Video: Dr. Matt Walker: Protocols to Improve Your Sleep | Huberman Lab Guest Series (DocDrop)

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[Music] welcome to the hubman lab guest Series where I and an expert guest discuss science and science-based tools for everyday life I'm Andrew huberman and I'm a professor of neurobiology and

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Opthalmology at Stanford school of medicine today marks the second episode in our sixth episode series all about sleep with our expert guest Dr Matthew Walker during today's episode we discuss the dos and the do Nots of sleep

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focusing for instance on how to use light and absence of light as well as temperature both of your sleep environment specifically the room you're in your body temperature and much more in order to regulate the timing and

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quality of your sleep and we discuss how things like alcohol caffeine and cannabis impact sleep and the various stages of sleep and we discuss the various tools that exist now and that are rapidly becoming available to

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improve your sleep this episode is essential for anyone trying to optimize their sleep and when I say optimize your sleep I mean trying to optimize the formula that was addressed in the first episode of the series which is the qqr

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formula the quality quantity regularity and timing of your sleep four variables that combine to determine whether or not your sleep is optimized for you and thereby providing the most restoration and Improvement to your mental health

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physical health and performance before we begin I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford it is however part of my desire and effort to bring zero cost of consumer information about science and science related tools to the

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general public in keeping with that theme I'd like to thank the sponsors of today's podcast our first sponsor is Helix sleep Helix sleep makes mattresses and pillows that are customized to your unique sleep needs it's abundantly clear

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that sleep is the foundation of mental health physical health and performance when we're getting enough quality sleep everything in life goes so much better and when we are not getting enough quality sleep everything in life is that much more challenging now one of the key

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huberman to save up to $350 off and two free pillows today's episode is also brought To Us by whoop whoop is a fitness wearable device that tracks your daily activity and sleep but also goes beyond that by providing real-time

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feedback on how to adjust your training and sleep schedule to perform better I I've been working with whoop on their scientific advisory Council to try and help Advance wop's mission of unlocking Human Performance as a whoop user I've

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experienced the health benefits of their technology firsthand for sleep tracking for monitoring other features of my physiology and for giving me a lot of feedback about metrics within my brain and body that tell me how hard I should train or not train and basically point

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to the things that I'm doing correctly and incorrectly in my daily life that I can adjust using protocols some of which are actually within the whoop app given that many of us have goals such as improving our sleep building better habits or just focusing more on our

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to get your first month free again that's join. woop.com huberman today's episode is also brought To Us by waking up waking up is a meditation app that has hundreds of different meditations as well as scripts

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for Yoga Nidra and non-sleep deep rest or nsdr protocols by now there's an abundance of data showing that even short daily meditations can greatly improve our mood reduce anxiety improve

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showing that after a Yoga Nidra session levels of dopamine in certain areas of the brain are enhanced by up to 60% which places the brain and body into a state of enhanced Readiness for mental work and for physical work another thing

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I really like about the waking up app is that it provides a 30-day introduction course so for those of you that have not meditated before or getting back to a meditation practice that's fantastic or if you're somebody who's already a

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free 30-day trial again that's waking up.com huberman and now for my conversation with Dr Matthew Walker Professor Matt Walker welcome back we're all so happy to have you here and in

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episode one you beautifully described the biology of sleep why sleep is important what happens when we don't get enough sleep and you incentivized getting adequate amounts of great sleep

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and you defined what great sleep is and you provided some excellent practical protocols and tools for getting great sleep however today you're going to tell us I

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believe about the protocols for really optimizing one's sleep both conventional tools and protocols and some let's say unconventional not heretical but

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unconventional tools for optimizing one's sleep so let's start with the basics what are the basics of what I think I've heard you refer to previously as sleep hygiene yeah I think we many of

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us can resonate with the idea of dental hygiene but turns out there's something called Sleep hygiene and there are probably I would say five edicts of

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sleep hygiene I offer them as as tools and not necessarily rules because I don't think people respond to rules

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people respond to reasons and not rules so if it's okay I'll probably just unpack each one of them rather than just sort of bark them at you and hope people assume that it's the right uh answer

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I'll explain the answer so people understand why it's important so as I said there are probably five things that you can start doing tonight to try to improve your sleep the first we've spoken a little

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bit about in that first episode it's part of the four macros of good sleep first piece of advice regularity go to bed at the same time and wake up at the same time

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no matter whether it's the weekday or the weekend regularity is king and the reason is because when you feed your brain the signals of timed regularity

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for your sleep it will anchor your sleep and improve the quantity and the quality of that sleep because part of that signal of regularity going into your brain in terms of that repeated Behavior

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night after night sleep in other words helps train that Central 24-hour Cadian clock that we also spoke about in the first episode so that's the first piece

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of advice try to keep it as regular as you possibly can the second piece of advice is darkness in my view we are a dark

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deprived Society in this modern era and we need Darkness at night as well you've spoken about to release a hormone called melatonin and melatonin will help time

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the regular onset of your sleep so that sounds great but what boots on the ground Matt what does that mean I would suggest the following in the last hour

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before bed try to dim down 50% if not more of your lights in your home and you will be quite surprised at how sleepy and soric that will make you feel

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I will do this in a regimented way I have uh little reminder that pops up and tells me now is the time to dim the lights based on your bedtime and I'll go

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around and I'll shut lights down in my bedroom I will actually have a small light bulb and it is way down to probably as little as maybe five luxs

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and look is just a a metric of the light um it's way down there and it's also very deep orange sort of red and we can come on to why that's the case so that's the first thing even before you're

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thinking about sleep start to decrease the light for example if you were there at let's say for a standard sleep schedule at 1000 p.m. and normally

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you are getting into bed at 10:30 p.m. but you feel pretty wide awake if there was an electrical blackout and you lost your phone magnetic to phone goes down

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lights go down Total Blackout my suspicion is that fairly soon you'd say gosh how you feel quite sleepy whereas if the lights were blazing you've got your phone television's on lots of

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stimulation you're probably going to think 10:30 no I could I could probably push through for at least another hour so try to dissipate that light and then if you need to wear an eye mask blackout

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curtains always good as well but we need that Darkness at night because when you give the brain the signal of Darkness it releases effectively a brake pedal that brake pedal has normally been applied by

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way of light on the release of that spigot of meel melatonin and when you take the brake pedal off it starts starts pumping out into the brain you can also then of course

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probably reverse engineer this trick in the morning and this is another component of why you've been I think so such a wonderful advocate for light in the morning it does many things but one

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of the things that it does is reapply that break on melatonin and therefore you lose the signal to your brain of Darkness that's what melatonin in some ways is doing we often call it the

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hormone of Darkness or the vampire hormone not necessarily because it makes you look longingly at people's necklines and want to to to bite it which is great if you're into that but it's really

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simply about it's releasing melatonin which tells the brain my goodness it's nighttime but if you've got bright light on you come from your office you're driving home so you've got artificial

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light during the day which is probably not strong enough to stimulate you and bring you awake you come home and you've got again bright light but it's still strong enough now to prevent the release

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of melatonin you start to shift in your timing and you may have problems with your sleep so that's the second piece of advice I would love to ask you about that Morning Light two and the alertness

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benefits I'm as a sleep researcher more focused on the evening component of light and decreasing it but you've done a great job I don't know if there's anything yeah there are a couple of quick points that um are based on some

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what I consider really nice studies uh there's beautiful work in human showing that bright light exposure in the morning especially from sunlight but um if one doesn't have access to sunlight for whatever reason there are

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commercially available so-called sad lamps Seasonal effective disorder lamps they range anywhere from 5,000 to 10,000 Lux very bright W but um but certainly uh morning sunlight viewing and lamps of

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the sort I just described have been shown to increase the amplitude of the morning cortisol Spike by as much as 50% 5 so people hear cortisol and they freak out they think that's not good I

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want cortisol low but you actually want your cortisol highest in the morning and lower in the afternoon and evening um and there's a lot of reasons for that elevated mood focus and alertness in the

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morning and throughout the day and uh ease of getting to sleep at night lower anxiety lower depressive symptoms and so on so that bright light also serves to um control the amplitude of cortisol uh it in the direction you want in the

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early part of the day the other thing that's just more of a uh underlying dynamics of the Circadian visual system which is a system that I worked on for years um these wonderful um cells in the

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eyes that are not for image forming but rather for detecting sunlight and bright light for sake of setting circadian rhythm is that the sensitivity of that system early in the day is actually quite low so you need a lot of bright

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light early in the day to effectively wake up your system and shut down the sleepiness signals such as melatonin but later in the day it's a rather diabolical system it takes very little

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light even from artificial sources to disrupt your circadian rhythm and quash melatonin as little as 15 seconds of bright light in the evening I think CH Chuck Zer laboratory at Harvard Medical

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School showed can quash melatonin in the evening now I don't want people to freak out and think that if they go into a hotel bathroom which oftentimes those are very bright in the middle of the night flip on the light that they're going to um completely uh screw up their

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circadian rhythms but if I'm honest they'd be much better off using um their phone as a flashlight to navigate people always say well wait but the flashlight on the phone is very bright but let's just get logical here a light shown into

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your eyes if such as a a flashlight is very different than looking at a flashlight Beam on the ground yeah Far and Away difference so the point is that if you don't get enough bright sunlight or light in your eyes early in the day

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and then you're indoors under artificial lighting you might think well this is really bright lighting this is the kind of lighting that could disrupt my circadian rhythm at night and therefore it's sufficient to wake up my system no early in the day and throughout the day

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you need a lot of bright light as much as safely possible to avoid Sunburn and things of that sort which you don't want but then as the evening comes around after Sundown you need very little artificial light in order to disrupt

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your circadian rhythm and then just very quickly light from candles fireplaces is okay this is kind of interesting it seems bright it's but the but the measurements uh indicate that that's not going to shift your circadian rhythm

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much candles are great but of course don't burn your house down so the the orange and red tones in the evening way dim down that's the way to go early in the day bright bright bright light as

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bright as you safely can tolerate and what I like about firstly your mention of cortisol do you described how cortisol is rising in the morning and that's a great thing and it is a good thing and in the evening it's starting

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to drop and if you look right around your prototypical bedtime and we're going to speak later in this episode as to what your real natural bedtime is versus the one that you may be taking

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right now it's very interesting cortisol will almost hit its lowest point something that we call its Nader it's the lowest point in that trough of its decline right around the time when you

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should be sleeping however there's a great study that looked at people with insomnia and in uh subsequent episodes we'll we'll discuss this too but one of the ways that we think about or

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conceptualize insomnia is in two different flavors sleep onset insomnia I can't fall asleep and sleep maintenance insomnia I wake up I can't get back to sleep and what they looked at was

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essentially cortisol levels they had um a catheter in the arm and they were sampling it from the bloodstream and they were able to do that every 30 minutes so it's a little bit like time-lapse photography and you're

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getting a data point every 30 minutes across the 24 hour period looking at cortisol across now a full 24-hour period and sure enough when you look at healthy controls who can sleep well and

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insomnia patients they look almost identical across the day but then when it comes to falling asleep right around that bedtime period the healthy controls

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are going all the way down the insomnia patients go down and down and down and then they have a rise back up right around that sleep onset period and then they start to drop back down again just

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as the control group but then they also often will have a spike in the middle of the night which then comes down and then both of them are staying low throughout the early morning period and then it

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starts to rise back up so it's not as though net net overall there is a higher level of cortisol in people with insomnia it seems to be right at those trigger zones that map very nicely to

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sleep onet problems sleep maintenance problems very interesting as somebody who wakes up in the middle of the night and sometimes has trouble getting back to sleep that that resonates I I have no trouble falling asleep whatsoever yeah

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knock on wood superstitious about this at this point but I use tools like non-sleep deep breast Yoga Nidra long exhale breathing but you know and I think these wakeup uh episodes seem to

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happen more when I'm processing a lot of stuff from my daily life that's right you know it's um the unconscious brain um often times it's working through things and and will wake us up yeah I often think

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that sleep maintenance insomnia that you've just described is the Revenge of daytime emotions unresolved that's a great way to put it yeah so that would be so we've spoken

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about regularity we've spoken about darkness and we've spoken about the inverse of that in the morning which is light a little bit of cortisol so the third out of the five is going to be temperature and the advice here is keep

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it cool as we mentioned a little bit in the first episode and we will go into great detail when we speak not just about these conventional and unconventional tips but we're also going to go into the future of Science and

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where sleep science is taking us to in fact optimize and even enhance our sleep we will speak a lot about temperature suffice to say that you need to drop

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your core body temperature and your brain temperature by a little less than 1° cus 2 to 3 Dees fhe to get to sleep and stay asleep the general Target that we have

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in sleep science if you look across the literature is somewhere around about the 67 Dee Fahrenheit or I'm trying to do the calculation maybe 18.5 is degrees C

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now I know that that sounds cold and cold it it is but you can also wear thick socks to bed you can have a hot water bottle at the end of the bed that's great too but the ambient must be

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cold the fourth piece of advice is Walk It Out and here what I mean is do not stay in bed for long periods of time awake and I think we mentioned this

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perhaps in the first episode too when you are awake in your bed for long stretches of time because your brain is an incredibly associative device it will

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quickly learn that that this thing called my bed is the place where I'm awake and not asleep and what you need to do is break that Association if you've learned that

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time and time again because you've stayed in bed and the rule of thumb and it's just a a rule of thumb about 20 25 minutes if you can't fall back asleep or you can't fall asleep it's okay just say

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tonight is not my night it's not a problem it's tomorrow is not completely shot it's fine I'm just going to get up get out of bed if you can if you're lucky enough try to go to a different room and in dim light read a book listen

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to a podcast whatever it is that relaxes you just do that don't check email don't eat because if you start eating that again trains your brain to start waking up and feeding at that time and only

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return to bed when you are sleepy and there is no time limit for that I don't want you to come back after half an hour when you are still awake and not feeling sleepy enough why because you're going

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to get back into bed and be in the same problem again and gradually if you do this and it's hard to do it you will relearn the association that you had I'm sure as a child which is

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that your bed is this place of sleepiness because often people will be saying I I feel so tired in the evening and then they get into bed and they say but now I can't fall asleep at all and I

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don't understand it in part it's because of that learned Association so that would be the fourth tip the fifth tip um makes me um even more unpopular as a

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personality and character which is try to be mindful of your alcohol and caffeine now in a subsequent episode we'll go into great detail as to how caffeine Works its mechanisms why it is

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sleep disruptive and why in fact I've even perhaps changed my mind on caffeine and and its benefits but it also does have significant detriment to your sleep so the rule of thumb here

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would be try to cut yourself off from caffeine probably at least 10 or so hours before you expect to go to bed and you can just calculate back calculate

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that and try to limit it so the dose and the timing make the poison cut yourself off after maybe two or three cups of coffee coffee and then that timing component count yourself back cut

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yourself off decaffeinated coffee not too bad if you find the right thing too if you need that fix alcohol is probably one of the most misunderstood sleep aids in a quotes

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that there is it is no sleep aid at all now if I didn't understand what I know about alcohol and and sleep I would think that too which is look when I have a night cap just before bed or two even

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though I don't wear them um I I may actually just fall asleep very easily and feels like I stay asleep very soundly across the night so it's a great sleep aid and it really helps me there

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are at least I would say three issues with alcohol the first is that alcohol is in a class of drugs that we call the sedatives and sedation is not sleep

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but when you take on board alcohol in the evening you mistake the former for the latter and you think it helps you fall asleep the second thing is that because it's sedation or actually it's probably

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related to sedation if I were to show you the electrical signature of your deep sleep when you're just sleeping naturally versus when you have alcohol in your system it's not really the same

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it's not a naturalistic form of deep s it mimics it it looks not too dissimilar but if I really do my analyses and I almost like that Pink Floyd album where I take the white light of electrical brain activity coming from your head as

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you're sleeping and split it apart into all of the different components there are some components that are no longer present or some that are abnormally present the second issue with alcohol is that it fragments your sleep so it will

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litter your sleep with all these punctuated Awakenings throughout the night the danger that is that many of those Awakenings with alcohol you don't remember because they're too

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brief but then you wake up the next day and you think well I didn't have a problem falling asleep I didn't have a problem staying asleep but I just I feel rough I just don't feel restored by my

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sleep and you don't add two and two together the final concern with alcohol is that it's quite a potent Blocker of your rapid eye movement sleep or REM sleep and in subsequent episodes we'll

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go into great detail as to the incredible learning and memory creativity benefits that come by way of REM sleep also it's essential for our emotional regulation and recalibrating

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our moods so for all of those reasons I would say two things first if you are struggling with sleep not feeling restored by your sleep keep in mind your

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alcohol intake and also just in general be mindful of that if you are thinking about your sleep and want to preserve it so much of what you just said resonates uh I confess that in my lifetime I've

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had periods of um pretty spectacular sleep I characterize myself as somebody that could fall asleep anywhere anytime but I've also experienced the extreme

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challenges of sleep and um and that relates to different things life circumstances Etc in fact recently I've had some challenges with sleep despite using the protocols that I and uh others suggest I hadn't heard some of the

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things that you're um referring to here and um middle of the night waking has become more of an issue I communicated this to uh former girlfriend of mine who um was uh I was in relationship with

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when I was a a junior Professor meaning before I got tenure and she said you don't remember you had a Andrew but I do you had a pattern back then of um after

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I would fall asleep you would continue working on your laptop probably on grants um and then I would fall asleep working and then according to her I would wake up in the middle of the night and work a little bit until I'd get

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tired again and then fall asleep and then this would repeat so um really stamping down the uh the associative learning element that you talked about before so that was probably the first

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period of time in my life in which I I created this um rather uh delerious Association of work in the middle of the night in bed right um and then more recently I've had the

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the uh experience of waking up probably due to these like daytime things that I I'm waking up in the middle of the night thinking about and now because of our discussion during the course of of recording this series I get out of bed

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after even 1015 minutes um so that I can start to eliminate that Association and another piece is that I've always felt that when I get out of bed in the middle of the night because I can't sleep and I go to the sofa I often can sleep very

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well reason being proving right it's a control experiment proving that the location of sleep is uh the and the association of wakefulness at sleep in bed as opposed to on the sofa is is a

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clear component and this is in an environment that's of equal temperature I it's not a perfect experiment right um it's anakata as we say but I I think that the associative piece is oh so strong um for many people and so this is

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something to to really take seriously I love that notion of and people will often say I just get up I go to the couch or the sofa and that's where I'll wake up in the morning also they'll say

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when I travel and I go to a hotel room I just can sleep fine now for some people it's the inverse but for those people it's the contextual difference meaning the change of the environment is so

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unfamiliar that it has not been bound to Association of wakefulness it's related to sleep or at least the opportunity to sleep sometimes even I've heard from some people and there's no studies or

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data on this even turning yourself around now this is hard if you have a partner in bed but you just switch top to bottom of the bed and you take your pillow and you pull the duvet all the

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way down and you put the pillow at the opposite end where your feet used to be and you get into bed and even just looking around and sort of having a difference that alone is so subtle but it can make a real difference so again

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just keep these things in mind I know it sounds strange or this whole sort of get up get out of bed break the associate and we'll come on to something well actually I'll come on to it now because I think it's one of the

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unconventional tips and you mentioned it a lot of people say to me that all sounds great I the science makes sense I just don't it's dark it's kind of cold I really don't want to get out of bed so

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give me some Alternatives I think the the single best piece of unconventional sleep advice I can give you is do anything that gets

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your mind off itself the principal reason that if you look at insomnia as a physiological condition or current working model mechanistically of how insomnia um plays

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out is that you are in this state of almost low-level anxiety and you are somewhat stressed and when you go to sleep or you try to go to sleep or you

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wake back up and you try to get back to sleep you just have this Rolodex of anxiety in the modern world we are constantly on reception and very rarely do we do

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reflection and unfortunately for many of us and I've been guilty of this the only time we do reflection is when our head is placed on the pillow and we turn the light out and that is the last time you

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want to be doing reflection that's the worst moment and at that point I think everyone can empathize with the idea of you turn the light out you're under

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stress your mind goes to those few things in the darkness of night thoughts become almost 10 times worse than they do in the brigh of

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day and at that moment you start to ruminate when you ruminate you begin to catastrophize and when you catastrophize you're dead in the water for the next two hours so what do you do the problem

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is as I said your mind is on itself and it's going through these repeated Loops anything you can do for example you can do some kind of a meditation and I when

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I was researching data for my book some years ago I did look into meditation and I wasn't a meditator I was a hard-nosed scientist and didn't really kind of

00:32:03

embrace with that notion or even that um that group of people but time and again I read paper after paper and the data was very strong and it was coming from research groups that I respected very

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much indeed so I thought well okay I should probably give this a try and that was 6 years ago and since then I now meditate for 10 minutes every single

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night before bed I do a guided meditation because I'm not particularly skilled so I use an app that moves me through that but you can do whatever you how whatever meditation you like that's

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one example the second example is you can do breathing methods because again you're focused on your breath and what are you not focused on your

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thoughts and so anything that will allow you to um explore some other Focus maybe it's a body scan where you start at the top of your head or you start at your feet and you work your way up and you just say

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you know moving through now my neck what Sensations am I feeling now into my shoulders moving down into my chest now I can feel the ends of my fingers am I

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sensing anything and when you start doing that or any of these types of things the next thing that you remember is your alarm going off in the morning because you got

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your mind off itself so I would say that that's probably one of the unconventional tips but let me come back to the conventional anything else I've probably missed out or being unclear about the um actually I should probably

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say one thing in terms of these not they're not tips I don't like the word I know you don't either or hacks or um these are protocols and they're well-informed scientific protocols in

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all of this discussion today you can get all of these things in place and still have problems with sleep the reason is because you may be suffering from a Sleep Disorder so the

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analogy would be let's say that I'm your athletic coach and you're a sports Superstar I can perfect everything I can perfect your your diet your supplements we can perfect your Technique we can

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perfect but if you've got a broken ankle none of those things are going to alter your performance right now you've got to get to a doctor and get that scen to and then we can come back to fine-tuning

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your performance it's the same with sleep if you've got a sleep disorder such as snoring sleep apnea or insomnia we need to get you to a doctor first and then only after that come back once you're resolved then we can start to

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optimize that's the only other thing I probably should mention yeah this is all very useful discussion because I think that um of course there will be those folks out there that just like what are they talking about I sleep so well at

00:35:01

night you know consider yourself blessed many many people struggle with uh challenges with sleep and I think it's fair to say that sooner or later most everybody experiences some challenges with sleep for whatever reason you look

00:35:13

at the statistics that's highly likely in your lifetime you are more than likely to go through either a period of challenging sleep or in fact about of insomnia I'd like to take a brief break and acknowledge our sponsor ag1 AG one

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00:36:29

travel packs plus a year supply of vitamin D3 K2 again that's drink a1.com huberman you talked about alcohol I'm not a consumer of alcohol anymore um nor

00:36:42

am I and it's not I it's not because I have anything against it yeah many people do enjoy it and um and know uh we're not calling judgment on on them I mean certainly much of the world enjoys uh alcohol could we talk a little bit

00:36:54

more about um aside from demolishing REM sleep um you know do we know that alcohol causes these disruptions in sleep directly meaning by changing the

00:37:07

um pattern of release of neurotransmitters like Gaba things of that sort or is this an indirect effect you know is this like through the gut microbiome that then impacts sleep um and the reason I ask is maybe we could

00:37:20

get to some more specific uh dos and do not protocols so for instance if somebody wants to have a cocktail how close to sleep can they get and uh not diminish their rapid ey

00:37:34

movement sleep too much you know because people are still going to want to drink um and with that said if people do have a couple of drinks and then they they go to sleep is there is there anything they can do prior to sleep to uh try and

00:37:47

rescue um their some of their quality sleep great question so in terms of the mechanism it seems actually not to be the alcohol but some of the metabolic

00:37:59

byproducts of alcohol we think that perhaps the main culprit may be some of the aldah highs that are the metabolic um separate consequences of alcohol

00:38:11

metabolism you make a good point though in terms of the the the dose response timing curve how late or how early do I have to cut

00:38:24

myself off from alcohol people have done those studies and they have found that even an afternoon single glass of wine if you measure sleep in the way that we measure it at my center with High Fidelity you can see compromises and

00:38:38

impairments I wish I could tell you otherwise I would say that based on that data the principal protocol advice I would have for you is go to the pub in the morning that way by the time you're

00:38:52

about to sleep the alcohol is out your system and you could no no I would never as a as a public scientist I would never Advocate necessarily for wanting I'm just kidding you but um that's that's

00:39:03

sort of one of the unfortunate consequences there does seem to be an impact to say that there isn't is just me not being truthful about the data but again if

00:39:16

you are think about the tradeoff here if you're going out or you're having friends over and you're going to make an incredible evening of memories and you're going to open a favorite bottle of wine and have a couple of glasses of

00:39:29

wine is your sleep going to be compromised yes it is but maybe that's worth the tradeoff for that specific night I would just not wish you to and you've spoken a lot and so is our dear

00:39:41

friend Peter and others there just doesn't seem to be any safe amount of alcohol um but I would say think about that trade-off simply

00:39:53

however don't make it habit that you're doing it you know multiple nights a week or more that would probably be the advice great what about food and sleep um how

00:40:07

close to sleep um is it okay to have a meal if you want to optimize your sleep um I I like to eat my final meal somewhere around 6:30 p.m. but and I go to sleep

00:40:21

somewhere around 8:30 900 p.m. in an Ideal World sometimes I go to sleep a bit later uh sometimes I eat a little bit later it's just you know there's some variability with these but um put differently what is the relationship

00:40:34

between food intake and Sleep Quality in terms of timing of food intake and then perhaps we can talk a little bit about um food macronutrients it's very interesting there was somewhat of a Dogma out there

00:40:48

that we have to stop eating you know three or 4 hours before bed for optimal sleep if you look at the data the data is quite a spread no pun intended there is there are some people for whom that

00:41:01

works very well and if they eat even two hours before bed they just get disrupted in terms of their sleep some of that is about people just feeling too full and

00:41:14

not feeling comfortable other aspects are that when you become recumbent when you lie down you have a higher risk of gastric reflux coming back up and therefore you get heartburn and that's

00:41:27

pretty miserable and people will describe that too by way of closer proximity of food intake relative to when you're falling asleep nevertheless if you look at the

00:41:38

data and I I did a recent very deep dive on this personally myself about 12 months ago it's not quite as Extreme as the Dogma makes out if you eat 2 hours

00:41:51

before bed on average it doesn't seem to necessarily harm your sleep now that's very different than saying what is best to improve or enhance your sleep but the way these studies were designed it was looking at detriments they then went to

00:42:06

90 minutes before sleep onset and even there there didn't seem to be Market impermanence 60 Minutes you started to see maybe some signs but on average the

00:42:19

effect size was somewhat weak but then when you get close to sort of 45 minutes or so then things did start to deteriorate I think it depends hugely on your

00:42:31

chronotype and also just on your appetite Cadian Rhythm preferences too I am someone who I do not feel very hungry when I first wake up in the morning I don't feel very hungry throughout most

00:42:45

of the day and I will onboard most of my calories probably in the hours probably in about a 4H hour period maybe less even 3-hour period and

00:43:00

then I will cut myself off about 90 minutes before sleep so I classically I would have been considered as you know violating this sleep dogma of of cutting

00:43:13

yourself off at least three hours I think it's very personal though just experiment with it you will know the situation um as for macros and specific food

00:43:25

components the data is a little bit mixed certainly what we know is that if you're eating a diet that is high in sugar and low in protein your sleep is

00:43:40

worse why would that be the case well one of the reasons that we think is that if you onboard sugar it can be somewhat metabolically active and when it becomes metabolically active it can increase

00:43:54

your body temperature your core body temperature even just for very subtly but that's enough to disrupt your sleep as we spoke about with temperature but I think in terms

00:44:05

of really the you know what would be the ideal macron nutrient and even micronutrient um dietry recommendation that I would have for you I don't think

00:44:17

we have enough data yet above and beyond that that statement um yeah yeah I I've experienced um when I eat a very low carbohydrate diet which I've

00:44:30

experimented with in the past maybe even even full ketogenic diet for for brief periods of time although I'm an omnivore so I eat meat and eggs and I also eat starches pastas rice Etc um but we know

00:44:43

based on beautiful work from for example Chris Palmer from from Harvard Medical School uh who is a guest on this podcast I listen to that it was great podcast yeah Chris is is spectacular and and U

00:44:55

has advocated the exploration of ketogenic diets for the treatment of various psychiatric conditions not all but psychiatric conditions and and it seems and he agreed with me on this that when people go on very low starch very

00:45:09

low carbohydrate diets that sometimes they can experience a bit of hypomania some people can and challenge this with sleep and um sometimes there are

00:45:20

psychiatric reasons why um people stay on those diets anyway and then they have to do other things to encourage their sleep by their pharmacology or supplementation or some combination but I I can say anecdotally for myself if I

00:45:34

if I don't eat starches for a extended amount of time a couple of days I find it very hard to get quality sleep as indicated by Sleep trackers um and uh

00:45:47

and just uh sleep late latency to fall asleep is longer than it is ETC um so i' I've opted to eat most of my carbohydrates Ates later in the evening

00:45:58

um which and violates you know every rule of you know eat your carbs early in the day and and and I think there are some data to support that eating carbohydrates early in the day may actually um have certain benefits for weight maintenance or weight loss so I

00:46:10

realized that but those aren't my my goals at the moment weight maintenance yes weight loss no so I think um I certainly feel after eating a dinner that has a bit more starch pasta rice these things of that sort and a little

00:46:24

bit lower protein as opposed to the inverse like eating a couple couple of riy steaks and a salad but no starch that um my sleep is substantially better um and I always uh attributed that to

00:46:37

the relationship between some of the starches and the tryptophan serotonin pathway yeah there is some data on that with the carbohydrate intake in the evening and of course that that tryptophan and that

00:46:50

carbohydrate intake um will contain the precursor ingredients to something else that we've spoken about which is melatonin and so that may actually help healthily boost that melatonin signal

00:47:02

and there's a little bit of data on that to supported to we also did a study where we um we were looking at night to night to night sleep and carbohydrate intake the next day and it did seem to support what

00:47:16

you're describing in terms of some of the carbohydrate benefits we also found a strange result that was almost the opposite prediction that we made carbohydrate intake in the morning to

00:47:28

equally help people wake up and we were a little bit uncertain as to why but we're going to go into more detail the reason that you mentioned the the suggestion of not take on carbs

00:47:41

in the evening is in part based on the evidence that your body's ability to dispose of sugar and obviously when you're eating carbohydrate you can have a higher um Spike of sugar now that in

00:47:55

part depends on what you're eating with that carbohydrate and also of course the nature of that carbohydrate whether it's simple or whether it's complex whether it's simple sugars versus you know

00:48:06

complex more um starchy uh carbohydrate but the idea is that your body even if you were to eat the same amount of carbohydrate in the morning in the afternoon or in the evening same

00:48:20

carbohydrate dose and type but your body's ability to dispose of that without having excessive spikes of glucose is worse in the evening better in the morning I.E if you're concerned

00:48:32

about your blood sugar um and your metabolic Health maybe that's what you should do I think that that data is unclear on the basis of if you are um

00:48:44

glycemic normal meaning that you currently do not have signs of type two two diabetes or you're not pre-diabetic then that may not necessarily be the case and so I think that's why it could be you know beneficial for you and I

00:48:56

know that you've um you think deeply about that and and um I've even been tracking blood sugar as well I don't have any signs of that but I'm just fascinated by some of that data and how it interacts with my sleep because I'm a

00:49:08

a sleep nerd so I think right now we just don't have plentiful data to recommend a particular sleep quote unquote diet for improved optimization I would say though that we can be a little

00:49:22

bit more relaxed about the timing of our food earlier you mentioned C caffeine and caffeine is a topic that we get into into substantial depth in episode three

00:49:33

but there and now I uh I will emphasize that caffeine is the most commonly used drug worldwide I think the statistic says that 90 plus perent of adults

00:49:46

consume caffeinated beverages every day which is remarkable and a few years back I recall there was an article in The Economist that charted the country's for which the caffeine

00:49:57

consumption was highest and way out on the peak Peak peak of was almost uh triple or quadruple what other what the second place country um consumed each

00:50:13

day was can you guess the country that consumes the most caffeine could be tea coffee any form I'm going to suggest it's a Scandinavian country no but uh but they're they're up they're up there it was Switzerland now I don't know if

00:50:26

that's still the case but apparently the the reason I went I was thinking it was because I've seen the graph I was thinking it was Sweden but Scandinavian and if I have that wrong um certainly someone will put it in the the comments

00:50:37

on YouTube I recall the Swiss drink so much caffeine they have uh a lot to think about so I love caffeine I drink black coffee black espresso and Y Bronte

00:50:50

um I love Yerba Monte been drinking it since I was a little one um because of the argentines in my family um and I drink it in the early part of the day typically um a couple hours after waking

00:51:02

or so I'll have my first um sip of caffeine and then I try to stop drinking caffeine somewhere around noon or 1 p.m. occasionally I'll have a shot or two of a espresso in the early afternoon if

00:51:14

there's important work to be done and I need to do that but I I've noticed that even that can alter my sleep in ways that that I don't like but the afternoon coffee for some reason tastes so much better than the morning coffee for me I

00:51:26

don't know what it is so it's coffee year bate packed early into the day and a lot of it for me yeah I have a high tolerance for it um but then I let it taper is

00:51:39

that an optimal Contour of caffeine intake um would Zero caffeine be better if someone's just really committed to sleep and they don't like caffeine would zero be better than any and what about

00:51:50

that afternoon coffee or tea containing caffeine I mean how disruptive is it for sleep so the profile that you describe which is high peak early on and first thing when you wake up and then tapering

00:52:04

off nicely down into the sort of early afternoon ideal that sounds great to me as for that afternoon coffee it really depends again on when you are expecting

00:52:17

to go to sleep now for someone like you I would say I would love to look at abstaining from that or just switching it out to if you're using you know these pods or however you're Brewing it let's

00:52:29

just switch it out and do an experiment for two weeks and we will look to see how much is that afternoon coffee really impacting your sleep and will track your sleep with some degree of High Fidelity

00:52:41

with a wearable and let's test that hypothesis because you go to sleep quite early you are an early bird maybe bordering on an extreme um early bird and we'll speak

00:52:54

about um or we have spoken about those different flavors of chronotype I would prefer you not to be having that caffeine in the afternoon

00:53:08

based on how early you go to sleep and I mention that preference because of what you described regarding your sleep maintenance insomnia one of the issues with caffeine is that not only can it

00:53:21

make it more difficult for you to fall asleep which you don't have in part because if you're waking up quite frequently throughout the night and struggling to get back to sleep you're going to be carrying a sleep debt into

00:53:34

every night and that debt continues to grow and it's almost like compounding interest on a loan so you will not have a problem falling asleep in fact sometimes the speed with which people fall asleep and some of these uh sleep

00:53:46

trackers will almost penalize you for falling asleep too quickly is because in sleep science and clinical sleep medicine if your it should take you somewhere you know healthy sleep onset

00:54:00

you know 5 to 15 20 minutes but if you put your head on the pillow and you turn off the light and within a minute or so you're dead to the world and you're gone I'm exactly I'm worried that you're a

00:54:15

carrying a sleep dead now not necessarily but I'm I would like to explore it um with you and then I would say even if you can fall asleep fine this factor of waking up in the

00:54:27

middle of the night is also related to caffeine why because caffeine not only can make it harder to fall asleep not your problem but it keeps you out of that deep deep sleep and it puts you

00:54:40

into a more shallow state of nonrapid ey movement sleep and when you are in this shallow State it's a easier for you to be woken up but be and I think more of

00:54:54

the problem it's hard harder for you to fall back asleep because your brain doesn't necessarily want to go back down into that deep sleep and nor has it come up out of that deep sleep so you're not

00:55:06

in that wonderful glorious thick triy sort of sleepy State when you wake up you go to the restroom you come back and you just know this is going to be great I'm as as long as I can fumble my

00:55:18

way back to my mattress I'm going to be asleep within another two minutes going back to it whereas for you you probably wake up and you feel pretty Wide Awake I would like to see what happens when we negate that afternoon coffee on the

00:55:30

frequency and the duration of those middle of the night Awakenings for you yeah I'm definitely making the effort to avoid caffeine intake in the afternoon and I think um already starting to see some of the positive benefits of doing

00:55:44

that great as evidenced by the days that I consume caffeine in the afternoon and experience the the deficits it's a real thing and I I believe you've um about the numbers uh on a different podcast

00:55:56

previously could talk a little bit about the metabolism of caffeine and um and maybe even some of the variations that exist between people in terms of the metabolic U regulation of caffeine so how long let's say uh drink a standard

00:56:10

cup of coffee or a cuple of espresso and it has a gosh I don't know 150 milligrams of caffeine is that 200 could 150 200 let's say 200 because certainly uh you know a barista these days is

00:56:23

going to draw a a beverage over index yeah so let's say 200 milligrams and and somebody consumes that after lunch at uh 100 p.m. and their bedtime is let's let's make them more conventional than I

00:56:36

uh somewhere between 10: and 11: p.m. yeah okay so they're they're about 10 9 to 10 hours out from their bedtime they're having a nice strong quote unquote nice strong cup of coffee after lunch um what what does that look like

00:56:51

in terms of their biochemistry and and impact on sleep so caffeine has something that we call a halflife of about 5 to 6 hours meaning that after 5 to 6 hours about 50% of that caffeine is

00:57:05

still circulating in your bloodstream and thus your brain that means that caffeine has a quarter life of somewhere between 10 to 12 hours now this is on average and we'll come back to

00:57:19

variations but think of it this way if you're taking a cup of coffee like you described there at midday and then you're going to bed at let's say 11: or midnight that would be the equivalent

00:57:32

based on what I've just told you the quarter life of getting yourself into bed and just before you took yourself into bed you Swig a quarter of a cup of coffee and you H for a good night of sleep and the chances are that it it may

00:57:45

not happen now again that's a little bit sort of hyperbolic as a as a statement but just try to conceptualize it in that way you would never think about taking off on you know a last quarter a cup of

00:57:59

coffee just before you put your eye mask on no but I have some friends and um somebody actually who works with the podcast team and we'll go out to dinner as a team when we're on the road and he'll order like a big coffee right

00:58:12

after a 900 p.m. dinner and I was just like can you sleep on like oh yeah no problem and that no problem is in part this I don't have an issue with falling asleep but if we were to based on the

00:58:24

data map there electrical brain activity you would be able to see this reduction in the deep non-rm sleep and it can reduce it if you look at the data

00:58:36

somewhere between 15 to 20% now for me to reduce your deep sleep by 15 to 20% I would probably have to age you by about 20 to 22 years or you could just do it

00:58:51

every night with a late night coffee should you should you wish so again I've and maybe we'll speak about this in in later episodes I have changed my mind on caffeine I think morning caffeine use or

00:59:05

coffee I should say being more specific is fine because I think there are health benefits and we can go into in subsequent episodes why coffee and the coffee be in itself can provide those benefits so I've become a little bit

00:59:18

more bullish on morning caffeine but evening caffeine I just think it's the data is just not supportive even if you are and there are variations and you were very um astute

00:59:32

in your question some people I said on average caffeine has a half life of about 5 to six hours for some people it's quicker and for other people it's slower why is that it's based on a gene

00:59:45

and we know the gene it's a gene that is part of a set of liver enzymes and the gene is called the cyp1 A2 Gene and there are variations in that Gene

00:59:59

what we call polymorphisms and you can do these genetic tests that you can buy these kits and they all probably tell you which you are are you sensitive or you're not sensitive you probably already know and so some people will not

01:00:12

be as sensitive and therefore they can have a more compressed time frame of a halflife because it's moving out of their system in a quicker manner so again I'm not trying to be skir mongering I think you can have coffeee

01:00:24

in the morning and you'll be just fine that late night coffee I would I would like to see you obviate that if you are someone who's doing it and the afternoon coffee sounds like a you know maybe only

01:00:37

every once in a while and try and make it mostly decaf or decaf for that matter if it's really just for the taste yeah if it's just for the taste go decaf if it's not I understand that in some ways what I'm talking about is the ideal

01:00:49

world and drum roll it turns out that most of us don't live in that we live in this thing called the real world and so if you are facing a circumstance where if you're under pressure at work or if you're high performing athlete and this

01:01:02

is it this is the event this is you it's all in a think understand that you you are going to sacrifice some sleep at night but maybe that sacrifice is well worth it so again I'm very open-minded

01:01:13

I'm not trying to be um simply you know too rigid with this I want to take a brief break and acknowledge our sponsor insid tracker insid tracker is a personalized nutrition platform that analyzes data from your blood and DNA to

01:01:27

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20% off any of insid trackers plans again that's insidetracker docomo so you've talked about alcohol and its effects on sleep you've talked about caffeine its effects on sleep and

01:02:29

we talked about food and its effects on sleep what about THC and CBD sometimes referred to more uh generally as cannabis and you know it's interesting you know gosh when I was

01:02:42

growing up um you know cannabis was illegal um nowadays it's um either legal or tolerated or decriminalized in many places not all

01:02:55

but I I would would say there's been a um a a tide shift in terms of um cannabis meaning that many people consume cannabis who are um

01:03:07

consuming it legally and consume it for a lot of reasons that other people consume alcohol in you know a sedative effect a slight hypnotic effect I mean you know the actual definition of what these drugs do it goes by certain terms

01:03:20

in the psychiatric literature of course but but in order to quote unquote mellow out to feel more relx to reduce their anxiety um it's it's far and away different than when I was growing up where I me you would get into a lot of

01:03:32

trouble uh if you were caught um smoking a joint or um taking a bong rip in the middle of the day but not and I realize most people aren't doing that at work I guess it depends on where you work um

01:03:45

but it you know Edibles tinctures I mean the the consumption of THC and CBD is is quite um quite robust in a lot of places so um with all the issues of legality

01:03:58

and the fact that people who young people um should not be consuming them me people 18 and younger not just for legal reasons but the brain is still developing um what is the story with THC

01:04:10

CBD cannabis edibl smoked uh tinctures on sleep specifically it's very interesting if you look firstly at the motivational reasons why people use

01:04:24

cannabis based on [Music] the published study somewhere in the top two reasons sleep to fall and stay asleep fall asleep and stay asleep obviously

01:04:36

usually the principle first reason is just to get high and have the experience and the pleasure of being high if that's what sort of floats your um floats your train floats your train but certainly it's you know sleep um as and what we

01:04:50

call a hypnotic to put you asleep from um the Greek derivative of the God for for sleep that is high among the reasons that people will use we currently don't recommend it and

01:05:03

here is why certainly THC helps you fall asleep faster very clear in the data the problem is that first you start to develop a tolerance and to get that same

01:05:16

sleep onset benefit you need to get use I should say a higher dose so you start to develop dependency and your dose regimen starts to increase the second issue with THC is

01:05:29

that it's very good at blocking your dream sleep your REM sleep in fact many people when they come and they tell me look I was a heavy cannabis user even a light cannabis user for some time and

01:05:41

then I stopped using and one of the strangest things happened to me I just started to have the most wild Vivid crazy dreams and I didn't know what was going on and it's a very simple

01:05:54

explanation as you've been using your brain has been compromised in the amount of REM sleep it's been getting and you've been building up chronically a

01:06:06

REM sleep debt and your brain is smart in the sense that it does try to clock to some degree a counter of how much REM sleep you've lost and many people will

01:06:19

say yeah I don't really remember my dreams when I'm using but when they stop the brain finally because it's been cleansed of the thing that's the roadblock to REM sleep not only did they go back to having the normal amount of

01:06:32

REM sleep that people would have they have that plus they have what we call a REM sleep rebound which is even more and more intense REM sleep which leads to more intense dreaming so it's a very I

01:06:46

suspect there's a lot of people who've had that experience listening if they have been users and they've stopped so that's the second reason we don't Advocate it the third third reason is

01:06:56

that when you stop using you also go or go through a very vicious insomnia withdrawal syndrome often many people will do now that depends on you know how much you've been using for how long

01:07:10

you've been using if you look at the data and by the way part of the um clinical diagnostic the psychiatric diagnostic um description of cannabis withdrawal is

01:07:23

insomnia that's how reliable this insomnia problem is when you come off cannabis and if you look at the data the one of the main reasons that people

01:07:35

relapse and start using cannabis again even though they don't want to is because they can't deal with the insomnia that withdrawal has given them so you don't want to get into that vicious

01:07:49

cycle should you wish again it's your choice um so THC I think is not to be advised right now CBD is interesting I

01:08:01

don't think there's enough data yet for us to have a very strong opinion but I can at least offer mine the data so far is a little bit mixed in what we call the effect size in other words how

01:08:13

reliable and how powerful is the benefit of CBD on sleep but it does seem to have some benefit what's interesting is that it doesn't seem to have the detriments that

01:08:23

I just described for or THC you've got to be looking at the data a little bit careful with CBD it has what's called a u-shape function to it which is that if you're

01:08:37

taking too little and again I really I'm so mindful of not trying to be okay here are the numbers but if you look at them I would say you know kind of cross your

01:08:49

eyes squint your eyes maybe less than 25 migr you run into the danger of CBD being wake promoting rather than sleep promoting

01:09:02

but once you get past if you look is 50 milligrams and above then you start to go in the opposite direction where it seems to be sleep promoting and I mention that just because at least here in the United

01:09:16

States and in many places in the world that industry is not regulated so it may say 50 milligrams on the bottle you don't really know now some of those

01:09:28

companies will have what's called thirdparty Laboratory Testing where they'll send it out and you can scan a qri code and you can look at an independent laboratory that tested it and show you the p p uh purity of it so that may be one way to

01:09:40

go so CBD I think has some favorable evidence right now if that's the case let's just assume that you and I speak in another five years time and there's really good data now for this what could

01:09:54

be the mechanisms I think there's at least there's probably at least two maybe three mechanisms the first is an indirect mechanism CBD has been demonstrated very nicely in some

01:10:07

fantastic studies to be an anotic which is a fancy term for saying it reduces down your anxiety and earlier you and I discussed that anxiety and stress is one of the things that will

01:10:20

keep you awake so indirectly it removes this kind of gate that is preventing you from moving down the Royal Road of sleep and it opens back up the gate because

01:10:33

it's remove that gate mechanism which is high anxiety and by way of being an anxiolytic IT soften that anxiety and it's easier for you to fall asleep I think that's probably the principal mechanistic bet I would have right now

01:10:47

another indirect mechanism if you look at some of the studies in rats and we do um human work at my sleep center so we don't do animal studies but if you look at the data in the

01:10:58

rats CBD can be hypothermic which means that it drops your core body temperature and just as we spoke about in earlier in this episode you need to drop your body temperature to get to sleep so I think

01:11:12

that's the second reason I think the third reason is that it could have a direct sleep promoting mechanism I think it's unclear right now exactly how it's interacting with the Sleep Machinery of the brain we've got

01:11:24

some hypothesis the danger is again it's just not a well-regulated substance so I am actually just um full disclosure I'm working with a company in the United Kingdom uh in collaboration with um

01:11:38

King's College and The Institute of Psychiatry there to see if we can create an analog a clean analog of CBD but I think the potential upside of it not

01:11:50

just for sleep but for a number of different psychiatric conditions like anxiety um could be beneficial so I would say that that's right now the the sort of the skinny on THC and and CBD okay so

01:12:03

just to make sure that I have the basic list of sleep hygiene factors correct I have regularity is King yep light and

01:12:16

dark meaning that one should optimize or at least seek to optimize their exposure to light in the morning and throughout the day and in the evening to make things dim and dark yes temperature and

01:12:30

there you have a a little um it's not a montra but what is it it's a warm up to cool down to fall asleep and then it's stay cool like Fonzi stay cool to stay

01:12:44

asleep and then warm up to wake up yep and we will come on to that I think in a little while again then there's walk it out which is if I understand correctly if you're trying to fall asleep or fall back asleep and it's taking you longer

01:12:57

than about 20 25 minutes you should just get out of bed and go elsewhere in the house do something else maybe even lie down on a different surface in the house to try and see if you can sleep there but don't stay in bed don't create a parir Association of wakefulness and

01:13:10

your bed because that can lead to problems in subsequent nights yeah and I would only say that try to resist if you can if you really want your bedroom to be the place where you now become consistently asleep try not to start

01:13:22

sleeping in some other location consistently because then all of a sudden you bond that with good sleep and you unbuckle this notion that we're trying to relearn which is know your

01:13:34

bedroom is the place of sleep so it's fine to go elsewhere try to stay awake and force yourself to stay awake until you are absolutely sleepy then go back to bed okay and then we discussed

01:13:46

alcohol food caffeine and THC CBD AKA cannabis and with respect to alcohol it's clear that none is best if you're going to have some uh you don't want to drink too

01:14:01

early in the day but you don't want to drink too much or too close to bedtime because it can disrupt rapid eye movement sleep food uh seems that creating some sort of buffer between the uh your last bite of food and uh your to

01:14:13

bedtime by anyway somewhere between you know maybe 2 three hours but for some people it'll be more like 90 minutes and of course that's going to depend on the size of the meal Etc but eating a big meal and then going straight to bed probably not a good

01:14:26

idea caffeine has this long halflife so if you're going to indulge which I do do so early in the day beware the afternoon caffeine yeah do the hubman tapa is what I'm going to

01:14:41

call it right now which is not interpretive dense it's simply the caffeine tape and then um THC CBD uh does nothing good for your sleep architecture although some people have the uh impression that it is good for

01:14:54

their sleep because it makes it easier for them to fall asleep but what they are unaware of is that it is disrupting the quality and architecture of the different stages of sleep in ways that are not serving people well that seems

01:15:06

to be the case for THC and I think CBD you know has promise and research must try harder including my own and you um very uh kindly emphasize that you're not

01:15:20

telling people what to do they just should know what they're doing so that they can make uh changes uh if they so choose that's right I would always say that um I'm not trying to be a medical doctor any advice that I give is simply

01:15:33

scientifically descriptive advice it's not medically prescriptive nor lifestyle prescriptive advice I'm smiling because what I always say is um I'm a scientist not a physician so I don't prescribe

01:15:45

anything but I profess lots of things so or as my good friend who's a musician Tim Armstrong says I'm not a cop that's right so so do what you want um okay what a wonderful list to leap off

01:15:59

into the unconventional and more advanced tools for Sleep enhancement so um let's go there so I think many people may have heard of some of the conventional but what about the

01:16:12

unconventional I would probably offer five or six the first one I would say is that if you are struggling with sleep and you have had a bad night of sleep

01:16:24

the first first recommendation is do nothing and what I mean by that is if you've had a bad night of sleep you're awake for 3 hours do not sleep in any

01:16:36

later into the morning do not go to bed any earlier do not increase your caffeine intake to try to offset it and do not nap during the day why am I telling you

01:16:50

those things if you wake up later that following morning your adenosine clock that we spoking about this building up of sleepiness that happens when we wake up is going to

01:17:03

start later in the day so when it comes time for you to fall asleep at what would then be the next night at your normal time you're not going to feel as sleepy why because you woke up that much

01:17:16

later and you're setting yourself up for failure again equally don't go to bed any earlier if you have become a customed and your brain has and your Cadian clock has become accustomed to

01:17:28

going to bed at a certain time and hopefully you're doing it regularly then getting into bed 2 or 3 hours early has the danger it's not a certainty but a danger of you then getting into bed and thinking well I'm I know I had a bad

01:17:41

night of sleep last night but I still can't fall asleep straight away so now you're spending another 90 minutes in bed at the beginning because you've gone to bed 90 minutes earlier thinking it's a good idea to compensate don't do that

01:17:52

either hold out even if you do feel tired my recommendation would be after that bad night of sleep hold out for as long as you can as close to your natural bedtime as possible then go to sleep and

01:18:06

you'll give yourself highest chance of success don't over caffeinate that's the obvious one follow the beautiful hubman taper and then obviously try not to compensate with a nap why because that

01:18:19

nap as happens when we sleep is going to remove some of that sleepiness that pene and once again you get into bed and you're not as sleepy as you would naturally be so you again go through a

01:18:31

bad night cuz you're struggling to sleep or you wake up and you can't get back because you've got less weight of sleepiness on your shoulders due to the nap that happened earlier so I know it's

01:18:43

hard but I would say when the alarm goes off after a bad night you just think I do not want to get up it's been such a rough night I know it's a shortterm gain but trust me it's a long-term loss

01:18:56

because you're going to then just get into this vicious cycle so that's the first unconventional tip the can I just pause you for a second I I'm a little wide-eyed over here because um I did not know any of that typically

01:19:10

if I get a poor night sleep I'll do whatever I can to recover that sleep um take a nap I'll do you know I'll adjust my to bedtime the next evening um so I hope everyone is paying uh careful

01:19:22

attention to what Matt just said I mean the that's a important list because I think one of the very common things is for people to just not get a great night's sleep and I think most people think okay I'll drink a little more caffeine I will um go to bed a little

01:19:36

earlier tonight you know maybe catch a nap in the afternoon this kind of thing um and I would have thought that too and maybe even suggested that and if you listen to the first episode and where we you know I list in a doomsday manner the

01:19:49

things that can happen by way of a short night you you would think that that's what I would then recommend but it was imprinted On Me by um a wonderful sleep clinician U Michael pis um who sort of described some of these features and

01:20:01

exactly the reasons sort of underlying them and I think I've just tried to bake that out into a formula that makes sense again it's not about the rule it's about explaining it because when you explain it at first it sounds contradictory and

01:20:15

paradoxical when you understand it it hopefully sounds logical and actionable um so that would be the first suggestion could I just sorry interrupt again my audience hates when I interrupt but I'm

01:20:26

doing it on their behalf because because because I I like to think that there's um some value in some of at least what you say in response um I saw a really uh terrific post from Dr Ronda Patrick um

01:20:40

who we both know and admire um for her public education work public health education work and she described a study whereby if people are I think it was slightly sleep deprived Maybe by a few

01:20:52

hours that some of the uh disruption to morning blood glucose regulation that is known to accompany partial sleep deprivation and certainly complete sleep deprivation but um in this case partial

01:21:04

sleep deprivation could be offset by still exercising in the morning that's right um which frankly I have to say if I haven't slept that well then you know normally I'm like H maybe today's the day I don't exercise but now having

01:21:17

heard that information I make it a point to still exercise um sometimes a with a little bit less intensity yeah um because I don't want to be completely exhausted in the afternoon um and and go

01:21:30

to sleep at you know 4 p.m. or something really disrupt my schedule but I thought that was really interesting because it's it's a it's a sort of um partial inoculation of of the blood glucose disruption caused by uh sleep

01:21:42

deprivation I I'm so glad you brought it up it's a fantastic study and I um Rond and I um I think even tried to discuss it some years ago on a show but I like it because it does offer some degree of

01:21:56

actionable Hope and a strategy blood sugar absolutely critical it is very sensitive to sleep when you don't get enough it goes in bad

01:22:08

directions you used a very specific word cleverly so that word was partially at first you hear or read that study and Ronda was never suggesting

01:22:19

this too I'm not saying that you think well if it offsets blood sugar and the city was saying exercise can nullify a lack of sleep you conflate that single outcome

01:22:34

benefit with the idea that well but maybe it doesn't actually re or does it compensate for the deficits in immune function or cardiovascular disease concerns or my

01:22:48

hormonal health or my learning in memory or my emotional and brain health maybe it does but maybe it doesn't so I think I would always just caution people to saying when you hear a study like that it's very natural to think oh that must

01:23:02

mean that it translates to everything else in my body and everything else in my brain it may but it also may not be terrific so if you don't sleep that well do your best to still get some

01:23:15

exercise but just be mindful of the um the fact that you know in the winter months especially that might if you go too hard in the gym or on a run you might be a little bit immune compromised just be mindful of the fact that you're

01:23:28

you're a more vulnerable being when you're sleep deprived and that but that exercise can help adjust things in the right direction and if it's early in the day um presumably that's not going to disrupt your the proper bedtime and if

01:23:41

it's later in the day I suppose as long as you don't need caffeine in order to uh to do that exercise and or um if you're familiar with exercising later in the day fine I you know I find if I

01:23:55

exercise like I'm not one of these people think can go for a run at you know 7:00 at night and then just shower you're a morning type because I'm a morning type other people can okay we'll get into exercise a bit more in a later episode um we'll be sure to do that but

01:24:08

nonetheless I just rais that now um so what are some of the other unconventional protocols for sleep so I think other suggestions I would have after do nothing would be try to think

01:24:22

about limiting your time embed if you are struggling with sleep this is something that is used in the probably the most well validated psychological

01:24:33

intervention for insomnia and it's called cognitive behavioral therapy for insomnia or cbti for short what happens is that you work with a clinician they interview you they assess all of the

01:24:46

reasons that you may not be sleeping and then they create from their toolbox of many different options a bespoke tailored sort of saval R soup prescription for you for your treatment

01:24:58

if you look at the studies of that collection of different tools in the cbti Box for intervention of insomnia and you ask of all of those which seems to carry the greatest impact on insomnia

01:25:12

which has the greatest sort of Gravitas it seems to be this thing that we call bedtime rescheduling it used to be known as sleep restriction therapy but obviously if you come to to mean you

01:25:24

say look I'm not sleeping very well I've got insomnia I say I understand and I've got a treatment for you it's called Sleep restriction therapy and you say no no no you didn't understand it I I'm not getting enough

01:25:36

sleep but it's not quite that here's how it works if you are spending so much time in bed too much time in bed you are not forcing your brain to be

01:25:49

efficient and by way of constraining your sleep window even to let's say five hours a night to begin with i Brute Force ruthless efficiency from your

01:26:02

sleeping brain after several days so another analogy would be let's say you're trying to make a nice thin crust of of pizza base and you put the dough on the table and you start rolling it out if you roll it too thin it starts to

01:26:15

get gaps and holes in it why because you've spread it out too far and you've started to create these absences that's the same thing that happens and it's very natural as an insomnia patient

01:26:28

you would say I'm just not getting enough sleep so I'm going to start spending more time in bed it's the very worst idea another way would be to say look I go to the gym and I you know spend about an hour and a half working

01:26:40

out but if I were to videotape you a lot of people are doing the I think you've I've coed as your phrase but um the 11th rep where people you know do the 10 reps and then all of a sudden there's the selfie or there's the social media oh

01:26:53

yeah the texting they finish the lastup put down and then straight away on the TT and if you look they're only working out for about let's say 45 minutes and the other is wasted so what if the next

01:27:06

day you came to the gym and I said look I'm sorry and there's some big bouncer guys at the door um you are only allowed to work out for 40 minutes and then we're going to eject you and the first day you go back and you do the same

01:27:19

thing and then you've only got through 30% of your workout so you get booted the next day you come back in you do a little bit more and you get booted again after about five or six days you you've built up such a strong desire and hunger

01:27:33

to get your workout in you walk in you put your phone on silent you put it over in the corner and you just get to it and that's the same thing that we're trying to do with sleep restriction therapy so you have to be a little bit careful do

01:27:46

it under supervision especially if you're driving or you're operating heavy machinery we just want to keep an eye it's not necessarily a big concern but we would say Okay Andrew you're currently spending almost total about

01:27:59

you know 8ish or 7 and a half hours in bed tonight I'm going to restrict you down to 5 hours a night and we're going to do this for the next week and the way that we normally do it is I don't change

01:28:10

your wakeup time I change your to bed time why it's easier to stay awake longer than it is to wake up earlier so I put it on the front end to the compromise and at first things don't

01:28:24

change but after maybe about four or five days of going through this I build up enough of a shortterm debt in your system that your system all of a sudden

01:28:37

thinks gosh I just cannot be as lazy anymore I can't do this thing of waking up in the middle of the night and spending an hour and a half awake I don't have the choice anymore there's so much physiological buildup and pressure

01:28:50

to do this and gradually what happens is that you sleep longer you don't wake up as much and after maybe about 2 weeks of doing this all of a sudden you go to bed at this later time so for you let's say

01:29:04

you normally go to bed at 8: I'm going to have you go to bed at maybe 10:30 11: but we're still going to have you wake up at that sort of 4:30 a.m. Mark that you would normally wake up and all of a

01:29:17

sudden you go to bed at 10:30 11 you're out like a light and then again the next thing you remember is your alarm going off saying I'm sorry you've got to wake up and what happens by way of that reset

01:29:30

is gradually we will then once you're stable we will start to back it off we'll start to have you go to bed at 10: and if it stays stable then 9:45 then 9:30 and tit trate you back to where you

01:29:43

were and if there's any sign that you're starting to not sleep well we zip it back up again the goal here is in some ways almost like hitting the reset button on your Wi-Fi router I'm trying

01:29:56

to retrain your brain to better sleep because when you are not sleeping well you've lost your confidence in your ability to sleep and when I do this

01:30:08

technique with you gradually your system and you cognitively relearn that you are a good sleeper and you can trust in sleep and now your sleep does not control you you control your sleep the

01:30:22

hard part however is that it's not easy to go through and we have to be we have to usually ask two questions with individuals firstly what is your motivation for better sleep um we need

01:30:35

to know that you really are motivated and then second you just stay with a hi touch White Glove frequency checking in on individuals and motivating them to keep going because it's very easy to fall off the wagon so that's the the

01:30:48

next suggestion sleep restriction therapy or bedtime rescheduling as we would call it you said it's difficult for people to go through you know it takes a little bit of rigor a little bit of attention means in some cases getting

01:31:00

less sleep than one would like but as compared to something that you know sadly I've experienced a lot in my life of having challenges with sleep and trying to get things back in order and looking at the the bed and just going oh

01:31:13

my God Battle Ground you know Battle Ground you know it's um I think it it makes a lot of sense and I love the analogy to the gym somehow if there's a restriction into 1 hour in and out the door or maybe 70 minutes in and out the

01:31:27

door CU you need to put your stuff in the locker or something like that it always at least for me gets done best when you just have those constraints I think there's something about the human brain that we don't do well in um un

01:31:39

unrestrained systems that I I really think guard rails are are fantastic I love deadlines for instance yeah discipline is essentially the hard hard deadlines like or as they say in Academia because we you know write

01:31:51

grants all the time drop deadlines which who up that ter but like if you don't make it that's it it's like there isn't a hey I'll send this in tomorrow 5:00 p.m. Pacific time that website closes and you better Bo do you get

01:32:04

things done all of a sudden it's surprising how much distraction you can you know pull out the noise and focus on the signal it's great signal to noise ratio yeah and I I love the idea that you that one can control their sleep as

01:32:17

opposed to sleep controlling them I think that that's um and and this notion of sleep confidence um one's conf idence in their ability to sleep these are important terms and they're more than just terms

01:32:27

because I think that um a a field and and an area of Health practice and gosh what's more important than sleep it's the foundation of mental health physical health and performance period um really

01:32:39

thrives on a common um common nomenclature and and I really appreciate that you're you know peppering these episodes with it with um new nomenclature um that captures a lot of

01:32:52

the essence of the protocols and the mechanisms so there that's my editorial please please continue I would say that in terms of other things maybe just to go through them um a little more quickly we've spoken some about a wind down

01:33:06

routine most people underappreciate the importance of a wi down routine we often think that sleep is like a light bulb that we dive into bed we switch off the light bulb and sleep should appear just

01:33:18

as quickly it's untrue sleep in terms of a process is much more physiologically like trying to land a plane it just takes time to come down onto the terraferma of good sleep at night

01:33:32

whatever it is you enjoy as a relaxation method engage in it could be listening to a podcast could be reading a book maybe it's a meditation it's light stretching maybe whatever it is that you

01:33:44

do just build it into your regiment you know you would never you know be driving down the road and then pull into your garage at the same 40 mph speed you gradually

01:33:58

decelerate and you come to a stop it's the same thing with sleep so you need to find some way to decelerate and we've spoken about methods already as to how to do that the next tip is a little quirky and

01:34:12

funny do not count sheep there's a great study from my colleague Dr Alison Harvey at UC berley and she put this to the test didn't make people fall asleep faster it made them take longer to fall

01:34:26

asleep however she did find an alternative if you are not into meditation or podcasts or sleep stories or whatever it is that you you wish for

01:34:38

try taking yourself on a mental walk and it has to be a walk that you know very well so let's say that you walk your dog every day and you know there's a couple of walks that you take with your dog do

01:34:50

it in hyperd detail So Close Your Eyes you go to the front door you clip in the dog to the leash you walk out you go down the steps out to the driveway then you take a right but you always cross

01:35:04

over and you look to the left and the right CU that's the place where traffic always comes you cross over and now you're walking up and there's that strange sort of set of garbage that's been outside of that house for a long time and you don't know why it hasn't

01:35:16

been cleared and then you move that type of High Fidelity detail allows you to do what we said earlier which is get your mind off

01:35:28

itself and when you do that again typically you fall asleep faster and that's what she found it was a great great study I really enjoyed that I'm curious as to why it works so well and

01:35:43

I'm not challenging that it works I I can imagine having just closed my eyes and kind of imagine what that would be like it's very pleasant um there might be here I'm just specul ating something about engaging one's procedural memory

01:35:56

because that's procedural memory you're trying to remember how you do something as opposed to declarative memory which is about facts you know I remember this and this is going to happen tomorrow I wonder whether or not there's something

01:36:08

about using a procedural memory um as opposed to a declarative memory visualization somebody should do that study they should and I think it's certainly possible that when you're

01:36:21

incorporating some aspect you know some aspects of the scene and the information is more sort of veridical and maybe EP sort of episodic declarative memory but when you're taking yourself for a mental

01:36:33

walk what is the fundamental premise of that it's a walk it's motion it's procedural memory and so maybe it's something to do about with being more attentive to becoming embodied because

01:36:44

when you're out walking and you're moving it is a more embodied experience than just sitting there at your desk which is your mostly your head and very little your body so I think it's an

01:36:56

intriguing idea and um I think another tip that I now think of which also comes from the work of Dr Allison Harvey when individuals come up to me um

01:37:09

after sort of public events or they see me at the airport they'll say look every night for some strange reason at 2:45 a.m. I wake up and it happens three or

01:37:22

four nights a week my first question to them is how do you know it's 2:45 and they say well I look at the clock or I look at my phone best piece of advice next remove

01:37:37

all clock faces from the bedroom no matter how bad your sleep is going to be that night knowing what time it is is only going to make matters worse it is not going to make matters any

01:37:51

better and that can create an anxiety trigger that you think it's 245 and then you're tossing and turning you look back at the clock and now it's 3:14 a.m. and you think I've got to be

01:38:04

awake at 600 I've got that big meeting and now it's 5:2 don't do that to yourself and I even though I don't typically struggle with sleep I have no clock faces in my

01:38:16

bedroom the phone that I use to help do the guided meditation is an old phone and it has only Wi-Fi connectivity and nothing else on it and I will only hit play and then

01:38:31

I will never turn it around um I will not look at the clock face just doesn't help me another incentive for keeping the phone out of the room um if if one can I I understand there are reasons

01:38:44

when um one would want the phone in the room if you know it's potentially signaling an emergency you know well I think I think it's a very important point and we've done some work in this

01:38:56

area too what that phone does is create a a low level of anxiety it's what we call anticipatory anxiety one of the mechanisms separate

01:39:10

from that well it's related to that if you look at teen phone use one of the reasons that they don't sleep very well at night is that they're constantly checking their phones because of fomo a fear of missing out what has gone on as

01:39:22

I've been asleep and it's stunning the data but for most adults the other reason I don't like advocating for phone use when your alarm goes off in the morning what is the first thing that you

01:39:35

do as you're in bed you swipe right or you unlock your phone and you instantly start checking social media emails text messages and this tsunami of Stress and

01:39:48

Anxiety just floods over you it hits you like this wall of anxiet and I bring this up because it again trains your brain for expectation of

01:40:01

that anticipatory anxiety has a consequence on your sleep and everyone knows this let's say that you've booked an early morning flight and you've got to wake up at 5:00 a.m. when normally

01:40:14

you wake up at 7 a.m. two things will usually happen first you know that you're just not going to sleep as deeply that night because you're on edge and this is for an interview or it's for critical like

01:40:27

this is a non-negotiable trip that has to happen you've got to wake up the second thing is that when you are expecting that that wave of sort of

01:40:40

a need to wake up and maybe it's just I'm expecting the phone again you will wake up just a few minutes before your alarm it's stunning how many people will say I had this big flight the next day

01:40:53

and you almost know I'm going to wake up 2 minutes before my alarm goes off why because your brain has stayed in this shallow state of anticipatory anxiety and you don't get as much deep sleep and

01:41:05

we've now demonstrated that we others when you have that low level anxiety the depth of your deep sleep is not as deep you don't get the good so again not to be trying to dictate what people do just

01:41:17

be aware that when you do create that behavior and that regiment it becomes almost like a knee Jack sort of trained habitual response terrific let's talk about some of the advanced tools for

01:41:31

Sleep enhancement you know what sorts of methods could one incorporate um you know what are some of the data and um and is there any way that we can sort of lump these into uh sort of a some framework or categories because I know

01:41:45

there are a lot of different tools there are and I suppose this would be you know I know our friend pet has spoken about medicine 3.0 I think this would probably be sleep optimization 3.0 what is coming

01:41:57

down the pike what is in the research and I think you know could make it to Market or has made it to Market but yet we're still right on the cusp we've seen

01:42:12

Wei again in the Royal Wii have been able to augment human sleep in at least four different ways there are methods for electrical brain stimulation there

01:42:25

are methods for acoustic stimulation of sleep so electrical stimulation of sleep acoustic stimulation of sleep thermal manipulation of sleep and then finally kinesthetic manipulation of

01:42:39

sleep meaning movement based stimulation and I maybe I can just of go into each one of those the electrical stimulation is probably the most well rendered of all of those four

01:42:54

in part because we started there and we and here it's not the Royal Wii we have done a lot of work on on this and um I can tell you a little bit about a company emerging from that but when you're trying to manipulate the human

01:43:08

brain the principal currency in which the brain communicates is electricity now there are lots of things that help it do that such as chemicals but the principal language and um verbiage of

01:43:20

the brain is electricity so if you're going to manipulate the brain why don't you speak in its currency of electricity so we and others have developed a method based on something

01:43:31

called direct current brain stimulation and specifically something called transcranial direct current stimulation and I'll unpack that trans meaning movement so if you've heard of

01:43:44

Transport it's about moving things from one port to another um transatlantic moving you know across the Atlantic so here the start of it is moving you're moving something from one place to the

01:43:56

next trans cranial means through your skull so we're moving something through your skull transcranial direct current is the type of voltage or the type of electrical impulse that we're putting in

01:44:09

it could be alternating current or it could be direct current and early methods and those we use have been direct current so transcranial direct current and then stimulation we're trying to stimulate the brain

01:44:21

specifically the cortex and the way that we do this is that we apply electrode pads to your head and we insert a small amount of voltage into your brain now it's so small that you

01:44:34

typically don't feel it but it has a measurable impact on that electrical brain activity so very early on scientists and we weren't the first to do do this by any means there was a great paper now

01:44:46

famous paper in my field by um wonderful scientist yam born in Germany and they took a group of subjects and they applied these electrod pads and specifically to the front of the brain

01:44:58

and I'll explain why we target the front of the brain with sleep electrical enhancement or the electruepart slow powerful waves that define deep sleep and what they did in one of those groups the other group was

01:45:29

the placebo group they still had the electrodes applied they still went to sleep in the stimulation group they waited until those individuals went into deep sleep and I told you in the first episode that those deep sleep brain

01:45:42

waves were going up and down very very slowly maybe just once or twice a second so they started to stimulate the brain inputting the stimulation pulses at a

01:45:54

very slow Rhythm trying to match the rhythm of the brain in fact they were less than one Hertz less than one cycle per second in terms of a pulse it's almost as though we're trying to act

01:46:07

like a a choir to a flagging lead vocalist and as these brain waves are going up and down you're trying to sing in time with those deep sleep brain waves and in doing so you're trying to boost and amplify the size of those deep

01:46:21

sleep brain waves now to begin with they just waited until they went into deep sleep and they started to stimulate at that frequency and I'll come back to why that's important in a second but sure enough what they demonstrated they were able to boost the electrical quality of

01:46:35

that deep sleep by about 60% and they were also able to almost double the amount of memory benefit that sleep provided wow which is very impressive that is impressive now I

01:46:47

should note that there was more recently a replication attempt of that paper and they did very good job they really did it to the letter and they weren't able to replicate the effects as powerfully

01:47:00

however subsequent Studies have now taken a more nuanced approach and it's the one that we've taken too and it's called closed loop stimulation Clos Loop here simply means

01:47:13

that I'm not going to just wait until you go into deep sleep and then just take a chance and start stimulating your brain not knowing of the synchrony of my pulses into your brain relative to the

01:47:26

brain waves that you're experiencing closed loop does do that so what I'm doing is I'm measuring the electrical brain waves that occurring and because they're nice and slow they're very predictable and I can program my

01:47:39

algorithm and my brain stimulation machine to say I'm going to wait and wait and as soon as you are on this peak of your slow wave it turns out to be the negative trough but I'll forgo that we

01:47:52

then try to strike at that point of midnight when you're going through the biggest sort of powerful sort of dip in the the brain wave and we're trying to sort of enhance it and same with the

01:48:04

peak so this is where we take a we get a stimulus from the brain your electrical brain activity and then we create a timed response so it's a stimulus response it's a call and response Loop

01:48:17

and by way of doing that it's a much smarter specific method than a more generalized I'm just going to stimulate and hope I catch those waves at the Peaks the reason is important because

01:48:30

different people have different speeds of their slow brain waves they're all slow but your speed of brain wave may be a little bit different to mine and if I'm off with my stimulation by let's say

01:48:42

just half a second or a quarter of a second time and time again I may be leaving some benefit on the table but closed loop stimulation creates this personalized electrical prescription of

01:48:55

stimulation and when you do that you get very reliable benefits you can boost those deep slope brain waves you get the memory benefits but also what we found is you not only boost those deep sleep

01:49:07

brain waves you boost another electrical signature that I spoke about in the first episode called sleep spindles and it seems to be the combination of those two things by way of electrical stimulation that provides the benefits

01:49:20

now I should know I haven't mentioned this before you can buy these devices on the internet DIY style do not do that if you go on to the internet too you can also find some horror stories people

01:49:33

have misappropriated the voltage they've got skin burs they've lost their eyesight for several weeks do not do this at home I promise you use you know wait until these products come out and that's one of the reasons why we've

01:49:46

scaled it into a company and we're we're trying to do this we've got a long way to go yet huge number of trials that we have to do before you know I feel ready to to Really lay it on the on the table

01:49:58

and say you should absolutely buy this it's it's well worth it but we're getting very very close I would say great what about thermal manipulations temperature

01:50:11

I mean there's such a tight relationship between temperature and sleep and and wakefulness for that matter uh what sort of Technologies tools protocols exist to

01:50:22

uh that use thermal manipulation as a way to augment sleep I love this topic because there are high-fi low-fi and noi technologies that you can

01:50:35

use the story of sleep and temperature as you mentioned before and reiterated in terms of the three-part stanza that tur set that I would describe is again you need to warm up to

01:50:49

cool down to fall asleep you need to stay cool to stay asleep you need to to warm up to wake up what that refers to technically in sleep science are what we call the thermal trigger zones so warming up to cool down to fall asleep

01:51:02

is what we call the Sleep onset thermal trigger Zone cooling down or staying cool to stay asleep is about the deep sleep trigger Zone and then warming up

01:51:13

to wake up is the activating alertness trigger Zone studies if you looked at them to begin with before they manipulated that found something fascinating if I take

01:51:25

you Andrew huberman and I bring you into my lab and I remove your phone all your laptop and you say goodbye to your friends and family and you I bring you into the center and there are no cues as

01:51:37

to what time of day no windows no nothing and I'm just going to say look I'll keep asking you but at the moment that you feel most

01:51:49

sleepy just let me know it turns out that before that we' done the um delightful um intervention of inserting a rectal probe into you because that's the best way that we can

01:52:02

measure your core body temperature so we're measuring your core body temperature and sure enough despite you knowing nothing about what time it is the moment that you will tell me I am ready to go to bed and I am sleepy is

01:52:15

the moment when you are on the greatest decelerating trajectory of your core body temperature it is high highly predictive of how sleepy you will feel the way that your body does this is by

01:52:28

pushing blood out to the surface regions of your skin notably your hands and your feet because these are these highly vascular regions and you had a great podcast from one of my heroes and good

01:52:40

friend Craig hel who's done some amazing work on this at Stanford so naturally as we lie down blood races to our hands and our feet and also our head and we start

01:52:53

to release that heat trapped in the core of our body and by releasing that heat at the surface our core body temperature drops hence the outer surfaces of you

01:53:05

hands feet and face have to warm up for your core to cool down for you to fall asleep and in fact there was a great nature paper some years ago they just measured the temperature of someone's

01:53:18

feet and they looked at how quickly they fell asleep and when they fell asleep sure enough the warmer your feet the faster you fell asleep why because the Warmness reflects the blood dilation and

01:53:32

the pumping out of the blood to the periphery and then they did it in rats where they started to warm the pores of the rats and the Rats fell asleep more quickly and I love this notion of again I we don't do an but kind of love the

01:53:45

notion of wrapping a beautiful little rat up in Cotton wall and I'm I'm warming its feet with this pad and it's just Bliss out out and then poof he's gone his after she I respect their

01:53:56

privacy um so that was the early evidence that then led to a series of manipulation studies the most notable is brilliant it comes from a colleague uh in the Netherlands usan summeran and his

01:54:09

group they created essentially what was a a wet think about a wet suit but that wet suit is covered with all of these thin tubes almost like veins that go all

01:54:22

over the suit to all territories of your body and then what they would be able to do is peruse water warm water or hot water exquisitly to different parts of

01:54:35

the brain or the body cool amazing yeah no pun intended thank so what they did was then they started to manipulate these peripheral regions sort of and

01:54:47

sure enough when they did this they were able to have indiv uals fall asleep 25% faster and these were healthy individuals who are normally sleeping

01:54:59

within a very natural quick period of time but they were able to Lop off 25% of that time simply by warming these certain parts of the brain to lift the

01:55:11

blood away from the core of the body and by doing that they accelerated the temperature core deceleration and therefore increased or accelerated the the speed with which

01:55:23

sleep arrived to those individuals sleep appeared with much greater alacrity than it would have done otherwise even though it was quick anyway so then not being satisfied with

01:55:35

that they moved on to the deep sleep trigger Zone and this isn't you need to stay cool to stay asleep and here now they started to just continue to cool the core the central aspects of the

01:55:50

body what they were able to do is increased the amount of deep sleep by somewhere between 25 to look at some of the data almost 40 minutes they were able to boost the amount of deep sleep

01:56:03

with the thermal manipulation and when they were measuring the electrical brain waves and they decompose those brain waves even the power and the electrical quality of those slow waves was

01:56:15

increased very impressive too next not being satisfied with that they turned to older adults for the reasons that we've just described what they found was that in those older adults when they were not manipulated with this thermal

01:56:28

temperature in the second half of the night there was a 50% probability that they were going to be awake for some part of the second half of the night when they did the thermal manipulation they dropped that number down to

01:56:40

5% so they reduced a 50% probability of waking up down to 5% in older adults and again they improved the quality of their deep sleep Think About by by the way why

01:56:53

that was so effective for older adults I guarantee you you've probably seen you've been in a warm climate or you've been down on the beach you know here sort of um in Los Angeles and people are

01:57:04

out in shorts and t-shirts or crop tops and then occasionally there will be someone and I love seeing these sites where you know a child is sort of Wheeling along their elderly parents it's a beautiful sort of scene of caring

01:57:18

but the older adult they're not dressed in the same way that every one else is dressed on the beach they are wrapped up some of them have a Woolen hat on why older adults cannot Thermo regulate

01:57:31

anywhere near as well as young adults is that right and it's the reason that older adults will always be saying I'm I'm just so cold and my hands and my feet especially are always cold now that's a problem for sleep because if

01:57:44

you cannot Vaso dilate at the level of your hands and your feet you can't get the blood out from the core you can't drop your core body temperature as much and we started to understand from those types of data that part of the Aging

01:57:59

sleep related problem equation is not just that the brain deteriorates in sleep related regions which we've been doing most of our work on it's also part of a body equation and a thermo

01:58:12

regulatory equation there was also a great study unrelated from Australia they looked at insomnia patients and they put their hands or their feet in warm water and by doing that it's a manipulation you can see how quickly

01:58:24

their hands and their feet what we call vasod dilate fill with blood healthy people phaso dieted very quickly in response to that warm water meaning that their hands and their feet sort of you know had this red or at

01:58:37

least for my feet they would be this red tone to them however in the insomnia patients they did not Vaso dilate anywhere near as well so once again it suggests that when you have problems with Sleep part of the equation may be

01:58:51

that you have imper Thermo regulatory ability and we do see this in insomnia patients so that's that was I think a brilliant causal manipulation the

01:59:03

problem is that most of us don't have access to a sort of come to bed eyes thermal suit so what can we do as a con please don't cut that I get myself

01:59:16

into terrible trouble rightly so I should I should be punished you'll be right what they did then was to say well okay let's look at this is there something that we could do that's cheaper and more accessible to the

01:59:28

general public and if you look there's a literature that preceded that manipulation and it's so reliable that we now have a term for it in sleep science it's called the warm bath effect

01:59:40

and many people will say look I love to have a a warm bath or a hot shower before bed and I think when I get out I'm nice and toasty and it's because I'm nice and warm that I fall asleep and I

01:59:53

stay asleep it's the exact opposite when you get out of the warm bath or the shower you have once again vasod dilated at the surface of your skin you get out of the bath you get this huge thermal

02:00:06

dump of heat away from the core what happens you fall asleep and you stay asleep more soundly now there are other reasons that that has a benefit it's relaxing you decompress you're staying away from technology Etc but that is one

02:00:19

of the the thermal benefits and in fact there were Studies by a legend in my field who passed away just a few years ago um Jim horn at lury University in the UK and they did some of these pioneering studies they were able to

02:00:32

improve the amount of deep sleep by almost 40 minutes in some individuals what was the protocol there as I recall I think they were in the bath for somewhere around or the bath duration

02:00:45

time was somewhere around 30 minutes but they were doing sort of segments where it was maybe it was 40 minutes 10 minutes in and then you could sort of get out I think the temperature because it was UK was around about 40°

02:01:00

celsus somewhere in that region I may be getting those numbers wrong because I know we like to protocolized some of this but they were able to show some really Pleasant benefits to to Deep Sleep it also helped people fall asleep

02:01:14

helped them fall asleep by about 25 minutes faster in those people who are really having a hard time with sleep I'm going to take a hot bath tonight I sometimes do the sauna in the evening before sleep I'm a big fan of cold in

02:01:26

the morning cold shower cold Plunge in the morning reverse engineering the the equation you're trapping the heat into the core of your body you're waking yourself up right and then the and in the evening I've used sauna the one issue with sauna is I really crank the

02:01:39

heat of the sauna and then sometimes if you do that right before bed you take a you know warmish shower right afterwards you get into bed oftentimes I'll wake up thirsty and then um because it dehydrates you and then if I drink a lot of water to hydrate after in the sauna

02:01:52

then I'm waking up too much in the middle of the night so I think sauna is great but um right before bed I try I would love to I don't have a a sauna at home or nor an access to I mean there

02:02:03

are saunas in and around where I live but what I want to do is have it proximal to my bedtime and my bedtime because I'm a neutral type you know sort of around 11-ish nowhere is open and

02:02:17

willing to allow me to sit in the how long do you you sit in there usually I I'm a little Bonker about this I well if it's in the evening and I just want to relax I would say maybe 20 30 minutes and I I tend to go really warm warmer than I want to stay here P do pet our

02:02:31

friend I've done Sonic cold plunge with pet he usually does it in the evening goes Sonic cold Sonic cold Sonic cold okay uh warm shower um and I don't know how many nights a week he's doing that

02:02:43

but terms of the temperature of the sauna you know generally somewhere between 175 and 210° depending on how heat adapted you are but I think a hot bath is great or a

02:02:54

nice hot shower yeah I've certainly done that and when I'm traveling with jet lag I will absolutely that's part of my sort of jet lag protocol I'll make sure I do I'll because I don't really struggle too

02:03:07

much with sleep at least at present but when I go through jet lag and I go back home to to London of course it's tough the worst The Living Daylights out of that and do as much as I can so I think

02:03:19

that's probably the end of the the thermal story although we are now trying to see if we can take lowf fire approaches where we're going to do some footw we're trying to develop some footw

02:03:31

technology that can be built into um maybe a mattress and some mattress companies uh there are some great ones uh I know obviously Mato at 8 sleep and

02:03:43

they are they are doing amazing things I think his company again I have no affiliation but I we connect very well and he's brilliant so they're doing something like that I do uh use and love my eight sleep here's what I'd love

02:03:56

somebody to engineer and we got a lot of people who listen to the podcast you think about product development it would be wonderful to have a portable pair of socks so that you can use them when you travel or when

02:04:08

you go you know sleep anywhere at home or elsewhere that would warm your feet up at the beginning of the night so this is a place for us to recap warm up to cool down to fall asleep right stay cool

02:04:20

stay cool to stay asleep and then warm up in the morning to wake up and so that is pretty straightforward to build into a pair of socks somebody can do this somebody do this okay uh so that's so

02:04:33

we've done electrical we've done thermal what about auditory auditory so acoustic stimulation in a very similar way

02:04:46

to electrical stimulation where you're trying to Target that deep sleep and see if you a better analogy is probably a metronome and you're trying to see if you can kind of force the metronome

02:05:00

further over back and forth with these types of Technologies so auditory stimulation came on the map again I think probably yam born's group in Germany was some of the first to do this they initially started with this same

02:05:14

generalized approach where they would take acoustic tones and they would first assess what is your level of aw weening threshold so you would be asleep and they would just have these tones very

02:05:25

light tones like a sort of ping ping and they would gradually increase the volume up and they would look to see what is the point where that volume of the tone wakes you up and then they understood your specific threshold what's called an

02:05:39

Awakening threshold and they would set the volume to a sub Awakening threshold great so you've got that locked in place and now you start and they did this within the first 90 minutes of people

02:05:52

falling asleep they started to play these sub Awakening level volume levels of tones but they were playing them at this very slow frequency as if again

02:06:04

they're trying to syn and match the slow dancing Rhythm of the slow brain waves and sure enough in that first study and it was indiscriminate meaning they just

02:06:17

set the tones PL like a metronome set the tone set the and sorry set the volume and then set the Cadence of the volume the speed the frequency of those tones to just a little bit less than one

02:06:30

Hertz a little bit less than one cycle per second and then off you drifted to sleep and they played it for the first 90 minutes cuz that's the rich phase of deep sleep and they were able to increase the amount of Deep Sleep

02:06:43

significantly the problem in that first study was that they also did a memory test because in all of these studies including my own even if I boost your sleep tonight Andrew hubman my next if

02:06:55

that's the result that you show me I have four words for you as a scientist yes and so what is it functional because if I boost your sleep but it doesn't change

02:07:07

anything to you the organism the next day I'm going to suggest that that enhancement is Epi phenomenal not functional so it has to improve some um some reasonable metric in wakefulness

02:07:20

that like improves improved memory um improved uh task switching ability so it's outcome measures strength correct something yeah so even if I for example you know lower your blood pressure with

02:07:32

a new drug if I'm not changing your cardiovascular disease risk then the question is why am I just continuing on with the drug if it's not really changing much same thing here and what they found was that when they did the

02:07:45

memory test the next morning by enhancing that deep sleep there actually wasn't a memory benefit so perhaps what was happening is that this was just non-specific so again they then returned

02:07:57

and now others have returned to the closed loop mechanism where now I've got electrodes on your head and I'm measuring your slow wave brain waves and literally I am next door in the room and I'm watching those slow brainwaves go up

02:08:09

and down and then I've got a computer algorithm that is watching those watching in quotes watching that too and it's predicting when the next wave is going to come and when it does auditory tone clicks Awakening you don't wake up

02:08:23

and sure enough when you sort of tone into the brain at that time you boost the the size of that brain wave and once again they boosted the size of those deep sleep brain waves they also improve

02:08:36

those more quick burst of activity the sleep spindles and now sure enough they were able to improve memory however if you look at that paper and here's why I think the first method may not have

02:08:48

worked very well and why I don't suggest people start trying to set this up themselves when they kept stimulating the brain slow wave after slow wave after

02:09:01

about three or four strikes of the metronome to boost those slow waves the benefits stopped and if they kept going you started to inhibit the amount of

02:09:15

naturally occurring deep sleep brain waves why would it do this deep sleep brain waves I told you in the first episode are a Act of incredible neural coordination it's Mass coordination now

02:09:27

one of the extreme versions of mass coordinated propagated activity that is maladaptive that is pathological is called an epileptic seizure and your brain has in place for the most part

02:09:40

stop gaps to prevent that type of spread of vast amounts of coordinated spontaneous electrical oscillations because the brain is such a conductive device that once you get it going you've

02:09:54

got to be careful because it may start to conduct out of control so we think that these checks and balances that were in place even though you can artificially stimulate it for a while after a while the brain

02:10:06

says you've got to back off for a while because this is getting a little bit out of control you do a breath pause and then you restart again and you get the benefit and then you breath pause so you've got to do it a little bit intimately now you've got to read the

02:10:19

what we call the supplemental materials of that paper you've got to go it's like the fine print on a legal document if you dig into it you can see that that was the case but um it it wasn't necessarily evident so those were really

02:10:32

the data on acoustic stimulation and now with this closed loop acoustic stimulation that we've got going on it seems to provide these nice benefits some people then will probably

02:10:45

be asking what about these noise machines what about white noise Etc I've taken a look at this and so far I think for White Noise machines the data is

02:10:57

equivocal there was a recent study review article I think it looked at about 37 different studies I could have this wrong and what they found was that there was no reliable robust directional

02:11:11

effect of white noise machines on sleep some studies demonstrated that it helped sleep some studies didn't change sleep some studies suggested it may make sleep a little bit worse just nothing reliable

02:11:23

but maybe it's masking external sound correct so I think if and the one of the positive studies in that scenario was a study that was done in New York City and it was in a region where there was a lot

02:11:38

of um external sound pollution and noise as you could well imagine it's New York City and sure enough that's where they got some really nice benefits of the white noise machine so I think it is

02:11:51

you're right context dependent there was a an interesting recent study that came out from uh eaman Learners group at uh the University of Texas San Antonio and

02:12:03

they didn't use White Noise they used pink noise now what's the difference pink noise has a little less what we call power or intensity in the higher

02:12:16

frequency ranges of the sound spectrum and it's more enriched in the slower domain of that power Spectrum which you could argue is a bit more fitting with sleep and I think this study may have

02:12:30

been a nap study or I may be wrong but anyway what they found was that they increased Total Sleep Time by I think it was close to 30 minutes with the pink noise they did not change the amount of

02:12:43

deep sleep but they did inhance the amount of stage two non-rm sleep which we have spoken about before and we will in subsequent episod epodes that is beneficial for things like learning in memory including motor skills and they

02:12:56

increased the amount of REM sleep to a much more modest degree but those changes were significant so I'm not trying to rule out noise machines right

02:13:08

now and I have no affiliation with any company or anything in that space um I don't want to throw the baby out with the bath water I just simply think that right now we don't have enough evidence but as you and I know as scientists

02:13:21

absence of evidence is not evidence of absence just because it doesn't exist doesn't mean that I don't think that it's still a potential root these types of machines what about

02:13:33

kinesthetic stipular uh tools protocols um you know body position is something that has an interesting relationship to propensity to fall asleep based on brain cooling that we talked about in another

02:13:46

episode but what about manipulation of the body's mov movement um uh yeah what is there anything in that domain it sounds wacky at first yeah it does but

02:13:59

but I said it so you I still want to know come on social media just be be nice be friendly um I would say that if you look back in again the annals of

02:14:12

human history from the very early Inception you will see mentions of a child being rocked in a Manger or rocked in a crib often parents will have will take their

02:14:25

young infant and you will quote unquote Rock them to sleep and we as adults will sometimes get in a hammock and if you're rocked what happens you will fall as

02:14:37

it's that prototypical image of someone with their hat over their face and in a hammock and they've sort of fallen asleep so it was very clear that something was going on in this space and

02:14:50

then a group from the University of Geneva um led by another fantastic sleep scientist Sophie Schwarz did an epic study that again it's one of those studies that I

02:15:03

probably once more wished I'd done here's what they did they took a bed frame and then they suspended it on chains from the ceiling now stick with me I'm not going in that you know

02:15:16

there's no hot candle wax being applied here don't worry I'll I'll keep it PG again and then the next thing that they did was connect a rotating arm to that bed at the side of the bed and that arm

02:15:29

would start to simply just push the bed laterally from left to right left to right and they started just swinging the bed in a very controlled manner but here and I should ask Sophie exactly why they

02:15:41

made this choice they were rotating the bed not at this sort of around one Hertz which is what we've done with electrical stimulation or acoustic stimulation they were doing it

02:15:52

at25 Herz which is much slower still almost imper is rocking you know once every four seconds it's a very

02:16:06

slow lull and sure enough what they found in the first series of studies they did a nap study a 90-minute nap study when you did this rocking Motion versus when the

02:16:18

bed was still they increased the speed with which people fell asleep they boosted the amount of deep sleep and they boosted the amount of those sleep spindle oscillations that we described

02:16:31

not satisfied they then said well what happens across a night of sleep they did it then across a night of sleep they replicated the same findings and now they got a memory benefit now the memory benefit you could argue was modest it

02:16:43

was 10% of a memory improvement benefit when you woke up from sleep relative to the already aable benefit that sleep naturally gives when you're not rocking the bed but you think well 10% if I were

02:16:58

let's say a student and I got you know a b and someone the professor said Look by the way there is something that you can do and we can increase your grade by 10% and you can get to an A or an A plus

02:17:11

depending on the grading system would you take it would you take 10% benefit absolutely you would s grade point average in increase so it's it it isn't

02:17:22

trivial necessarily well I also I'm I'm positively surprised how important this um but so what uh condition is for you sleep researchers you know that that an enhancement in say deep sleep or rapid

02:17:36

eye Moon movement sleep needs to translate to some Daytime benefit um in order to really get you guys excited but but here's why I I think that's great it's always great to have a high threshold for excitement um but one of

02:17:49

the things that that one could argue is that you know there are only so many tests that you can have in a Laboratory um of daytime functioning I think I am on board the the fact that sleep is the

02:18:04

Bedrock of mental health physical health and performance so an improvement in in you know sign a statistically significant Improvement in deep sleep or REM sleep to me just seems like that's

02:18:16

got to be good for something we might not know what that something is to test in the laborat but it could be that the threshold for improvement of say gut microbiome production of neurotransmitters is you know .1% Improvement in deep so we don't

02:18:29

know I made that up so don't quote that statistic anyone but I so admire the the the um kind of extreme thresholds of what you what gets you guys excited well no your point is a very good one because you could argue based on what I just

02:18:42

went back and said regarding the exercise study with Ronda Patrick I've just reversed my own threshold logic I said to you well okay exercise was able to overcome some of the deficits that

02:18:57

occur by way of sleep deprivation for your blood sugar but don't assume that that necessarily means it overcomes the detriments the other detriments that you'll have for your hormonal Health

02:19:08

your you know Thermo regulatory capacity your cardiovascular disease your brain function so I've just said look simply you know one thing doesn't mean that you've assessed all things and now now

02:19:20

I'm saying okay if you don't show that it improved that one thing then it's not functional but Matt by your own logic you've said that but you didn't assess many of the other things so even if it

02:19:33

didn't improve memory as you said it's the Bedrock of all things Health you need to assess all of them before you make your conclusion of the yes and so what failed test so you're

02:19:46

absolutely right to point that out um so what was interesting after that data came out in humans which is usually the opposite way around they started to look in in animal models and you mentioned

02:19:59

the vestibular system this ability for us to understand motion and movement and there's lots of mechanisms for that they looked at mice and they started doing

02:20:11

this rocking again and sure enough the mice fell asleep faster but then they found a strain of mice that did not have the lateral vestibular sensation

02:20:25

mechanism and they rocked them just the same way zero change in their sleep because you could imagine well it's important to understand the mechanism here is it that when you're rocking

02:20:37

there is it's not just about vestibular stimulation maybe that rocking sort of modestly changes friction which changes temperature you could come up with all sorts of wacky

02:20:48

reasons this was a very clear C caal manipulation of the lateral vestibular system and if that is not in place you fail to get the benefit so it clearly has something to do with the vestibular

02:21:00

system can I Venture a guess as to why that is yeah I interrupted but in case that happen to be right by some chance I previously talked about the um the need

02:21:11

to lose uh a sense of one's posture in relationship to gravity in order to fall asleep right you have to go into this uh lack of propr receptive awareness in order to fall asleep propri reception being the knowledge of where one's limbs

02:21:25

are relative to the body and body relative to other surfaces and gravity yeah and um this is something that can be accomplished in these uh you know flotation tanks and things like that um

02:21:35

and other ways go to outer space but um the cheaper version the cheaper version um so could it be that the rocking at that very slow frequency um is tapping into

02:21:49

the vestibular system in a way that that propri receptive feedback about body position is somehow um uh starts to vanish and because I'm intrigued by this idea that you have to lose perception of

02:22:03

your body's positioning and and propr receptive awareness in order to fall asleep uh and maybe your a description earlier of a protocol of going on a mental walk um in order to fall asleep I

02:22:15

I just feel like these things are starting to converge on on on some themes here central Comm pathway that could be the absence of I think it's entirely possible in some ways right now we think that these two things are

02:22:28

associated that as you're falling asleep gradually you will lose propri receptive sensation okay but simply the fact that two things are associated doesn't necessarily mean

02:22:40

they're causal but your suggestion here is a very elegant way of testing that hypothesis which is that perhaps if you could show that the symmetric of proprioception becomes compromised when

02:22:53

you start doing lateral sort of kinesthetic or movement stimulation that's a very powerful demonstration that it's not just so here

02:23:04

with the study in the mice they lacked the lateral vestibular sensation and you lost the Sleep benefit but maybe there's one step down which is that when you lose that vestibular stimulation you

02:23:17

lose the benefit on the thing that really is augment ing the Sleep which is the change in propr reception so this is the first step in a chain of command and you've missed the final common

02:23:29

transactor of that ingredient called better sleep and those I would say are probably the the four current bastions of sleep augmentation hopefully that describes to

02:23:41

listeners the range of where sort of sleep 3.0 sleep enhancement 3.0 is going and also describes the way in which which we can come down the strata from high friction low friction to no

02:23:53

friction um and also in terms of cost where you can have high cost minimal cost low cost I mean hot bath or shower is Pennies on the dollars so especially if you take a cold shower in the morning and save on your heating bill so you can

02:24:06

take a little bit longer hot shower in the evening and then you net the zero difference um it's just my way of saying take a cold shower in the morning feels great when you get out what about some ways to enh rapid

02:24:21

eye movement sleep beyond what you've covered up until now so I think there are probably two emerging data sets that I've been intrigued by one of which we've been doing some work on and it

02:24:34

comes back to Thermal what I fail to mention is not just that you need to warm up to wake up which you do but you also need to warm up to REM sleep but not too much if you take an organism or

02:24:48

a human being and you strip them of bed sheets and strip them of clothes so they're basically almost on natural if you warm the body up to what we call the Thermon neutral point so it

02:25:02

tends to be and this sounds extreme and it you don't have to do this because you're under sheets and that makes a world of difference but if you warm the room to about 30° C which gets close to

02:25:16

at the surface ambient level for your skin something that can bring your core body temperature up back up to operating because I told you when you go when you're in that deep sleep trigger Zone the middle Zone your core body

02:25:30

temperature drops and it drops significantly and to wake up you have to warm up but on the journey to warming up you also have to get to Thermon neutrality for you to have REM sleep if

02:25:43

I keep you too cold I can reduce the amount of REM sleep if I get you too hot but I can imper the amount of REM sleep so it's a Goldilocks phenomenon not too little not too much just the right

02:25:57

amount if I keep you there in terms of your thermal um net neutrality I can boost your RAM sleep now that's fishlyn they run at different hot temperatures they've got different

02:26:14

partner situations so you need a Clos loop system again but it's something that very interested in because almost all of the methods that I've described and you are smart to pick this up all

02:26:26

target deep non-rm sleep but we spoke about in the first episode every stage of sleep is important and in subsequent episodes I'll tell you exactly why REM sleep is so critical so how can we boost that that's one way that was starting to

02:26:40

explore it but nothing I think solid yet the other is some of the drugs the newer sleep medications that have come onto the market and um again I think I mentioned I I did take the task and I

02:26:54

feel perhaps rightfully so about the classic sleep medications that if you look at the scientific data if you can avoid them it's probably best to do so things like ambient Etc we call them the

02:27:06

Z drugs because they all start their sort of generic names are sort of start with a zed you know um ambian for example um has uh has a

02:27:18

zed at the start of it for its generic name but but I don't want to get into naming any necessarily yeah but um for ambient what's interesting about those medications again they're are in a class

02:27:31

of drugs that we call the sedative hypnotics so again sedation not sleep and also there's been some great work again by D and dyin colleagues if I were to show you the that that electrical signature of your deep sleep it does

02:27:43

look as though those drugs kind of increased the amount of electrical activity in that slower deep sleep range except once you go all the way to the far left to the slowest of those slow brain movies which turns out to be the

02:27:57

the types of waves that are most beneficial for most health related brain and body functions you get this huge dent in your electrical brain wave activity it's almost as though those

02:28:09

drugs take a bite out of that realm of of electrical activity and of course there are issues with daytime sleepiness and some safety related issues that has been Health associations not necessarily

02:28:22

causal and so I was you know I I offered one scientific Viewpoint of those medications in the book and um and so be it it's not as though i' I'm anti-m medication as I said and some of the new

02:28:36

medications are very interesting brings me back to REM sleep there's a new class of sleep medications called the Doras and it stands for it's d o r a small s

02:28:48

and it stands for Jew orexin receptor antagonists oh my goodness mouthful that just sounds like word salad to anyone who's not a

02:29:00

neuroscientist orexin which is part of that um set of words is a chemical in the brain and ereen became prominent with the study of noopsy and what we we

02:29:12

as the Royal Wii people like Emanuel Mano and others um at Stanford what they discovered was that noptic patients have a found deficit in this this chemical

02:29:23

orexin and receptors also called hypocretin and it has a function both it turns out for wakefulness and a function for feeding and eating related behaviors hypocretin was probably more related to it when it was because it was discovered

02:29:37

right around the same time um two different groups yes exactly beautiful two different groups named it differently but noopsy as some people may know is it's a condition to sleep

02:29:50

disorder and one of the symptoms is called excessive daytime sleepiness where you have inappropriate invasions of sleep during the day when you want to be awake why well it turns out that this

02:30:02

chemical ereen acts like a finger on the light switch of all of the apparatus in your brain that switches on to force you awake it reaches down into the it's released from a central part of your

02:30:15

brain called the hypothalamus and it releases down into the brain stem to activate what we call the ascending arousal system or the reticular ascending arousal system of the brain and when that lights up it's like the

02:30:26

light switch which says on for waking brain activity and so what was happening was that this ereen up higher up was not forcing the finger of wakefulness on

02:30:40

during the day so almost instead of a switch which is what you want it was more like a dimmer switch and you know when you get to that dimmer switch point right in the middle where it's flickering it's on it's off it's on it's off that's almost the state in

02:30:54

which the narcoleptic brain was because they had a deficiency of orexin so that was the ereen story in nopy so why is it relevant for insomnia well people realized the problem with Epsy is that

02:31:07

they're asleep during the day when they want to be awake but the opposite problem is true of insomnia patients they want to be asleep at night but they're awake so why don't we

02:31:19

selectively de develop a drug that goes after this finger that flips the light switch on for wakefulness but now let's block it at night so we flick the switch back in the off position we turn out the

02:31:32

lights of the brain and we remove the problem of insomnia which is excessive wakefulness at night which is one of its problems but and therefore when you

02:31:44

remove that indirectly what comes in its place is this thing called more naturalist sleep and that's why it's being more favored now as the principal drug um it's still not necessarily well known by physicians or it's not very

02:31:58

well prescribed it's not very well covered here in the United States unfortunately with insurance so it's a very expensive option right now Health Providers will choose not to do that unfortunately so what's interesting

02:32:10

about that drug though is that it's mixed in terms of the studies but quite reliably it does seem to improve sleep very much so but it seems to unlike those classic sleeping pills which artificially look like they're

02:32:22

increasing deep sleep even though they're they're not doing sedation these drugs can improve most all aspects of sleep but including REM sleep which those classic sleeping pills did not why

02:32:34

is it doing that we still don't know but one of the things that the these Dora drugs do that block the erex in that take off the the the on position of the light switch and flip them off when you

02:32:47

switch it off it can actually then then allow the activation or the stimulation of something called melanin concentrated hor hormone or MCH in the brain and that

02:33:00

when it is um triggered on can stimulate another chemical called acety choline in the brain which is a neurotransmitter if there is one neurotransmitter in the brain that seems

02:33:12

to be responsible almost exclusively for this thing called REM sleep or dominantly I should say for REM sleep it is atile Coline this was discovered way back in the 1970s by my former um uh one

02:33:25

of my former mentors Alan Hobson at Harvard and what this drug may be doing is indirectly boosting the amounts of acetal choline in the brain particularly in a region of the brain called the basil forbrain which is a REM sleep

02:33:38

regulating region and that's the reason that you get boosts in REM sleep and people also report dreaming a little bit more too on those medications so thermal manipulation getting you to net neutral

02:33:50

thermal zones helps increase REM sleep but also there are some medications that were not necessarily designed for REM sleep enhancements selectively but there is evidence that they do that so if you ask me where are we at with REM it's

02:34:04

it's certainly more bereft of methods than deep non-rem sleep but we are starting to find some now given what you just told us about the role of ACL choline in Rapid eyee movement sleep

02:34:17

what about taking um precur cursors to acetylcholine I mean certainly a good number of them exist yeah um you know even like over-the-counter supplements like Alpha GPC um and then of course there are uh

02:34:30

choline donors and things like that that can increase uh col energic transmission um is that get into issues of um you know if one does that globally is it possible that you increase arousal and

02:34:43

have trouble falling asleep because some of those coleric agents be activating so one of the problems the second is you may stop because you're going to

02:34:55

have to take them before bed you may Brute Force REM sleep to arrive earlier and you may therefore come at the cost of of deep non-rem sleep and so you'd have to get uh some kind of timed

02:35:08

release capsule which you can do you can coat these capsule you can get a timed release and you would want to take it before bed and then maybe after about four or five hours you would want to kick it into gear because now you're in

02:35:21

so it's a littleit gets bit tricky yeah this is one of the reasons why I personally this is just my experience I'm not a fan of of supplements that tap into the serotonergic system for sake of sleep because um certainly serotonin

02:35:34

plays an important role in sleep but anytime I've taken something you know 5htp or something like that to try and improve sleep I find that um I fall asleep and then I wake up very deep deep sleep and then I wake up um very alert

02:35:47

and I have trouble with the later phases of sleep and I think that is because yes serotonin is involved in sleep but it's involved in sleep at a very specific point in this as you refer to it this like Symphony or ballet of different

02:35:59

sleep stages and how they evolve and um interdigitate with one another across the night so um while I do think there are things that one can use pharmacologically or supplement based to improve sleep generally I I like to

02:36:11

think of those as the kind of thing that kind of pushes a away front of the whole sleep process yeah as opposed to trying to tap into one specific neurotransmitter within the sleep ballet exactly yeah I I like that way of

02:36:23

thinking and you you do have to be careful because in biology it's often rare that there are any free lunches in truth you know Nature has optimized our system so exquisitly that when you start

02:36:37

to try and gain the system for one thing be very mindful that it may come at the cost of something else and that's why whenever we're doing these types of sort of developments of Technologies for

02:36:49

sleep we are very cautious not just to say did we improve the thing that we're targeting but first call of business in medicine is not will this drug help you but firstly is there any downside in

02:37:02

terms of will this drug hurt you and then you have to understand the cost ratio benefit between those two things yeah just one more anecdote uh that is in agreement with what you said nowadays there's an increased excitement around

02:37:15

peptides the use of peptides there is um and I I currently don't use any but I did a short run with you know occasional use of cellin which is a secretagogue which is a growth hormone right SEC it

02:37:28

promotes the secretion of growth hormone not growth hormone itself I took it not many times and I was tracking my sleep and what I noticed is it um put me into a little bit of a hypnotic State dreams were very intense but um deep deep sleep

02:37:42

but according to my sleep tracker I only ran this for maybe three nights um according to my sleep tracker it completely eliminate all my rapid eye movement sleep at least as measured by the sleep tracker but the amount of of

02:37:56

Deep Sleep of slow wave sleep just like massively expanded so that that can't be good that that can't be good I mean know you don't want to mess with that cocktail ratio that we described in the first

02:38:08

episode presume that it's it's emerged as the correct you know Da Vinci Code of sleep stage recipes and there may be a time and a place where you want to over

02:38:21

index on one of those things for whatever reason but to do it consistently and permanently I would again say if if you think within the space of a

02:38:34

lifetime that you know something that you know 2.6 million years of evolution has not understood chances are you're probably

02:38:47

wrong I agree um um and certainly later in this series we will touch into some of the over-the-counter supplements and other things that one can do in order to augment sleep that do seem to have some benefit because there are uh such things

02:39:01

um but in the meantime thank you for providing this incredible Arc of description of basic sleep hygiene and regularity light dark

02:39:12

temperature getting out of bed when you can't sleep alcohol food caffeine cannabis unconventional protocols and let's call them Advanced protocols electrical protocol brain stimulation in

02:39:26

other words um thermal manipulation auditory stimulation kinesthetic and then these rapid eye movement enhancing um drugs and on and on um Matt uh I

02:39:40

can't thank you enough this has been a just uh replete with actionable tools and considerations and I love that you took us to the the The Cutting Edge of of what's Happening Now I think uh it's

02:39:53

wonderful to talk about the history of a field and what was discovered it's wonderful to talk about the present but it's wonderful that you've um put our eyes uh a bit into the future of what the technology for Sleep uh enhancement

02:40:06

and monitoring holds so once again thank you um you're so welcome if folks haven't already seen um or listen to episode one highly recommend they do and of course we will be back soon soon with

02:40:20

episode three which is going to get into all the science and acual protocols related to napping and caffeine and some other exciting things

02:40:32

that I know impact people's daily lives and that they can get moving on should they choose right away and by moving on I mean to sleep thank you again Delight cannot wait for the next recording thank you

02:40:45

for joining me for today's episode with Dr Matthew Walker to learn more about Dr Walker's research and to learn more about his book and his social media handles please see the links in our show note captions if you're learning from

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02:41:33

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