individuals

01:30:42.900 | and motivating them to keep going

01:30:44.780 | 'cause it's very easy to fall off the wagon.

01:30:47.060 | So that's the next suggestion, sleep restriction therapy

01:30:51.540 | or bedtime rescheduling, as we would call it.

01:30:54.060 | - You said it's difficult for people to go through.

01:30:56.540 | You know, it takes a little bit of rigor,

01:30:58.060 | a little bit of attention,

01:30:59.140 | means in some cases getting less sleep than one would like.

01:31:02.740 | But as compared to something that, you know,

01:31:05.660 | sadly I've experienced a lot in my life

01:31:07.780 | of having challenges with sleep

01:31:10.300 | and trying to get things back in order

01:31:11.700 | and looking at the bed and just going,

01:31:13.540 | "Oh my God, battleground," you know, battleground.

01:31:16.700 | You know, it's, I think it makes a lot of sense.

01:31:19.740 | And I love the analogy to the gym.

01:31:21.620 | Somehow, if there's a restriction to one hour

01:31:24.860 | in and out the door, or maybe 70 minutes in and out the door

01:31:27.380 | 'cause you need to put your stuff in a locker

01:31:28.780 | or something like that,

01:31:30.180 | it always, at least for me, gets done best

01:31:33.100 | when you just have those constraints.

01:31:34.660 | I think there's something about the human brain

01:31:36.380 | that we don't do well in unrestrained systems

01:31:41.140 | that I really think guardrails are fantastic.

01:31:43.740 | I love deadlines, for instance.

01:31:45.180 | - Yeah, discipline is essentially the--

01:31:46.820 | - Yeah, hard deadlines.

01:31:48.700 | Like, or as they say in academia,

01:31:50.260 | 'cause we, you know, write grants all the time,

01:31:51.980 | drop deadlines, which who made up that term?

01:31:54.580 | But like, if you don't make it, that's it.

01:31:56.100 | It's like, there isn't a, "Hey, I'll send this in tomorrow."

01:31:58.380 | 5 p.m. Pacific time, that website closes

01:32:02.460 | and you better have you--

01:32:04.060 | - Boy, do you get things done all of a sudden.

01:32:06.180 | It's surprising how much distraction you can, you know,

01:32:09.420 | pull out the noise and focus on the signal.

01:32:12.180 | It's great signal to noise ratio.

01:32:13.980 | - Yeah, and I love the idea that one can control their sleep

01:32:17.140 | as opposed to sleep controlling them.

01:32:18.580 | I think that that's, and this notion of sleep confidence,

01:32:22.180 | one's confidence in their ability to sleep.

01:32:25.460 | These are important terms and they're more than just terms

01:32:27.700 | because I think that a field and an area of health practice

01:32:32.700 | and gosh, what's more important than sleep?

01:32:34.980 | It's the foundation of mental health,

01:32:36.260 | physical health and performance, period.

01:32:39.180 | Really thrives on a common nomenclature.

01:32:44.180 | And I really appreciate that you're, you know,

01:32:46.340 | peppering these episodes with new nomenclature

01:32:50.980 | that captures a lot of the essence of the protocols

01:32:53.900 | and the mechanisms.

01:32:54.740 | So there, that's my editorial, please continue.

01:32:58.380 | - I would say that in terms of other things,

01:33:00.060 | maybe just to go through them a little more quickly,

01:33:03.540 | we've spoken some about a wind down routine.

01:33:06.900 | Most people under-appreciate the importance

01:33:09.340 | of a wind down routine.

01:33:11.260 | We often think that sleep is like a light bulb,

01:33:13.900 | that we dive into bed, we switch off the light bulb

01:33:16.820 | and sleep should appear just as quickly.

01:33:19.660 | It's untrue.

01:33:21.140 | Sleep in terms of a process is much more physiologically

01:33:24.580 | like trying to land a plane.

01:33:26.460 | It just takes time to come down onto the terra firma

01:33:29.780 | of good sleep at night.

01:33:31.980 | Whatever it is you enjoy as a relaxation method,

01:33:35.580 | engage in it, could be listening to a podcast,

01:33:37.940 | could be reading a book.

01:33:39.420 | Maybe it's a meditation, it's light stretching.

01:33:42.420 | Maybe, whatever it is that you do,

01:33:45.540 | just build it in to your regimen.

01:33:48.300 | You know, you would never, you know,

01:33:50.260 | be driving down the road and then pull into your garage

01:33:54.380 | at the same 40 mile an hour speed.

01:33:57.500 | You gradually decelerate and you come to a stop.

01:34:00.620 | It's the same thing with sleep.

01:34:03.180 | So you need to find some way to decelerate

01:34:05.820 | and we've spoken about methods already as to how to do that.

01:34:08.940 | The next tip is a little quirky and funny.

01:34:12.940 | Do not count sheep.

01:34:15.540 | There's a great study from my colleague,

01:34:17.380 | Dr. Alison Harvey at UC Berkeley,

01:34:19.620 | and she put this to the test.

01:34:21.060 | Didn't make people fall asleep faster.

01:34:23.780 | It made them take longer to fall asleep.

01:34:27.020 | However, she did find an alternative.

01:34:30.420 | If you are not into meditation or podcasts or sleep stories

01:34:35.380 | or whatever it is that you wish for,

01:34:38.380 | try taking yourself on a mental walk.

01:34:41.500 | And it has to be a walk that you know very well.

01:34:44.900 | So let's say that you walk your dog every day

01:34:46.900 | and you know there's a couple of walks

01:34:48.580 | that you take with your dog.

01:34:50.180 | Do it in hyper detail.

01:34:52.340 | So close your eyes, you go to the front door,

01:34:55.620 | you clip in the dog to the leash, you walk out,

01:34:58.580 | you go down the steps, out to the driveway,

01:35:02.140 | then you take a right, but you always cross over

01:35:04.420 | and you look to the left and the right

01:35:05.620 | 'cause that's the place where traffic always comes.

01:35:07.420 | You cross over and now you're walking up

01:35:09.620 | and there's that strange sort of set of garbage

01:35:13.300 | that's been outside of that house for a long time

01:35:15.420 | and you don't know why it hasn't been cleared.

01:35:17.300 | And then you move.

01:35:18.500 | That type of high fidelity detail

01:35:22.940 | allows you to do what we said earlier,

01:35:26.420 | which is get your mind off itself.

01:35:29.380 | And when you do that, again,

01:35:31.580 | typically you fall asleep faster and that's what she found.

01:35:34.900 | It was a great, great study.

01:35:36.540 | I really enjoyed that.

01:35:38.260 | - I'm curious as to why it works so well.

01:35:42.700 | And I'm not challenging that it works.

01:35:44.860 | I can imagine having just closed my eyes

01:35:47.580 | and kind of imagine what that would be like.

01:35:49.020 | It's very pleasant.

01:35:49.980 | There might be, and here I'm just speculating,

01:35:53.900 | something about engaging one's procedural memory

01:35:56.860 | because that's procedural memory.

01:35:58.180 | You're trying to remember how you do something

01:35:59.740 | as opposed to declarative memory, which is about facts.

01:36:03.140 | I remember this and this is gonna happen tomorrow.

01:36:05.380 | I wonder whether or not there's something

01:36:07.620 | about using a procedural memory

01:36:10.980 | as opposed to a declarative memory visualization.

01:36:17.020 | Somebody should do that study.

01:36:19.100 | - They should.

01:36:19.940 | And I think it's certainly possible

01:36:20.900 | that when you're incorporating some aspect,

01:36:22.940 | some aspects of the scene and the information

01:36:26.660 | is more sort of veridical

01:36:28.020 | and maybe sort of episodic declarative memory.

01:36:30.780 | But when you're taking yourself for a mental walk,

01:36:33.780 | what is the fundamental premise of that?

01:36:35.580 | It's a walk, it's motion, it's procedural memory.

01:36:38.780 | And so maybe it's something to do about

01:36:40.660 | with being more attentive to becoming embodied

01:36:44.260 | because when you're out walking and you're moving,

01:36:48.020 | it is a more embodied experience

01:36:50.060 | than just sitting there at your desk,

01:36:52.500 | which is mostly your head and very little your body.

01:36:56.300 | So I think it's an intriguing idea.

01:36:58.300 | And I think another tip that I now think of,

01:37:02.820 | which also comes from the work of Dr. Alison Harvey,

01:37:05.660 | when individuals come up to me after sort of public events

01:37:11.820 | or they see me at the airport,

01:37:14.300 | they'll say, look, every night for some strange reason

01:37:17.460 | at 2.45 a.m. I wake up and it happens three or four nights

01:37:22.820 | a week, my first question to them is,

01:37:26.540 | how do you know it's 2.45?

01:37:28.660 | And they say, well, I look at the clock

01:37:32.460 | or I look at my phone.

01:37:33.660 | Best piece of advice next,

01:37:36.660 | remove all clock faces from the bedroom.

01:37:40.660 | No matter how bad your sleep is going to be that night,

01:37:44.220 | knowing what time it is,

01:37:46.460 | is only going to make matters worse.

01:37:48.660 | It is not going to make matters any better.

01:37:52.500 | And that can create an anxiety trigger that you think

01:37:56.580 | it's 2.45 and then you're tossing and turning,

01:37:59.820 | you look back at the clock and now it's 3.14 a.m.

01:38:03.180 | And you think I've got to be awake at six,

01:38:05.180 | I've got a big meeting and now it's 5.25.

01:38:08.940 | Don't do that to yourself.

01:38:10.620 | And I, even though I don't typically struggle with sleep,

01:38:14.180 | I have no clock faces in my bedroom.

01:38:17.140 | The phone that I use to help do the guided meditation

01:38:21.020 | is an old phone and it has only wifi connectivity

01:38:25.900 | and nothing else on it.

01:38:27.740 | And I will only hit play

01:38:30.660 | and then I will never turn it around.

01:38:32.820 | I will not look at the clock face, just doesn't help me.

01:38:37.340 | - Another incentive for keeping the phone out of the room,

01:38:40.860 | if one can, I understand there are reasons

01:38:44.460 | when one would want the phone in the room

01:38:47.820 | if it's potentially signaling an emergency.

01:38:52.820 | - I think it's a very important point

01:38:55.140 | and we've done some work in this area too.

01:38:58.060 | What that phone does is create a low level of anxiety.

01:39:03.060 | It's what we call anticipatory anxiety.

01:39:06.940 | One of the mechanisms separate from that,

01:39:10.900 | well, it's related to that.

01:39:12.220 | If you look at teen phone use,

01:39:14.140 | one of the reasons that they don't sleep very well at night

01:39:16.580 | is that they're constantly checking their phones

01:39:19.100 | because of FOMO, a fear of missing out.

01:39:21.140 | What has gone on as I've been asleep?

01:39:23.620 | And it's stunning the data, but for most adults,

01:39:26.260 | the other reason I don't like advocating for phone use,

01:39:30.140 | when your alarm goes off in the morning,

01:39:34.340 | what is the first thing that you do as you're in bed?

01:39:37.740 | You swipe right or you unlock your phone

01:39:40.620 | and you instantly start checking social media,

01:39:43.140 | emails, text messages.

01:39:45.420 | And this tsunami of stress and anxiety just floods over you.

01:39:50.420 | It hits you like this wall of anxiety.

01:39:54.660 | And I bring this up because it again,

01:39:57.420 | trains your brain for expectation of that.

01:40:02.260 | Anticipatory anxiety has a consequence on your sleep.

01:40:06.180 | And everyone knows this.

01:40:08.020 | Let's say that you've booked an early morning flight

01:40:11.900 | and you've got to wake up at 5 a.m.

01:40:13.940 | when normally you wake up at 7 a.m.

01:40:16.900 | Two things will usually happen.

01:40:19.460 | First, you know that you're just not going to sleep

01:40:22.100 | as deeply that night because you're on edge.

01:40:24.220 | And this is for an interview or it's for a critical,

01:40:27.020 | this is a non-negotiable trip that has to happen.

01:40:29.620 | You've got to wake up.

01:40:31.460 | The second thing is that when you are expecting

01:40:36.460 | that wave of sort of a need to wake up

01:40:41.260 | and maybe it's just, I'm expecting the phone again,

01:40:44.820 | you will wake up just a few minutes before your alarm.

01:40:49.060 | It's stunning how many people will say,

01:40:51.420 | I had this big flight the next day.

01:40:53.340 | And you almost know I'm going to wake up two minutes

01:40:56.260 | before my alarm goes off.

01:40:58.180 | Why?

01:40:59.020 | Because your brain has stayed in the shallow state

01:41:01.900 | of anticipatory anxiety

01:41:03.820 | and you don't get as much deep sleep.

01:41:05.420 | And we've now demonstrated that we know this.

01:41:07.780 | When you have that low level of anxiety,

01:41:10.140 | the depth of your deep sleep is not as deep.

01:41:12.220 | You don't get the good.

01:41:13.540 | So again, not to be trying to dictate what people do,

01:41:17.740 | just be aware that when you do create that behavior

01:41:21.540 | and that regiment, it becomes almost like a knee jerk

01:41:26.060 | sort of trained habitual response.

01:41:28.420 | - Terrific.

01:41:29.500 | Let's talk about some of the advanced tools

01:41:31.540 | for sleep enhancement.

01:41:33.140 | You know, what sorts of methods could one incorporate?

01:41:36.780 | You know, what are some of the data?

01:41:38.380 | And is there any way that we can sort of lump these

01:41:41.260 | into sort of some framework or categories?

01:41:44.940 | Because I know there are a lot of different tools.

01:41:47.260 | - There are.

01:41:48.100 | And I suppose this would be, you know,

01:41:50.220 | I know our friend Petra Teer has spoken about medicine 3.0.

01:41:53.140 | I think this would probably be sleep optimization 3.0.

01:41:56.820 | What is coming down the pike?

01:41:58.500 | What is in the research?

01:42:00.780 | And I think, you know, could make it to market

01:42:04.940 | or has made it to market,

01:42:06.900 | but yet we're still right on the cusp.

01:42:10.420 | We've seen, we again in the Royal We,

01:42:13.940 | have been able to augment human sleep

01:42:17.940 | in at least four different ways.

01:42:20.940 | There are methods for electrical brain stimulation.

01:42:25.180 | There are methods for acoustic stimulation of sleep.

01:42:29.980 | So electrical stimulation of sleep,

01:42:31.540 | acoustic stimulation of sleep,

01:42:34.020 | thermal manipulation of sleep,

01:42:36.420 | and then finally kinesthetic manipulation of sleep,

01:42:39.820 | meaning movement-based stimulation.

01:42:42.220 | And maybe I can just sort of go into each one of those.

01:42:46.700 | The electrical stimulation is probably the most well-rendered

01:42:51.060 | of all of those four.

01:42:52.900 | In part, because we started there

01:42:56.660 | and here it's not the Royal We,

01:42:58.740 | we have done a lot of work on this.

01:43:00.940 | And I can tell you a little bit

01:43:02.660 | about a company emerging from that.

01:43:04.540 | But when you're trying to manipulate the human brain,

01:43:08.940 | the principal currency in which the brain communicates

01:43:11.900 | is electricity.

01:43:13.100 | Now, there are lots of things that help it do that,

01:43:15.220 | such as chemicals,

01:43:16.660 | but the principal language

01:43:18.420 | and verbiage of the brain is electricity.

01:43:21.980 | So if you're going to manipulate the brain,

01:43:23.940 | why don't you speak in its currency of electricity?

01:43:27.620 | So we and others have developed a method

01:43:30.540 | based on something called direct current brain stimulation,

01:43:36.060 | and specifically something called transcranial direct current stimulation.

01:43:40.460 | And I'll unpack that.

01:43:41.980 | Trans meaning movement, so if you've heard of transport,

01:43:44.780 | it's about moving things from one port to another.

01:43:47.780 | Transatlantic, moving, you know, across the Atlantic.

01:43:51.900 | So here, the start of it is moving.

01:43:54.300 | You're moving something from one place to the next.

01:43:56.660 | Transcranial means through your skull.

01:43:59.380 | So we're moving something through your skull.

01:44:01.340 | Transcranial direct current is the type of voltage

01:44:05.940 | or the type of electrical impulse that we're putting in.

01:44:09.260 | It could be alternating current, or it could be direct current.

01:44:12.780 | And early methods and those we use have been direct current.

01:44:16.580 | So transcranial direct current, and then stimulation.

01:44:19.700 | We're trying to stimulate the brain, specifically the cortex.

01:44:23.940 | And the way that we do this

01:44:25.380 | is that we apply electrode pads to your head,

01:44:28.300 | and we insert a small amount of voltage into your brain.

01:44:32.060 | Now, it's so small that you typically don't feel it,

01:44:35.540 | but it has a measurable impact on that electrical brain activity.

01:44:39.860 | So very early on, scientists,

01:44:41.980 | and we weren't the first to do this by any means,

01:44:44.300 | there was a great paper, now a famous paper in my field,

01:44:47.060 | by a wonderful scientist, Jan Born in Germany.

01:44:50.660 | And they took a group of subjects,

01:44:52.900 | and they applied these electrode pads specifically to the front of the brain.

01:44:57.980 | And I'll explain why we target the front of the brain

01:45:00.380 | with sleep electrical enhancement, or the electroceutical, as it were.

01:45:04.740 | They applied these electrode pads to two groups of participants,

01:45:08.580 | and then they let them go into sleep.

01:45:12.020 | And as you'll remember, we described that in the first two or three hours of sleep

01:45:15.660 | is when you get most of your deep sleep.

01:45:17.620 | And they were targeting those deep, slow brain waves that we spoke about,

01:45:21.820 | those big, slow, powerful waves that define deep sleep.

01:45:26.140 | And what they did in one of those groups,

01:45:28.740 | the other group was the placebo group,

01:45:30.500 | they still had the electrodes applied, they still went to sleep.

01:45:33.740 | In the stimulation group,

01:45:35.460 | they waited until those individuals went into deep sleep.

01:45:39.260 | And I told you in the first episode

01:45:41.060 | that those deep sleep brain waves were going up and down very, very slowly,

01:45:45.340 | maybe just once or twice a second.

01:45:48.500 | So they started to stimulate the brain,

01:45:51.980 | inputting these stimulation pulses at a very slow rhythm,

01:45:56.260 | trying to match the rhythm of the brain.

01:45:58.300 | In fact, they were less than one hertz,

01:46:00.140 | less than one cycle per second in terms of a pulse.

01:46:04.460 | It's almost as though we're trying to act like a choir to a flagging lead vocalist.

01:46:12.020 | And as these brain waves are going up and down,

01:46:14.780 | you're trying to sing in time with those deep sleep brain waves.

01:46:18.020 | And in doing so, you're trying to boost and amplify

01:46:20.740 | the size of those deep sleep brain waves.

01:46:22.900 | Now, to begin with, they just waited until they went into deep sleep

01:46:25.740 | and they started to stimulate at that frequency.

01:46:28.020 | And I'll come back to why that's important in a second.

01:46:30.580 | But sure enough, what they demonstrated,

01:46:32.700 | they were able to boost the electrical quality of that deep sleep by about 60%.

01:46:38.540 | And they were also able to almost double the amount of memory benefit

01:46:43.020 | that sleep provided, which is very impressive.

01:46:45.980 | That is impressive.

01:46:47.100 | Now, I should note that there was more recently a replication attempt of that paper,

01:46:52.100 | and they did a very good job.

01:46:53.460 | They really did it to the letter.

01:46:55.620 | And they weren't able to replicate the effects as powerfully.

01:46:59.340 | However, subsequent studies have now taken a more nuanced approach,

01:47:04.900 | and it's the one that we've taken too.

01:47:06.940 | And it's called closed loop stimulation.

01:47:10.900 | Closed loop here simply means that I'm not going to just wait

01:47:14.940 | until you go into deep sleep, and then just take a chance

01:47:17.900 | and start stimulating your brain,

01:47:19.900 | not knowing of the synchrony of my pulses into your brain

01:47:24.940 | relative to the brain waves that you're experiencing.

01:47:28.220 | Closed loop does do that.

01:47:29.900 | So what I'm doing is I'm measuring the electrical brain waves that are occurring.

01:47:34.380 | And because they're nice and slow, they're very predictable.

01:47:38.220 | And I can program my algorithm and my brain stimulation machine

01:47:42.060 | to say I'm going to wait and wait.

01:47:44.020 | And as soon as you are on this peak of your slow wave,

01:47:48.460 | which turns out to be the negative trough, but I'll forego that,

01:47:52.340 | we then try to strike at that point of midnight

01:47:56.020 | when you're going through the biggest sort of powerful dip in the brain wave.

01:48:01.340 | And we're trying to sort of enhance it, same with the peak.

01:48:04.620 | So this is where we get a stimulus from the brain,

01:48:09.700 | your electrical brain activity,

01:48:11.020 | and then we create a timed response.

01:48:13.900 | So it's a stimulus response. It's a call and response loop.

01:48:17.700 | And by way of doing that, it's a much smarter specific method

01:48:22.100 | than a more generalized, I'm just going to stimulate

01:48:24.700 | and hope I catch those waves at the peaks.

01:48:27.580 | The reason is important because different people

01:48:30.740 | have different speeds of their slow brain waves.

01:48:33.940 | They're all slow, but your speed of brain wave

01:48:37.060 | may be a little bit different to mine.

01:48:39.380 | And if I'm off with my stimulation by let's say just half a second

01:48:43.820 | or a quarter of a second, time and time again,

01:48:46.220 | I may be leaving some benefit on the table.

01:48:49.460 | But closed loops stimulation creates this personalized

01:48:53.180 | electrical prescription of stimulation.

01:48:55.980 | And when you do that, you get very reliable benefits.

01:49:00.100 | You can boost those deep slow brain waves.

01:49:02.500 | You get the memory benefits, but also what we found

01:49:05.420 | is you not only boost those deep sleep brain waves,

01:49:08.060 | you boost another electrical signature that I spoke about

01:49:11.020 | in the first episode called sleep spindles.

01:49:13.980 | And it seems to be the combination of those two things

01:49:16.780 | by way of electrical stimulation that provides the benefits.

01:49:20.500 | Now, I should note, I haven't mentioned this before,

01:49:23.620 | you can buy these devices on the internet DIY style.

01:49:28.220 | Do not do that.

01:49:29.740 | If you go onto the internet too,

01:49:31.180 | you can also find some horror stories.

01:49:32.860 | People have misappropriated the voltage.

01:49:35.700 | They've got skin burns, they've lost their eyesight for several weeks.

01:49:38.420 | Do not do this at home.

01:49:39.860 | I promise you, use, you know, wait until these products come out.

01:49:44.100 | And that's one of the reasons why we've scaled into a company

01:49:46.940 | and we're trying to do this.

01:49:48.740 | We've got a long way to go yet.

01:49:50.940 | Huge number of trials that we have to do before, you know,

01:49:54.540 | I feel ready to really lay it on the table and say,

01:50:00.500 | "You should absolutely buy this. It's well worth it."

01:50:03.980 | But we're getting very, very close, I would say.

01:50:06.660 | Great. What about thermal manipulations, temperature?

01:50:11.140 | I mean, there's such a tight relationship between temperature and sleep

01:50:15.420 | and wakefulness for that matter.

01:50:18.420 | What sort of technologies, tools, protocols exist

01:50:22.780 | that use thermal manipulation as a way to augment sleep?

01:50:27.860 | I love this topic because there are

01:50:30.780 | high-fi, low-fi and no-fi technologies that you can use.

01:50:35.980 | The story of sleep and temperature, as you mentioned before and reiterated,

01:50:41.220 | in terms of the three-part stanza, that terse that I would describe is,

01:50:45.860 | again, you need to warm up to cool down to fall asleep.

01:50:50.300 | You need to stay cool to stay asleep. You need to warm up to wake up.

01:50:53.900 | What that refers to technically in sleep science

01:50:56.700 | are what we call the thermal trigger zones.

01:50:59.140 | So, warming up to cool down to fall asleep

01:51:01.900 | is what we call the sleep onset thermal trigger zone.

01:51:05.620 | Cooling down or staying cool to stay asleep

01:51:09.100 | is about the deep sleep trigger zone.

01:51:12.300 | And then warming up to wake up is the activating alertness trigger zone.

01:51:18.780 | Studies, if you looked at them to begin with

01:51:21.140 | before they manipulated that, found something fascinating.

01:51:24.540 | If I take you, Andrew Huberman, and I bring you into my lab

01:51:27.740 | and I remove your phone or your laptop

01:51:31.460 | and you say goodbye to your friends and family

01:51:33.700 | and I bring you into the center

01:51:35.900 | and there are no cues as to what time of day, no windows, no nothing.

01:51:40.380 | And I'm just going to say, "Look, I'll keep asking you,

01:51:44.300 | but at the moment that you feel most sleepy, just let me know."

01:51:52.380 | It turns out that before that we'd done the delightful intervention

01:51:57.860 | of inserting a rectal probe into you

01:52:00.540 | because that's the best way that we can measure your core body temperature.

01:52:03.780 | So, we're measuring your core body temperature

01:52:05.740 | and sure enough, despite you knowing nothing about what time it is,

01:52:09.940 | the moment that you will tell me, "I am ready to go to bed and I am sleepy,"

01:52:15.060 | is the moment when you are on the greatest decelerating trajectory

01:52:19.700 | of your core body temperature.

01:52:21.540 | It is highly predictive of how sleepy you will feel.

01:52:25.620 | The way that your body does this

01:52:27.860 | is by pushing blood out to the surface regions of your skin,

01:52:32.460 | notably your hands and your feet,

01:52:34.460 | because these are these highly vascular regions.

01:52:37.220 | And you had a great podcast from one of my heroes and good friend, Craig Heller,

01:52:41.380 | who's done some amazing work on this at Stanford.

01:52:45.100 | So, naturally, as we lie down, blood races to our hands and our feet

01:52:50.740 | and also our head,

01:52:52.420 | and we start to release that heat trapped in the core of our body.

01:52:57.860 | And by releasing that heat at the surface, our core body temperature drops.

01:53:02.300 | Hence, the outer surfaces of you, hands, feet and face,

01:53:06.500 | have to warm up for your core to cool down for you to fall asleep.

01:53:12.940 | And in fact, there was a great nature paper some years ago,

01:53:16.420 | they just measured the temperature of someone's feet

01:53:18.940 | and they looked at how quickly they fell asleep and when they fell asleep.

01:53:23.340 | Sure enough, the warmer your feet, the faster you fell asleep.

01:53:28.100 | Why? Because the warmness reflects the blood dilation

01:53:31.980 | and the pumping out of the blood to the periphery.

01:53:34.940 | And then they did it in rats, where they started to warm the paws of the rats

01:53:38.980 | and the rats fell asleep more quickly.

01:53:41.100 | I love this notion of, again, we don't do anamorphic,

01:53:44.340 | but I love the notion of wrapping a beautiful little rat up in cotton wool

01:53:48.700 | and I'm warming its feet with this pad and it's just blissed out

01:53:52.500 | and then, poof, he's gone, after all, she, I respect their privacy.

01:53:58.060 | So, that was the early evidence.

01:54:00.020 | That then led to a series of manipulation studies.

01:54:02.700 | The most notable is brilliant.

01:54:05.660 | It comes from a colleague in the Netherlands, Ousmane Semmeren and his group.

01:54:10.380 | They created essentially what was a wet, think about a wetsuit.

01:54:16.020 | But that wetsuit is covered with all of these thin tubes,

01:54:20.780 | almost like veins that go all over the suit to all territories of your body.

01:54:26.980 | And then what they would be able to do is perfuse water, warm water or hot water,

01:54:33.060 | exquisitely to different parts of the brain or the body.

01:54:36.860 | - Cool. - Amazing. Yeah, no pun intended.

01:54:40.060 | So, what they did was then they started to manipulate these peripheral regions.

01:54:46.820 | And sure enough, when they did this,

01:54:49.860 | they were able to have individuals fall asleep 25% faster.

01:54:55.980 | And these were healthy individuals who are normally sleeping

01:54:59.140 | within a very natural quick period of time.

01:55:03.140 | But they were able to lop off 25% of that time

01:55:06.660 | simply by warming these certain parts of the brain

01:55:10.020 | to lift the blood away from the core of the body.

01:55:13.620 | And by doing that, they accelerated the temperature core deceleration

01:55:19.700 | and therefore increased or accelerated the speed

01:55:22.540 | with which sleep arrived to those individuals.

01:55:25.540 | Sleep appeared with much greater alacrity than it would have done otherwise,

01:55:30.220 | even though it was quick anyway.

01:55:32.780 | So, them not being satisfied with that,

01:55:36.140 | they moved on to the deep sleep trigger zone.

01:55:39.460 | And this isn't, you need to stay cool to stay asleep.

01:55:43.180 | And here now, they started to just continue to cool the core,

01:55:47.180 | the central aspects of the body.

01:55:50.860 | What they were able to do is increase the amount of deep sleep

01:55:55.620 | by somewhere between 25 to, look at some of the data,

01:55:59.940 | almost 40 minutes they were able to boost the amount of deep sleep

01:56:03.620 | with the thermal manipulation.

01:56:05.460 | And when they were measuring the electrical brainwaves

01:56:08.780 | and they decomposed those brainwaves,

01:56:11.180 | even the power and the electrical quality of those slow waves was increased.

01:56:15.780 | Very impressive too.

01:56:17.740 | Next, not being satisfied with that,

01:56:19.580 | they turned to older adults for the reasons that we've just described.

01:56:23.300 | What they found was that in those older adults

01:56:25.460 | when they were not manipulated with this thermal temperature,

01:56:28.900 | in the second half of the night,

01:56:30.420 | there was a 50% probability that they were going to be awake

01:56:33.740 | for some part of the second half of the night.

01:56:36.100 | When they did the thermal manipulation,

01:56:38.220 | they dropped that number down to 5%.

01:56:41.460 | So they reduced a 50% probability of waking up down to 5% in older adults.

01:56:47.140 | And again, they improved the quality of their deep sleep.

01:56:51.260 | Think about, by the way, why that was so effective for older adults.

01:56:55.300 | I guarantee you, you've probably seen,

01:56:57.580 | you've been in a warm climate or you've been down on the beach,

01:57:00.420 | you know, here sort of in Los Angeles,

01:57:03.620 | and people are out in shorts and t-shirts or crop tops.

01:57:07.540 | And then occasionally there will be someone,

01:57:09.820 | and I've seen these sites where, you know,

01:57:11.900 | a child is sort of wheeling along their elderly parents,

01:57:15.340 | a beautiful sort of scene of caring.

01:57:18.300 | But the older adult,

01:57:19.940 | they're not dressed in the same way that everyone else is dressed on the beach.

01:57:23.860 | They are wrapped up, some of them have a woolen hat on.

01:57:27.100 | Why?

01:57:28.380 | Older adults cannot thermoregulate anywhere near as well as young adults.

01:57:33.740 | Is that right?

01:57:35.020 | And it's the reason that older adults will always be saying,

01:57:37.740 | "I'm just so cold and my hands and my feet especially are always cold."

01:57:41.820 | Now, that's a problem for sleep,

01:57:44.220 | because if you cannot vasodilate at the level of your hands and your feet,

01:57:48.820 | you can't get the blood out from the core,

01:57:50.980 | you can't drop your core body temperature as much.

01:57:53.980 | And we started to understand from those types of data

01:57:57.260 | that part of the aging sleep-related problem equation

01:58:01.420 | is not just that the brain deteriorates in sleep-related regions,

01:58:05.460 | which we've been doing most of our work on,

01:58:08.780 | it's also part of a body equation and a thermoregulatory equation.

01:58:13.900 | There was also a great study unrelated from Australia.

01:58:16.580 | They looked at insomnia patients,

01:58:18.860 | and they put their hands or their feet in warm water.

01:58:22.140 | And by doing that, it's a manipulation.

01:58:23.980 | And you can see how quickly their hands and their feet,

01:58:26.460 | what we call vasodilate, fill with blood.

01:58:29.140 | Healthy people vasodilated very quickly in response to that warm water,

01:58:33.300 | meaning that their hands and their feet sort of had this red,

01:58:37.020 | or at least for my feet, they would be this red tone to them.

01:58:40.980 | However, in the insomnia patients,

01:58:43.220 | they did not vasodilate anywhere near as well.

01:58:46.260 | So once again, it suggests that when you have problems with sleep,

01:58:49.300 | part of the equation may be that you have impaired thermoregulatory ability.

01:58:54.340 | And we do see this in insomnia patients.

01:58:57.300 | So that was, I think, a brilliant causal manipulation.

01:59:02.500 | The problem is that most of us don't have access

01:59:06.140 | to a sort of come-to-bed-at-eyes thermal suit.

01:59:10.500 | So what can we do as a consequence?

01:59:14.460 | Please don't cut that. I get myself into terrible trouble, rightly so.

01:59:17.940 | -You'll be all right. -I should be punished.

01:59:20.180 | What they did then was to say, "Well, okay, let's look at this.

01:59:24.580 | Is there something that we could do that's cheaper

01:59:27.300 | and more accessible to the general public?"

01:59:30.220 | And if you look, there's a literature that preceded that manipulation,

01:59:34.460 | and it's so reliable that we now have a term for it in sleep science.

01:59:38.060 | It's called the warm bath effect.

01:59:40.420 | And many people will say, "Look, I love to have a warm bath

01:59:45.020 | or a hot shower before bed, and I think when I get out, I'm nice and toasty,

01:59:50.780 | and it's because I'm nice and warm that I fall asleep and I stay asleep."

01:59:54.300 | It's the exact opposite.

01:59:55.780 | When you get out of the warm bath or the shower,

01:59:58.900 | you have once again vasodilated at the surface of your skin.

02:00:03.500 | You get out of the bath, you get this huge thermal dump of heat away from the core.

02:00:08.420 | What happens? You fall asleep and you stay asleep more soundly.

02:00:11.380 | Now, there are other reasons that that has a benefit.

02:00:14.100 | It's relaxing, you decompress, you're staying away from technology, etc.

02:00:18.420 | But that is one of the thermal benefits.

02:00:21.900 | And in fact, there were studies by a legend in my field

02:00:24.420 | who passed away just a few years ago, Jim Horn at Loughborough University in the UK.

02:00:29.060 | And they did some of these pioneering studies.

02:00:31.580 | They were able to improve the amount of deep sleep

02:00:34.300 | by almost 40 minutes in some individuals.

02:00:37.820 | What was the protocol there?

02:00:40.300 | As I recall, I think they were in the bath for somewhere around...

02:00:44.300 | The bath duration time was somewhere around 30 minutes,

02:00:47.660 | but they were doing sort of segments where it was maybe 40 minutes,

02:00:51.260 | 10 minutes in and then you could sort of get out.

02:00:53.500 | I think the temperature, because it was UK,

02:00:56.540 | was around about 40 degrees Celsius somewhere in that region.

02:01:02.580 | I may be getting those numbers wrong because I know we like to protocolize some of this.

02:01:07.060 | But they were able to show some really pleasant benefits to deep sleep.

02:01:12.580 | It also helped people fall asleep,

02:01:14.340 | helped them fall asleep by about 25 minutes faster

02:01:17.660 | in those people who were really having a hard time with sleep.

02:01:20.580 | I'm going to take a hot bath tonight.

02:01:22.260 | I sometimes do the sauna in the evening before sleep.

02:01:25.180 | I'm a big fan of cold in the morning, cold shower, cold plunge in the morning.

02:01:28.700 | Because you're reverse engineering the equation.

02:01:30.620 | You're trapping the heat into the core of your body, you're waking yourself up.

02:01:33.820 | Right. And then in the evening, I've used sauna.

02:01:36.780 | The one issue with sauna is I really crank the heat of the sauna.

02:01:40.420 | And then sometimes if you do that right before bed,

02:01:42.380 | you take a warm shower right afterwards, you get into bed.

02:01:45.340 | Oftentimes, I'll wake up thirsty because it dehydrates you.

02:01:49.140 | And then if I drink a lot of water to hydrate after I'm in the sauna,

02:01:52.340 | then I'm waking up too much in the middle of the night.

02:01:54.140 | So I think sauna is great, but right before bed...

02:01:57.980 | I would love to... I don't have a sauna at home or an access to...

02:02:03.340 | I mean, there are saunas in and around where I live.

02:02:07.220 | But what I want to do is have it proximal to my bedtime.

02:02:11.300 | And my bedtime, because I'm a neutral type, you know, sort of around 11-ish,

02:02:16.060 | nowhere is open and willing to allow me to sit in the sauna.

02:02:19.060 | How long do you sit in there usually?

02:02:20.940 | I'm a little bonkers about this.

02:02:22.700 | Well, if it's in the evening and I just want to relax,

02:02:25.060 | I would say maybe 20, 30 minutes.

02:02:26.700 | And I tend to go really warm, warmer than I want to stay here.

02:02:29.340 | What does Peter do? Peter, is he your friend?

02:02:31.060 | I've done sauna cold plunge with Peter.

02:02:33.300 | He usually does it in the evening, goes sauna cold, sauna cold, sauna cold.

02:02:37.060 | Okay.

02:02:38.060 | Warm shower.

02:02:40.060 | And I don't know how many nights a week he's doing that.

02:02:43.020 | But in terms of the temperature of the sauna, you know,

02:02:45.820 | generally somewhere between 175 and 210 degrees,

02:02:50.100 | depending on how heat adapted you are.

02:02:51.820 | But I think a hot bath is great or a nice hot shower.

02:02:55.220 | Yeah, I've certainly done that.

02:02:56.660 | And when I'm traveling with jet lag, I will absolutely...

02:03:00.460 | That's part of my sort of jet lag protocol.

02:03:04.140 | I'll make sure I do...

02:03:05.900 | 'Cause I don't really struggle too much with sleep, at least at present.

02:03:09.820 | But when I go through jet lag and I go back home to London,

02:03:13.500 | of course it's tough.

02:03:14.540 | The worst.

02:03:15.540 | Protocolize the living daylights out of that and do as much as I can.

02:03:18.660 | So I think that's probably the end of the thermal story.

02:03:23.860 | Although we are now trying to see if we can take low fire approaches

02:03:28.300 | where we're going to do some foot warming.

02:03:30.500 | We're trying to develop some foot warming technology

02:03:32.500 | that can be built into maybe a mattress.

02:03:37.900 | And some mattress companies, there are some great ones.

02:03:40.460 | I know, obviously, Matteo at Eight Sleep,

02:03:43.500 | and they are doing amazing things.

02:03:46.180 | I think his company, again, I have no affiliation,

02:03:49.380 | but we connect very well and he's brilliant.

02:03:51.940 | So they're doing something like that.

02:03:53.700 | I do use and love my Eight Sleep.

02:03:55.860 | Here's what I'd love somebody to engineer.

02:03:58.220 | And we've got a lot of people who listen to the podcast

02:04:00.420 | who think about product development.

02:04:02.980 | It would be wonderful to have a portable pair of socks

02:04:06.980 | so that you can use them when you travel

02:04:08.340 | or when you go to sleep anywhere at home or elsewhere

02:04:11.420 | that would warm your feet up at the beginning of the night.

02:04:13.660 | So this is a place for us to recap.

02:04:15.500 | Warm up to cool down, to fall asleep, right?

02:04:18.620 | Stay cool, stay cool.

02:04:21.060 | To stay asleep and then warm up in the morning to wake up.

02:04:25.740 | And so that is pretty straightforward

02:04:28.140 | to build into a pair of socks.

02:04:29.540 | Somebody can do this, somebody do this.

02:04:31.340 | Okay.

02:04:32.180 | - So we've done electrical, we've done thermal.

02:04:36.340 | - What about auditory?

02:04:40.100 | - Auditory, so acoustic stimulation.

02:04:43.620 | In a very similar way to electrical stimulation

02:04:49.380 | where you're trying to target that deep sleep

02:04:52.740 | and see if you, a better analogy is probably a metronome.

02:04:57.060 | And you're trying to see if you can kind of

02:04:59.620 | force the metronome further over back and forth

02:05:02.900 | with these types of technologies.

02:05:04.660 | So auditory stimulation came on the map.

02:05:07.460 | Again, I think probably Jan Born's group in Germany

02:05:09.780 | was some of the first to do this.

02:05:11.420 | They initially started with the same generalized approach

02:05:15.220 | where they would take acoustic tones

02:05:17.740 | and they would first assess

02:05:19.260 | what is your level of awakening threshold?

02:05:22.660 | So you'd be asleep and they would just have these tones,

02:05:25.420 | very light tones, like a sort of a ping, ping.

02:05:28.700 | And they would gradually increase the volume up

02:05:30.900 | and they would look to see what is the point

02:05:32.980 | where that volume of the tone wakes you up.

02:05:36.300 | And then they understood your specific threshold,

02:05:38.900 | what's called an awakening threshold.

02:05:41.260 | And they would set the volume

02:05:42.460 | to a sub-awakening threshold.

02:05:45.100 | Great, so you've got that locked in place.

02:05:47.140 | And now you start, and they did this

02:05:50.060 | within the first 90 minutes of people falling asleep.

02:05:53.780 | They started to play these sub-awakening level,

02:05:57.260 | volume levels of tones,

02:05:59.420 | but they were playing them at this very slow frequency

02:06:03.780 | as if again, they're trying to sync and match

02:06:07.620 | the slow dancing rhythm of the slow brainwaves.

02:06:12.380 | And sure enough in that first study,

02:06:14.180 | and it was indiscriminate, meaning they just set the tones,

02:06:18.660 | playing like a metronome, set the tone,

02:06:20.620 | set the, and then, sorry, set the volume

02:06:22.980 | and then set the cadence of the volume,

02:06:25.340 | the speed, the frequency of those tones

02:06:28.260 | to just a little bit less than one hertz,

02:06:30.740 | a little bit less than one cycle per second.

02:06:33.180 | And then off you drifted to sleep

02:06:34.540 | and they played it for the first 90 minutes

02:06:36.100 | 'cause that's the rich phase of deep sleep.

02:06:38.460 | And they were able to increase

02:06:40.860 | the amount of deep sleep significantly.

02:06:44.100 | The problem in that first study

02:06:45.780 | was that they also did a memory test

02:06:47.980 | because in all of these studies, including my own,

02:06:50.740 | even if I boost your sleep tonight, Andrew Huberman,

02:06:54.460 | my next, if that's the result that you show me,

02:06:56.780 | I have four words for you as a scientist.

02:06:59.420 | Yes, and so what? (laughs)

02:07:02.340 | Is it functional?

02:07:04.420 | Because if I boost your sleep,

02:07:06.340 | but it doesn't change anything to you,

02:07:08.260 | the organism the next day,

02:07:09.940 | I'm going to suggest that that enhancement

02:07:12.340 | is epiphenomenal, not functional.

02:07:15.540 | - So it has to improve some reasonable metric

02:07:19.740 | in wakefulness that like improved memory,

02:07:22.780 | improved task switching ability.

02:07:25.540 | - So it's outcome measures.

02:07:26.820 | - Grip strength.

02:07:27.780 | - Correct.

02:07:28.620 | - Something.

02:07:29.460 | - Yeah, so even if I, for example,

02:07:31.740 | lower your blood pressure with a new drug,

02:07:33.980 | if I'm not changing your cardiovascular disease risk,

02:07:36.900 | then the question is,

02:07:38.020 | why am I just continuing on with the drug

02:07:40.780 | if it's not really changing much?

02:07:42.780 | Same thing here.

02:07:43.620 | And what they found was that

02:07:44.580 | when they did the memory test the next morning,

02:07:46.860 | by enhancing that deep sleep,

02:07:48.300 | there actually wasn't a memory benefit.

02:07:51.420 | So perhaps what was happening

02:07:52.940 | is that this was just non-specific.

02:07:55.100 | So again, they then returned,

02:07:57.220 | and now others have returned to the closed loop mechanism,

02:08:00.540 | where now I've got electrodes on your head

02:08:02.980 | and I'm measuring your slow wave brainwaves.

02:08:05.580 | And literally I am next door in the room

02:08:08.060 | and I'm watching those slow brainwaves go up and down.

02:08:10.540 | And then I've got a computer algorithm

02:08:12.420 | that is watching those, "watching" in quotes,

02:08:15.260 | watching that too.

02:08:16.340 | And it's predicting when the next wave is going to come.

02:08:18.660 | And when it does, auditory tone clicks, sub-awakening,

02:08:22.300 | you don't wake up.

02:08:23.580 | And sure enough,

02:08:24.700 | when you sort of tone into the brain at that time,

02:08:29.460 | you boost the size of that brainwave.

02:08:32.820 | And once again,

02:08:33.660 | they boosted the size of those deep sleep brainwaves.

02:08:35.860 | They also improve those more quick bursts of activity,

02:08:39.620 | the sleep spindles.

02:08:40.740 | And now sure enough, they were able to improve memory.

02:08:44.140 | However, if you look at that paper,

02:08:45.740 | and here's why I think the first method

02:08:47.780 | may not have worked very well,

02:08:49.580 | and why I don't suggest people start

02:08:52.380 | trying to set this up themselves.

02:08:54.020 | When they kept stimulating the brain,

02:08:58.300 | slow wave after slow wave,

02:09:01.180 | after about three or four strikes of the metronome

02:09:06.180 | to boost those slow waves, the benefits stopped.

02:09:10.020 | And if they kept going,

02:09:11.980 | you started to inhibit the amount

02:09:14.700 | of naturally occurring deep sleep brainwaves.

02:09:17.180 | Why would it do this?

02:09:18.860 | Deep sleep brainwaves, I told you in the first episode,

02:09:21.660 | are a act of incredible neural coordination.

02:09:25.220 | It's mass coordination.

02:09:27.420 | Now, one of the extreme versions

02:09:29.740 | of mass coordinated propagated activity

02:09:32.180 | that is maladaptive, that is pathological,

02:09:35.260 | is called an epileptic seizure.

02:09:37.780 | And your brain has in place for the most part,

02:09:40.620 | stop gaps to prevent that type of spread

02:09:45.060 | of vast amounts of coordinated,

02:09:47.460 | spontaneous electrical oscillations,

02:09:50.460 | because the brain is such a conductive device

02:09:52.820 | that once you get it going, you've got to be careful,

02:09:55.380 | because it may start to conduct out of control.

02:09:58.060 | So we think that these checks and balances

02:10:00.380 | that were in place,

02:10:01.700 | even though you can artificially stimulate it for a while,

02:10:04.420 | after a while, the brain says,

02:10:07.620 | "You've got to back off for a while

02:10:09.020 | because this is getting a little bit out of control."

02:10:10.980 | You do a breath pause, and then you restart again,

02:10:14.300 | and you get the benefit, and then you breath pause.

02:10:16.380 | So you've got to do it a little bit intimately.

02:10:18.220 | Now, you've got to read the,

02:10:19.780 | what we call the supplemental materials of that paper.

02:10:22.500 | You've got to go,

02:10:23.340 | it's like the fine print on a legal document.

02:10:24.940 | If you dig into it, you can see that that was the case,

02:10:27.540 | but it wasn't necessarily evident.

02:10:30.820 | So those were really the data on acoustic stimulation.

02:10:36.020 | And now with this closed loop acoustic stimulation

02:10:38.820 | that we've got going on,

02:10:40.380 | it seems to provide these nice benefits.

02:10:42.700 | Some people then will probably be asking,

02:10:46.740 | what about these noise machines?

02:10:48.940 | What about white noise, et cetera?

02:10:51.900 | I've taken a look at this,

02:10:53.460 | and so far, I think for white noise machines,

02:10:56.220 | the data is equivocal.

02:10:58.780 | There was a recent study, a review article,

02:11:01.340 | I think it looked at about 37 different studies.

02:11:04.420 | I could have this wrong.

02:11:06.340 | And what they found was that there was no reliable,

02:11:09.580 | robust directional effect of white noise machines on sleep.

02:11:14.580 | Some studies demonstrated that it helped sleep.

02:11:17.700 | Some studies didn't change sleep.

02:11:19.500 | Some studies suggested it may make sleep

02:11:21.820 | a little bit worse, just nothing reliable.

02:11:23.860 | - But maybe it's masking external sound.

02:11:26.500 | - Correct, so I think if,

02:11:27.580 | and one of the positive studies in that scenario

02:11:30.180 | was a study that was done in New York City.

02:11:33.220 | And it was in a region where there was a lot

02:11:37.620 | of external sound pollution and noise.

02:11:42.020 | As you could well imagine, it's New York City.

02:11:44.580 | And sure enough, that's where they got

02:11:47.620 | some really nice benefits of the white noise machine.

02:11:50.460 | So I think it is, you're right, context dependent.

02:11:53.620 | There was an interesting recent study

02:11:55.620 | that came out from Eterman Lerner's group

02:12:00.100 | at the University of Texas, San Antonio.

02:12:03.620 | And they didn't use white noise, they used pink noise.

02:12:07.540 | Now, what's the difference?

02:12:09.060 | Pink noise has a little less what we call power

02:12:14.060 | or intensity in the higher frequency ranges

02:12:17.820 | of the sound spectrum.

02:12:19.860 | And it's more enriched in the slower domain

02:12:23.980 | of that power spectrum, which you could argue

02:12:26.660 | is a bit more fitting with sleep.

02:12:28.900 | And I think this study may have been a nap study

02:12:32.020 | or I may be wrong, but anyway,

02:12:33.620 | what they found was that they increased total sleep time

02:12:37.420 | by, I think it was close to 30 minutes with the pink noise.

02:12:41.500 | They did not change the amount of deep sleep,

02:12:44.220 | but they did enhance the amount of stage two non-REM sleep,

02:12:47.900 | which we have spoken about before

02:12:49.500 | and we will in subsequent episodes

02:12:51.780 | that is beneficial for things like learning and memory,

02:12:53.980 | including motor skills.

02:12:55.820 | And they increased the amount of REM sleep

02:12:58.180 | to a much more modest degree,

02:13:00.460 | but those changes were significant.

02:13:02.740 | So I'm not trying to rule out noise machines right now

02:13:07.740 | and I have no affiliation with any company

02:13:10.580 | or anything in that space.

02:13:11.860 | I don't want to throw the baby out with the bath water.

02:13:15.500 | I just simply think that right now

02:13:17.420 | that we don't have enough evidence,

02:13:18.820 | but as you and I know, as scientists,

02:13:21.380 | absence of evidence is not evidence of absence.

02:13:24.220 | Just because it doesn't exist,

02:13:25.740 | doesn't mean that I don't think

02:13:27.020 | that it's still a potential route, these types of machines.

02:13:30.620 | - What about kinesthetic, stipular tools, protocols?

02:13:35.620 | Body position is something that has

02:13:40.780 | an interesting relationship to propensity to fall asleep

02:13:43.740 | based on brain cooling

02:13:45.140 | that we talked about in another episode,

02:13:47.660 | but what about manipulation of the body's movement?

02:13:51.700 | Is there anything in that domain?

02:13:55.540 | - It sounds wacky at first.

02:13:58.300 | - Yeah, it does, but I said it, so I still want to know.

02:14:03.140 | - Come on, social media, just be nice, be friendly.

02:14:06.620 | I would say that if you look back in, again,

02:14:11.420 | the annals of human history,

02:14:13.340 | from the very early inception,

02:14:16.140 | you will see mentions of a child being rocked in a manger

02:14:20.660 | or rocked in a crib.

02:14:22.700 | Often parents will take their young infant

02:14:26.540 | and you will quote unquote rock them to sleep.

02:14:30.300 | And we as adults will sometimes get in a hammock

02:14:34.900 | and if you're rocked, what happens?

02:14:36.820 | You will fall asleep.

02:14:37.820 | It's that prototypical image of someone

02:14:40.180 | with a hat over their face and in a hammock

02:14:42.820 | and they've sort of fallen asleep.

02:14:44.540 | So it was very clear that something was going on

02:14:48.940 | in this space.

02:14:50.220 | And then a group from the University of Geneva

02:14:53.740 | led by another fantastic sleep scientist, Sophie Schwartz,

02:14:57.220 | did an epic study that, again,

02:15:01.060 | it's one of those studies

02:15:01.900 | that I probably once more wished I'd done.

02:15:06.380 | Here's what they did.

02:15:08.500 | They took a bed frame

02:15:10.660 | and then they suspended it on chains from the ceiling.

02:15:13.820 | Now stick with me.

02:15:14.660 | I'm not going in that, you know,

02:15:16.540 | there's no hot candle wax being applied here.

02:15:18.780 | Don't worry, I'll keep it PG again.

02:15:21.460 | And then the next thing that they did

02:15:22.860 | was connect a rotating arm to that bed

02:15:25.580 | at the side of the bed.

02:15:27.460 | And that arm would start to simply just push the bed

02:15:32.220 | laterally from left to right, left to right.

02:15:35.260 | And they started just swinging the bed

02:15:37.140 | in a very controlled manner.

02:15:39.260 | But here, and I should ask Sophie exactly

02:15:41.420 | why they made this choice.

02:15:42.820 | They were rotating the bed,

02:15:45.100 | not at this sort of around one Hertz,

02:15:48.060 | which is what we'd done with electrical stimulation

02:15:49.940 | or acoustic stimulation.

02:15:51.580 | They were doing it at 0.25 Hertz,

02:15:54.300 | which is much slower still.

02:15:56.260 | - Almost imperceptibly.

02:15:57.100 | - The bed is rocking, you know,

02:16:00.740 | once every four seconds.

02:16:04.460 | It's a very slow lull.

02:16:08.620 | And sure enough, what they found

02:16:11.940 | in the first series of studies,

02:16:13.180 | they did a nap study, a 90 minute nap study.

02:16:16.180 | When you did this rocking motion

02:16:17.900 | versus when the bed was still,

02:16:19.860 | they increased the speed with which people fell asleep.

02:16:23.540 | They boosted the amount of deep sleep

02:16:25.700 | and they boosted the amount of those sleep spindle

02:16:28.860 | oscillations that we described.

02:16:31.140 | Not satisfied, they then said,

02:16:32.500 | well, what happens across a night of sleep?

02:16:35.180 | They did it then across a night of sleep.

02:16:37.020 | They replicated the same findings

02:16:38.700 | and now they got a memory benefit.

02:16:40.500 | Now the memory benefit you could argue is modest.

02:16:43.380 | It was 10% of a memory improvement benefit

02:16:47.500 | when you woke up from sleep

02:16:49.060 | relative to the already sizable benefit

02:16:51.740 | that sleep naturally gives

02:16:53.060 | when you're not rocking the bed.

02:16:54.900 | But you think, well, 10%.

02:16:57.140 | If I were, let's say a student

02:17:00.260 | and I got a B and someone, the professor said,

02:17:04.660 | look, by the way, there is something that you can do

02:17:07.220 | and we can increase your grade by 10%

02:17:09.340 | and you can get to an A or an A plus

02:17:11.340 | depending on the grading system.

02:17:12.900 | Would you take it?

02:17:13.740 | Would you take 10% benefit?

02:17:16.260 | Absolutely, you would.

02:17:17.500 | So grade point averaging increase.

02:17:20.700 | So it isn't trivial necessarily.

02:17:23.860 | - Well, I also, I'm positively surprised

02:17:26.940 | how important this but so what condition

02:17:31.380 | is for you sleep researchers.

02:17:32.700 | - Yeah, and so what?

02:17:33.540 | - You know, that enhancement in say deep sleep

02:17:35.860 | or rapid eye movement sleep

02:17:37.460 | needs to translate to some daytime benefit

02:17:40.460 | in order to really get you guys excited.

02:17:43.740 | But here's why I think that's great.

02:17:45.900 | It's always great to have a high threshold for excitement.

02:17:49.300 | But one of the things that one could argue

02:17:53.020 | is that there are only so many tests

02:17:55.380 | that you can have in a laboratory of daytime functioning.

02:17:59.820 | I think I am on board the fact that sleep

02:18:03.940 | is the bedrock of mental health,

02:18:05.580 | physical health and performance.

02:18:06.820 | So an improvement in, you know,

02:18:10.460 | a statistically significant improvement

02:18:12.860 | in deep sleep or REM sleep,

02:18:14.940 | to me just seems like that's gotta be good for something.

02:18:18.180 | We might not know what that something is

02:18:19.860 | to test in the laboratory,

02:18:21.380 | but it could be that the threshold for improvement

02:18:23.380 | of say gut microbiome production of neurotransmitters

02:18:26.340 | is, you know, 0.1% improvement in deep sleep.

02:18:29.540 | We don't know, I made that up.

02:18:30.580 | So don't quote that statistic anyone.

02:18:32.180 | But I so admire the kind of extreme thresholds

02:18:36.740 | of what gets you guys excited.

02:18:38.420 | - No, your point is a very good one

02:18:40.020 | because you could argue based on what I just went back

02:18:43.180 | and said regarding the exercise study with Rhonda Patrick,

02:18:47.820 | I've just reversed my own threshold logic.

02:18:50.900 | I said to you, well, okay, exercise was able to overcome

02:18:55.620 | some of the deficits that occur by way of sleep deprivation

02:18:58.660 | for your blood sugar.

02:19:00.020 | But don't assume that that necessarily means

02:19:02.540 | it overcomes the detriments,

02:19:04.900 | the other detriments that you'll have

02:19:06.340 | for your hormonal health, your thermoregulatory capacity,

02:19:10.940 | your cardiovascular disease, your brain function.

02:19:13.260 | So I've just said, look, simply, you know,

02:19:16.940 | one thing doesn't mean that you've assessed all things.

02:19:20.340 | And now I'm saying, okay, if you don't show

02:19:23.500 | that it improved that one thing, then it's not functional.

02:19:26.940 | But Matt, by your own logic, you've said,

02:19:30.100 | but you didn't assess many of the other things.

02:19:32.220 | So even if it didn't improve memory,

02:19:35.260 | as you said, the bedrock of all things health,

02:19:39.500 | you need to assess all of them

02:19:41.300 | before you make your conclusion

02:19:43.140 | of the yes and so what failed test.

02:19:46.060 | So you're absolutely right to point that out.

02:19:48.500 | So what was interesting after that data came out in humans,

02:19:54.900 | which is usually the opposite way around,

02:19:56.460 | they started to look in animal models

02:19:59.100 | and you mentioned the vestibular system,

02:20:01.220 | this ability for us to understand motion and movement.

02:20:05.140 | And there's lots of mechanisms for that.

02:20:07.620 | They looked at mice and they started doing this rocking

02:20:11.900 | again and sure enough, the mice fell asleep faster.

02:20:16.900 | But then they found a strain of mice

02:20:19.420 | that did not have the lateral vestibular sensation mechanism

02:20:24.420 | and they rocked them just the same way,

02:20:29.180 | zero change in their sleep.

02:20:31.740 | Because you could imagine,

02:20:32.700 | well, it's important to understand the mechanism here.

02:20:35.220 | Is it that when you're rocking,

02:20:37.180 | there is, it's not just about vestibular stimulation,

02:20:39.740 | maybe that rocking sort of modestly changes friction,

02:20:44.740 | which changes temperature.

02:20:47.100 | You could come up with all sorts of wacky reasons.

02:20:49.100 | This was a very clear causal manipulation

02:20:51.740 | of the lateral vestibular system.

02:20:53.820 | And if that is not in place, you fail to get the benefit.

02:20:57.020 | So it clearly has something to do

02:20:59.140 | with the vestibular system.

02:21:01.100 | - Can I venture a guess as to why that is?

02:21:03.060 | - Yeah, please. - I interrupted,

02:21:04.420 | but in case I happen to be right by some chance,

02:21:07.660 | previously we talked about the need

02:21:11.220 | to lose a sense of one's posture

02:21:15.460 | and relationship to gravity in order to fall asleep.

02:21:18.460 | But you have to go into this lack

02:21:20.340 | of proprioceptive awareness in order to fall asleep.

02:21:23.340 | Proprioception being the knowledge of where one's limbs

02:21:25.420 | are relative to the body and body relative

02:21:27.220 | to other surfaces in gravity.

02:21:29.020 | And this is something that can be accomplished

02:21:31.540 | in these, you know, flotation tanks and things like that

02:21:34.700 | and other ways go to outer space.

02:21:38.140 | But- - The cheaper version.

02:21:40.660 | - The cheaper version.

02:21:41.780 | So could it be that the rocking at that very slow frequency

02:21:47.860 | is tapping into the vestibular system

02:21:50.780 | in a way that that proprioceptive feedback

02:21:53.300 | about body position is somehow starts to vanish?

02:21:58.300 | And because I'm intrigued by this idea

02:22:00.740 | that you have to lose perception of your body's positioning

02:22:04.580 | and proprioceptive awareness in order to fall asleep.

02:22:08.460 | And maybe your description earlier of a protocol

02:22:11.820 | of going on a mental walk in order to fall asleep.

02:22:15.660 | I just feel like these things are starting to converge

02:22:17.780 | on some themes here. - On a central common pathway

02:22:20.620 | that could be the absence of proprioceptive.

02:22:23.300 | I think it's entirely possible.

02:22:25.380 | In some ways right now,

02:22:26.820 | we think that these two things are associated

02:22:28.820 | that as you're falling asleep,

02:22:30.660 | gradually you will lose proprioceptive sensation.

02:22:34.620 | But simply the fact that two things are associated

02:22:39.620 | doesn't necessarily mean they're causal.

02:22:41.380 | But your suggestion here is a very elegant way

02:22:44.220 | of testing that hypothesis,

02:22:46.500 | which is that perhaps if you could show

02:22:48.860 | that the symmetric of proprioception becomes compromised

02:22:53.620 | when you start doing lateral sort of kinesthetic

02:22:58.100 | or movement stimulation,

02:23:00.220 | that's a very powerful demonstration

02:23:02.460 | that it's not just so here with the study in the mice,

02:23:06.780 | they lacked the lateral vestibular sensation

02:23:09.820 | and you lost the sleep benefit.

02:23:11.580 | But maybe there's one step down,

02:23:13.100 | which is that when you lose that vestibular stimulation,

02:23:17.060 | you lose the benefit on the thing

02:23:18.740 | that really is augmenting the sleep,

02:23:21.180 | which is the change in proprioception.

02:23:23.740 | So this is the first step in a chain of command

02:23:27.340 | and you've missed the final common transactor

02:23:29.900 | of that ingredient called better sleep.

02:23:32.300 | And those I would say are probably

02:23:34.860 | the four current bastions of sleep augmentation.

02:23:39.860 | Hopefully that describes to listeners

02:23:42.180 | the range of where sort of sleep 3.0,

02:23:45.460 | sleep enhancement 3.0 is going

02:23:48.100 | and also describes the way in which we can come down

02:23:51.380 | the strata from high friction, low friction to no friction.

02:23:54.660 | And also in terms of cost where you can have high cost,

02:23:58.340 | minimal cost, low cost.

02:23:59.540 | I mean, hot bath or a shower is pennies on the dollars so.

02:24:03.460 | - Especially if you take a cold shower in the morning

02:24:05.460 | and save on your heating bill.

02:24:06.580 | So you can take a little bit longer hot shower

02:24:08.660 | in the evening and then you net to zero difference.

02:24:11.740 | It's just my way of saying,

02:24:13.940 | take a cold shower in the morning.

02:24:15.380 | Feels great when you get out.

02:24:16.940 | What about some ways to enhance rapid eye movement sleep

02:24:22.540 | beyond what you've covered up until now?

02:24:25.420 | - So I think there are probably two emerging data sets

02:24:30.540 | that I've been intrigued by.

02:24:31.780 | One of which we've been doing some work on

02:24:34.220 | and it comes back to thermal.

02:24:35.940 | What I failed to mention is not just that you need

02:24:38.380 | to warm up to wake up, which you do,

02:24:40.860 | but you also need to warm up to REM sleep, but not too much.

02:24:45.860 | If you take an organism or a human being

02:24:49.260 | and you strip them of bedsheets and strip them of clothes

02:24:51.940 | so they're basically almost au naturel.

02:24:54.980 | If you warm the body up to what we call

02:24:59.100 | the thermo neutral point.

02:25:02.020 | So it tends to be, and this sounds extreme

02:25:04.660 | and you don't have to do this because you're under sheets

02:25:07.260 | and that makes a world of difference.

02:25:10.100 | But if you warm the room to about 30 degrees Celsius,

02:25:14.620 | which gets close to at the surface ambient level

02:25:19.220 | for your skin, something that can bring

02:25:21.900 | your core body temperature up back up to operating.

02:25:24.780 | Because I told you when you go,

02:25:26.740 | when you're in that deep sleep trigger zone,

02:25:28.380 | the middle zone, your core body temperature drops

02:25:31.100 | and it drops significantly.

02:25:32.700 | And to wake up, you have to warm up.

02:25:35.380 | But on the journey to warming up,

02:25:37.060 | you also have to get to thermo neutrality

02:25:41.340 | for you to have REM sleep.

02:25:43.220 | If I keep you too cold,

02:25:46.260 | I can reduce the amount of REM sleep.

02:25:48.940 | If I get you too hot, I can impair the amount of REM sleep.

02:25:53.780 | So it's a Goldilocks phenomenon, not too little,

02:25:56.180 | not too much, just the right amount.

02:25:58.500 | If I keep you there in terms of your thermal net neutrality,

02:26:03.140 | I can boost your REM sleep.

02:26:05.580 | Now that's fiendishly difficult

02:26:07.260 | when you're trying to solve that equation

02:26:09.340 | as a commercial device,

02:26:10.420 | because different people are under different blankets,

02:26:12.460 | they run at different hot temperatures,

02:26:13.940 | they've got different partner situations.

02:26:16.380 | So you need a closed loop system again.

02:26:19.340 | But it's something that we're very interested in

02:26:21.460 | because almost all of the methods that I've described,

02:26:24.700 | and you are smart to pick this up,

02:26:26.780 | all target deep non-REM sleep.

02:26:29.020 | But we spoke about in the first episode,

02:26:30.860 | every stage of sleep is important.

02:26:32.380 | And in subsequent episodes,

02:26:33.820 | I'll tell you exactly why REM sleep is so critical.

02:26:37.140 | So how can we boost that?

02:26:38.300 | That's one way that we're starting to explore it,

02:26:41.260 | but nothing, I think, solid yet.

02:26:44.220 | The other is some of the drugs,

02:26:46.660 | the newer sleep medications that have come onto the market.

02:26:49.380 | And again, I think I mentioned I did take the task

02:26:53.420 | and I feel perhaps rightfully so

02:26:56.340 | about the classic sleep medications

02:26:58.220 | that if you look at the scientific data,

02:27:00.300 | if you can avoid them, it's probably best to do so.

02:27:03.580 | - Things like Ambien, et cetera.

02:27:05.860 | - We call them the Z drugs 'cause they all start,

02:27:07.820 | they're sort of generic names,

02:27:09.660 | sort of start with a Z, you know.

02:27:12.500 | Ambien, for example,

02:27:16.700 | has a Z at the start of it for its generic name,

02:27:20.180 | but I don't want to get into naming any necessarily.

02:27:22.540 | - That's all right, they'll come after me, not you.

02:27:23.980 | - Yeah, but for Ambien.

02:27:26.300 | What's interesting about those medications,

02:27:30.220 | again, they're in a class of drugs

02:27:31.540 | that we call the sedative hypnotics.

02:27:33.700 | So again, sedation, not sleep.

02:27:35.940 | And also there's been some great work,

02:27:37.420 | again, by Dirk and colleagues.

02:27:38.940 | If I were to show you that electrical signature

02:27:41.620 | of your deep sleep,

02:27:43.100 | it does look as though those drugs

02:27:44.740 | kind of increase the amount of electrical activity

02:27:47.980 | in that slower deep sleep range,

02:27:49.780 | except once you go all the way to the far left

02:27:52.420 | to the slowest of those slow brain waves,

02:27:54.860 | which turns out to be the types of waves

02:27:58.260 | that are most beneficial

02:27:59.700 | for most health-related brain and body functions.

02:28:03.580 | You get this huge dent

02:28:06.180 | in your electrical brainwave activity.

02:28:08.860 | It's almost as though those drugs take a bite

02:28:10.860 | out of that realm of electrical activity.

02:28:14.820 | And of course there are issues with daytime sleepiness

02:28:18.700 | and some safety-related issues.

02:28:20.140 | There's been health associations, not necessarily causal.

02:28:23.700 | And so I offered one scientific viewpoint

02:28:28.140 | of those medications in the book, and so be it.

02:28:32.220 | It's not as though I'm anti-medication, as I said,

02:28:35.260 | and some of the new medications are very interesting.

02:28:37.620 | Brings me back to REM sleep.

02:28:38.740 | There's a new class of sleep medications called the DORAs,

02:28:42.580 | and it stands for, it's D-O-R-A, small S,

02:28:47.580 | and it stands for dual orexin receptor antagonists.

02:28:53.380 | Oh my goodness, mouthful.

02:28:56.820 | That just sounds like word salad

02:28:58.300 | to anyone who's not a neuroscientist.

02:29:00.220 | Orexin, which is part of that set of words,

02:29:05.740 | is a chemical in the brain.

02:29:07.300 | And orexin became prominent with the study of narcolepsy.

02:29:11.420 | And what we, we as the Royal We,

02:29:13.580 | people like Emmanuel Mignot and others at Stanford,

02:29:17.180 | what they discovered was that narcoleptic patients

02:29:19.580 | have a profound deficit in this chemical, orexin,

02:29:24.580 | and in the receptors. - Also called hypocretin.

02:29:25.860 | - Also called hypocretin.

02:29:27.460 | And it has a function both, it turns out,

02:29:29.300 | for wakefulness and a function for feeding

02:29:31.900 | and eating-related behaviors.

02:29:33.700 | Hypocretin was probably more related to it

02:29:35.980 | when it was time, 'cause it was discovered

02:29:37.460 | right around the same time.

02:29:38.940 | - So early 2000s. - And two different groups,

02:29:40.700 | yes, exactly, beautiful.

02:29:42.380 | Two different groups named it differently.

02:29:45.220 | But narcolepsy, as some people may know,

02:29:48.580 | is it's a condition, it's a sleep disorder.

02:29:50.820 | And one of the symptoms is called

02:29:52.700 | excessive daytime sleepiness,

02:29:54.300 | where you have inappropriate invasions of sleep

02:29:57.620 | during the day when you want to be awake.

02:30:00.100 | Why?

02:30:00.940 | Well, it turns out that this chemical orexin

02:30:03.900 | acts like a finger on the light switch

02:30:06.540 | of all of the apparatus in your brain

02:30:09.260 | that switches on to force you awake.

02:30:11.900 | It reaches down into the,

02:30:13.500 | it's released from a central part of your brain

02:30:15.780 | called the hypothalamus,

02:30:16.660 | and it releases down into the brainstem

02:30:18.700 | to activate what we call the ascending arousal system,

02:30:22.220 | or the reticular ascending arousal system of the brain.

02:30:25.140 | And when that lights up, it's like the light switch,

02:30:27.460 | which says on for waking brain activity.

02:30:31.260 | And so what was happening was that this orexin up higher up

02:30:36.260 | was not forcing the finger of wakefulness on during the day.

02:30:41.500 | So almost instead of a switch, which is what you want,

02:30:45.220 | it was more like a dimmer switch.

02:30:47.300 | And you know, when you get to that dimmer switch point

02:30:49.300 | right in the middle where it's flickering,

02:30:50.740 | it's on, it's off, it's on, it's off,

02:30:52.580 | that's almost the state in which the narcoleptic brain was

02:30:55.540 | because they had a deficiency of orexin.

02:30:57.980 | So that was the orexin story in narcolepsy.

02:31:01.380 | So why is it relevant for insomnia?

02:31:03.500 | Well, people realized the problem with narcolepsy

02:31:06.900 | is that they're asleep during the day

02:31:08.820 | when they want to be awake.

02:31:10.660 | But the opposite problem is true of insomnia patients.

02:31:14.220 | They want to be asleep at night, but they're awake.

02:31:18.300 | So why don't we selectively develop a drug

02:31:21.220 | that goes after this finger

02:31:23.100 | that flips the light switch on for wakefulness,

02:31:25.900 | but now let's block it at night.

02:31:28.500 | So we flick the switch back in the off position,

02:31:31.980 | we turn out the lights for the brain,

02:31:34.420 | and we remove the problem of insomnia,

02:31:37.860 | which is excessive wakefulness at night,

02:31:41.140 | which is one of its problems.

02:31:42.340 | And therefore, when you remove that,

02:31:45.900 | indirectly what comes in its place

02:31:48.460 | is this thing called more naturalistic sleep.

02:31:50.540 | And that's why it's been more favored now

02:31:52.740 | as the principal drug.

02:31:54.860 | It's still not necessarily well known by physicians

02:31:57.460 | or it's not very well prescribed.

02:31:58.780 | It's not very well covered here in the United States,

02:32:00.660 | unfortunately, with insurance.

02:32:01.980 | So it's a very expensive option right now.

02:32:05.220 | Health providers will choose not to do that, unfortunately.

02:32:08.540 | So what's interesting about that drug though,

02:32:11.180 | is that it's mixed in terms of the studies,

02:32:13.940 | but quite reliably, it does seem to improve sleep,

02:32:16.980 | very much so, but it seems to,

02:32:18.940 | unlike those classic sleeping pills,

02:32:20.820 | which artificially look like they're increasing deep sleep,

02:32:24.020 | even though they're not, they're doing sedation.

02:32:26.860 | These drugs can improve most all aspects of sleep,

02:32:30.100 | but including REM sleep,

02:32:31.660 | which those classic sleeping pills did not.

02:32:34.540 | Why is it doing that?

02:32:35.540 | We still don't know,

02:32:36.380 | but one of the things that these DORA drugs do

02:32:39.900 | that block the orexin,

02:32:41.900 | take off the on position of the light switch

02:32:45.300 | and flip them off,

02:32:46.700 | when you switch it off,

02:32:48.660 | it can actually then allow the activation

02:32:52.300 | or the stimulation of something called

02:32:54.380 | melanin concentrated hormone or MCH in the brain.

02:32:59.380 | And that, when it is triggered on,

02:33:03.500 | can stimulate another chemical called acetylcholine

02:33:07.300 | in the brain, which is a neurotransmitter.

02:33:09.980 | If there is one neurotransmitter in the brain

02:33:12.260 | that seems to be responsible almost exclusively

02:33:15.180 | for this thing called REM sleep,

02:33:16.620 | or dominantly I should say for REM sleep,

02:33:18.700 | it is acetylcholine.

02:33:20.300 | And this was discovered way back in the 1970s

02:33:22.660 | by my former, one of my former mentors,

02:33:26.140 | Alan Hobson at Harvard.

02:33:28.060 | And what this drug may be doing

02:33:30.980 | is indirectly boosting the amounts

02:33:33.340 | of acetylcholine in the brain,

02:33:35.020 | particularly in a region of the brain

02:33:36.180 | called the basal forebrain,

02:33:37.340 | which is a REM sleep regulating region.

02:33:39.500 | And that's the reason that you get boosts in REM sleep.

02:33:42.260 | And people also report dreaming a little bit more too

02:33:45.300 | on those medications.

02:33:46.660 | So thermal manipulation,

02:33:48.740 | getting you to net neutral thermal zones

02:33:51.460 | helped increase REM sleep.

02:33:53.060 | But also there are some medications

02:33:54.660 | that were not necessarily designed

02:33:56.700 | for REM sleep enhancements selectively,

02:33:58.820 | but there is evidence that they do that.

02:34:00.460 | So if you ask me, where are we at with REM?

02:34:03.580 | It's certainly more bereft of methods

02:34:07.700 | than deep non-REM sleep,

02:34:09.820 | but we are starting to find some now.

02:34:12.140 | - Given what you just told us about the role

02:34:14.020 | of acetylcholine in rapid eye movement sleep,

02:34:17.060 | what about taking precursors to acetylcholine?

02:34:21.300 | I mean, certainly a good number of them exist,

02:34:23.580 | even like over-the-counter supplements like alpha-GPC.

02:34:27.780 | And then of course there are choline donors

02:34:31.660 | and things like that that can increase

02:34:33.940 | cholinergic transmission.

02:34:35.940 | Does that get into issues of,

02:34:38.340 | if one does that globally,

02:34:41.660 | is it possible that you increase arousal

02:34:43.700 | and have trouble falling asleep?

02:34:44.940 | Because some of those cholinergic agents

02:34:47.060 | can be activating. - Can be quite activating.

02:34:49.380 | So that's one of the problems.

02:34:50.660 | The second is you may stop

02:34:54.500 | because you're going to have to take them before bed.

02:34:57.220 | You may brute force REM sleep to arrive earlier

02:35:00.860 | and you may therefore come at the cost

02:35:02.900 | of deep non-REM sleep.

02:35:05.660 | And so you'd have to get some kind of timed release capsule,

02:35:09.540 | which you can do.

02:35:10.500 | You can coat these capsule and you can get a timed release

02:35:13.100 | and you would want to take it before bed.

02:35:15.660 | And then maybe after about four or five hours,

02:35:18.460 | you would want to kick it into gear because now you're in.

02:35:21.420 | So it's a little bit, it gets a bit tricky.

02:35:23.900 | - Yeah, this is one of the reasons why I personally,

02:35:26.180 | this is just my experience.

02:35:27.100 | I'm not a fan of supplements that tap

02:35:29.380 | into the serotonergic system for sake of sleep

02:35:32.340 | because certainly serotonin plays an important role in sleep

02:35:35.460 | but anytime I've taken something,

02:35:37.660 | 5-HTP or something like that to try and improve sleep,

02:35:40.700 | I find that I fall asleep and then I wake up very deep,

02:35:44.660 | deep sleep and then I wake up very alert

02:35:47.380 | and I have trouble with the later phases of sleep.

02:35:49.380 | And I think that is because yes,

02:35:52.180 | serotonin is involved in sleep,

02:35:53.580 | but it's involved in sleep at a very specific point

02:35:55.900 | in this, as you refer to it,

02:35:57.100 | this like symphony or ballet of different sleep stages

02:35:59.820 | and how they evolve and interdigitate

02:36:02.460 | with one another across the night.

02:36:04.300 | So, while I do think there are things

02:36:06.740 | that one can use pharmacologically

02:36:08.380 | or supplement based to improve sleep,

02:36:10.340 | generally, I like to think of those as the kind of thing

02:36:12.540 | that kind of pushes away front of the whole sleep process

02:36:15.660 | as opposed to trying to tap into one specific neurotransmitter

02:36:18.740 | within the sleep ballet.

02:36:20.660 | - Exactly.

02:36:21.500 | Yeah, I like that way of thinking

02:36:23.740 | and you do have to be careful because in biology,

02:36:27.980 | it's often rare that there are any free lunches in truth.

02:36:32.180 | Nature has optimized our systems so exquisitely

02:36:36.300 | that when you start to try and gain the system

02:36:38.820 | for one thing, be very mindful

02:36:41.540 | that it may come at the cost of something else.

02:36:43.940 | And that's why whenever we're doing these types

02:36:46.980 | of sort of developments of technologies for sleep,

02:36:50.260 | we are very cautious, not just to say,

02:36:52.300 | did we improve the thing that we're targeting?

02:36:54.540 | But first call of business in medicine

02:36:57.140 | is not will this drug help you,

02:36:59.340 | but firstly, is there any downside in terms of

02:37:02.620 | will this drug hurt you?

02:37:04.340 | And then you have to understand the cost ratio benefit

02:37:06.900 | between those two things.

02:37:08.500 | - Yeah, just one more anecdote

02:37:10.500 | that is in agreement with what you said.

02:37:12.420 | Nowadays, there's an increased excitement around peptides,

02:37:15.780 | the use of peptides.

02:37:16.700 | - There is, yeah.

02:37:17.820 | - And I currently don't use any,

02:37:20.020 | but I did a short run with occasional use of cermorelin,

02:37:24.340 | which is a secretagogue, which is a growth hormone.

02:37:27.380 | - That's right.

02:37:28.220 | - It promotes the secretion of growth hormone,

02:37:30.660 | not growth hormone itself.

02:37:31.620 | I took it not many times and I was tracking my sleep.

02:37:34.260 | And what I noticed is it put me into a little bit

02:37:37.060 | of a hypnotic state.

02:37:37.900 | Dreams were very intense, but deep, deep sleep.

02:37:42.140 | But according to my sleep tracker,

02:37:44.380 | and I only ran this for maybe three nights,

02:37:46.540 | according to my sleep tracker,

02:37:48.700 | it completely eliminated all my rapid eye movement sleep,

02:37:52.060 | at least as measured by the sleep tracker.

02:37:54.700 | But the amount of deep sleep, of slow wave sleep,

02:37:57.580 | just like massively expanded.

02:38:00.260 | So that can't be good.

02:38:02.020 | That can't be good.

02:38:02.900 | - No, you don't want to mess with that cocktail ratio

02:38:06.500 | that we described in the first episode.

02:38:08.340 | We presume that it's emerged as the correct Da Vinci code

02:38:13.340 | of sleep stage recipes.

02:38:16.380 | And there may be a time and a place where you want

02:38:20.220 | to over-index on one of those things for whatever reason,

02:38:26.060 | but to do it consistently and permanently,

02:38:29.220 | I would again say, if you think within the space

02:38:33.460 | of a lifetime that you know something that,

02:38:38.460 | 2.6 million years of evolution has not understood,

02:38:44.480 | chances are you're probably wrong.

02:38:48.220 | - I agree.

02:38:49.060 | And certainly later in this series,

02:38:52.520 | we will touch into some of the over-the-counter supplements

02:38:55.300 | and other things that one can do in order to augment sleep

02:38:57.820 | that do seem to have some benefit

02:38:59.180 | because there are such things.

02:39:01.780 | But in the meantime, thank you for providing

02:39:05.500 | this incredible arc of description of basic sleep hygiene

02:39:10.500 | and regularity, light, dark temperature,

02:39:13.940 | getting out of bed when you can't sleep,

02:39:15.340 | alcohol, food, caffeine, cannabis, unconventional protocols,

02:39:20.340 | and let's call them advanced protocols,

02:39:24.220 | electrical protocol, brain stimulation, in other words,

02:39:27.620 | thermal manipulation, auditory stimulation, kinesthetic,

02:39:32.140 | and then these rapid eye movement enhancing drugs

02:39:36.260 | and on and on.

02:39:38.880 | Matt, I can't thank you enough.

02:39:41.920 | This has been just replete with actionable tools

02:39:46.920 | and considerations, and I love that you took us

02:39:48.820 | to the cutting edge of what's happening now.

02:39:51.980 | I think it's wonderful to talk about the history of the field

02:39:55.880 | and what was discovered.

02:39:56.840 | It's wonderful to talk about the present,

02:39:58.340 | but it's wonderful that you've put our eyes

02:40:01.780 | a bit into the future of what the technology

02:40:04.140 | for sleep enhancement and monitoring holds.

02:40:07.340 | So once again, thank you.

02:40:10.340 | - You're so welcome.

02:40:12.060 | - If folks haven't already seen or listened to episode one,

02:40:16.380 | highly recommend they do.

02:40:17.620 | And of course, we will be back soon with episode three,

02:40:21.660 | which is going to get into all the science

02:40:25.040 | and actionable protocols related to napping and caffeine

02:40:30.040 | and some other exciting things that I know

02:40:33.460 | impact people's daily lives and that they can get moving on

02:40:36.620 | should they choose right away.

02:40:38.420 | And by moving on, I mean to sleep.

02:40:40.280 | - Thank you again, a delight.

02:40:43.500 | Cannot wait for the next recording.

02:40:45.380 | - Thank you for joining me for today's episode

02:40:47.240 | with Dr. Matthew Walker.

02:40:48.780 | To learn more about Dr. Walker's research

02:40:50.980 | and to learn more about his book

02:40:52.620 | and his social media handles,

02:40:53.900 | please see the links in our show note captions.

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02:41:16.880 | If you have any questions for me

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02:41:27.580 | On many episodes of the Huberman Lab Podcast,

02:41:29.580 | we discuss supplements.

02:41:31.080 | While supplements aren't necessary for everybody,

02:41:33.220 | many people derive tremendous benefit from them

02:41:35.260 | for things like improving sleep,

02:41:36.620 | for hormone support, and for focus.

02:41:38.620 | To learn more about the supplements discussed

02:41:40.140 | on the Huberman Lab Podcast,

02:41:41.380 | go to livemomentous, spelled O-U-S,

02:41:43.960 | that's livemomentous.com/huberman.

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02:41:51.800 | So that's Instagram, X, LinkedIn, Facebook, and Threads.

02:41:55.280 | And on all those platforms,

02:41:56.780 | I discuss science and science-related tools,

02:41:59.080 | some of which overlaps with the content

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02:42:02.040 | but much of which is distinct from the content

02:42:03.880 | covered on the Huberman Lab Podcast.

02:42:05.380 | So again, it's Huberman Lab on all social media platforms.

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02:42:17.340 | in the form of brief one-to-three-page PDFs

02:42:19.820 | that cover everything from neuroplasticity and learning

02:42:22.460 | to sleep to deliberate cold exposure

02:42:24.520 | and deliberate heat exposure.

02:42:25.960 | We have a foundational fitness protocol and much more,

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02:42:39.860 | with anybody.

02:42:40.780 | Thank you once again for joining me

02:42:42.120 | for today's discussion all about sleep

02:42:44.260 | with Dr. Matthew Walker.

02:42:45.860 | And last but certainly not least,

02:42:47.860 | thank you for your interest in science.

02:42:49.820 | (upbeat music)

02:42:52.400 | (upbeat music)

Dr. Matthew Walker: Protocols to Improve Your Sleep | Huberman Lab Guest Series

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